Take a Quiz to Test Your Asthma Knowledge

American Lung Association's

Test Your Asthma Knowledge Quiz

1.	Question - Not Required -What makes it hard to breathe when you have asthma? Inflammation swelling inside the airways Bronchoconstriction muscles tighten around the airways Mucus excess mucus clog the airway All of the above
2.	Question - Not Required -An asthma trigger is a substance, activity or condition that makes asthma worse. Common asthma triggers are tobacco smoke, pollen, and mold. True or False: Strong emotions such as stress and crying or laughing too hard are also asthma triggers. True False
3.	Question - Not Required -True or False: People with asthma should not exercise. True False
4.	Question - Not Required -True or False: People with asthma should get a yearly flu shot. True False
5.	Question - Not Required -Asthma cannot be cured, but it can be controlled. Steps to keeping your asthma in good control are: Taking your asthma medication as prescribed by your health care provider Reducing your exposure to asthma triggers Monitoring your asthma symptoms All of the above Asthma Knowledge Quiz Answers 1.  ANSWER: All of the above EXPLANATION: When you have asthma there are three primary changes in the airways – inflammation, bronchoconstriction and excess mucus production. Watch What is Asthma? an animated video to  see how these changes affect the airway. 2.  ANSWER: True EXPLANATION: Common, everyday emotions can make asthma worse. Anger, fear, feeling anxious, stress or crying can trigger asthma, so can excitement or laughing to hard. Click to learn more about asthma triggers.      3.  ANSWER: False EXPLANATION: Exercise is good for everyone, including those with asthma, and helps keep us healthy and strong. Olympic gold medalist Peter Vanderkaay is just one of many Olympic athletes that have asthma, including Kristi Yamaguchi and Jackie Joyner-Kersee, and former NFL players Jerome Bettis and Chris Draft. Click to learn more about asthma and exercise. 4.  ANSWER: True EXPLANATION: Respiratory infections such as the flu can worsen asthma. Protect your loved ones and yourself from influenza by getting a yearly flu shot. Learn more at www.facesofinfluenza.org. 5.  ANSWER: All of the above EXPLANATION: You can keep your asthma in good control by taking medications as prescribed, identifying and reducing asthma triggers, and monitoring your asthma symptoms. Talk to your health care provider about an Asthma Action Plan which can guide you through the steps of keeping your asthma in good control.

SOURCE: Taken directly from http://www.lung.org/lung-disease/asthma/test-your-asthma-knowledge-quiz.html 

Asthma Resources

For More Information, contact:

Source: http://www.nhlbi.nih.gov/

NHLBI (The National Heart, Lung, and Blood Institute) Health Information Center

P.O. Box 30105

Bethesda, MD 20824–0105

Phone: 301–592–8573

Fax: 301–592–8563

Web site: www.nhlbi.nih.gov

Allergy and Asthma Network: Mothers of Asthmatics

8201 Greensboro Drive, Suite 300

McLean, VA 22102

800–878–4403

Web site: www.aanma.org

American Academy of Allergy, Asthma, and Immunology

555 East Wells Street, Suite 1100

Milwaukee, WI 53202–3823

414–272–6071

Web site: www.aaaai.org

American Association for Respiratory Care

9425 North MacArthur Boulevard, Suite 100

Irving, TX 75063

972–243–2272

Web site: www.aarc.org

American College of Allergy, Asthma and Immunology

85 West Algonquin Road, Suite 550

Arlington Heights, IL 60005

847–427–1200

Web site: www.acaai.org

*Pollen Count Stations: National Allergy Bureau (NAB): http://www.aaaai.org/global/nab-pollen-counts.aspx

National Allergy Bureau's Pollen Count Stations

Source: http://www.aaaai.org/global/nab-pollen-counts.aspx

American Lung Association

1301 Pennsylvania Avenue, NW, Suite 800

Washington, DC 20004

800–586–4872 (800–LUNG–USA)

202–785–3355

Web site: www.lungusa.org

Association of Asthma Educators

1215 Anthony Avenue

Columbia, SC 29201

888–988–7747

Web site: www.asthmaeducators.org

Asthma and Allergy Foundation of America

8201 Corporate Drive, Suite 1000

Landover, MD 20785

800–727–8462

Web site: www.aafa.org

Centers for Disease Control and Prevention (CDC)

1600 Clifton Road, NE

Atlanta, GA 30333

800–232–4636 (800–CDC–INFO)

TTY: 888–232–6348

Web site: www.cdc.gov/asthma

Food Allergy and Research; Anaphylaxis Network

11781 Lee Jackson Highway, Suite 160

Fairfax, VA 22033

800–929–4040

Web site: www.foodallergy.org

National Jewish Health

1400 Jackson Street

Denver, CO 80206

877-225-5654

Web site: www.njc.org

U.S. Environmental Protection Agency:

1200 Pennsylvania Ave. SW

Mail Code 66095

Washington, DC 20460

Website: www.epa.gov/asthma

Indoor Air Division: www.airnow.gov

*Agencia de Protección Ambiental de Estados Unidos: http://www.epa.gov/iaq/espanol/asma.html

http://www.epa.gov/iaq/espanol/asma.html

Virginia Asthma Coalition (VAC) 

Virginia Hospital and Healthcare Association

4200 Innslake Dr.

Glen Allen, VA 23060

540-985-8371

http://virginiaasthmacoalition.org/

* Hay mas informacion en espanol aqui (El Asma: Latino Asthma Resources)

(EPA, 2014)

(EPA en español, 2013)

(NHLBI, 2013)

(Virginia Asthma Coalition, 2013)

El Asma: Latino Asthma Resources

"¿Qué es el asma?  El asma es una enfermedad pulmonar seria. Si usted o su niño tiene asma, usted no está solo. Cerca de 23 millones de personas en los Estados Unidos padecen de asma. El asma es la causa principal de enfermedad es de larga duración en los niños" (EPA, 2013). 

CÓMO USAR EL inhalador de dosis medida - http://www.nhlbi.nih.gov/health/public/lung/asthma/asthma_tipsheets_sp.pdf Video: "Respirar es vida: el control del asma en nuestros niños" - http://youtu.be/pGUo-3-R8wk ¿ApoyA su escuelA A los niños que tienen AsmA? - http://www.nhlbi.nih.gov/health/public/lung/asthma/asthma_friendly_checklist_sp.pdf http://www.aaaai.org/about-the-aaaai/newsroom/media-gallery/photos---graphics--illustrations.aspx http://www.aaaai.org/about-the-aaaai/newsroom/media-gallery/photos---graphics--illustrations.aspx http://www.aaaai.org/about-the-aaaai/newsroom/media-gallery/photos---graphics--illustrations.aspx

Fuentes:
http://www.nhlbi.nih.gov/health/public/lung/index.htm#asthma
http://www.aaaai.org/about-the-aaaai/newsroom/media-gallery/photos---graphics--illustrations.aspx
http://www.epa.gov/iaq/espanol/asma.html

Interdisciplinary Resources - Can a Specialist Help?

Referral Guidelines:

You may want to see a doctor specializing in treating asthma (a pulmonologist or an allergist/immunologist) if your child’s diagnosis is uncertain, the side effects of the medications are unbearable, or the asthma is difficult to control with frequent exacerbations (asthma attacks) (UpToDate, 2014). 

A pulmonologist is a doctor who specializes in the diagnosis and treatment of pulmonary (lung) conditions.  Pulmonologists are helpful when a pulmonary (lung) disease other than asthma is suspected or when additional pulmonary testing (tests evaluating the how well the lungs function) or bronchoscopy (a procedure that allows the doctor to look inside the lower respiratory tract) are needed (UpToDate, 2014).  

http://www.return2health.net/articles/healthy-lungs/

An allergist (or immunologist) is a doctor who specializes in the diagnosis and treatment of allergies, asthma, and immune deficiency disorders.  Seeing an allergists/immunologist is helpful when allergic triggers need evaluation or allergy symptoms are uncontrollable.  Allergists are familiar with the many types of indoor and outdoor allergens that may impact asthma and breathing, have received special training in how to identify these environmental triggers, and can provide advice on how to avoid them (UpToDate, 2014; AAAAI, 2014).  

Learn about common asthma triggers here – http://www.epa.gov/asthma/triggers.html.

Patients with allergic asthma (asthma triggered by allergens) who see an allergist/immunologist have been shown to experience improved outcomes (AAAAI, 2014).  While not every child with asthma needs to see a specialist, for many, asthma care in children provided by a specialist as the usual source of care has been shown to improve both the degree of care received and be more consistent with national guidelines (Lieberman, 2012).  Patients with asthma who see allergists (as opposed to primary care providers) report experiencing wide-ranging outcome improvement, including:

•  Higher quality of life
• Fewer problems controlling asthma
• Less severe symptoms 
• Higher patient satisfaction
• Better understanding of how to management their asthma
•  Fewer asthma-related hospitalizations
• Fewer asthma-related unscheduled doctor visits
• Less frequent use of rescue medication and increased use of inhaled steroids

(Lieberman, 2012)

The American Academy of Allergy, Asthma, and Immunology has developed referral guidelines to help determine when referral to an allergist is necessary.  You can ask your health care provider if your child might benefit from a referral (AAAAI, 2014). Those who might benefit from a referral to an allergist/immunologist include:

• Children with asthma that is not well controlled 
• Children with asthma that is classified as moderate or severe persistent asthma
• Children who frequently use rescuer/reliever medications
• Children who require emergency room care for asthma attacks
•  Children with a possible connection between their asthma and an unavoidable airborne allergens who also have a poor response to their medications, desire to avoid long-term medication, or have other allergy symptoms (like a frequent runny nose and itchy eyes)
• Children and families requiring education about possible environmental triggers
• Any child with potentially fatal asthma, including those with a previous life threatening episode or intubation (intubation = tube inserted to help with breathing). 

(AAAAI, 2014)

Patients may also benefit from joining a local Educational Support Group (ESG).  The Asthma and Allergy Foundation of America (AAFA) has support groups in many states.  These groups provide  emotional support while offering helpful information about asthma and allergies.  Search for a group in your state here: 
HTTP://WWW.AAFA.ORG/ESG_SEARCH.CFM. You can also start your own AAFA Educational Support Group by calling AAFA at 800-7-ASTHMA.

How to Use Your Inhaler

Check out this website (http://www.asthma.ca/adults/treatment/howToUse.php) 

for great step-by-step instructions on:

How to Use Your Inhaler, 

How to Clean Your Spacer or MDI, and 

Important Reminders About Spacers or MDI.

Source: http://www.asthma.ca/adults/treatment/meteredDoseInhaler.php

Source: http://www.asthma.ca/adults/treatment/spacers.php 

Videos about How to Use your Inhaler: 

http://asthma.ca/inhalertraining.php

(in English, Español, Português, Français, Italiano, Polski, 中国的, العربية, Việt, and हिंदी)

Developmental Considerations

Asthma in Children Under 5:

Many children develop asthma before age 5, and these infant, toddlers, and preschooler require different treatment than teens and adults.  Infants, toddlers and 4-year-olds are diagnosed and treated differently than are, and it may be impossible to obtain a diagnosis of asthma until a later age (Mayo, 2014). Older children and adults can confirm an asthma diagnosis by doing breathing tests (spirometry or peak flows) but most children under 5 can’t perform these tests yet (Mayo, 2014).  

Children in this age range may not be able to express to you verbally that they are having symptoms and will need help taking their medications.  Infants also tend to have less obvious symptoms of asthma because their chests are more flexible, but you may be able to see chest retractions (you may be able to see the outline of their ribs as they are trying hard to breath) (Hockenberry and Wilson, 2006).  They may feed slowly or get short of breath while feeding (Mayo, 2014).  Young children may sit in the Tripod Position (leaning forwards with hands on their knees) when attempting to breath better (Hockenberry and Wilson, 2006).  You may also notice shortness of breath, cough, and a decreased desire to run and play when your young child is having asthma symptoms (Mayo, 2014).   

Source: http://childrenshospitalblog.org/?s=asthma

For the child under 5, much of the stress of managing the disease falls on the parent(s) and may seem overwhelming.  Here are FIVE STEPS to help manage your infant, toddler, or preschooler’s asthma (Mayo, 2014):

1.  Learn about Asthma

• Understand your child’s medications, how they work, and when to give them
• Learn to recognize the signs and symptoms of asthma and to keep a record of symptoms
• Know what to do when your child's asthma gets worse

2.  Develop a Written Asthma ACTION PLAN (Find them here)

• Create this plan WITH your child's doctor
• An action plan outline the steps needed to manage asthma symptoms
• Everyone providing care to the child, including preschool teachers, should have a copy

3.  See the Doctor to Make Changes

• Every child is different, so your doctor will work with you to adjust medication types and dosages until you find what is most effective for your child’s asthma symptoms.
• Report any medication side effects (irritability, shaking, trouble sleeping or excitability)

4.  Control Asthma Triggers

• Learning to avoid asthma triggers is very important, but triggers vary from child to child, so the first step is identifying these triggers.  Once you have identified your child’s triggers, you can take step to avoid them.  
• Common asthma triggers are:
• Respiratory Infections/Colds
• Environmental Allergens (dust mites, pollen)
• Pets
• Exercise
• Cold Weather
• Cigarette Smoke
• Heartburn

5. Stick to the Plan!

• The best way to keep asthma under control is to follow your child's asthma action plan and update it when it isn’t working. You should carefully track changes in your child’s symptoms so that medication changes can be made BEFORE a severe attack occurs.

Asthma in Children Ages 5-11:

Physical Activity and Being a Kid:

Children with asthma that is well controlled should be able to run and play and participate in normal activities with other children, although they may need to take some precautions (Hockenberry  and Wilson, 2006).  Many children with asthma have exercised induced asthma (EIB), which means that symptoms are brought on by rigorous activity (Mayo, 2014). Exercise induced asthma is caused by the loss of heat and water from the lungs during exercise and occurs during or just after vigorous exercise (Sadaf and Kaslovsky, 2011). It should reach its peak 5-10 minutes after stopping exercise, and symptoms should resolve within 30 minutes (Sadaf and Kaslovsky, 2011).  

At this age, children can become very anxious about their condition and may fear dying, peer rejection for being "different,” and adverse drug affects (UpToDate, 2014). This may lead children to self-limit their activity; however, this does NOT need to be the case (Mayo, 2014).  If a child is receiving appropriate asthma treatment, physical activity doesn’t need to be restricted, and your child can participate in any type of sport at any level, even the Olympics (Mayo, 2014)!  However, without proper treatment, exercised induced asthma can result in negative physical outcomes, including poor overall fitness, decreased stamina, a sedentary lifestyle, and exercise avoidance (Mayo, 2014).

By the time a child is five years old, he should be able to be an active participant in controlling his asthma.  A pre-adolescent child should learn to use his rescue medication, avoid allergens, and practice good hand hygiene.  Children who take inhaled medication, such as through a nebulizer or metered dose inhaler (MDI), can be taught to use the device themselves (See How to use your Inhaler Post), but young children who cannot use the MDI correctly should use a spacer to make sure they all the medication into the lungs (Hockenberry and Wilson, 2006). Most children, 5 years of age or older, can also learn to use a peak expiratory flow meters (PEFMs), although they should be supervised while learning to use it (Hockenberry and Wilson, 2006). Children in the age range may sit in the Tripod Position (leaning forwards with hands on their knees) when attempting to breath, although older children may also sit upright with shoulders hunched and arms outstretched on a bed or chair (Hockenberry and Wilson, 2006).

Source: http://childrenshospitalblog.org/?s=asthma

Concerns About Growth:    

There is a concern that some asthma medications can impact growth when taken during the age range of 5-11 years of age, or children who have not yet gone though puberty (NIH, 2012).  A study published in 2012, found that children with asthma who took high doses of corticosteroids were shorter by half an inch than other children (NIH).  Other researchers argue that these children will catch up in height later.  Parents should discuss the risks and benefits of any medication with their child’s provider.  There are definite benefits gained by taking inhaled steroids (like Advair), including better asthma control and fewer, shorter hospitalizations;  inhaled steroids are generally considered the safest and most effective means of controlling asthma available (NIH, 2012).

Asthma in Children Ages 12 and older: 

Source: http://childrenshospitalblog.org/?s=asthma

For many people with asthma, symptoms can improve with adolescence and adulthood.  Some children’s asthma symptoms go away during their teen year, but for about two-thirds of kids, their asthma will continue into adulthood (Hockenberry and Wilson, 2006).  In general, when symptoms are frequent and severe, this is an indication they will continue into adulthood, and even children who “outgrow” having asthma attacks can continue to have overly reactive airways and a cough as adults (Hockenberry and Wilson, 2006). 

However, teens with asthma are actually at high risk for serious disease complications (Sadaf and Kaslovsky, 2011).  This is because many teens will deny the severity of their disease, underreport symptoms, stop taking their medication correctly, and engage in risk-taking behaviors that can greatly aggravate asthma like smoking tobacco and marijuana and using cocaine (Sadaf and Kaslovsky, 2011).  Many teens begin to view the strict treatment schedule necessary to control asthma as interfering with their newly emerging sense of independence (Sadaf and Kaslovsky, 2011).  Many teens with asthma also experience a number of psychiatric conditions at a higher rate than other teens, including depression, anxiety, ADHD, behavioral and learning disorders, and even posttraumatic stress disorder, especially in those who have experienced life threatening asthma complications (Sadaf and Kaslovsky, 2011). 

As children grow up, the balance of influences from friends, family, and their healthcare providers will change.  In early and middle adolescence, however, teens are often very concerned about how having asthma will affect their friendships and popularity with peers, but as teens progress from early to middle to late adolescence, they should eventually begin to think more like adults and begin to understand the importance of taking their medication again regardless of peer influence (Sadaf and Kaslovsky, 2011).  As adolescents begin to think like adults, it is important to let them speak to their doctor alone and take on the primary role in planning and evaluating their asthma therapy (Sadaf and Kaslovsky, 2011).  For parent, this is the time period in which the role transitions to being more of a supportive one.  Adolescents will also need guidance in making the transition into the adult healthcare world, as they often have significant financial barriers to getting care arise at this stage (Sadaf and Kaslovsky, 2011). 

What Causes an Asthma Flare?

Source: https://www.youtube.com/watch?v=mVEIwf5r0dE