World Asthma Day
en per cent of Australian children have asthma. It’s the most common respiratory condition in Australia, and also one of the most common reasons for presentation to emergency departments and admission to hospital each year. Today is World Asthma Day, and this year’s theme “Uncovering Asthma Misconceptions”, provides a call to address common myths and misconceptions which can impact the health and day to day lives of people with asthma. Our Respiratory departments are used to dispelling common asthma myths, and among the most common misconceptions are:
Asthma isn’t a very serious disease
“Asthma is a really serious disease and an average of 8 - 10 kids still die in Australia from asthma every year,” says Dr Louisa Owens, Head of the Respiratory Department, Sydney Children’s Hospital, Randwick. “Everyone knows people with asthma and it can vary so greatly from some who just need a little bit of their reliever medicine before sport, to kids whose education is being affected, and are constantly missing school because they are too unwell to attend." Dr Hiran Selvadurai, Department Head of Respiratory Medicine at The Children's Hospital, Westmead agrees, saying "Asthma is an important and serious lung disease that requires appropriate management. It's vitally important that children with asthma are reviewed regularly by their doctor."
It’s fine to use your reliever medication constantly throughout the day
“Some people think it’s normal to use their reliever medicines such as Ventolin every day, and you can take it as much as you want – that’s not right!” says Melinda Gray, Clinical Nurse Consultant, Asthma, SCH “If you’re using your puffer every day, it’s a sign your asthma is being poorly controlled and relying on it so much means you are at risk of a severe exacerbation. As a general rule, using your reliever medicine 2 – 3 times a week (excluding sports) is ok. If you’re using it more than that, you need to go to your GP for a review.”
Spotlight on SCH’s Complex Asthma Clinic:
It was becoming increasingly clear that for some children with severe asthma who, despite ongoing follow up and regular tweaks to medication, their chronic asthma just wasn’t improving. In September 2020, Dr Louisa Owens, Head of Respiratory, Sydney Children’s Hospital, Randwick brought together an experienced and passionate team to open the first Complex Asthma Clinic at the Hospital.
“There was a lot more complexity to these patients’ asthma, whether it was allergies, anxiety, or dysfunctional breathing. What was needed was a multidisciplinary team approach to manage these complexities,” says Dr Louisa Owens.
The team consists of a specialist Asthma Clinical Nurse Consultant and a clinical nurse consultant (CNC) dedicated to supporting schools, a physiotherapist, a speech pathologist, a psychologist, with input from social work, immunology, pharmacy, and the anaphylaxis Clinical Nurse Consultants. This multidisciplinary approach has seen kids reduce their medications, control their asthma symptoms and get them back exercising, back to school and greatly improve their quality of life.
“A lot of children start to avoid any sort of exertion because they’re worried about it triggering their asthma. Our physio provides a supervised, controlled exercise program, giving kids the confidence to know they can manage stairs, or go for a bike ride because they’ve done it in clinic with a physio who helps them understand their limits,” says Dr Owens.
Asthma CNC Melinda Gray also highlights the unique inclusion of the psychologist to support kids through the anxiety that comes with asthma has made a significant impact on our patient’s wellbeing.
“Kids with severe asthma are often missing school and social events, they are struggling with anxiety and depression because they feel they can’t do things ‘normal kids’ do,” says Melinda Gray, Asthma CNC.
In addition to the regular clinics, the team also offer virtual home visits which provide insight into a family’s home environment. This can help to identify triggers the family may not even be aware existed. So far, the feedback from patients has been overwhelmingly positive. “We love witnessing the real changes our team are making to the lives of children and their families too. They’re going to school more regularly, learning to surf, or going back to a favourite sport or on school camps, it’s changing children with asthma’s lives in such a significant way,” says Melinda.