Managing asthma during the holiday season

 Children find great joy and excitement during holiday time.  There are special treats to eat, pretty decorations, a steady stream of friends and family visiting or being visited, and the excitement of presents.  Adults have much or the same joy as the kids but also the stress and hectic rush to get it all done.  With all that needs to be done it's easy to miss the subtle signs that a child's asthma may be flaring.  Then, instead of a joyous time with family and friends, it often results in worry and a trip to the local emergency room.  Here are a few tips to help those with asthmatic kids hopefully avoid a flare this holiday season:

Try to minimize the stress as much as possible  Holidays are fun but also stressful.  Kids are wound up, adults have less time and everybody is rushing.  Although stress doesn't cause asthma it can aggravate it.  Better to skip the "Breakfast with Santa" and the holiday parade than to try to do it all and end up with a child who cannot breathe.  Pick those activities that are important to you family, but don't try to cram too much in.

Remember to be aware of what triggers your child's asthma  As we go to our many activities and places, children are exposed to various triggers more than they normally are.  For example, if your child is sensitive to mold, a real Christmas tree at a friend's house may trigger an attack as mold spores are very fond of pine trees!  If a real tree is in your house vacuum often - at least once a day. 

They may be exposed to a greater variety of  triggers which cause inflammation.  Some of the common ones are mold, dust mites, animals, or the various winter infections.  Add to that the greater exposure to symtom triggers (which don't necessarily cause inflammation but can make the already sensitive airway to twitch and tighten) such as: cigarette smoke, air pollutants and even cold air (face masks and scarves are an easy way to prevent this one).

Know that while one of the triggers by itself may not cause that much of a problem, when a child is exposed to many a flare may occur.  As you enter someone else's house, quietly note the surroundings and be alert to potential problems.

Check on the kids at regular intervals  While visiting with friends and family be aware of what your child is doing.  Make a point of checking periodically.  When kids are having fun playing they'll often ignore symptoms of an attack.  They'd rather continue playing hide and seek with the cousins than stop and take a nebulizer treatment.  My own son would absolutely not give up until he was literally unable to walk and his lips were turning blue.  I quickly learned to check on him and engage him in a brief conversation.  By listening to him speak a couple of sentences I could quickly tell if he was beginning to wheeze or having to pause for breath.  We also learned it was very easy to put the nebulizer (machine that administers medication in an aerosol form) in the car in case we needed it.  As any parent of a severely asthmatic child knows, the nebulizer delivers a more effective treatment than the inhaler does. 

Do peak flow readings morning and evening  A peak flow meter is a simple, inexpensive device that shows how well air is being moved through the lungs.  Readily available at local pharmacies or medical supply stores even very young children can use them.  By charting the daily numbers it is easy to see if an attack is building.  If the numbers begin to chart downward, even though there are not yet symptoms of wheezing, struggling for air, etc. a parent knows lung changes are taking place.  Usually a slight adjustment in medication will prevent a full blown attack.

Hopefully, with a bit of extra attention to detail, parents and caregivers can skip the trip to the emergency room this year.