Magazine article FDA Consumer

Childhood Asthma

Magazine article FDA Consumer

Childhood Asthma

Article excerpt

As a child, author John Updike, like many other children, had the snuffles in the winter and hay fever in warm weather. It wasn't until years later as an adult, however, that Updike's asthma was diagnosed during a physical exam. Noting Updike's spread rib cage, or barre, chest-the sign of the chronic asthmatic-and the characteristic wheezing sounds heard through the stethoscope, a doctor correctly identified his condition.

While some children eventually "outgrow" asthma as the size of their breathing tubes increases, Updike's disease grew worse in maturity. He describes an acute episode that occurred on a visit to his parents' farm in Pennsylvania on a summer day, at the height of the pollen season, in the company of a dog and cats, and surrounded by dust, mold, and plants and trees in full bloom:

An asthma attack feels like two walls drawn closer and closer, until they are pressed together. Your back begins to hurt, between the shoulder blades, and you hunch. I could not stand up straight and looked down at the flourishing grass between the sandstones. I thought, This is the last thing I'll see. This is death. The breathless blackness within me was overlaying the visual world, this patch of my mother's grass, with a thin gray film, and the space between the two walls I was struggling to pry apart felt hardly wide enough for a razor- blade. My children and parents had come out on the back porch to watch me, and a rictus twitched my face as I thought how, comic this performance must look, this wrestle with invisible demons.... I felt immensely angry at my own body and at everybody. Like a child blind in his tantrum I thought, Serve them right, and waited to die, standing bent over and gasping, of suffocation. (Copyright 1989 by John Updike. Reprinted with permission of Alfred A. Knopf from Self-Consciousness.)

Updike didn't die. After a quick visit to the hospital emergency room and two injections of adrenalin, he experienced that "opening of the bronchial tree which is to asthmatics an interior sunrise, a rebirth into the normal world."

Such scenes are played out in emergency rooms throughout the United States, most of the time with a similar euphoric ending. But sometimes not. In 1988, according to statistics from the National Institutes of Health, 4,580 Americans died from asthma, some of them children. Though asthma can come on with such suddenness and severity that medical help is not available in time, doctors believe that most asthma deaths are preventable.

Common Childhood Disease

Asthma is the most common chronic childhood disease. It causes more hospital admissions and visits to the emergency room and is responsible for more school absenteeism than any other chronic disease in childhood.

Estimates of the number of children under 17 with asthma vary from 3 million to 8 million, but Nancy Sander, founder of the national organization Mothers of Asthmatics, Inc., believes the incidence is much higher than the statistics show. Says Sander: "Asthma is often misdiagnosed as acute infectious bronchitis [inflammation of the bronchi] or bronchiolitis [infectious inflammation of the bronchioles]-viral diseases-or recurrent pneumonia."

Though asthma can occur at any age, about 80 percent of the children who will develop asthma do so before starting school. The common "trigger" is a viral upper respiratory infection.

Childhood asthma appears to be increasing worldwide. In American children 3 to 17 years old, asthma's prevalence rose 50 percent in the 1980s, according to the National Center for Health Statistics, and the death rate for children under 14 doubled from 1977 to 1983. Health professionals don't know why asthma is on the rise, but they think that air pollution or other environmental changes may be implicated.

What Is Asthma?

Asthma is a bronchial disease in which the airways are so sensitive that they sometimes become blocked, making breathing difficult. …

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