Understanding Asthma and How to Overcome Its Challenges
Nobody knows for sure what causes asthma, but we do know you’re more likely to develop it if you have a family history of asthma, eczema or other allergies. You’re twice as likely to develop asthma if your parents have it.
Modern lifestyles, such as housing and diet, also may have contributed to the rise in asthma over the last 30 years.
Every 10 seconds someone has a potentially life-threatening asthma attack, and the latest data shows that deaths from asthma are on the rise again.
What Causes Asthma?
There are many theories about what’s caused the increase in the number of people with asthma.
One of the most popular is the “hygiene hypothesis”. According to this theory, asthma is more common in western societies. Because western society is becoming cleaner, we have less exposure to allergens and pathogens.
When a person with asthma comes into contact with a “trigger”, their airways become irritated. The muscles tighten, the airways narrow, and the lining of the airways gets inflamed and swollen.
The main symptoms are chest “wheeze” or noisy breathing, chest tightness and breathlessness. You may also develop a cough, particularly at night, but this is more common in children.
Boys under the age of two are more susceptible to asthma because their airways are narrower when they’re younger. But they usually grow out of it, whereas girls are more likely to have asthma beyond puberty.
Obesity is also thought to make asthma more likely. Symptoms often get better when the person loses weight.
Find out more in Are we too clean for our own good?
Smoking and Asthma
Smoking also has a definite impact. Parents’ cigarette smoke will affect their child’s lung function development, and it irritates the airways. People with asthma are advised not to smoke.
Research shows that smoking during pregnancy increases the risk of your child developing asthma. Children whose parents smoke are also more likely to develop the condition.
Once you have asthma, high levels of pollution and smoking may make it worse. But there’s no proof that these triggers actually cause it.
Asthma Treatment
How to Help Yourself/Your Child
If certain things trigger your asthma, such as dust mites, minimise your exposure to them. Put mattress covers on your bed, use a damp cloth when you dust, don’t have too many soft furnishings in your house, and put down laminate or wooden flooring instead of carpets.
Asthma Triggers
Asthma triggers include pets, but studies show that getting rid of animals doesn’t improve asthma. In fact, the emotional upset of getting rid of your pet may make your asthma worse. Keep your exposure to pets to a minimum in areas such as the bedroom, and consider not getting any new pets.
Asthma Medicines
If you have symptoms more than three times a week and you need to use a reliever inhaler (usually blue), you should also use a preventer inhaler (usually brown).
But if you only have symptoms a few times a week when exercising, you can manage your symptoms safely with a reliever inhaler before you exercise.
Asthma is an inflammatory disease. This means preventative treatment is vital, and you must take it even when your asthma symptoms aren’t present. This will ensure your asthma is well controlled.
Review your treatment with your asthma nurse or GP (*family doctor) at least once a year as you might be able to reduce your dosage of medicine.
Find out more information about asthma treatments.
Taking Steroids When You Have Asthma
Because asthma is caused by an inflammation of the airways, anti-inflammatory drugs such as steroids are sometimes used to treat it.
You may be concerned about the potential side effects of steroids, such as weight gain, stunted growth (in children) and weakened bones.
The risk of side effects if you or your child are using a steroid inhaler is lower than with steroid tablets because less of the medicine gets into your system. With both steroid inhalers and tablets, the risk of side effects increases if the dose is high and if you use them for long periods.
Generally, if inhaled steroids are prescribed carefully and at the lowest dose needed, the risk of side effects is outweighed by the ability to reduce your or your child’s need for steroid tablets. Discuss the risks of steroid treatment with your doctor if you’re concerned.
If you have queries about any aspect of asthma, you can call the Asthma UK helpline, which is a free telephone helpline staffed by asthma nurse specialists on 0800 121 62 44, Monday to Friday, 9am to 5pm.
Find asthma services in your area. (*UK)
Asthma Resources in the US:
- Asthma and Allergy Foundation of America
- Asthma Information – acaai.org
Editor’s Note: *clarification provided for our US readers.
Video: Parents Talk about Their Children with Diabetes
Parents describe how they deal with having a diabetic child, including daily routines such as insulin injections, and how children can live life to the fullest.
https://youtu.be/-OL1KbO00_g
Editor’s Note: Video Highlights
Parents talk about the challenges of their child’s diabetes diagnosis- Others describe how they must learn to care for their children like medical professionals
- A particular concern is when the children go off to school – it can be hard to accept someone else taking control over their diabetes
- This requires a close, integrated approach between the family and school
- Some of the children also talk about managing their diabetes while at school
- Parents also describe the disruption that diabetes management represents for their kids’ lives
- But these steps are absolutely required to keep them alive
- Another worry covered is when children grow into teenagers – and that new habits and concerns could get in the way of good diabetes control
- A diabetes physician talks about how the real challenge of diabetes for both parents and the child is maintaining motivation to manage this chronic condition well over decades
- Parents also emphasize that you will make mistakes and shouldn’t beat yourself up about it – you’re only human and you will get the hang of it all
- Managing your child’s diabetes can be challenging and stressful, but it does become more normal over time – and your family will be able to focus on other things in life
- Finally, parents emphasize that a child with diabetes can live a normal life to a full extent
For more information on babies and rashes, click on this link from NHS Choices.
From www.nhs.uk
Hay Fever Facts to Help You and Your Family
Hay fever is a type of allergy. It happens when your body makes antibodies in response to certain triggers, such as pollen.
The charity Allergy UK estimates that nearly 18 million people have hay fever in the UK (*over 26 million in US). It’s most common in children, particularly teenagers, but you can develop hay fever at any age.
The symptoms usually include sneezing, itchy and watery eyes, and a stuffy nose.
Read more about the symptoms of hay fever.
What Causes Hay Fever?
In Britain, hay fever is mainly caused by grass pollen. Around 95% of hay fever sufferers are allergic to grass pollen.
Tree pollen can cause hay fever too. Around a quarter of hay fever sufferers are allergic to tree pollen. Mould spores and weed pollen can also trigger symptoms (*in US spring symptoms are caused by tree pollen, summer issues by grasses and weeds).
This is because your body sees these pollens as a threat, so your hay fever symptoms are caused by your immune system attempting to prevent the spread of what it mistakenly thinks is a harmful organism.
Check this Met Office pollen calendar to see if you’re allergic to tree, grass or weed pollen.
The pollens that cause hay fever vary from person to person and from region to region. The amount of pollen in the air will affect how bad your hay fever is.
It’s more likely that there will be more pollen in the air on hot, dry, windy days than on cool, damp, rainy days. Research shows that pollution, such as cigarette smoke or car exhaust fumes, also makes some allergies worse. Pollen can also attach to clothing, hair and pets’ fur, which means it can be hard to avoid even indoors.
Read more about the causes of hay fever.
When is Hay Fever Worst?
The time of year when you begin to experience hay fever symptoms depends on the types of pollen you’re allergic to.
Trees release their pollen in March to early May, while grasses release pollen from late May to early August. Weeds and certain shrubs release their pollen in late summer.
The hay fever season can therefore last from March to October. And if you’re unlucky enough to be allergic to more than one type of pollen, you may only have just two or three months without symptoms in the winter before the cycle starts again.
Find out how the weather affects hay fever symptoms.
How Can I Avoid Getting Hay Fever?
If your parents are allergic to something, you’re more likely to develop an allergy too (it doesn’t have to be the same allergy as your parents).
If you smoke while you’re pregnant or smoke around your child, your child could be more likely to develop an allergy. Not smoking and eating a healthy diet can limit the chances of your children being affected.
Hay Fever and Asthma
Speak to your GP (*family doctor) or pharmacist before you decide on a hay fever treatment. It’s particularly important to speak to your GP if you have asthma. Hay fever often makes asthma symptoms worse. If this happens, you may need to increase the dosage of your asthma medication.
As well as aggravating people who already have asthma, hay fever can also triple the likelihood of people developing asthma, according to Allergy UK’s 2014 report One Airway One Disease.
Read more about treatments for hay fever.
Hay Fever in Pregnancy
Hay fever during pregnancy can be a particular problem. Hormonal changes make nasal congestion more common during pregnancy, and this often gets worse during hay fever season. Pregnant women are also advised not to take some hay fever medicines.
Read more about taking hay fever medicines during pregnancy.
Tips to Relieve Hay Fever
Avoiding exposure to pollen is the best way to reduce the allergic symptoms of hay fever:
- Keep windows shut at night and first thing in the morning.
- Stay indoors when the pollen count is high (between 50 and 150).
- Wear wraparound sunglasses.
- Put some petroleum jelly (Vaseline) or another nasal blocker just inside your nostrils to trap some of the pollen.
- Don’t mow the grass or sit in fields or large areas of grass.
- Wash your hands and face regularly.
- Avoid exposure to other allergens, such as pet fur, or environmental irritants, such as insect sprays or tobacco smoke.
Get more tips to prevent hay fever.
Check the Met Office pollen forecast to find out your chance of hay fever symptoms over the next five days.
Treating Hay Fever
As with most allergies, the best way to control hay fever is to avoid the triggers. But it’s difficult to avoid pollen, particularly during the summer.
Even straightforward hay fever can be debilitating, causing runny eyes, sleepless nights, a bunged-up nose and headaches.
A range of over-the-counter products can treat the symptoms of hay fever, including tablets, nasal sprays and eye drops.
Antihistamines are the usual treatment for the main symptoms, such as itchy, watery eyes and a runny nose, while steroid nasal sprays are the main treatment for a stuffy nose. Your pharmacist can help advise you on which treatment is best for you.
Talk to Your GP or Pharmacist about Your Hay Fever
If you have particularly severe hay fever symptoms, you may need a prescription from your GP (*family doctor).
According to the charity Allergy UK, most treatments recommended for people with moderate-to-severe symptoms are not available without a prescription.
But despite this, only one in five hay fever sufferers have ever booked an appointment with a GP or pharmacist to discuss their symptoms and treatment options.
Editor’s Note: *clarification provided for our US readers.
From www.nhs.uk
Urgent Care or ER for Kids? Resources to Help Decide
My husband recently had an “incident” with one of our dogs, Nelson, and ended up being bitten. Now I should clarify that we have two wonderful dogs who are both very sweet and are absolutely full members of the family. Nevertheless, Nelson, – who we’ve had since he was a puppy – weighs in at 100 pounds and is EXTREMELY fond of food, or anything remotely resembling or smelling of food.
This incident happened because Nelson got a food soaked paper towel and had retreated with it under a corner table – his usual “safe” space. My husband got plenty of doggy warnings not to come near – and yet he insisted on trying to drag Nelson out and get the paper towel. The result was a series of impressive and bloody puncture wounds on his fingers. This was also rather ironic since he’s known among family and friends as the “dog whisperer” – and was rated as such in a quiz from an excellent post on dog bites which ran on this site last November.
As a result, he spent over an hour in the ER getting checked out, filling out paperwork about our dog, and…incurring over $600 in costs to us. It was only later, when we took our son to our local Urgent Care center for a sprained ankle, that it occurred to us that maybe Urgent Care could have taken care of the dog bite issue. My husband went to the ER because he thought he might need stitches. In the end he didn’t need them – but it turns out that our Urgent Care does stitches for minor cuts and injuries – at a much lower cost. If we’d only known this, he would have gotten the care he needed for about $500 less!
Given this incident, it seemed like a good idea to take stock of what Urgent Care typically offers, especially with respect to children. Urgent care is ideal in “non-emergency situations” for after-hours care or when you can’t get in to see your regular doctor. But what is “non-emergency”? Apparently a minor broken bone is non-emergency, since our Urgent Care handles these and has onsite x-rays. But it’s not always so easy to determine the difference between “urgent” and “emergency”. Thankfully some excellent web resources can help with that. The Children’s Hospital Colorado has a nice overview of when go to urgent care versus the emergency room. Head straight to the ER if your child’s skin or lips have turned blue, your child is unresponsive or difficult to arouse, or your child is having serious trouble breathing. Urgent care can usually handle simple cuts, injuries or illnesses – including fractures (unless the bone is sticking out!). The full guidance can be found on their website.
Seattle Children’s Hospital has a very handy review on their website, listed by condition or issue – and they have a nice downloadable version which you can print out (scroll down to the bottom of their webpage). Further below is a snapshot of some of the guidancethey provide.
Buyer Beware
One thing I learned from my research on this topic is that the services offered by Urgent Care centers are not yet standardized, especially for children. This is essentially a new industry and the rapid growth of these types of centers has spawned – as described by a doctor at Johns Hopkins in this article – “a mishmash of clinics, some offering fairly sophisticated care, while others providing only the most rudimentary.” And general Urgent Care centers are sometimes uncomfortable treating more serious pediatric concerns. This field is so new that the American Academy of Pediatrics only just established a sub-committee on pediatric treatment in urgent care in 2015. So, probably the best advice is to check out what services your local Urgent Care center provides – ideally in advance of needing them! – and follow your instinct if you think the ER is really the better bet.
Can I Give My Child Painkillers?
Both paracetamol (known as acetaminophen or Tylenol in the US*) and ibuprofen are safe and effective painkillers for children. However, always follow the manufacturer’s instructions for the correct dose. If you’re not sure, get advice from your pharmacist, GP (pediatrician*) or health visitor.
Medicines aren’t always needed for childhood illnesses. Most illnesses get better by themselves, and make your child stronger and able to resist similar illnesses in the future.
Always keep medicines stored in a safe place at home.
Paracetamol for Children
Paracetamol (acetaminophen*) can be given to children aged over two months to relieve pain and reduce fever (high temperature). Make sure you’ve got the right strength for your child. Overdosing is dangerous. Check with your pharmacist when you buy it and read the label carefully.
Ibuprofen for Children
Ibuprofen can be given to relieve pain and reduce fever in children aged three months and over who weigh more than 5kg (11lbs). Check the correct dose for your child’s age. Avoid ibuprofen if your child has asthma, unless advised by your GP (pediatrician*).
Don’t use Aspirin
Never give aspirin to children under 16 unless it’s specifically prescribed by a doctor. It has been linked with a rare but dangerous illness called Reye’s syndrome.
Giving your Child Paracetamol or Ibuprofen
Liquid paracetamol (acetaminophen*) and ibuprofen are available for babies and younger children. Older children may be able to swallow paracetamol or ibuprofen tablets with plenty of water.
Soluble paracetamol tablets that dissolve in water are also available. You can get ibuprofen powder that dissolves in water, but this is only suitable for children over 12.
It is important to:
- Make sure you know how much medicine to give your child and how often to give it
- Always follow the instructions on the label to make sure you give your child the correct dose for their age and weight
- Never give the medicine more often than your GP (pediatrician*) or pharmacist recommends, and don’t take any more than the stated dose
Remember to keep all medicines out of the reach of children and out of their sight, if possible.
For more information, including when to get medical advice, see:
Read the answers to more questions about children’s medicines.
Further information:
- What is a fever (high temperature) in children?
- Can I give my child paracetamol and ibuprofen together?
- Can I give my child paracetamol or ibuprofen with cough or cold medicines?
- Children’s medicines
- Painkillers – paracetamol
- Painkillers – ibuprofen
- Pharmacy and medicines
Editor’s Note: *clarification provided for our US audience.From www.nhs.uk
Common Skin Conditions & Treatments for Kids and Adults
Warts
Most people develop a wart at some stage in their life, usually by the age of 20.
What are they?
Warts are flesh-coloured lumps, which can be 1mm to more than 1cm across. Warts can appear anywhere, but usually affect the hands and feet. A wart on the foot is called a verruca (plantar wart*). Genital warts appear around the genitals or anus.
What causes warts?
They are caused by infection with the human papilloma virus (HPV), which can be passed on through skin-to-skin contact and sometimes through surfaces such as floors and towels. If you have a wart, you can spread it to other people through close contact. You can also spread it to other parts of your own body.
What’s the treatment?
Most warts go away by themselves, but this can take up to two years. Treatments include:
- Over-the-counter creams and gels (not for use on genital warts) – ask your pharmacist which ones may be suitable for you
- Prescription chemicals to be dabbed on to the wart
- Cryotherapy (freezing), which should be carried out by a practitioner trained in cryotherapy
- Surgery and laser treatment, but these are not commonly used
There is limited evidence that duct tape placed over the wart can be effective.
These treatments may be painful and the warts may come back.
Do I need to see a doctor?
See your GP (family doctor*) if the wart is bothering you, if you want your GP to treat it, or if treatments from the pharmacy have not worked. If you have genital warts, it’s important to go to your GP or a genitourinary medicine (GUM) clinic so you can be given appropriate treatment.
Find out more about treating warts.
Impetigo
Impetigo is common in babies and children, but can affect anyone. It usually develops on the face and hands. In babies it affects the nappy (diaper*) area.
What is it?
Impetigo is an infection in the skin. Small blisters appear and burst, leaving yellow, moist, itchy patches that dry to a crust. The skin underneath can be red and inflamed.
What causes impetigo?
It is caused by bacteria that enter the skin through a cut, scratch or damage from an existing skin condition, such as eczema. Impetigo can be spread by direct contact and sharing towels or bedding with someone who has it.
What’s the treatment?
Impetigo is likely to clear up by itself within three weeks. However, it’s very contagious, so antibiotic cream or tablets should be used to get rid of it quickly.
Do I need to see a doctor?
See your GP (family doctor*) for a diagnosis and to prescribe antibiotics. Most people are not contagious after 48 hours of treatment or once their sores have dried. It’s sensible for children not to go to school or nursery until they are no longer contagious.
Find out more about treatment for impetigo.
Psoriasis
Psoriasis affects 2% of people in the UK. It usually begins between the ages of 11 and 45. Psoriasis runs in families, and one-third of people with psoriasis have a close relative with the condition. Psoriasis is not infectious.
What is it?
Psoriasis causes flaky, red patches on the skin. They can look shiny and cause itching or burning. They can be anywhere, but are more common on elbows, knees and the lower back.
What causes psoriasis?
Some of the body’s antibodies attack skin cells by mistake, causing them to reproduce too quickly and build up on the skin. Certain things may make symptoms worse, including alcohol, smoking and some medicines, such as anti-inflammatories (for example, ibuprofen) and beta-blockers (used to treat heart problems). It is not passed on through close contact.
What’s the treatment?
Treatments to reduce the patches depend on their severity. They include:
- Creams containing vitamin D or vitamin A
- Steroid creams
- Tar preparations
- Exposing the skin to ultraviolet (UV) light
- Medication taken by mouth or injection
Do I need to see a doctor?
Most people are treated by their GP (family doctor*), but some are referred to a dermatologist (skin specialist).
Find out more about treatment for psoriasis.
Read about Ray’s experience of psoriasis.
Ringworm
Ringworm is common in children, but can affect anyone. It appears on the head, body, groin, feet, nails or beard area.
What is it?
Ringworm is not a worm, but a number of fungal infections that grow in a patch or circle on the skin. It can be a few millimetres to a few centimetres across. The patches or circles look red or silvery and can blister and ooze.
What causes ringworm?
Fungal spores enter the skin through a break, such as a scratch or a patch of eczema. Ringworm can be passed on through direct contact and sharing items such as towels, bedding or combs. It can also be passed on from the floor of shower or swimming pool areas. Pets can pass it to people.
What’s the treatment?
Antifungal creams, powders or tablets, available from the pharmacy, can be effective.
Do I need to see a doctor?
See your GP (family doctor*) if you aren’t sure if it’s ringworm, or if the infection has not responded to pharmacy treatment after two weeks.
Find out about the symptoms of ringworm.
Vitiligo
One in 100 people in the UK develops vitiligo. It can occur at any age, but more than half of cases begin before the age of 20. It affects men and women of any skin colour. Vitiligo is not infectious.
What is it?
Vitiligo causes pale white patches on the skin. These patches can occur anywhere, but are more noticeable on areas that are exposed to sunlight, such as the face and hands, and on dark or tanned skin. On the scalp, vitiligo can cause hair to turn white. Patches can be small or large, stay the same size, or grow. Vitiligo cannot be passed on through close contact.
What causes vitiligo?
It is caused by a lack of melanocyte cells, which colour the skin. These cells can be missing because:
- The immune system isn’t working properly and attacks them
- The skin has come into contact with certain chemicals or has been severely sunburnt
Vitiligo is also linked to having an overactive thyroid gland (hyperthyroidism).
What’s the treatment?
Treatment aims to restore skin colour and control the spread of vitiligo. Treatment can include:
- Steroid creams
- Ultraviolet A (UVA) light
- Disguising the patches with coloured creams, some of which are available on prescription
If vitiligo affects more than 50% of the skin, treatment may involve lightening the healthy skin using prescription creams. It’s important that this treatment is carried out under the supervision of a doctor.
Creams that you can buy without a prescription that claim to lighten skin can contain harmful chemicals, so don’t use them.
Find out more about the risks of skin lightening.
Do I need to see a doctor?
See your GP (family doctor*) to confirm the diagnosis and prescribe treatment.
Find out more about treatment for vitiligo.
Read Elena’s story of life with vitiligo.
Editor’s Note: * clarification provided for our U.S. audience
From www.nhs.uk
