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?

Ypu may have recently read a great deal about proposed health care reform. Which proposal do you think is best for your asthma? Which option do you think is best and why? Take the quiz and leave a comment.

As you think about getting away for the holiday weekend, you need to think about your asthma. These simple steps from the American Academy of Allergy Asthma & Immunology may help you PACK and keep your asthma under control while gone over the long holiday weekend.

• Plan ahead. Think about what you will need. If flying, you need to make sure that you carry your asthma medications with you. Lost luggage could lead to an emergency. If driving, you may need to ask others not to smoke or wear strong fragrances.
• Anticipate problems and allergens. Are you traveling to a high pollen area or to an area where the weather is drastically different? Are you traveling to a friend or family members home that has pets? It is best to have your asthma well controlled before going on a trip. Make sure that you tell your host about any food allergies and be sure to ask at restaurants. Always have your rescue medications and other medications for your action plan
• Continue to take your medications on your regular schedule. Just because you are going on vacation, you, unfortunately, do not get a break from your asthma. Mention your trip to your asthma doctor to see if you need to make any short term changes to your treatment plan.
• Keep your emergency contact information (asthma doctor, primary care doctor, pharmacy) with your important travel documents. Consider looking to see what sort of asthma doctors are located in the area you are visiting in case of an emergency.

Have you ever had an asthma traveling nightmare? Why not share your story here.

Source:

Pack Smart When Traveling. American Academy of Allergy Asthma & Immunology. Accessed July 2,2009

Sometimes doctors ask us questions that seem to make no sense and are clearly annoying to us. Breathinstephen outlines his 7 silliest asthma questions that doctors ask and his humorous responses.

What questions annoy you the most? Why not go to the forum and let us know.

A Mediterranean diet-- well known to protect your heart and decrease cancer risk-- might just also improve your asthma. While there is no one Mediterranean diet, it can be thought of as a 'cocktail' containing the following key components:

• Generous amounts of fruits and vegetables
• Healthy fats such as olive oil
• Non-salt flavorings such as herbs and spices
• Red wine in moderation
• Less red meat consumption
• Eating fish or shellfish several times per week
• Daily exercise

Mediterranean diets may decrease allergic rhinitis and asthma symptoms according to a research study that found over a 1 year period children taking in more vegetables, fruits, nuts, fish and cereals and less dairy products, meat, junk food and fat had less asthma and wheezing symptoms , as well as allergy symptoms like runny nose, sneezing and itchy-watery eyes. Overall risk for developing asthma or allergic rhinitis was not altered.

A Mediterranean diet may not only be good for your heart, but may also be good for your lungs.

You hear, read and see a lot of information about alternative treatments for asthma. How commonly do you think alternative treatments are used?

Learn more about alternative asthma treatment:

• Is alternative asthma therapy safe and effective?
• What is alternative asthma therapy?
• Talking with your doctor about alternative asthma therapy

FDA has requested that the manufacturers of montelukast (Singulair), zafirlukast (Accolate), and zileuton (Zyflo and Zyflo CR) include a labeling precaution related to potential psychiatric events.

Post marketing surveillance of this class of drugs, leukotriene inhibitors, has revealed potential neuropsychiatric events such as agitation, aggression, anxiousness, dream abnormalities and hallucinations, depression, insomnia, irritability, restlessness, suicidal thinking and behavior (including suicide), and tremor. The FDA has recommened the following:

• Patients and healthcare professionals should be aware of the potential for neuropsychiatric events with these medications.
• Patients should talk with their healthcare providers if these events occur.
• Healthcare professionals should consider discontinuing these medications if patients develop neuropsychiatric symptoms.
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Nearly 25% of adults with asthma smoke and, unfortunately, most probably began smoking when they were young. Tobacco smoke irritates the lungs and makes asthma worse. But did you know smoking during pregnancy can increase your child's risk of developing asthma? Take the quiz and see what everyone else thinks the risk is. I will put the correct answer in next weeks newsletter.