When Mark and Brenda Frei heard their youngest son's croupy cough, they knew what to do.
They didn't waste time or money using cough medicines or antibiotics in an attempt to fight a cold. They recognized the cough as a symptom of viral-triggered asthma, and they knew the condition could be managed effectively with an infant mask and a standard aerochamber.
The Freis know asthma all too well. They and their four children Guerin, 1; Bailey, 6; Addison, 8; and Anthony, 11 have the condition.
Last year, they spent more than $1,000 on asthma medicines and another $500 or so on allergy medicines. Add in a half dozen doctor visits, one trip to the emergency room when Anthony had a severe episode last winter and elevated insurance premiums, and the costs rise quickly.
"Every child has different medications and different regimens," Brenda said.
Still, the Freis consider themselves lucky. Anthony said that he sometimes forgets he has asthma because his preventive care only takes 30 seconds a day and he experiences only about one troublesome bout a year.
"Our children are generally very healthy," Brenda said, adding that the youngsters are involved in baseball, swimming and dance classes. "Occasionally, they may need to have short-term limitations in physical activities if (they are) having a viral-triggered flare-up."
Asthma is the third-ranking cause of hospitalizations among children under the age of 15, according to the American Lung Association of Kansas. Asthma may account for as many as one in six of all pediatric emergency room visits.
The good news, the Freis said, is that asthma can be controlled. Early warning signs of asthma that parents and children can identify include:
anxious or scared look
cough; coughing when the child has no cold; clearing of throat a lot
unusual paleness or sweating
flared nostrils when the child tries to get some air
pursed lips when breathing
fast breathing; noisy or difficult breathing; wheezing, however light
hunched-over body posture; the child can't stand or sit straight and can't relax
restlessness during sleep
the notch above the child's adam's apple sinks in as they inhale
spaces between the ribs sink in when the child inhales.
If asthma is suspected, a visit to the doctor's office is in order. But parents need to make sure their child's physician is up-to-date on current asthma treatments.
"Parents need to recognize the importance of finding the right physician," Brenda warned. " And seek care elsewhere if you don't feel you're not receiving the right care. It's unfortunate how often asthma goes undiagnosed or misdiagnosed."
According to the Freis, other important tips for parents are:
Get educated about the appropriate treatment for asthma. Preventive medicines can be helpful.
Follow through with treatment and teach your children how to care for their asthma. "Kids even (as young as) age 5 can be taught to use inhalers responsibly," Mark said.
Be observant of your child's symptoms as well as triggers, and then respond quickly to those triggers. Triggers may include exercise; viral cold; pollution; cold air; allergens, such as grass or mites; coughing; yelling and laughing; and some medicines and chemicals.
Communicate clearly with child-care providers and school personnel as needed.
The Freis said the factors causing asthma vary from person to person. Recent articles regarding research have suggested the onset of childhood asthma may be caused by having a pet in the house, not breast-feeding, obesity in the mother, low-birth weight, parental smoking and even early menses in the mother.
Both those findings don't fit with the Freis' case.
"None of these factors fits for us," Brenda said, "instead it appears to be an inherited factor."