Asthmagirl had an interesting post recently about how laughter sometimes caused her to need to use her rescue inhaler. This got me thinking about asthma triggers other than the traditional triggers your doctor talks to you about.

Do you have anything that triggers your asthma that is out of the ordinary? If so, leave a comment and let us know about it.

Swimming is one of the great summer pastimes and has been long thought of as a great exercise for asthmatics.

Swimming is promoted as an exercise for people with asthma because you breathe in warm, moist air rather than the cold, dry air that may trigger asthma symptoms. Swimming can also help you develop good breathing practices.

Recent research, however, has indicated that some of the byproducts of chlorine can significantly contaminant the air around swimming pools. Not surprisingly, people using indoor pools seem to be more affected.

While more study needs to be done before your doctor tells you to stay away from the pool, I wanted to know what your experience with asthma and swimming pools was? Please take the quiz and leave a comment.

When you think about it, one of our most important jobs as a parent is to make sure our kids are positioned to be the best adults they can possibly be. Teenagers, especially, need to learn to make responsible decisions about their asthma. Consider these tips to help your teen with asthma.

• Responsibility: It is important to increase your child's responsibility as they get older. You cannot be there forever or every minute of every day. By increasing your child's freedom and responsibility in their own self-care, they will hopefully learn to take better care of their own asthma. This freedom and responsibility, however, needs to be tempered by supervision and restrictions as well.


• Difficulty: Some teenagers find it difficult to accept their asthma diagnosis.This can make parental guidance and support both all that much more difficult and important.


• Goal Setting: As your child enters the teenage years, they should actively participate in their asthma management plan. This would include peak flow monitoring, preventive medications, and rescue management. As a parent you should stress the consequences of not managing asthma appropriately. As a parent, you need to step back and let your child take control of their asthma, but be available for communication and intervention if necessary.


• Assume your child is a risk taker: Teenagers frequently stop their asthma medications or take them less frequently than they should. They also will resist monitoring peak flows as you and their doctor would like. Making your child's asthma action plan as simple as possible may help with this.

Learn More

• 10 Tips For Coping With Asthma
• Is My Child at Risk for Fatal Asthma
• Have a Plan

What pointers do you have for parents of teenagers with asthma?

Source: Asthma. Patient Education. Connecticut Department of Public Health

A couple of people have recently asked about the use of exhaled nitric oxide markers as part of your asthma care plan. Exhaled nitric oxide is a marker of airway inflammation, one of the key components of the pathophysiology of asthma. While exhaled nitric oxide testing has been available for some time at specialized asthma centers, the development of home monitoring devices for exhaled nitric oxide has recently had researchers asking the question if home monitoring could improve asthma control.

In a 2008 study sponsored by the National Institute of Allergy and Infectious Disease Inner City Asthma Consortium, compared standard asthma guideline treatment to treatment based on exhaled nitric oxide levels. While there was no difference in asthma symptoms, admissions to the hospital, or asthma exacerbations, it appeared that obese and highly allergic patients might benefit from using exhaled nitric oxide testing.

A 2005 study published in the New England Journal Of Medicine demonstrated that while inhaled nitric oxide did not decrease symptoms compared to standard care, patients utilizing inhaled nitric oxide could lower the doses of their inhaled steroids compared to standard care potentially decreasing risk of side effects.

A 2008 Cochrave Collaboration, an international not-for-profit and independent organization providing non-biased reviews of the evidence of healthcare treatments, review concluded "Tailoring the dose of inhaled corticosteroids based on exhaled nitric oxide in comparison to clinical symptoms was carried out in different ways in the four studies that were found, and the results show only modest differences. The role of utilising exhaled nitric oxide to tailor the dose of inhaled corticosteroids is currently uncertain."

Currently, many insurers consider exhaled nitric oxide testing investigational which means they will not pay for it. In reviewing the clinical policy guidelines of a national insurer, the insurer cites numerous studies which failed to show a clinical benefit. However, in reviewing clinical trials websites, there are several ongoing studies of inhaled nitric oxide in asthma patients. Thus, exhaled nitric oxide testing has not yet been definitively proven to improve asthma care although it may improve asthma outcomes in some groups.

Until more results are made available, you might want to discuss your particular case with your doctor, but expect to bear the costs if you decide to move forward. Alternatively, you could consider looking into a clinical trial using exhaled nitric oxide monitoring.

What do you think? Have you ever used exhaled nitric oxide monitoring?