September is a wicked month for children with asthma

Returning to a musty school and exposure to children with viruses and bacteria can make it a stressful time

Tue, Aug 26, 2014, 01:00

Orla Dunne has had her share of “scary moments” with her son Max, who suffered uncontrollable bouts of coughing from about the age of two.

Even just running across the road would leave him spluttering and out of breath. Although Orla had some experience of asthma, she hadn’t seen this form before and didn’t make the link.

At times, particularly during the night, it got so bad. “Max couldn’t catch his breath, it was that severe, and he would go blue on us. It was quite scary at the time.”

Their GP prescribed a reliever inhaler to be used with an aerochamber, but he was young for a diagnosis of asthma, so he wasn’t given preventative medication and they had to wait a year to see a respiratory consultant in Tallaght hospital.

The Dunnes thought the inhaler device wasn’t working. Then they brought it along to an open day hosted by the Asthma Society of Ireland (ASI) and found out they weren’t using it properly. A nurse sat them down to work out an asthma management plan, and demonstrated how to use the inhaler.

“The main thing for us was maintaining it until we got the diagnosis and he was put on the preventative [medication],” says Orla. And the support of the ASI was invaluable during that time of limbo.

The consultant was great, once “you got your foot in the door”, she says, and Max saw him every three months initially but now, three years later, he needs only an annual check-up.

Takes time

It takes time for the preventative medication to kick in and doses were raised and lowered in an effort to find the right balance for Max. There were occasions when Orla would “sit by the bedside, afraid to turn away in case he would stop breathing on us”.

Max had to be brought to the emergency department at Tallaght hospital a number of times. There he would go on a nebuliser and be given steroids. That was “until the age of four; until we got it completely managed,” says Orla.

Now that he is six, the difference in Max is “fantastic”. “We don’t actually have to use the Ventolin [reliever] inhaler that often anymore.”

But he uses the preventative inhaler twice daily, which controls everything, she says. He races up and down the road outside their house in Tallaght with no problem, and can jump on the trampoline in their back garden without sparking a coughing fit after a couple of bounces.

They used to have to ensure Max was indoors early because damp air in the evenings was a trigger. “This summer he has had a ball and been able to stay out.”

Cold air and dust are among the more common triggers for asthma, a condition in which the airways become oversensitive to such things. (Smoke, mould, pets, pollen, colds and flu are also likely to affect those who are susceptible.)

Muscles around the airway tighten up, making it more difficult for the air to flow in and out. A longer-term effect is swelling of the airway, and accumulation of mucus.

No direct cause has been identified but it is understood to be an inter-reaction between genetics and the environment; having cleaner homes is thought to be a factor in the rise of cases in developed countries. Ireland has the fourth-highest rate of asthma in the world, with an estimated 470,000 adults and children affected.

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