Classification Of Asthma
The treatment of your child's asthma depends also on how severely the disease affects your child.
Asthma is classified into 4 categories:
- Severe persistent
- Moderate persistent
- Mild persistent
- Mild intermittent
It is important to realize that the classification may change depending on the time of year. Children whose asthma symptoms are triggered by viral infections may be sick all winter and clear the rest of the year. Children triggered by pollens will have problems in the spring and fall. The treatment intensity can therefore change from season to season. A few unfortunate kids are sick all year round.
Severe persistent asthma: This type of asthma is not hard to diagnose. These are the kids who are in the hospital frequently and in the ER or the doctor's office all the time. They have very frightening episodes and often need intense medical support. They are rarely clear and their activities are often limited despite frequent use of several medicines.
Moderate persistent asthma: Children with moderate persistent asthma can also experience symptoms that are quite frightening. They have occasional severe episodes that require hospitalization and ER visits and often do not clear between episodes. They require daily use of medications. Mild persistent asthma: Children with mild persistent asthma are children that may once in a while have a frightening episode. They have prolonged periods of coughing and do not always clear between episodes. They use inhaled medications more than twice weekly but not every day.
Mild intermittent asthma: These kids have occasional episodes that are usually not severe. They clear completely between episodes and use inhaled medicines less than twice weekly.
The most important point to make is that all children with persistent asthma of any type need daily use of anti-inflammatory medications even when they appear to be clear. It is also important to note that, in children who have seasonal variations in their asthma, the medications and their dosing may vary.
Creating an Effective Treatment Plan
Parents hate to give children medicine. Most children hate to take medicine. My philosophy about medicine is that you should use as little as possible, but as much as you need. People like to ignore that last part. You must use all the medicine necessary to get a good outcome. But if your doctor is just writing prescriptions, you are not getting everything that you need, because the treatment of childhood asthma involves much more than medicines.
The first step is education of the patient and parent. Asthma is a complex disease process, which the patient and his family must understand in order to cooperate with the often-confusing treatments that are prescribed.
Education takes time, a commodity that is often in short supply in a busy pediatrician's office. In my opinion, all asthmatics need to have at least one long (45 min - 1 hour) visit devoted solely to patient education and decision making. Many insurance companies will cover a home health nurse for this type of education as well.