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Monday, November 27, 2006

Asthma - What you need to know! Part 1

Part I: Issues involved in the management of Asthma


A
sthma is one of those diseases in which many people have preconceived ideas. Just me just give you some examples of the things which the person on the street believe in which are either not true or only half correct:


  1. I don't want to use steriods for my child because it is bad for him
  2. If I start using the puffer, my child will get addicted to it
  3. Aiya, he will eventually grow out of it anyway
  4. Ventolin syrup is the way to treat asthma
  5. My child will never be like a normal child because he has asthma, there is a lot of things he cannot do
  6. Olympic atheletes cannot possibly have asthma
  7. Asthma is a disease that is just a bit of wheeze so it is not life threatening
  8. He does not have a wheeze, therefore he does not have asthma
In Singapore, 1 in 5 children have asthma. But somehow asthma is still underdiagnosed, meaning that many people with asthma are not being treated properly. For a developed country, Singapore has a very high incidence of Asthma related deaths.

The central issue, in my opinion, in properly managing asthma in children is Parent Education.

First the parent needs to be convinced that the child has asthma and accept that he does. This is not so easy and from a parent's point of view I can understand why. Once you accept that the child has asthma then there are a lot of implications. He'll need to be on puffers, steroids and the rest. Some parents prefer NOT to believe their child has asthma. So they go on taking cough mixtures and resist giving puffers. They will seek alternative forms of medicines like herbal remedies.

In children, the diagnosis of asthma is most often made on clinical grounds based on the history and symptoms of the child. So if the child's parents have asthma, the child wheezes twice a month for the last 3 months and also coughs incessantly at night, then we are highly suspicious that she has asthma.

The Bottomline in Asthma
  1. Asthma kills
  2. An asthmatic child without proper treatment may suffer growth retardation
  3. If asthma goes untreated, the child has a higher probability of developing more severe and persistent forms of the disease
  4. Proper treatment of Asthma, by giving inhalers with or without steroids can mean your child will live a "normal" life without wheeze, night coughs and be able to play sport without getting short of breath
  5. Asthma is a chronic disease that needs regular visits to the doctor for at least 6 months
  6. The only way to treat Asthma is when parents are empowered with the right knowledge to manage the disease with the help of their doctor
In Part 2, I will talk more about the diagnosis of Asthma and how to stage the severity of Asthma.

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