At home, a peak flow meter – a hand-held tool that measures breathing ability – can be used. When peak flow readings drop, it’s a sign of increasing airway inflammation. The peak flow meter can detect even subtle airway inflammation and obstruction – even when a child feels fine. In some cases, it can detect drops in peak flow readings two to three days before a flare-up occurs, providing plenty of time to treat and prevent it.
During the first stages of treatment, the doctor usually will have a child take a series of peak flow readings for a period of time. The readings help to establish a child’s baseline PEFR, or peak expiratory flow rate – his personal best during a time when he has the least symptoms. After establishing a baseline reading, peak flow readings should be taken at least once a day so daily readings may be compared with the baseline.
Another way to know when a flare-up is brewing is to look for early warning signs (EWS). EWS are little changes in a child that signal medication adjustments may be needed (as directed in a child’s individual asthma action plan) to prevent a flare-up. EWS can help to detect a flare-up hours or even a day before the appearance of obvious flare-up symptoms (such as wheezing and coughing). Kids can develop changes in appearance, mood, or breathing, or they’ll complain of “feeling funny” in some way. EWS are not always definite proof that a flare-up is on the way, but they are signals to plan ahead, just in case. It can take some time to “tune in” to these little changes, but over time, recognizing them becomes easier.
Parents with very young children who can’t talk or use a peak flow meter often find early warning signs very helpful in predicting and preventing flare-ups. And EWS can be helpful for older children and even teens because they can learn to sense little changes in themselves. If they are old enough, they can adjust medication by themselves according to the asthma action plan, and if not, they can ask for help.
Step 3: Taking Medications as Prescribed
Developing an effective medication plan to control a child’s asthma can take a little time and experimentation. There’s no single remedy that works for every child with asthma. The different categories of asthma are treated differently, and some medication combinations work well for some children but not for others.
There are two main categories of asthma medications: rescue medications and controller medications. Asthma medications treat both symptoms and causes, so they effectively control asthma for nearly every child. Over-the-counter medications, home remedies, and herbal combinations are not substitutes for prescription asthma medication. First, they can be life-threatening to rely upon during a flare-up because they cannot reverse airway obstruction quickly and effectively (if at all). Second, they don’t address the cause of many flare-ups: the hidden inflammation smoldering in a child’s airways. As a result, asthma is not controlled by these non-prescription cold medicines, and may even become worse with their use.
Step 4: Controlling Flare-Ups By Following the Doctor’s Written, Step-by-Step Plan
Mastering the first three steps of asthma control means a child will have fewer asthma symptoms and flare-ups. But any child with asthma can still have an occasional flare-up, particularly during the learning period (between diagnosis and control) or after exposure to a very strong or new trigger. With the proper patient education, on-hand medications, and keen observation, families today can learn to control nearly every asthma flare-up by initiating treatment early, which will mean less emergency room visits and fewer admissions, if any, to the hospital.
The doctor provides a written, step-by-step plan (asthma action plan) outlining exactly what to do between flare-ups and how to recognize and manage flare-ups when they occur. The plan is different for each child. Over time, families learn to recognize when to start treatment early and when to call the doctor for help.
Step 5: Learning More About Asthma, New Medications, and Treatments
It’s a fact: those who learn the most about asthma are the most successful in controlling it. Fortunately, more is being discovered about asthma every day! There are several organizations you can contact for information, videos, books, educational video games, and pamphlets.They can often direct you to local support groups where families and kids can meet others going through the same frustrations and learning processes. Together, they share experiences, helpful strategies and tips, and coping skills.