Talking with Your Health Care Provider
One of the critical members of your asthma “team” is your health care provider. In raising your asthmatic child, the health care provider should be there to provide guidance and advice, note changes in symptoms, adjust medications when necessary, keep up to date with the latest science and guidelines, and answer your questions.
But, the type of communication you have with this health care provider — be it a pediatrician, a family health care provider, or a specialist — will differ somewhat from visits with other health care providers. Each time your child sees this provider — whether it's a follow-up visit or a visit related to an asthma event — the health care provider should wear not only the hat of a prescriber but that of an educator, consultant, and even good listener. At least two or three times a year, your child should be re-evaluated to see if her treatment plan is adequate.
Fact
Asthma is not a static condition: it can change with each visit. Children can develop new triggers or change responses to medications. Sometimes children aren't even using the medications as required. The health care provider needs to work with the other members of your team — you and your child — to see what adjustments are needed to best manage your child's condition and prevent symptoms.
Unfortunately, many children with asthma do not appear to be getting the adjustments — or the education and advice — that they need. In a study of children with persistent asthma in Alabama, California, Illinois, and Texas, four out of five children were found not to be keeping their symptoms under control.
The reasons were numerous: nearly half had medications but failed to use their inhalers daily as required, and a third failed to obtain the medications that were prescribed.
In addition, about three out of four children with asthma symptoms were found to live with sources of asthma triggers in their homes including: a fireplace or wood stove, a kerosene heater, an unvented gas stove, cockroach infestation, dust mites, visible mold, and indoor pets. Almost one in six were exposed to secondhand tobacco smoke.
Also, poor office-based management was common among those children who were failing to control their asthma: more than half had not received an asthma management plan from a health care provider; more than a third had not been taught to use a peak flow meter; and one in six had never been taught to recognize their symptoms.
Essential
To help your child better manage her condition, first consider finding a health care provider who can work with you and your child. This provider should be familiar with updated asthma guidelines for children — which look at issues of asthma severity and control — released by the National Asthma Education and Prevention Program of the National Institutes of Health (NIH) in 2007.
The objective of good asthma management is to establish treatment goals that not only prevent asthma symptoms from occurring today but to ensure better outcomes and quality of life down the road. Next, put those goals in writing by developing an action management plan that is easy to understand and effective in monitoring asthma symptoms day to day.
