Topic: asthma
Researched and written by:  Michael Bryant
                                                I attest that the following report is a product of my own original work.

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Summary
 

Imagine your air supply slowly being cut off and you have no way of controlling it. The more you try to fight the worse it gets and now you are at the point where you feel there is nothing that can save you. But there is an inhaler which allows you to get the precious thing that you need to live, which is air. That is the life of children who suffer from asthma everyday. These children are always one physical activity, one allergic reaction or a scare away from having an asthma attack. Asthma is very common among children, teens and even adults (AAFA, 2004). It is a disease that causes the airways of the lungs to tighten (AAFA, 2004). When that happens, air is not being allowed to flow through the lungs. Some symptoms of an asthma attack include trouble breathing, wheezing, coughing, chest pain, and chest tightness.             An asthma attack is triggered by things in the environment. These triggers vary from person to person. But some common triggers are mold and dust mites, which are tiny bugs that live in furniture, pillows mattresses as well as clothes. Secondhand smoke can cause an attack for example a child who lives with parents that smoke can suffer from an attack on a daily basis. According to the Asthma and Allergy Foundation Association, another cause of asthma is cockroaches.  Their limbs that are left and or their droppings can cause an asthma attack. Pets are one of the biggest contributors to children having asthma, parents do not realize that the pet’s urine and dander cause attacks in small children. One other cause of asthma attacks in small children is Nitrogen Dioxide which is a gas that is dispersed when some thing is burnt or more specifically like a gas stove or a wood burning stove (AAFA, 2003). <>                 When you breathe in, air travels down the trachea, or also known as the windpipe. From the trachea it travels it enters a series of smaller tubes that branch off from the trachea. These smaller tubes are called the bronchi which divide into smaller tubes and they are called the bronchioles (AAFA, 2003). Asthma has main effects in the bronchi and the bronchioles. Asthma can be considered a chronic illness as no “cure” is currently available, and there is no time limit on its duration. Although asthma does not have the same constant effect on a person like someone who suffers from a mental illness, it still has a impact effect on a child’s life.                 The AAFA states that 17 million people in the United States have asthma. This disease is the over half the reason for hospital stays each year. People who have asthma can be of any race, age or sex. Treatment for asthma cost billions each year. Even though there are ongoing studies about asthma, the origin is still unknown. But certain traits make it more likely that a person will develop asthma. Some doctors say that asthma is hereditary as children with parents and siblings  seem to be more likely to have asthma. Another reason why a person may have asthma is that a person has atophy. Atophy is a person when he or she is said to be prone to have allergies, for reasons that are fully not known. Some people seem to inherit tendencies to develop allergies. Another thing that is a big issue with asthma is the perception of when a child is exactly having an asthma attack. A study (Yoos,Kitzman,Mcmullen,Sidora,2003) was done about how parents recognized the certain symptoms. Childhood asthma presents a unique challenge in symptom perception and evaluation. The child experiences the symptoms, which he or she may or may not effectively perceive and communicate to the parent, whereas the parent is dependent on various signs to evaluate symptom severity to decide or at least participate in deciding a course of management (Yoos, et el, 2003). In another study done by Gabe, Bury, and Ramsay (2003) say that the reason it is accepted that asthma prevalence has increased, with estimates ranging from 5 percent to 31 percent. The severity of asthma depends on how early the age asthma starts. In 1987 for people less than 20 years old was the most common disease. Scarce among the turn of the 20th century, asthma is now the most common chronic disease and number one reason for hospitalization. Gregerson (2000) mentions in his article that even though asthma is very common among everyone one study found that African Americans children, especially lower SES (socioeconomic status, account for the greatest percentage of asthma cases, hospitalization and readmissions. Also children who live in lower class neighborhoods have higher asthma mortality rates.  <>       To understand how the characteristics of the asthma you first need to understand what happens when an asthma attack happens. The Asthma and Allergy Foundation of America describes an attack is when the airways come in contact with an asthma trigger, the tissue inside the bronchi and bronchioles becomes inflamed. At the same time, the muscles on the outside of the airways tighten up, causing them to narrow. A thick fluid enters the airways, which become swollen. The breathing passages are narrowed still more, and breathing is hampered. The process described can be normal, up to a point. Apparently everyone’s airways constrict somewhat in response to irritating substances like dust and mold. But with a person with asthma, the airways are overly active. What this means is that the person’s airways tend to overreact to certain things that would just be minor in people without asthma. Some doctors use the term “twitchy” airways. This is a good description of how the airways of people with asthma are different from those without the disease. Not all patients with hyperactive airways have symptoms of asthma. In another study children describe their experiences when having an attack (Gabe, et el, 2002). One child mentioned that they felt like shriveling up, and they could not breathe and they felt wheezy. The article goes on to say that a majority of young people associate breathing difficulties with chest problems. The children described the feeling in the chest as being blocked , knotted or even a feeling of someone sitting on their chest. Another characteristic mentioned in the article was that tiredness and / or a feeling of being weak which reportedly lasted from 5 minutes up to 24 hours these symptoms served as indicators of an asthma episode coming or even after one has occurred.   <><><>             In today’s society asthma is not as much of a problem as it was in the classroom, because teachers and peers are more educated about asthmatics symptoms and how to deal with asthmatics if an episode was to take place. School was a setting where the management of asthma was a particular source of concerned in a study done by Gabe etel (2002). He mentions that students were allowed to use an inhaler before school to help minimize the chance of an attack on school premises. And then if an episode was to occur at school the child was allowed to take the inhaler again. It also mentions that in school girls are more likely to take the inhaler openly than boys, because it shows a sign of weakness and a threat to the boy’s masculine status. <> Even though asthma attacks can occur any where at anytime in school the most common place is PE class where the child is doing physical activity to aggravate the airways. Just because gym class is the most common does not mean that asthma episodes do not occur in the regular classroom setting. One child reported in the article by Gabe et el(2002) that when he was in a small classroom with a lot of people in he began to laugh and then he just started to cough and could not stop then he began to start wheezing and could not stop so he had to leave the classroom. Asthma in the classrooms is not so much of a factor just because episodes do not happen as much as they would with another chronic illness. <>            As I mentioned earlier asthma is now more understood now and teachers are more educated about it. Even the students seem to be knowledgeable about asthma. Peers seem to be a crucial source of comfort to children when they have minor accidents or become ill at school. Gabe et el (2002) reported in his study that when he asked the children with asthma where the particular help at school came from when they were having an episode surprisingly the answer the children gave was their classmates. They helped in a number of ways for example going to get help from a teacher, offering a class of water or simply getting someone’s inhaler. Not all peer are helpful but the ones that do help are very close to these <>children because it teaches them that their friends and classmates do care about their well being. In a sense the impact of a classroom on a asthmatic child can be a very good influence for a child to cope with having asthma. Knowing that there are people that support you and care about is a very good thing to know and have in today’s schools.             There are a lot of treatments out there to assist kids with controlling their asthma. One method which was suggested by Gabe is to allow the child to take the inhaler before school and also before he or she begins a physical activity. The child should leave the situation that he or she maybe in because it maybe the current environment that maybe causing the attack. While medication in some expert’s eyes seems to be the best way to handle an asthma attack, there are some self help methods that can help. For example once you have left the environment that has triggered the episode either sit down or stand up with your arms up in the air. What this allows is the opening of the lungs and the chest area so that the child’s airway can become more open and free.            Medications do have two types’ of either quick relief or long term control. Quick  relief medications generally control the immediate symptoms of asthma <>episode. The long term control medicine does not provide relief right away but lessens the frequency and severity of the attacks over time. The downside of controlling the asthma with medicine is that the medicine has side effects. Even though they are usually mild and go away on their own make sure you talk to your doctor about them and what warning signs should you look for if there is a problem.                         Another way to treat asthma in the school is to implement what the AAFA (2002) called the asthma action card. This is a card that you can fill out which help explain what to do with each child when an asthma attack seems to occur. For example when a child is having an episode the first step will be try to let the child get the episode under control themselves, then if that does not work try giving them the inhaler. As you move further down the card gives you more options like calling the emergency numbers like parents or guardians. Another way of treating for asthma is the trying to avoid triggers all together. In school children reported that trying to avoid triggers, for example running, were a lot more difficult because of the requirement that all the children had to run.                          While self coping strategies are helpful for a child trying to control his or her asthma parents and teachers are sometimes key for a child being able to cope with an asthma episode. If the teacher is well prepared and understands the <>dynamics of a child with asthma they can be that difference between a trip to the emergency room or not.

Gabe, Jonathan; Bury, Michael; Ramsay, Rosemary(2002). Living with asthma:           the experiences of young people at home and at school  ( vol. 55, pages       1619-1633) New York: Oxford Pergamon

Gregerson, M. Banks(2000) The Curious 2000 Year Case of Asthma ( vol. 62,           pages 816-827)

Duvdevany, Ilana; Harrel, Yael (2000) Behavioral Problems of asthmatic Children

            (vol. 8, pages 152-165)

Petterson, Eve; Gardulf, Ann; Nordstrom, Gun; Svanberg-johnsson; Bylin,Gunnar

(1999)Evaluation of a nurse run asthma school ( vol.36, pages 145-151)

Asthma and Allergy Foundation of America.(2004)  www.aafa.org

Yoos, H. Lorie; Kitzman,Harriet; McMullen, Ann; Sidora, Kimberly (2003)

            Symptom Perception in childhood asthma: How Accurate Are Children and their Parents?  (vol. 40, pages 27-39) New York: Marcel Dekker Inc.