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Posted by Dr. Monica Wonnacott | May 11, 2016

Coughing At Night Or When Running? Think Asthma.

The Asthma and Allergy Foundation of America (AAFA) calls May the National Asthma & Allergy Awareness month because this is the peak season for problems. So it seemed fitting to write about asthma and increase awareness.

Asthma is major health concern in America. Did you know (according to the AAFA)

  • 10 people a day die from asthma
  • Asthma affects 24 million Americans
  • 3 million children (younger than 18) have asthma

Asthma is chronic disease that causes the airways in the lungs to be inflamed. The inflammation causes the airways to become narrow. Those narrow airways spell trouble whenever the demands on the lungs are increased.  Those demands, or “triggers,” make it difficult to breathe when a person has asthma.

Common Asthma triggers

  1. Exercise
  2. Viruses/sickness
  3. Cigarette smoke (both first and secondhand)
  4. Pets
  5. Allergens
  6. Cold air/weather
  7. Molds and dust

If you don’t have asthma, it can be hard to understand what having an attack feels like. Imagine running a mile and only being allowed to breathe through a straw. Pretty quick you would feel terrible. Your head would hurt and you’d feel dizzy (from not getting enough oxygen to your brain). You’d be seriously winded, extremely tired, and your chest would be hurting. Even when someone with asthma is not having an attack, it is common to still be symptomatic.

Asthma Signs and Symptoms

  1. Cough (especially worse at night and first thing in the morning)
  2. Cough with exercise
  3. Wheezing
  4. Shortness of breath
  5. Chest tightness

What Causes Asthma?

The short answer is we don’t exactly know. The longer answer is that science has shown a number of different contributing factors.

  1. There’s a lot of different science to show that early and frequent exposure to certain common allergens and infections decreases the risk of developing asthma. For example, having a pet early in life can decrease the risk of developing asthma, but later the pet can act as a trigger. Coming from a large family or living on a farm is also protective against asthma. Early use of antibiotics in life is also linked to asthma (yet another reason to judiciously use antibiotics). Viruses can both decrease and increase the risk. For example, early exposure to respiratory syncytial virus (RSV) increases the risk.
  2. There is a strong genetic component to developing asthma. There are many specific genes that have been linked to development of asthma. Families that are “atopic,” that is, those with eczema, allergies, and asthma, are also at increased risk. So while one condition (e.g., eczema) doesn’t lead to the other (e.g., asthma), having one, increases the risk of developing another. This phenomenon is often referred to as the “atopic march.”

Ashtma Treatment

There is no cure for asthma. You may have heard of kids “outgrowing asthma.” While not exactly true, the concept is that the lungs continue to grow and develop in the first 6-8 years of life. Many kids, who had trouble when they were toddlers, will get better as their lungs mature. Treatment generally consists of using medications (commonly inhalers) to modify symptoms and avoiding triggers. Inhalers are divided into 2 groups:

  1. Controller inhalers. These medications are used daily to prevent the asthma attack. Generally, these are inhaled steroids.
  2. Rescue inhalers. These medications are used on an as needed basis to deal with symptoms when the asthma has flared.

You will work with your child’s pediatrician to help determine the severity of your child’s asthma. The severity will determine what and how often you’ll be giving your child medication. (As an aside, prep yourself. The medications can be really expensive and unfortunately, there aren’t a lot of generic drugs available).

If you managed to read the entire article, here’s the comical reward for your efforts. Whenever I write an article, I often double check facts (especially if I quote a statistic). I discovered this interesting historical note about asthma. In the 1930s-1950s, asthma was considered one of the “holy seven” psychosomatic illnesses. Asthma was considered psychological and was consequently often treated with psychoanalysis and other talking cures. The “wheeze” (which is really from a constricted/tight airway) was thought to be a suppressed cry of a child for its mother. The treatment of depression was especially important for people with asthma. Isn’t that a riot? If your doctor prescribes Prozac to your child who is having an asthma attack, your doc may be a little too old school. Throw that little historical nugget out at your next dinner party.