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Saturday, April 19, 2008

Asthma sidelining your child? Playing sports safely

Physical activity is a common trigger of asthma symptoms in people with asthma. If you have a child with asthma, you are understandably concerned about preventing flare-ups when you can — but does this mean that you should keep your child from participating in sports? No. In fact, regular exercise can benefit asthmatic lungs by conditioning them to work more efficiently. You can take steps to protect your child during physical activity — even if you can't be there for every practice.

Control the asthma first

Before your child participates in sports, be sure that his or her asthma is under control. Controlled asthma means that your child isn't having regular symptoms and flare-ups are rare.

Each child's asthma control will be different based on symptoms and triggers, but typically a treatment plan involves a combination of long-acting medications to control the asthma over time, and short-acting inhalers for quick relief of symptoms. Many children will benefit from using a short-acting bronchodilator such as albuterol about 15 minutes before exercise.

If your child is on medication but continues to have symptoms or regular flare-ups, check with your child's doctor for possible changes to medications or dosages.

Choose activities wisely

Certain physical activities are more likely to cause asthma attacks, particularly those that are aerobic, high intensity and high endurance, such as:

* Basketball
* Cross-country skiing
* Cycling
* Ice hockey
* Long-distance running
* Rugby
* Soccer

Although some activities are more likely to cause symptoms, your child may be able to participate in any sport he or she chooses with the right medications and asthma control.

If your child is especially sensitive to exercise as a trigger, you may want to consider activities that are less likely to trigger asthma, such as:

* Baseball
* Golf
* Sprinting
* Swimming
* Weightlifting

While sprinting and swimming are aerobic activities, they are less likely to cause symptoms. Sprinting is high intensity, but doesn't require endurance. Swimming can be high intensity and high endurance, but the warm, humid environment usually protects those with asthma from having attacks. Golf usually requires less intense exercise; however, the outdoor exposure may trigger asthma for kids who also have allergies.

It's also important to consider your child's competitiveness. Younger children tend to slow down their activity level when they feel discomfort. Older children are more likely to push themselves to perform even when having asthma symptoms. This is usually because they want recognition or find satisfaction in competing on the same level as their peers. A combination of high-endurance sports and a high level of competitiveness can be dangerous for children with asthma. If you notice growing competitiveness in your child, be sure to continue to involve him or her in maintaining the asthma treatment plan. Better control of asthma may result in better athletic performance. Involving your child in the decision-making process makes it more likely that he or she will follow the plan.

Keep preventive tips in mind

In addition to controlling symptoms with medication, be sure your child follows these practical tips to avoid flare-ups:

* Always warm up and cool down. Help your child make it a habit to spend 15 minutes warming up before more intense physical activity, and to do another 15 minutes of cool-down after exercise. While it's a good recommendation for all athletes, warm-ups and cool-downs are especially important for those with asthma.
* Pay attention to environmental conditions. Cold temperatures, poor air quality and high concentrations of pollen in the air make conditions right for an asthma attack. If possible, encourage your child to stay indoors during these times. When the weather is cold, your child may be able to control symptoms by wearing a scarf or mask to warm the air before it enters his or her lungs.
* Exercise only when healthy. Asthma attacks are more likely during or immediately after a cold or other respiratory infection. Wait a few days after cold symptoms subside before resuming physical activity.
* Use a peak flow meter to monitor airflow. A peak flow meter is a hand-held tool that monitors how well your child's lungs are working from day to day. With the help of your child's doctor, you first determine your child's average peak flow reading. A drop in the reading may indicate an increase in airway inflammation, even when your child feels fine. An abnormal peak flow reading prompts you and your child to take extra precautions that day to prevent an attack.

Communicate your child's asthma action plan

Every child with asthma should have an asthma action plan, which is a step-by-step guide for preventing, recognizing and treating an asthma attack. This important tool helps ensure that you, your child and other caregivers all follow the same plan if action needs to be taken.

Typical asthma action plans include a list of medications and dosages, symptoms and average peak flow readings, signs of an attack, when to seek emergency care, and contact numbers. Because teachers, coaches and other caregivers may have different levels of education on asthma, it's important that they know exactly what to do if your child needs help.

Make copies of your child's asthma action plan and give them to your child's school nurse, teachers and coaches, and be sure to regularly communicate the importance of knowing the plan and having it accessible in case of an attack.

With the help of your child's doctor, revise the plan regularly based on changing needs in different seasons, sports or ages as your child grows and treatments or symptoms change.

Asthma and sports can be a winning combination

Children with asthma can participate in sports; in fact, your child's condition may improve with regular physical activity. First, have an asthma action plan in place, and communicate regularly with your child's teachers and coaches. These and other practical steps allow your child to enjoy sports in an environment that keeps him or her safe.
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