Asthma

09 January 2012

Asthma

Asthma is a lung condition that affects 23 million Americans, including 6 million kids. People with asthma may cough, wheeze, or have trouble breathing.

Is Your Child’s Asthma Under Control? Take Our Assessment

If your child has asthma, it can seem like you’re fighting an invisible enemy. Youngsters with asthma often seem perfectly healthy, just like any other kid. But things most children can shrug off—a simple cold or a bout of exercise—can land the asthmatic child in the hospital if the respiratory disease is not well controlled by medication.

What’s so maddening, as a parent, is not knowing if you have a lid on asthma. When that trigger comes—be it mold, pollen, dust, a cold, or pet cat—will your child’s asthma escalate out of control?

The bottom line is, it’s hard to tell—but not impossible. Your child may be coughing at night, but there are ways to tell how much coughing is too much. And, sure, your child may need to use a rescue inhaler, but if he or she needs it too often, it’s an indicator that he or she could be edging into the danger zone.

If your child is ages 5 to 11, you can use this assessment tool to help determine if his or her asthma is under control. (This tool, which was adapted from asthma guidelines issued by the National Heart, Lung, and Blood Institute, in 2007, is not designed to replace a consultation with a doctor. Nor should it be used for children under age 5 or 12 and older.)

1 .  My child has asthma symptoms such as coughing or wheezing:
A. No more than two days each week and never more than once a day (+1 point)
B. Several times a day on at least two days a week, or more than two days each week (+2 points)
C. Throughout the day (+3 points)

2 .  My child has coughing or has wheezing that wakes him or her up at night:
A. Once a month or less (+1 point)
B. Twice a month or more (+2 points)
C. Twice a week or more (+3 points)

3 .  My child needs to use his or her rescue inhaler or nebulizer:
A. Two days a week or less (+1 point)
B. More than two days each week (+2 points)
C. Several times per day (+3 points)

4 .  When it comes to my child’s daily life, asthma symptoms:
A. Never limit his or her activities (+1 point)
B. Cause some limitation (+2 points)
C. Extremely limit activity (+3 points)

5 .  My child has had asthma symptoms so severe he or she needs a course of oral corticosteroids:
A. One time per year or not at all (+1 point)
B. More than twice per year (+3 points)

If your score is 5 points:

Based on symptoms alone, experts would consider your child’s asthma to be under control. You should make sure your child continues to take medication carefully and correctly, and be sure to see your doctor within one to six months.   Another way to measure asthma control is to check peak flow, which can be done at home with a peak flow meter. If peak flow is more than 80% of your child’s personal best, asthma is under control. If it’s 80% or less, asthma is not well controlled.

If your score is 6 points or more:

Based on symptoms alone, your score suggests that your child’s asthma is not as well controlled as it could be. Talk with your doctor as soon as possible to see if your child is taking the right amount and type of medication.   Another way to measure asthma control is to check peak flow, which can be done at home with a peak flow meter. If peak flow is more than 80% of your child’s personal best, asthma is under control. If it’s 80% or less, asthma is not well controlled.

Why You Need to Take Asthma Medicine, Even If You Feel Fine

Carolyn M. Kercsmar, MD, the director of the asthma center at Cincinnati Children’s Hospital Medical Center, recently had a 10-year-old patient who decided, on his own, to stop taking his asthma medicine—crucial maintenance steroids he was supposed to take regularly.

His reasoning: He felt fine and hadn’t had any asthma attacks for a while, so why bother? Dr. Kercsmar performed a series of tests, and it was clear his lung function was compromised, even though he didn’t have any coughing, wheezing, shortness of breath, or other signs of asthma. She made sure he knew that he needed to start his asthma medication again.

“We were to come into pollen season, which could have triggered his asthma symptoms, possibly leading to an emergency room visit or hospitalization,” she says.

Generally, asthma can be categorized into two classes: intermittent asthma, in which symptoms occur less than three times a week, and chronic asthma.

People with intermittent asthma can often get by using only a short-acting or “rescue” inhaler when symptoms develop. Those with more chronic asthma and more frequent flare-ups (like Dr. Kercsmar’s 10-year-old patient) need to take a maintenance medication to reduce inflammation between attacks. “The goal of asthma treatment is to prevent, prevent, prevent,” Dr. Kercsmar says.

Unfortunately, patients failing to take their maintenance medication is an all-too-common scenario. People may take medication incorrectly, in an erratic stop-and-start fashion, or just flat out skip it. It’s not that people with asthma are trying to dupe their doc. Asthma can be a sneaky foe. Most people feel perfectly fine, until they very quickly don’t. All it takes is a rise in pollen counts, a common cold, a chance encounter with a cat, a change in temperature, or a bout of exercise to send a patient into the danger zone. The problem? It’s hard to predict when that will happen.

“It can be hours, days, weeks, or months, so it’s pretty easy for patients to be lulled into a false sense of security,” says Dr. Kercsmar. “It’s an incredibly variable disease that can be punctuated by flare-ups, but the time between flare-ups can be variable.”

Asthma Symptoms

While asthma symptoms seem straightforward—coughing, wheezing, and shortness of breath—it’s not always easy for doctors to definitively diagnose the condition. It can be hard to determine if a chronic cough is asthma, a lingering respiratory ailment, or something else. Symptoms like wheezing can come and go, or coughing may only occur at specific times, such as at night or with exposure to pollen or other triggers.

To learn more about the symptoms of asthma in children, check out the following information from our A–Z Health Library. Asthma symptoms in adults are very similar to those in children.

Kategori Genel | Comments Off





Alzheimer’s Disease

20 January 2012

Alzheimer’s Disease

Alzheimer’s disease, the most common type of dementia, damages parts of the brain involved in memory, intelligence, judgment, language, and behavior. Almost half of people afflicted with Alzheimer’s are between 75 and 85, although a rare, inherited form of the disease can affect people in their 40s. While the loss of cognitive ability is irreversible, the rate of disease progression varies by individual.

Is It Alzheimer’s? Probably Not

If you forget to pick up your dry cleaning once or twice, it’s unlikely that dementia is around the corner (although your favorite silk dress may be). Letting a few errands slip isn’t a sure sign of the disease. Really important symptoms include loss of control over speech, trouble completing simple tasks like balancing a checkbook, and confusion about where you are. In fact, your memory losses may simply be due to a shortage of vitamin B12. According to Harvard research, a deficiency can produce symptoms similar to dementia and Alzheimer’s. There’s plenty of the vitamin in meats, chicken, fish, dairy products, and fortified breakfast cereal.

Still worried? Consider talking to a therapist if you’re superanxious about memory loss. A study by the Rush Alzheimer’s Disease Center in Chicago found that people plagued by worry, anxiety, or depression are more prone to developing a condition that’s a precursor to Alzheimer’s.

How Is Depression in the Elderly Different From Dementia?

There’s no single test that can differentiate depression from dementia. But some behavior clues may help the doctor make an educated assessment.

“Alzheimer’s disease and depression are probably related in ways we don’t understand,” says Brent Forester, MD, director of the mood disorders divison in the geriatric psychiatry research program at McLean Hospital in Belmont, Mass. “Forty to 50% of people with Alzheimer’s disease get depression, but depression also may be a risk factor for Alzheimer’s.”

•Memory: People who are depressed may have trouble concentrating. They may even suffer occasional memory lapses, which can make their mood worse. But people with Alzheimer’s disease consistently have trouble storing new information, such as the recent visit of a close relative or what they ate for dinner. They may not remember eating dinner at all.
•Orientation: Most people who are depressed generally know with whom they’re speaking, what time and day it is, and where they are. People with dementia tend to be confused about some or all of this.
•Language use: Depressed people use language properly, although they may speak slowly at times. People who are demented because of Alzheimer’s disease or strokes often have lots of language problems. Particularly hard: remembering the names of common objects such as “pen” or “lamp” or “birthday cake.”
•Use of familiar objects: Again, not a problem for people with depression. Someone with dementia may not recall how to get a pullover sweater on, for example. This is called apraxia—trouble remembering how to perform previously learned and routine motor activities.
•Negativity: Depressed people have a general tendency to put a negative spin on events. For example, if asked to take a test designed to screen for depression or Alzheimer’s, they may jump to the conclusion that they did quite badly, and they often overestimate the problem. In contrast, someone with dementia may try to fabricate some story or excuse for a memory lapse or poor performance on a memory test.

Areas of the Brain Affected by Alzheimer’s and Other Dementias

Alzheimer’s disease is a progressive condition that damages areas of the brain involved in memory, intelligence, judgment, language, and behavior. It is the most common form of mental decline, or dementia, in older adults.

Kategori Genel | Comments Off

« Eski Yazılar