When your child was first diagnosed with asthma, attacks were frequent and severe. But with long-term controller medications and a rescue inhaler, thankfully her symptoms are finally under control. In fact, she hasn’t had an asthma flare-up in months.
So, it makes sense to stop treatment or skip some doses then, right? Wrong.
“When asthma medications work, they are very effective. Most kids are relatively symptom-free,” said Dr. David Karas, a pediatrician at Akron Children’s Hospital Pediatrics in Wadsworth and leader of the Easy Breathing program at the hospital. “However, that doesn’t mean kids are cured. It just means we have their chronic airway disease under control.”
The goal of treatment is to get kids’ symptoms under control, instead of the asthma controlling them. If kids stop taking their daily asthma medications, they’ll quickly return to where they started. Attacks could come on stronger and more frequently.
In addition, if kids stop taking their medicine and get an infection, seasonal allergies flare up or are exposed to other asthma triggers, they could get a dangerous attack and wind up in the emergency room.
Long-term controller medications are used to reduce inflammation and overproduction of mucus in the lungs to help prevent asthma flare-ups. These medicines might not seem to be doing anything and, in fact, a child may not feel anything at all when taking them. However, these medicines are quietly doing important work to control asthma every day.
“It’s one of the biggest challenges we face in treating kids with asthma,” said Dr. Karas. “When kids are compliant with their medication, we are more likely to maintain good control of the disease. So, it may be weeks or even months that kids go without any symptoms, lulling them into a false sense of security.”
Over time, kids may be able to step down medication and possibly even stop daily therapy. It’s a decision that should be made with a physician and not by the family alone.
“Our goal is to first get kids’ asthma symptoms under control, so they may start on a higher dose,” said Dr. Karas. “Then, once it’s controlled, we can slowly wean them until we find the lowest level of medication that keeps them symptom-free. But, families need a physician to best assess what that level is for their child.”