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A message bringing home awareness of airway disease. There are many times each year when I'm reminded – first hand – of what first drew me to this specialty. Specifically, the chance to help make a difference in patients' lives; and today, as I write about one patient’s scenario, it becomes one of those days of reflection. With World Asthma Day approaching on May 7, healthcare workers across the globe will be helping to raise awareness for asthma and I, too, am drawn to share about asthma – what it’s like in our Valley and to announce an outreach event where you can get information and have questions answered – for free at Community Regional Medical Center.
A real childhood asthma scenario
First, it’s just another day of living with asthma for Alia, an 8-year-old girl who has grown up in the Fresno area, the second most polluted city in the country, with an overall asthma rate of three times higher than the national average (ALA 2009 "State of the Air”). Alia loves to play outdoors, swim and go for walks with her dogs. Unfortunately, these activities have become increasingly difficult for her during the last few months due to cough and chest tightness. Even regular PE in school has become difficult. In spite of limiting all her activities to the bare minimum, she has now started to wake up several times at night coughing. Due to poor sleep, she cannot concentrate in school and her grades have started falling. Onset of asthma can strike at anytime in one’s life and within months, this once healthy eight year olds' life had completely changed. She went from an active and carefree youngster to an inactive, housebound and sickly child! Several rounds of antibiotics and cough syrups did not make her better. Her parents were baffled. It took a third pediatrician to diagnose her with asthma and start her on the right medications. It took a few weeks, but she is now back to enjoying her young life again – doing all the things she likes and getting straight A’s as she did before.
Alia’s story is just one way asthma can present. If you or any of your loved ones experience recurrent wheezing, chest tightness, difficulty breathing and/or a persistent dry cough, it could be from asthma. All asthma symptoms tend to get worse at night and with exercise. There is no single test for diagnosing asthma. Your doctor will be able to make a diagnosis of asthma based on your history, examination findings and sometimes after performing some breathing tests on you. Since many asthmatics have allergies along with asthma, your doctor might also consider doing an allergy test. Allergies and air pollutants like pollen and particulate matter generated from motor vehicles, agriculture activities such as land cultivation, pesticide application, dust and garbage burning are common triggers for asthmatics – especially here in the Central Valley where air quality is among the worst in the nation.
However, air pollution and allergies aren’t the only triggers or reasons for onset of asthma, many infants and young children wheeze with viral infections – eventually growing out of it. However, recurrent wheezing in a child with strong family history of asthma, present and or past history of eczema are warning signs of early asthma. Early diagnosis and prompt treatment of asthma is important in these children to prevent damage to the growing lungs.
There is help
Asthma medications are prescribed depending on the severity of your asthma. Long term, daily inhaled steroids are prescribed as controller medications if you have persistent asthma. Once an asthmatic is on medications, regular follow up is essential to see whether the asthma is getting under control. Your doctor can make appropriate changes to your medications if needed to get your asthma under control. All asthmatics should be well educated about the common asthma triggers (pollen, tobacco smoke, bad air days, cockroaches, mold, pets, dust mites), regular compliance with medication, and the right technique of administering the medications. Asthma is a chronic disease. However, in this day and age, an asthmatic can enjoy the best quality of life by taking control of his asthma, before the asthma takes control of his life.
Community Regional Medical Center’s dedication to our Valley
Community Regional Medical Center understands the burden that asthma places on patients, schools and the work force here in our own community. Community Regional recognizes that Fresno County has a disproportionately higher rate of asthma than the rest of California. In addition, the rate of asthma is higher amongst the poor. Even more alarming is the fact that the rate of asthma is higher amongst children than the general population. The leading cause of missed school and Emergency Department visits in children is asthma exacerbations.
In 1997, the former University Medical Center branch of Community Regional initiated a pilot program to address these disparities. A Respiratory Therapist who was also trained in Asthma Education was placed in the outpatient clinics and the Emergency Department to engage patients in conversation that improved their understanding of their disease and ways to improve their own health outcomes. The pilot program was successful and an Asthma Education Program was established. Since then, Children’s Health Center has partnered with the Asthma Education Program to seek grants from both the State and local organizations to institute Best Practices for Children with Asthma through asthma education for both families and pediatric medical providers. The most recent and currently ongoing program is the ‘Early Childhood Asthma Program’ funded by the ‘First Five of Fresno’ that emphasizes early detection and management of asthma in young children, family asthma education, and a home visit component by a community health worker for evaluation and prevention of home asthma triggers. These successful partnerships over the past years have resulted in significantly improved outcomes for the asthmatic children in our community.
To date, Community Regional is working to duplicate those successes in our high risk adult population who have frequent hospital admissions and Emergency Department visits and is dedicated to adding a Chronic Lung Disease Program to the already existing Disease Management Programs currently operating at Community Regional.
FREE outreach event
Learn more about asthma, its triggers and how you can control it by visiting with Asthma Educators and Respiratory Therapists in the Cafeteria at Community Regional Medical Center on National World Asthma Day, Tuesday, May 7, 2013 from 11:30 a.m. to 1 p.m. There will be educational displays available, as well as educational materials for all interested to take with them. We have some hands on activities to help people understand what their loved one with asthma feels like during an asthma exacerbation, and will have Peak Flow Meters available for testing one’s ability to perform a forced expiratory maneuver. Stop by the display area in the cafeteria and you can enter a raffle drawing for a chance to win a free prize. It will be a fun and educational event – we hope to see you there.
Maries Joseph MD
Associate Clinical Professor of Pediatrics, UCSF Fresno
Medical Director, Early Childhood Asthma Program (ECAP)
Community Regional Medical Center