My son has asthma

A reader writes: "My son has asthma and I would like to know what can be done to prevent his frequent attacks."

Asthma is a common condition which affects the ability to breathe freely. Many Jamaicans speak of someone who is never out of a cold but this could be a symptom of asthma.

Asthma manifests as recurrent attacks of wheezing or a troublesome cough at nights. Some people only cough or wheeze after exercise. Other people experience wheezing, chest tightness, or cough only after exposure to pollens, strong smells or pollutants in the air. People with asthma take longer to recover from a cold or the cold tends "to go the chest."

No one-off cure

Unfortunately, there is no one-off cure for asthma. The reader's son should be assessed for his level of control. He should be evaluated by a general practitioner or paediatrician for frequency of daytime symptoms, night-time symptoms and for medication. He may require tests such as spirometry to measure his airflow, but a simple test with a peak-flow meter can be used to measure his ability to blow out his mouth. This instrument can be kept by your son to assist with monitoring his asthma.

Prevention of attacks is an important part of controlling his asthma. Skin tests with allergens may be useful in identifying triggers for his asthma. These triggers should be avoided whenever possible. Your son's level of asthma control will determine the number and type of medication needed. The doctor will select from 'relievers' and 'maintainers' which serve to open the airways. If his asthma is not controlled on the present regimen, then his medication must be stepped up to include more relievers and maintainers until control is achieved. Once control has been maintained for at least three months, treatment can be stepped down to the lowest dose of treatment that maintains control.

Monitor the attacks

Asthma control requires monitoring by the patient and doctor. Your son may be asked to use a peak-flow meter to monitor his progress. The frequency of doctor visits will depend on the severity and number of attacks. After an attack, he will need to see the doctor within a week or two. Once his asthma is under control, he should visit the doctor every three months.

Asthma is a long-term, recurrent disease that affects the airways in the lungs. It is a significant cause of death and illness for children and adults. However, it can be controlled if people get information on the condition, monitor the level of control and take medications as required.

Dr Pauline Williams-Green is a family physician and past president of the Caribbean College of Family Physicians; email: yourhealth@gleanerjm.com.