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IBX Insights

Let’s Take a Deep Breath and Talk About Asthma

A girl uses an inhaler with a spacer attached.

In my work as the manager of the Maternity and Pediatric program at Independence Blue Cross (Independence), I’ve noticed an increase in asthma cases and related complications among our members. As the mother of a child with asthma, this really hits home for me.

When Matt was around ten, we noticed that he frequently started coughing after a few minutes of running or exertion. He was winded more easily than other kids and always seemed tired about halfway through every soccer game. After the game ended, Matt would keep coughing for up to an hour.

Since these symptoms always appeared in the spring and fall, when Matt played soccer, we first thought that seasonal allergies were the cause. However, we soon realized they were still happening in the winter when he played street hockey.

Finally, his pediatrician referred him to an allergy and asthma specialist. They did a very simple test right there in the office and concluded that Matt had asthma. The doctor gave us an asthma action plan that included daily medications along with instructions on what to do for a flareup of symptoms. This was really life-changing for Matt, who is now 16 years old and plays both football and lacrosse in high school, with minimal asthma complications if he follows the plan.

How Common is Asthma?

About 25 million people in the United States have asthma. That’s about one in 13 people. Rates are highest in the Black, Hispanic, and American Indian/Alaska Native populations.

Asthma affects 4.8 million children. Pennsylvania has some of the highest pediatric asthma rates in the country — between 8.5 and 11.6 percent. And in Philadelphia, about 21 percent of children have asthma!

Among U.S. children who have asthma, about half have asthma that’s uncontrolled. That tells me we need to do a much better job of educating people on how to recognize the symptoms of asthma, identify asthma triggers, and follow an asthma plan to keep it controlled. That is the goal of this blog — to increase awareness and overall asthma education.

What is Asthma?

Asthma is a chronic condition in which the tubes that carry air in and out of your lungs get inflamed. This makes breathing harder and causes coughing and wheezing. People can develop asthma at any age.

Asthma can have a major effect on someone’s quality of life. It can cause or contribute to insomnia, fatigue, weight gain, sleep apnea, pneumonia, and certain mental health conditions. So don’t ignore the symptoms. Get evaluated by a doctor and follow their advice. With the guidance of a doctor, and by following a personalized asthma action plan, asthma can be well managed and can cause little disruption to daily life.

What Causes Asthma?

It’s not clear why some people have asthma and others don’t, although environmental factors and family history may play a role in determining whether or not someone has the condition. However, asthma episodes can be caused (or “triggered”) by a range of stimuli:

It’s very helpful to know what someone’s triggers are so they can try to avoid them.

How Do You Know If You Have Asthma?

Common signs of asthma include wheezing, coughing, or shortness of breath.

In a severe asthma attack, there can be tightness in the chest, extreme difficulty breathing, sweating, feeling faint, nausea, a rapid pulse, and clammy skin. Lips and fingertips may even start turning blue due to a lack of oxygen. If you see someone having these symptoms, get them to an emergency room right away or call 911, and make sure they take their rescue medicine if they have one. Severe asthma attacks can be life-threatening.

How Is Asthma Diagnosed?

If you, or someone in your family, shows signs of having asthma, talk to a doctor. Start with your family doctor or pediatrician. They may refer you to an allergy and asthma specialist for further evaluation and treatment.

Asthma testing usually involves spirometry. A device measures how much air you can breathe out and how quickly you’re able to do it. Based on the results plus a review of your symptoms and health history, a doctor can determine whether you have asthma and outline the best treatment plan for its daily management.

How is Asthma Treated?

There are many types of asthma medicines, but they basically fall into two categories:

  • Rescue medications are taken when someone is experiencing asthma symptoms to quickly relieve the inflammation that makes breathing so difficult. They may be administered through an inhaler, which you should carry with you always, or a nebulizer, a machine that creates a vapor you inhale into your lungs.
  • Control medicines are taken daily to help prevent asthma episodes from happening in the first place.

Make sure your doctor shows you and your child how and when to take any asthma medicines. If using an inhaler, always use a spacer. This helps make sure the medicine gets into the lungs — where it’s needed — instead of the mouth or stomach. Spacers not only help medicines work better; they can also help prevent thrush, which is a yeast infection in your mouth and throat.

What Else Can You Do About Asthma?

First, take your control and rescue medicines as prescribed! Second, know your triggers so you can take steps to prevent asthma episodes. For instance:

  • If possible, improve your home’s air quality.
  • If your asthma gets triggered by exercise, using your rescue inhaler before a workout can prevent an asthma episode from happening.
  • If you get asthma whenever you get sick, you might want to start using your rescue medicines right when you start becoming ill.
  • If your asthma is triggered by allergies or air pollution, you can do things to limit your exposure.

Work with your doctor to form a comprehensive management plan covering all your medications, identifying and dealing with your triggers, and handling emergencies. This will help minimize asthma’s impact on your life.

Where Can You Get Support?

Asthma can be overwhelming and scary for both you and your child. Even when you’re seeing a specialist, there may be times — like in the middle of the night — when you’re worried or uncertain what to do.

If you’re an Independence member, Registered Nurse Health Coaches can answer your health questions 24/7. Just call 1-800-ASK-BLUE (1-800-275-2583 TTY/TDD: 711) and follow the prompt for “Health Coach.” You can also find many different types of support through the Asthma and Allergy Foundation of America.

Just know that you’re not alone. With support and medical supervision, asthma can usually be controlled, allowing people who have it to lead fairly normal lives. Just like my child.

Michele Ewing, RN, BSN, CCM

Michele has been a Registered Nurse for over 30 years with her primary focus in maternal/child health. She has experience in labor and delivery, high risk pregnancy, newborn nursery, NICU/continuing care nursery, and mother/baby care. Michele also worked in home care by providing home visits for the assessment and education of high-risk pregnancy patients, well mom/well baby visits, and NICU babies making their transition from hospital to home. Now in a leadership role at Independence, Michele oversees the Baby BluePrints, pediatric, and NICU team whose goal is to support a mom throughout her pregnancy and through the transition to motherhood as well as assisting families with the challenges of having a child in the hospital or dealing with a chronic illness. Michele enjoys reading, musical theatre, and spending time with her family.