Chapter 1: What is the significance of early intervention in managing asthma?
It is Asthma Awareness Week this week. The Asthma Society of Ireland is on a mission to encourage early intervention because the earlier a child's asthma is managed well, the better their future. I'm joined in studio by Professor Marcus Butler, Respiratory Consultant at St Vincent's University Hospital and by Dr Lucy Perham, Paediatric Respiratory Medicine Consultant at Children's Health Ireland.
On the line is Patricia Drennan, whose daughter Maya had a life-threatening asthma attack but is thankfully fully recovered. Good morning to you all. Thanks a million for coming in. Marcus, asthma, how common is it in Ireland?
It's a very common condition. I mean, overall, it's probably 8% of the population. Eight out of every 100 people you'll see wandering around a shopping centre, for example.
Chapter 2: How common is asthma among children in Ireland?
It's more common in children, as we all tend to think of it that way. But it's certainly the most common long-term lung disease we see outside of smokers in adults also.
Okay. And Lucy, obviously you deal with children and it really is, as Marcus says, is much more prevalent among children.
Indeed, it's about 1 in 10 in the paediatric age group, which means that in every school class in Ireland there's going to be at least a couple of kids who have asthma.
OK, Marcus, before we get into the conversation any deeper, explain to me exactly what asthma is.
So asthma is a long term condition where there is variable symptoms over time that come and go. And it's due to swelling and inflammation and sensitivity in the airways to all manner of exposures in the environment that trigger or set off this swelling.
such as exercise and viruses and air quality and infections like viruses and results in the typical symptoms that come and go over time of cough and breathlessness and wheeze and chest tightness.
OK, and Lucy, if it's not treated, if it's not identified properly, it can be serious enough.
Absolutely. There's a spectrum of severity that we see. But the biggest problems for children can impact their attendance at school, their ability to fully participate in sports and activities and to be able to sleep well at night. And of course, along the spectrum, kids can end up hospitalised and really very unwell with asthma.
So it is a serious problem that needs to be recognised and dealt with.
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Chapter 3: What exactly is asthma and what causes it?
It comes in different brands, which you take...
a little bit of every day all year round to stay well and you top up with the exact same inhaler when your symptoms intrude into your life because at the moment people tend to use different inhalers yes at different times and they often resort to blue inhalers I won't mention brand names but it would be well known to asthma patients the ones we're talking about
And these are a double edged sword. They're a trap because if you rely on those, you allow inflammation to run riot. And even in mild asthma, we know that MART is superior because in mild asthma, people often won't take their treatment every day. They'll only take treatment when they think they need it.
And when they reach for these blue inhalers on that basis, they'll end up in hospital much more often than if they just from time to time use their MART inhaler. So it's a superior treatment across the board at reducing flare ups and reducing the burden of symptoms and also ultimately reduces the exposure to the steroid side effects that can concern a lot of patients.
There's less inhaled steroid exposure over the course of a year with a MART treatment plan than with other conventional inhalers.
OK, and it will reduce the severity of attacks with it? Absolutely. Yeah. Lucy, would you recommend that as well, would you?
For sure, particularly in the adolescent group, the 12 to 18 year group where self-management is becoming more important. They're becoming more responsible for taking their medication. A one-stop shop medication like Marcus referred to really makes managing their asthma much more simple. So that leads to ultimately better control.
Okay, so just take one puff a day or whatever it might be, yeah?
Yeah, treatment plans are individualised for people and encourage people to talk to their GP and talk to the asthma society if they've got questions. But it can be one puff, one inhalation once or twice a day and then as needed if they need extra.
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Chapter 4: How can parents recognize if their child is not managing asthma properly?
But it just took a toll on her. It took a while to recover. But she's back to herself. She's doing brilliant. She's doing dancing. She's doing all the activities, football. She's a scout as well. She's an active child. She's kind of back to herself now. She's doing really well. We've no concerns. She's just, as I say, The inhaler, she's doing great, you know. So back to normal as such.
So it's a happy ending as such. Touch wood, I guess. But it was just really unexpected, you know.
It's so good to hear that everything is going OK now. Thank you. Other parents listening in today to you, Patricia, what would you say to them?
You know, it's just maybe, you know, like I say, we didn't know any symptoms, asthma symptoms. So, like, she's had coughs before and there was a tiny bit of wheezing before, but we just never paid any attention to it, didn't know. It cleared up on its own and we kind of moved on until it didn't, you know, and it went really badly for her.
And we did end up spending, you know, just three nights at the hospital, you know, where she...
go it's just they just couldn't get it under control especially the first night was really tough you know but eventually look it all cleared up but it's just maybe because I say I would be able to spot even meningitis symptoms there you know I would know all the but with asthma we just went to where so it's just maybe that it can turn bad really quickly as well as it did for us within 24 hours she was in in the ER you know the GP had to call the ambulance straight away so you know as I say we were lucky that it it worked out the way it did but it's just that it can just
Marcus and Lucy would be better able to say, but it just went bad really quickly, you know, so maybe just to know that, you know, kids have, you know, it's just people struggling for breath or wheezing that, you know, it's time to go to the GP or to the ER, you know.
Exactly. Okay, Patricia, thank you so much for that. Lucy, you are nodding in recognition at a lot of what Patricia was saying there and thank goodness that this story had a happy ending because, you know, a lot of parents would be worried now about how do they know, is it a cough, is it asthma, is it something I need to be worried about?
A terrifying situation for Maya and her family and really exemplifies that, you know, even children with mild asthma can still be at risk of having a severe attack like Maya. And so having an asthma action plan where you know what the green zone, orange zone and what a red zone symptoms look like. And Maya was in the red zone there.
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