"I think I'm just like everyone else ... I just have an inhaler, and every once in a while I take medicine," said Kendall, 12, of Roanoke, Ill.Kendall isn't unusual. Nearly 20 million people in the United States - including 9 million children - are affected by asthma. And studies show these numbers have been growing during the past 20 years, particularly in children.
According to the American Academy of Allergy, Asthma and Immunology, the prevalence of asthma increased 75 percent from 1980 to 1994. And asthma rates in children younger than 5 have increased more than 160 percent from 1980 to 1994. "Up until the '70s and '80s, they didn't talk about asthma in children. Asthma was thought to be in adults," Peoria, Ill., Dr. Ken Arnett said. "Now we are seeing more, in part ... because family practice doctors and pediatricians are recognizing it more."
Asthma causes recurring episodes of coughing, chest tightness, shortness of breath and wheezing, particularly in the evening and early morning. It causes obstructed airways, which limits airflow and makes it difficult to breathe.
"It is a very serious health condition. Not only does it frighten the parent, it scares the hell out of the kids," said Linda Carter of Knoxville, Ill., whose daughter Kelly has asthma. "I've seen that child with that petrified look in her eyes. It says, 'I can't breathe, help me.'"
Asthma is the cause of almost 3 million doctor visits and 200,000 hospitalizations each year, according to the American Academy of Allergy, Asthma and Immunology.
Asthma is most influenced by genetics and the environment, including cigarette smoke and animals. "Hardly a day goes by that I don't have to talk to someone about cigarette smoking and the effects on their child," Arnett said. "Even exposure in the womb to secondhand smoke makes you predisposed to asthma."
If you look at a father and mother who have asthma, the likelihood of a child having it is greater, Arnett said. In fact, children whose fathers have asthma are 25 percent more likely to have the disorder. Those whose mothers have asthma are 40 percent more likely to be affected.
Kelly was diagnosed as an infant, but it wasn't a surprise to her mother. "She was having a hard time breathing. I just knew she had asthma, I could tell by the wheeze," Carter said.
Kelly slept in her parents' room until she was 2, and Carter said she didn't get a decent night's sleep until Kelly was at least 4. She was too worried Kelly would stop breathing. "I don't think that people take it that seriously. They think it is like a cold, but it's not. It's an ongoing thing you live with your whole life," Linda Carter said.
Now in sixth grade, Kelly has been a patient of Arnett's her entire life. She sees him three to four times a year to keep her medicines regulated and for observation. She also administers her own medicine throughout the day. "It is so routine to us, we don't know anything else," Carter said.
Doctors subscribe to different theories as to why they have seen an increase in asthma.
"In the '70s and '80s, we made these houses airtight, so things in the house, like dust mites, stay in the house and cause breathing difficulties," Arnett said. Arnett also believes in the "hygiene hypothesis." "If you keep things too clean and you don't have exposure to funguses and bacteria, your immune system takes on the traits of a neonate ... and you are more likely to have asthma," he said.
Regardless of why they have it, Arnett wants children with asthma to know they are still capable of anything.
He likes to let kids know that one in six athletes participating in the recent Olympics had asthma. He calls that "an amazing feat" and said it sets a good example for children struggling with asthma.
"Back in the '70s, they thought kids with asthma couldn't play and be active. Now it is exactly opposite," Arnett said. "We want them to get out and play. You can get out there and exercise. You don't sit inside and watch others." Kendall plays soccer and likes to run around with his friends.
"I basically do whatever I want," the 12-year-old said.
The only difference is Kendall knows that when his chest begins to tighten, he needs to pay attention and use his inhaler.
By Dayna R. Brown
Copley News Service
- About 20 million Americans have asthma.
- Nine million U.S. children younger than 18 have been diagnosed with asthma.
- More than 4 million children have had an asthma attack in the previous year.
- There were 1.9 million asthma-related visits to emergency departments in 2002.
- Asthma causes about 5,000 deaths annually.
- Direct health-care costs for asthma in the United States total more than $11.5 billion annually; indirect costs (lost productivity) add another $4.6 billion for a total of $16.1 billion.
- Prescription drugs represented the largest single direct medical expenditure, more than $5 billion.
- 12.8 million school days and about 24.5 million work days are missed annually because of asthma.
- Asthma prevalence is 39 percent higher among blacks than among whites.
- The prevalence of asthma in adult females was 35 percent greater than the rate in males in 2003.
- About 40 percent of children with asthmatic parents will develop asthma.
SOURCE: The American Academy of Allergy, Asthma and Immunology