By Dr. W. Gifford Jones
August 28, 1988
Today an unprecedented number of children are being treated for asthma. Eight million in Canada and the U.S. under the age of 17 have been diagnosed as asthmatic. During the 1970's the prevalence of asthma increased 58 per cent in children between 6 to 11 years of age. And the number of deaths per year among children under 14 doubled from 1979 to 1985. Why are children dying from asthma today? And can parents of asthmatic children help them?
Asthma is characterized by narrowing of the bronchial tubes and subsequent difficulty breathing. The condition can be caused by allergic reaction, respiratory infections, air pollution, cigarette smoke, strenuous exercise, sudden changes in temperature or viral infections such as bronchitis.
The majority of children with asthma are "allergic asthmatics." Allergies may be triggered by various allergens such as pollen, animal dander and certain foods. But reactions can also be associated with nonallergenic factors such as infection, cold and exercise.
During an asthmatic attack, the smooth muscles surrounding the bronchial tubes constrict, the lining of the air tubes becomes inflamed, and swollen and increased mucus production clogs an already narrowed passageway.
Common symptoms are wheezing, a dry hacking cough and severe difficulty breathing. Some asthmatics are subjected to a double whammy. Immediate severe response to an irritant may be followed in 4 to 12 hours by increased airway inflammation. Children with these late phase reactions generally suffer from progressive, severe asthma.
Dr. Clifton Furrukkawa at the University of Washington says, " We see a common theme in childhood asthma deaths, undertreatment of the disease. Parents and physicians are not taking asthma seriously enough. Parents wait too long to get their child to the hospital."
DR. William Davis at Columbia University expands that criticism.He says," Many physicians continue to rely on traditional medications, which may cause unnecessary side-effects and affect the child's quality of life, even though better treatment is available."
Time-honoured treatment of asthma involves the use of drugs to dilate the bronchial tree. But these drugs have no effect on the underlying mechanisms of the disease. They also give a sense of false security creating the illusion that the asthma is under control. But the disease may actually be getting worse as these drugs do not treat bronchial inflammation.
Dr. Floyd Malveaux of Johns Hopkins Medical School stresses that proper management of asthma today no longer consists of treating a series of acute attacks. The emphasis is on preventing attacks before it is too late.
The modern drug Intal, (Cromolyn sodium) is becoming the first line of defence. It is very effective in decreasing bronchial inflammation and preventing late secondary response in children.
Dr. Martha White, an allergy specialist at the National Institute of Health, claims the combination of Intal and inhaled steroids is the only medical treatment presently able to alter the underlying mechanisms of the disease.
Dr. Leora Traynor, a clinician in Akron, Ohio, recently pinpointed the irrational behaviour of some parents. She reported to the American Academy of Allergy that parents with asthmatic children must accept and confront the basic realities of the disease. That if the dander of a domestic pet is causing asthmatic reactions in a child the use of drugs without getting rid of the pet will not achieve a cure. The response of too many parents is to push the inhaler and keep the pet.
Dr. Traynor cites an Australian study in which 31 per cent of parents stated they knew their child was allergic to animals. Yet 36 per cent kept animals in the home and 44 per cent of children were exposed to animals prior to being admitted to the hospital emergency ward in acute respiratory trouble.
Parents must realize that eliminating the causes of asthma is the cheapest and safest form of therapy for their children. But knowing human nature I'm sure children will continue to be given potentially harmful medication when the family cat or dog should both be given their walking papers. I admit it's a hard decision to get rid of a faithful dog. But I've also known families who are totally aware that the household pet triggers their children's asthmatic attacks immediately purchase another animal when the older one dies. Common sense is indeed a very uncommon commodity.
W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com
My book, �90 + How I Got There� can be obtained by sending $19.95 to:
Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1
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