Home Health Glenn Ellis Ellis: Asthma and back to school

Ellis: Asthma and back to school

By Glenn Ellis

As the days wind down for summer many parents and kids are preparing for another school year with the challenges of asthma.

Asthma is a leading chronic illness among children and adolescents in the United States. It is also one of the leading causes of school absenteeism. On average, in a classroom of 30 children, about three are likely to have asthma. This contributes to over 10 million school days lost to asthma each year.

According to the Centers for Disease Control and Prevention (CDC), black children are twice as likely to have asthma as white children. And black children are 10 times more likely than white kids to die of complications from asthma.

Asthma is a reversible lung disease caused by the narrowing or blocking of the lung’s airways, often as a response to various triggers. Asthma triggers vary from person to person, but may include cigarette and other smoke, mold, pollens, dust, animal dander, exercise, cold air, household and industrial products, air pollutants and infections.

One of the little-known asthma triggers are cockroaches…yes, I said cockroaches! These and other kinds of triggers can lead to spasms in the lungs, causing asthma attacks. Asthma symptoms include coughing, wheezing and shortness of breath, and can be life-threatening if not properly managed.

Though asthma is a manageable condition, it can be life-threatening. In addition, there are disparities in the burden of asthma. Although asthma affects Americans of all ages, races, and ethnic groups, low-income and minority populations experience substantially higher rates of fatalities, hospital admissions and emergency room visits due to asthma.

African-American children ages 4 and younger are six times as likely as whites to die of the disease. And those who don’t die are hospitalized more often than their white counterparts. Low-income populations, minorities, and children living in inner cities experience more emergency department visits, hospitalizations, and deaths due to asthma than the general population.

The burden of this chronic disease is felt everyday at the individual level, whether it’s a frightening asthma attack or the constant vigilance and adherence to treatment plans required to keep it under control. Asthma is the most common chronic illness and the number one cause for hospitalization and prescribed therapy among children.

As you prepare for a new school year, here are several tips to help parents of children with asthma get ready for the new school year:

  • Asthma Action Plan. Ask your child’s doctor for a written Asthma Action Plan for the school. This plan should include what medicine to use to treat asthma symptoms and changes in peak flow zones, what medication to use as a pretreatment before exercise, emergency telephone numbers and a list of things that make your child’s asthma worse.
  • Meet with school staff. Plan a meeting with school staff before or in the beginning weeks of the school year. It is helpful to have the school nurse, health aide, teacher and physical education teacher at the meeting, if possible. Your child also can be involved in the meeting. Take the written Asthma Action Plan to the meeting.
  • Special supplies at school. Keep a peak flow meter, spacer and rescue medicine at school for your child. Be sure your child’s teacher knows that the medication is there should a problem arise. Make sure the rescue medicine has not passed its expiration date. Take these items home at the end of each school year.
  • Gym class. Make sure your child has a pretreatment for gym class or other physical activities, especially outdoors in cold weather. It is important to be sure that all teachers know this medication is to prevent problems or to take care of them if they should occur.
  • Medication side effects. Studies have shown that asthma medicines typically don’t cause concentration problems. However, a child who receives high doses of medicine during an episode may experience side effects, such as restlessness and trouble concentrating. If your child’s’ doctors are giving increased doses or new medications, alert your child’s teacher.
  • Keep in touch. Continue talking with your child and school staff about managing asthma at school on a regular basis, even if everything is fine at school. Talk with the school staff if your child misses school and assignments. If your child is up at night with an attack, let the teacher know. Your child may be tired and have difficulty concentrating the next day at school.
  • When to stay home. Talk with your child’s doctor about when it is okay to stay home from school because of asthma or illness. Mild asthma symptoms can usually be handled at school but there are a number of factors (what triggered the asthma, the stability of peak flows, fever, how much medicine your child is taking, etc.) to consider when deciding whether to keep your child at home.

Parents take heed and do your best to help your child have a healthy, productive and physically active school year.

Glenn Ellis is Research Bioethics Fellow at Harvard Medical School and author of Which Doctor? and Information is the Best Medicine. Listen to Glenn, on radio in Birmingham or V94.9, Sundays at 7:50pm, or visit: www.glennellis.com.