There are many things that just seem to come naturally to some people. Maybe you know a girl who's a natural at sports - put her in a uniform and she's off and running. Some people are naturals at playing an instrument; it's like they were born knowing how to count in 4/4 time. Others are naturals at math; give them a test on theorems or equations and they're happy.
But some people have a problem with something that you'd think would come naturally to everyone: breathing. When a person has asthma, it can make breathing very difficult. And when it's hard to breathe, it can affect a person's game, that trumpet solo, and even the all-important geometry test.
What Is Asthma?
Asthma is a lung condition that causes a person to have difficulty breathing. Asthma is a common condition: More than 6 million kids and teens have it.
Asthma affects a person's bronchial (pronounced: brahn-kee-ul) tubes, also known as airways. When a person breathes normally, air is taken in through the nose or mouth and then goes into the trachea (windpipe), passing through the bronchial tubes, into the lungs, and finally back out again. But people with asthma have airways that are inflamed. This means that they swell and produce lots of thick mucus. They are also overly sensitive, or hyperreactive, to certain things, like exercise, dust, or cigarette smoke. This hyperreactivity causes the smooth muscle that lines the airways to tighten up. The combination of airway inflammation and muscle tightening narrows the airways and makes it difficult for air to move through.
In most people with asthma, the difficulty breathing happens periodically. When it does happen, it is known as an asthma flare - sometimes also referred to as an asthma attack or episode.
A person having an asthma flare may cough, wheeze (make a whistling sound while breathing), be short of breath, and feel an intense tightness in the chest. Many people with asthma compare a flare to the sensation of trying to breathe through a straw - it feels extremely hard to get air in and out of their lungs. An asthma flare can last for several hours or longer if a person doesn't use asthma medication. When an asthma flare is over, the person usually feels better.
Between flares, a person's breathing can seem completely normal, or a person may continue to have some symptoms, such as coughing. Some people with asthma feel as if they are always short of breath. Other people with the condition may only cough at night or while exercising and they may never have a noticeable flare.
What Causes It?
No one knows exactly what causes asthma. It's thought to be a combination of environmental and genetic (hereditary) factors. A teen with asthma may have a parent or other close relative who has asthma or had it as a child. Asthma isn't contagious, though, so you can't catch it from someone who has it.
Asthma symptoms can be brought on by
dozens of different things, and what causes asthma flares in one
person might not bother another at all. The things that set off
asthma symptoms are called triggers. The following are
some of the common triggers:
· Allergens.Some people with asthma find that allergens - certain substances that cause an allergic reaction in some people - can be a major trigger. Common allergens are dust mites (microscopic bugs that live in dust), molds, pollen, animal dander, and cockroaches.
· Airborne irritants and pollutants. Certain substances in the air, such as chalk dust or smoke, can trigger asthma because they irritate the airways. Cigarette smoke is a major cause of asthma symptoms, and not just for smokers - secondhand smoke can trigger asthma symptoms in people who are around smokers. Scented products such as perfumes, cosmetics, and cleaning solutions can trigger symptoms, as can strong odors from fresh paint or gasoline fumes. And some research studies have found that high levels of air pollutants such as ozone may irritate the sensitive tissues in the bronchial tubes and can possibly aggravate the symptoms of asthma in some people with the condition.
· Exercise. Some people have what's called exercise-induced asthma, which is triggered by physical activity. Although it can be especially frustrating, most cases of exercise-induced asthma can be treated so that people can still enjoy the sports they love.
· Weather. Cold or dry air can sometimes trigger asthma symptoms in certain people, as can extreme heat or humidity.
· Respiratory tract infections. Colds, flu, and other respiratory conditions can trigger asthma in some people.
There are lots of other things that can trigger asthma symptoms in people with the condition. For example, a girl's asthma can get worse just before her period. And even laughing, crying, and yelling can sometimes cause the airways to tighten in sensitive lungs, triggering an asthma flare.
How Do Doctors Diagnose Asthma?
Most people with asthma are diagnosed with the condition when they're kids, but some don't find out that they have it until their teen years. In diagnosing asthma, a doctor will ask about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues. This is called the medical history.
The doctor will also perform a physical exam. He or she may recommend that you take some tests. Tests that doctors use to diagnose asthma include spirometry and peak flow meter tests, which involve blowing into devices that can measure how well your lungs are performing. Your doctor may also recommend allergy tests to see if allergies are causing your symptoms, or special exercise tests to see whether your asthma symptoms may be brought on by physical activity. Doctors occasionally use X-rays in diagnosing asthma, but these are usually only to rule out other possible problems.
Your family doctor may refer you to a specialist for allergy diagnosis and treatment. Doctors who specialize in the treatment of asthma include those who have been trained in the fields of allergy, immunology (how the immune system works), and pulmonology (conditions that affect the lungs).
How Is It Treated?
There's no cure for asthma, but the condition can usually be managed and flares can be prevented. Asthma is treated in two ways: by avoiding potential triggers and with medication.
Teens who have asthma need to avoid the things that can cause their symptoms. Of course, some things that can cause symptoms can't be completely avoided (like catching a cold!), but people can control their exposure to some triggers, such as pet dander, for example.
In the case of exercise-induced asthma, the trigger (physical activity) needs to be managed rather than avoided. Exercise can help a person stay healthier overall, and doctors can help athletes find treatments that allow them to them participate in their sports.
Doctors treat every asthma case individually
because the severity of each person's asthma and what triggers
the symptoms are different. For this reason, doctors have
a variety of treatment medications at their disposal. Most asthma
medications are inhaled (which means that a person takes the medication
by breathing it into the lungs), but asthma medications can also
take the form of pills or liquids. They fall into two categories:
· Medications that act quickly to halt asthma symptoms once they start. Some medications can be used as needed to stop asthma symptoms (such as wheezing, coughing, and shortness of breath) when a person first notices them. These medications act fast to stop the symptoms, but they're not long lasting. They are also known as "rescue," "quick-relief, " or "fast-acting" medications.
· Long-term medications to manage asthma and prevent symptoms from occurring in the first place. Many people with asthma need to take medication every day to control the condition overall. Long-term medications (also called "controller," "preventive," or "maintenance" medications) work differently from quick-relief medications. They treat the problem of airway inflammation instead of the symptoms (coughing, wheezing, etc.) that it causes. Long-term medications are slow acting and can take days or even weeks to begin working. Although you may not notice them working in the same way as quick-relief medications, regular use of long-term medications should lessen your need for the quick-relief medications. Doctors also prescribe long-term medications as a way to minimize any permanent lung changes that may be associated with having asthma.
Some people with asthma rely only on quick-relief medications; others use quick-relief medications together with long-term control medications to keep their asthma in check overall. Each person needs to work closely with a doctor to find the treatment that's right for them.
In addition to avoiding triggers and
treating symptoms, people with asthma usually need to monitor
their condition to prevent flares and help their doctors adjust
medications if necessary. Two of the tools doctors give people
to do this are:
· Peak flow meter. This handheld device measures how well a person can blow out air from the lungs. A peak flow meter reading that falls in the meter's green (or good) zone means the airways are open. A reading in the yellow zone means there's potential for an asthma flare. A reading in the red zone means the flare is serious and could mean that a person needs medication or treatment immediately - maybe even a trip to the doctor or emergency room. Teens who take daily medicine to control their asthma symptoms should use a peak flow meter at least one to two times a day and whenever they are having symptoms.
· Asthma journal. Keeping a diary can also be an effective way to help prevent problems. A daily log of peak flow meter readings, times when symptoms occur, and when medications are taken can help a doctor develop the most appropriate treatment methods.
Dealing With Asthma
The best way to control asthma is prevention. Although medications can play an essential role in preventing flares, environmental control is also very important. Here are some things you can do to help prevent coming into contact with the allergens or irritants that cause your asthma flares:
· Keep your environment clear of potential allergens. For example, if dust is a trigger for you, vacuum (or remove) rugs and drapes where dust mites can hide. Placing pillows and mattresses in dust-proof covers can help. If pets trigger your symptoms, keep a pet-free household. If you can't part with Fido or Fluffy, keep certain rooms pet free and bathe your pet frequently to get rid of dander.
· Pay attention to the weather and take precautions when you know weather or air pollution conditions may affect you. You may need to stay indoors or limit your exercise to indoor activities.
· Don't smoke (or, if you're a smoker, quit). Smoking is always a bad idea for the lungs, but it's especially bad for someone who has asthma.
· Be smart about exercise. It's a great way to keep the body and mind healthy, so if you're prone to exercise-induced asthma flares, talk to your doctor about how to manage your symptoms. If you get flares during a game or workout, stop what you're doing until the flare has cleared or you've taken a fast-acting medication. When the symptoms have gone, you can start exercising again.
Asthma doesn't have to prevent you from doing what you love! Sure, it takes a bit of work (and remembering!) but if you take your medications properly, recognize your symptoms and triggers, and check in with your doctor regularly, you can do anything that other teens do. That includes any sports activity, even cross-country skiing, swimming, or playing basketball.
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Updated and reviewed by: Elana Pearl
Date reviewed: July 2004
Originally reviewed by: Kathleen Trczinski, RN, MSN, and Neil Izenberg, MD