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Learning to Live with Asthma


But we didn't really have a choice. Without the drugs, our sons had asthma attacks nearly every night. We followed all the crazy-making advice about buying special dust-mite-proof covers for mattresses and pillows, banishing pets, and getting rid of carpets and stuffed toys to keep dust away. But the only thing that clearly made a difference was asthma medicine.

There are two main classes of drugs. One is used only to prevent attacks, and works by treating the underlying cause of asthma, which is thought to be inflammation in the airways. Several medicines ease inflammation, including steroids related to cortisone and other drugs that act on the immune system.

Rescue medicines, or bronchodilators, are used to treat attacks in progress, or to help keep attacks at bay during colds or other respiratory infections. They work by relaxing muscles in the airways that go into spasm and make it hard to breathe. Albuterol, also called Ventolin, is a commonly used bronchodilator.

Guided by our doctors, we used various preventive drugs as the backbone of treatment. Most of the time, we used albuterol only to treat attacks. And if our sons needed it more than occasionally, we took that as a sign that they also needed more of the inflammation-fighting drugs.

Viral infections, sinus problems, and allergies seemed to bring on attacks. We also found out, the hard way, that the flu can play havoc with asthma, and at a pediatrician's urging, we all started getting flu shots every year when the boys were in elementary school. It was one of the best decisions we ever made.

When the kids were young, we spent a lot of time showing them how to use inhalers and making sure they did it right. I don't have asthma, but I practiced with an inhaler anyway so that I could help them learn. It's amazingly easy to do it wrong and have the medicine land at the back of your throat or on the roof of your mouth instead of in your lungs. When the boys were younger, they used a device called a spacer, which attaches to the inhaler, captures the mist in a chamber, and makes the inhaler a bit easier to use.

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