Allowing Your Child to Play Sports with Asthma

girl_soccerballYour 7-year-old son loves baseball and can’t wait to join the local Little League team. Your daughter is a big soccer fan and all her fourth-grade friends play soccer after school, so she wants to play soccer also. Both kids have asthma. What to do?

Just because your children have asthma does not mean they can’t participate in any sports or physical activities, says Dr. Stanley Galant, an asthma specialist and medical director of CHOC Children’s Breathmobile.

“I encourage every child to exercise. If you control the asthma you have less of a chance of a problem,” he says. “It’s very important for asthmatic kids to stay competitive. It’s important for the families and their providers to create a situation that allows them to participate.”

“First of all, exercise is very important for lung development. It’s important to take a deep breath, and exercise makes you take a deep breath. On the other hand, asthma is a known trigger for having a shortness of breath, or coughing or wheezing. The symptoms frequently occur after you stop exercising.”

Young athletes participating in sports can take some steps to minimize or avoid asthma trouble, according to Dr. Galant. He said children should warm up first with some “energy bursts” like sprints and other short exercises. They could also use their albuterol inhaler about 15 minutes before exercising to help prevent an attack caused by exercise if necessary.

If it’s a cold day, athletes with asthma should wear a mask to prevent the cold, dry air from getting into their lungs, Dr. Galant advised. “Swimming is the best exercise for asthmatic kids. Running is the hardest, particular in dry cold air,” he notes.

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Making Sense of Asthma Medication

The number of children with asthma continues to rise, but the evolution of asthma medication means most attacks can now be prevented before they start.

While rescue medication is still important, the standard practice today is to prescribe inhaled corticosteroids, usually taken once or twice daily. These preventive controller medications reduce the swelling inside the airways, minimizing attacks over time._MG_6020

When deciding whether to prescribe a corticosteroid, a child’s physician will typically use the rule of two: if a patient uses rescue medication more than twice a week, wakes up at night due to asthma more than twice a month, or refills their rescue inhaler more than twice a year, then controller medication should be used, according to Dr. Mark Ellis, a CHOC Children’s asthma specialist. Controller medication can be started in children as young as 12 months of age.

“We start inhaled corticosteroids whenever we think the benefits outweigh the risks,” Dr. Ellis says.

Corticosteroids are not addictive and have very little risk for long-term side effects. Dr. Ellis says children may experience slowed growth by up to a quarter inch the first year and a quarter inch the second year. However after two years, a child’s growth will catch up to normal levels. Your child’s physician will make sure your child is taking the lowest dose possible to minimize any effects.

Corticosteroids are not to be confused with anabolic steroids, which are sometimes used by athletes to increase performance and bulk up muscle.

For hard-to-control asthma, corticosteroids are occasionally combined with another medication – long-acting bronchodilators – in drugs such as Advair and Symbicort. These combination medications are considered safe, Dr. Ellis says, but the Federal Drug Administration has warned that long-acting bronchodilators, such as Serevent and Foradil, should not be used alone.

In addition to corticosteroids, rescue inhalers and nebulizers should still be used when an attack happens. Some children may feel shaky or have an increased heart rate afterward, but the effects are not harmful and should go away quickly.

CHOC is involved in a number of asthma research projects, including one study led by Dr. Ellis on using antibodies to cause an attack on the cells that inflame airways. Several medications are also being tested for safety and effectiveness in children.

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It’s National Asthma and Allergy Awareness Month

It’s peak season for asthma and allergy sufferers, a perfect time to educate yourself, as well as your family and friends about these conditions! Chances are, someone you know may be suffering from these common illnesses.

According to Kids Health, CHOC’s patient education online resource, Asthma is a lung condition that causes difficulty breathing, and it’s common among kids and teens. Symptoms include coughing, wheezing, chest tightness and shortness of breath. Anyone can have asthma, even infants, and the tendency to develop the condition is often inherited.

When someone breathes normally, air is taken in through the nose or mouth and then goes into the trachea (windpipe), passing through the bronchial tubes, into the lungs, and finally back out again. But people with asthma have inflamed airways that produce lots of thick mucus. They’re also overly sensitive, or hyperreactive, to certain things, like exercise, dust, or cigarette smoke. This hyperreactivity causes the smooth muscle that surrounds the airways to tighten up. The combination of airway inflammation and muscle tightening narrows the airways and makes it difficult for air to move through.

An estimated 75% to 85% of people with asthma have some type of allergy. Even if the primary triggers are colds or exercise, allergies – diseases of the immune system that cause an overreaction to substances, such as pollen – can sometimes play a minor role in aggravating the condition. An allergist can usually pinpoint allergies and, once identified, the best treatment is to avoid exposure to allergens whenever possible. Medications may also be prescribed.

Fortunately, asthma can be easily controlled and managed. Talk to your child’s health care provider about a customized asthma action plan. Make sure your child’s teachers and babysitters have copies of the action plan and understand what to do in an emergency.

CHOC is a leader in early detection and treatment of pediatric asthma, providing families the education they need to prevent asthma emergencies. If you suspect your child may have Asthma or Allergies, schedule an appointment with a CHOC Allergy/Immunology specialist, at 714-633-6363.

To learn more about these conditions, please visit these helpful sites:
http://kidshealth.chocchildrens.org/PageManager.jsp?lic=456&dn=Childrens_Hospital_of_Orange_County&article_set=21965&cat_id=143#

http://www.choc.org/publications/index.cfm?id=P00303&pub=KH&aid=545

http://www.aafa.org/display.cfm?ID=5&Sub=105&Cont=457

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