Asthma: A fight for breath

Yet often well-controlled

10/20/2017, 11:12 a.m.
It is estimated that 25 million people in this country have asthma. Although it is a very serious disease, it ...

Asthma is known by its telltale wheezing or whistling sound, but it’s the coughing, chest tightness and shortness of breath that often cause concern. In asthma the airways are inflamed and clogged with mucus. The muscles surrounding the airways contract leaving little space for air to enter. Symptoms are often worse at night, resulting in a persistent dry cough, making it hard to get a good night’s sleep.

Faye Holder-Niles, M.D., M.P.H. is the medical director of Primary Care Asthma Programs, Primary Care & Office 
of Community Health at Boston Children's Hospital.

Faye Holder-Niles, M.D., M.P.H. is the medical director of Primary Care Asthma Programs, Primary Care & Office of Community Health at Boston Children's Hospital.

There is no cure, but the news is not all that bleak. With medication asthma can often be well-controlled.

Roughly 25 million or 8 percent of people in this country are afflicted, according to the Centers for Disease Control and Prevention. Asthma is the leading chronic disease in children and the top reason for missed school days. In childhood the disease is more common in boys than girls, but in adulthood, the reverse is true. It is more prevalent in those of lower income and strikes the Northeast and Midwest more than other sections of the country.

For reasons unknown, the prevalence of asthma in black children is almost two times higher than it is in whites, and blacks are three times more likely to be hospitalized for asthma. Studies are underway to investigate the possibility that blacks may respond differently to asthma medications.

The impact of asthma on the economy is noteworthy. Yearly visits to emergency departments, physician offices and hospital outpatient departments can exceed 13 million. The total annual cost is estimated to be $56 billion.

Recognizing asthma symptoms in your child can be a bit tricky. The symptoms can closely mirror those of allergies or even the common cold. “For young kids in particular you rely on the symptoms and history,” explained Dr. Faye Holder-Niles, the medical director of Primary Care Asthma Programs at Boston Children’s Hospital. “A parent might say that the child is coughing a lot at night or when running and playing even when they are not sick.”


Take an active role in controlling your asthma:

1. Develop a partnership with your primary care provider

2. Learn what asthma is and how it affects your body

3. Create and follow your asthma action plan

4. Identify and avoid triggers

5. Know which medication is which and how to take it correctly

6. Be able to recognize a flare-up and know what to do

7. Exercise regularly and practice precautions to prevent a flare-up

8. Get regular check-ups

9. Don’t smoke or be around people who do

10. Learn to control your stress levels

11. Get a yearly flu shot

At age six and older the parameters of diagnosis change. In addition to the history and symptoms, asthma can be confirmed by a pulmonary function test called spirometry. This test measures how much and how fast you can move air into and out of the lungs.

The National Heart, Lung and Blood Institute has developed a series of guidelines to help diagnose the disease and measure its severity. Asthma ranges from intermittent to severe persistent, and varies by the frequency and seriousness of the symptoms. For instance, those with intermittent asthma may have no interference with normal activities. On the other end of the spectrum a person may experience symptoms throughout the day and have to rely on daily preventive medications.