Top Ranking Questions NURSES are asked by PARENTS
Q. Will my child grow out of their asthma?
This is a question we get asked often and there is not a simple answer. Asthma is a variable disease in that symptoms come and go. Sometimes their asthma will be really good and it might feel like medication is pointless. However, one thing we ask parents to think about is "why is my child's asthma so well controlled?" Almost always the parents can identify that it is likely due to the regular administration of inhaled corticosteroids (preventer inhaler) that their child does not have any symptoms. But if they were to stop using their preventer inhaler, would their asthma be so well controlled? and is it worth the risk? There is a chance asthma symptom may reduce in frequency and severity as the child grows along with their airways but it's never a given. Research shows that even small amounts of airway inflammation (like with asthma) can have poor respiratory and health outcomes in adulthood if it's left untreated. Thankfully, asthma is not a life sentence and we live in an an age where we have access to some great asthma medications so even if children had to be on life long medication and never grow out of their asthma, with good asthma control, they can certainly live a full life.
Q. When can my child start to manage their own asthma? I don't have the time to remember to give their inhalers twice a day with everything else going on!
Asthma is no doubt a difficult condition to manage at the best of times. As asthma nurses working in the community, we see some of the most poorly controlled asthma patients. Some of our nurses personally have asthma in which they have to take regular medication for and we can honestly say that as an adult and a registered nurse, we find managing our asthma quite difficult at times. How much harder it must be for a child to manage it independently. To remember to take their inhaler (and correctly) every morning and night is a big ask. However, we know that there are some young people who can take their inhalers as prescribed - but this would be the exception to the rule. Therefore, parents and caregivers play such a vital role in ensuring the ongoing management of their children's asthma. Research shows that some children can begin to start to manage their own asthma at 11 years of age but even then, may still require help and guidance. The precious time and effort parents put into giving their child their regular asthma inhaler or hay fever medications means the less symptoms of asthma the child will have ( for example a tight chest, wheeze, shortness of breath and cough), the less amount of reliever medication required, the less risk of the child having an acute life threatening exacerbation of their asthma (which is absolutely frightening for all involved), the less chance of needing hospitalisation and presentation to ED/GP (which means time off work/school, potential loss of income etc.,) and most importantly, asthma that is well controlled is far less likely to result in death. In short, putting in the hard mahi now will pay off. We remind parents that children are watching. Over time, they will pick up the skill and art of having to use an inhaler and understand the importance behind it. But it does take time. It takes dedication and sacrifice, literally. But we've yet to come across a parent who is unwilling to do what it takes for their child to breathe easy. Asthma is a disease which changes over the course of a person’s lifetime. During which, they may have episodes of being well controlled, with minimal inflammation and might not require inhalers/medication during that time. Asthma control can vary depending on a person’s triggers. Things like the environment, climate, foods, other illness, hormones, stress, along with other classic triggers can affect a person’s asthma. Some of these triggers will change according to a person’s stage of life and where they are living. This makes it hard to predict how someone’s asthma will be over a prolonged period of time. Regular check-up appointments with your G.P, monitoring symptoms with a peak flow meter and/or symptoms diary, being aware of your triggers and allergies, staying fit and healthy and taking your inhalers when prescribed are all ways you can keep your asthma and thus hopefully symptoms under control. Having an in date Asthma action plan, can help you know what to do when your asthma does flare up.
Q. Why are asthma action plans so important?
They are a great resource to have on hand- to view at a glance. If an emergency was to occur it can be very stressful and it may be hard to think rationally. So you can refer to your personalised action plan and know exactly what to do. We recommend having one on your fridge/stuck inside your pantry door. So, whoever is at home caring for your child they can the action plan and know exactly what to do. We would also recommend giving a copying to your child’s day care/ school as each asthma action is individualised. Your asthma action plan should be up dated every 2 years, or earlier if you medications change.
Q. What are the side effect of giving my child steroids?
Some parents share concerns around the affiliation between their child’s growth and inhaled corticosteroids. Firstly, it is important to note that steroids in inhalers are not the same as anabolic steroids, but they mimic a naturally occurring steroid that our bodies already produce.
Studies have shown that inhaled Corticosteroids steroids may stunt your child’s growth by less than 1 cm in the 1st year, ½ a cm in the second year and then nil effect on growth thereafter. However, we do ask parents to consider that the risks of uncontrolled asthma (I.e. increase in reliever use, days off school and work, hospitalisation and possibly death) far outweigh the potential for any growth underdevelopment. Also, if a child is not sleeping well (due to uncontrolled asthma), their growth may be impacted anyway along with their capacity to learn at school and partake fully in social activities. If your child is struggling to breathe, this can affect the level of oxygen in their blood which in turn affects growth, development, education and overall health. Studies have shown that even mildly uncontrolled asthma can cause long term lung damage. Long term damage can also be done to your child’s lungs if steroid treatment is withheld.
Inhaled steroids do have other side effects, albeit mild. They are hoarseness, cough, sore throat, and oral thrush. These side effects can be avoided by rinsing one’s mouth and spiting post inhalation.
To speak with an Asthma NZ nurse further click here.
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