Dear Doctor: Our 8-year-old grandson is coming from Atlanta to spend the summer with us in Idaho. He has asthma, and our daughter has mentioned that my husband and I have to become familiar with his “asthma action plan.” What is that? How should we prepare?
Dear Reader: An asthma action plan is a detailed roadmap for how to manage the disease, including medications and methods for preventing and controlling asthma attacks. It’s necessary because asthma, which is a chronic respiratory disease, is both complex and serious. It can cause symptoms that change not only from day to day but from minute to minute.
For most of us, the act of breathing is effortless. But people living with asthma can never take their next easy breath for granted. The airways of someone who has asthma can suddenly become inflamed and swollen, which makes it difficult to inhale and exhale. This type of chronic inflammation puts their airways on perpetual high alert and makes the tissues liable to overreact to a range of stimuli. These are known as triggers and include dust, pollution, mold, perfumes, smoke, pet dander and other allergens, as well as exertion and even certain weather conditions. Any of these triggers can cause asthma symptoms, which include a wheezing sound when someone breathes, shallow and rapid breathing, sustained coughing fits, labored breathing and weakness or exhaustion.
During an asthma attack, or flare-up, the airways become swollen enough that it becomes very difficult, or even impossible, to breathe. In addition, the groups of muscles that usually help with breathing will tighten up, making getting enough air even more challenging.
The disease is managed with two types of medications -- controllers and relievers. Controllers are typically corticosteroids delivered via an aerosol, which is inhaled. They are used in the day-to-day management of asthma to reduce chronic inflammation, decrease mucus production and relax the bands of muscles around the airways. People with mild asthma may find that this treatment is sufficient to keep the disease under control. Relievers are medications to be used when an asthma attack occurs. They work by swiftly opening up the airways and relaxing the muscles, which either stops the attack or reduces its severity.
Because asthma is both unpredictable and potentially dangerous, it’s important to plan ahead for all eventualities. That’s where the asthma action plan comes into play. It’s a written set of instructions that detail every aspect of an individual’s asthma treatment. This includes potential triggers for an asthma attack, which medications to take, their dosages, their timing and what to do in an emergency. In addition to being familiar with this plan, be sure your local pharmacy has your grandson’s asthma prescriptions on file, and that they include enough refills to last his entire visit. It’s also wise to line up local medical help, in case it is needed.
Some schools and recreational programs require a written asthma action plan on file before allowing a child to attend, so if your grandson will be taking part in any organized activities, be prepared to share the document with them.
Ask your daughter to send you a copy of your grandson’s action plan before he arrives. This will allow you to familiarize yourself with the specifics, and ask any questions you may have well in advance. Or you can find a variety of printable or electronic forms at cdc.gov/asthma/actionplan.html.
(Send your questions to firstname.lastname@example.org, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)