As
she settled into her cubicle, Debi noticed the blinking message
light on her office phone. She hit the button and Zak’s
physician’s voice boomed. He demanded Zak be brought
to his office immediately for monitoring. “What do you
want?” he asked. “A dead child or a child who
passes his state tests?” Debi’s stomach churned.
Had she made the wrong decision? Then the school nurse called,
worried that she could not be close enough to Zak during the
tests to help him in case he had an attack. The state had
strict guidelines regarding testing, and only certified monitors
were allowed in the testing room. Debi leaned back in her
chair and listened to the assistant principal’s message.
He said that Zak’s coughing had been a major distraction
to other students, and the school did not have the staff to
move him into a room alone. Debi knew then that she should
have stayed. She should have insisted on it.
Zak’s voice came over the phone’s speaker last.
“Mom, it’s me. I know I can take this test fast.
Then you can pick me up and we can go to the doctor’s
office.” His calm voice sounded mature beyond his eleven
years because Zak had endured many emergencies. Like nine
million U.S. children, Zak suffers from asthma. Diagnosed
before his first birthday, he has experienced one battle after
another in his struggle to breathe easy and be a normal kid.
Symptoms
and Diagnosis of Asthma
Dr.
William Neaville, Pediatric Allergy and Asthma Specialist
at Children’s Medical Center Dallas, describes asthma
as a chronic disease with no known cure. Asthma is also known
as reactive airway disease, a condition affecting the respiratory
system. Sufferers experience inflamed airways. Because of
the inflammation, airways are more sensitive than normal,
causing a greater potential for irritation. Obstruction of
airflow occurs when muscles around airways tighten, and often
mucus production increases. These problems combine to restrict
airflow to the lungs, resulting in the body not receiving
enough air to function properly. During an asthma attack,
a person experiences suffocation. Asthma claims five thousand
lives annually.
What causes asthma? Approximately 40% of children with asthmatic
parents will develop the condition. “Other factors,
such as delayed lung development, may also be involved,”
according to Dr. Neaville. “Some infants may be diagnosed
as asthmatic if they experience recurrent wheezing, even if
the wheezing is due to a viral infection.” Asthma can
be mild or severe and is usually affected by environmental
triggers such as pet dander, smoke, seasonal allergies, stress,
exercise or air pollution.
“Asthma symptoms include wheezing, coughing, tightness
in the chest, and shortness of breath,” Dr. Neaville
explained. “The average age for diagnosis is two years,
and some children may grow out of it.” Asthmatics may
also develop a skin condition known as eczema.
Treatments
of Asthma
For
children with asthma, the best prevention for attacks is trigger
avoidance. The most common treatment is steroids. Many young
children take asthma medication through a nebulizer. This
piece of equipment forces air over liquid medication to create
a mist, which patients inhale through a mask. Older children
may also use a metered dose inhaler, or MDI.
“The types of medications don’t change from patient
to patient,” according to Dr. Neaville. “What
does change is dosage and delivery method. Controller medications
are given, usually two times per day, to prevent symptoms.
Rescue medications are provided to counteract asthma attacks.”
Two classes of medications are currently used to treat asthma.
Anti-inflammatory medications include corticosteroids and
cromolyn sodium. Leukotriene modifiers are a new type of anti-inflammatory
medication. They differ from other anti-inflammatory medications
in that they block leukotrienes, chemicals that cause inflammation.
Bronchodilators are the second class of asthma medications.
By relaxing the bronchial muscles, bronchodilators dilate
airways, allowing unobstructed airflow. Some bronchodilators
are beta adrenergic antagonists, methylxanthines, and anticholinergics.
Zak’s symptoms subsided significantly after he had his
tonsils and adenoids removed at the age of five. Until that
time, recurring colds and strep throat aggravated his asthma.
According to Debi, “The colds and strep throat tapered
off when he developed some immunities, but having his tonsils
and adenoids removed helped his breathing immensely.”
While the old remedy of holding a chihuahua to transfer asthma
to the dog isn’t likely to be effective, asthmatics
have reported success with other natural treatments. These
include chiropractic care, nutritional supplements, herbal
and homeopathic remedies, and use of essential oils. Some
supplements, herbs, and essential oils act as bronchodilators.
They may also reduce inflammation, mucus, and seasonal allergies.
Barriers
and Hurdles
Parents
and caregivers of asthmatic children should enroll in classes
to learn about asthma and how to administer medications properly.
Pediatricians or hospitals can advise where asthma education
is offered. “The best things are for parents to know
as much as they can, avoid triggers, and use medications correctly,”
says Dr. Neaville, whose practice offers asthma education
classes.
Some parents are not with their children twenty-four hours
a day. Debi Kendrick remembered Zak’s daycare center.
“Nebulizers lined the kitchen counter. The daycare workers
were wonderful about giving Zak his required two times per
day treatments.” At Zak’s elementary school, the
PTA purchased three nebulizers for the school nurse. While
children cannot carry MDI’s on their persons in public
school, they can go to the nurse for medication as needed,
if parents provide appropriate documentation and supplies.
Debi first started administering nebulizer treatments to Zak
when he was a toddler. She would hold him down, feeling anxious
and nervous. Her husband, Aaron, who was diagnosed with asthma
at age sixteen, explained that holding Zak down and being
anxious would only cause more stress for Zak and intensify
his asthma attacks. Gradually, Debi learned administer treatments
calmly and methodically. This helped Zak and her deal with
treatments and attacks much better.
“I will never feel what Zak and Aaron feel because I
don’t have asthma,” Debi said. “But something
about watching my child unable to breathe makes it hard for
me to breathe too.”
Educational, physical, and psychological issues are not the
only challenge for a family with an asthmatic child. Because
of Zak’s asthma diagnosis, the Kendricks have been turned
down by insurance agencies and upgraded, which means they
were assigned a higher deductible than normal. Currently,
they can only attain catastrophic coverage for Zak. This means
a high deductible for emergency treatment, a deductible for
prescriptions, and a ceiling that is usually exceeded by June
of every year. “If Zak has to be hospitalized for asthma,
it’s not covered by insurance,” Debi explained.
“His medications cost about $150 per month.”
Living
With Asthma
Children with asthma do not have to live sheltered lives.
Zak has played soccer, baseball, basketball, and golf. He
also roller blades, skateboards, and “pretty much loves
every sport,” according to his mother. In the summer
he attends College for Kids at a local community college,
and he sings in his school’s honor choir.
Zak isn’t shy about telling people he has asthma. His
friends know what to do if he stops mid-court and says he
needs his inhaler. They run to his backpack, bring him his
inhaler, then hold up one finger at a time after Zak takes
a puff. When they get to ten, Zak releases his breath and
begins to relax, taking in more and more air until he’s
back to normal.
Not all asthmatic children can endure outdoor sports because
exercise and allergies may trigger an attack, even if they
are on a daily double dose of controller medication. The Consortium
of Children’s Asthma Camps hosts summer camps to allow
high-risk children a chance to enjoy a camp in a safe environment.
Specialists on staff assist with medications and emergencies.
Neaville advises parents to let children be themselves, and
that’s exactly what the Kendricks have done. Zak has
learned to deal with his asthma as a part of everyday life.
“At first I worried he wouldn’t be able to do
all the things boys do,” Debi said. “But he’s
accomplished everything he’s attempted pretty well,
I think. Of course, I wish he didn’t have asthma. It
would make all our lives much easier. But the older he gets,
I see him handle it more himself, and with confidence.”
Nine million children in the United States suffer from asthma.
For children under the age of fifteen, it is the third leading
cause of hospitalization, and it accounts for more than ten
million missed school days each year. Through education and
treatment, asthmatic children are living, breathing examples
of courage and confidence.
|
