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" When I first learned that my older son had asthma, I imagined that it would go away in a few weeks or months. I clung to that bit of denial, I guess, because it helped ease the fear and sadness as reality sank in. Brian was only 3, and deep down my husband and I knew we were facing a serious chronic disease that would probably hang on for years, maybe even for the rest of his life. It did hang on, and three years later, our younger son, Eric, also started to wake up at night with fits of coughing, wheezing, and choking. Both boys had a cluster of problems \u2014 asthma, eczema, and allergies to nuts, pollens, dust mites, and animals \u2014 that often go together and seem to have become more common in the past 20 years or so.  People with asthma are often described as having &amp;quot;twitchy&amp;quot; lungs, hypersensitive to all kinds of irritants that don&amp;#039;t bother others. The disease causes the airways to constrict temporarily and fill up with mucus, making it hard to breathe. Lots of things can trigger attacks: allergies, viruses, cigarette smoke, gas fumes, cold air, exercise, even laughing.  At least six million children in the United States have asthma. Worldwide, it affects about 300 million adults and children; 255,000 die from it each year, and deaths could increase by 20 percent over the next decade, reports the World Health Organization.  In this country, asthma rates in children climbed about 60 percent between 1980 and 2003, says the Centers for Disease Control and Prevention. In kids under 5, the rates rose even more, jumping 160 percent from 1980 to 1994. Our sons, born in 1984 and 1987, were part of this dismal trend; a surprising number of our friends and neighbors had children in the same boat. We didn&amp;#039;t remember there being so many kids with asthma when we were young. Everything from air pollutants to obesity has been blamed for the surge, but researchers have yet to arrive at definitive explanations.  My husband and I realized that we had two jobs: keeping our boys well and teaching them to take care of themselves when they were off with friends or at school and we weren&amp;#039;t around to remind them to use their inhalers.  We also felt we had to walk a fine line. We wanted our sons to be cautious but not afraid, to take asthma seriously and yet not become obsessive or hypochondriacal. We didn&amp;#039;t want them to be like the goofy neighbor kid who squirted his inhaler at classmates for laughs \u2014 or like the one whose parents kept him home at the first sign of a cough. We weren&amp;#039;t really sure how to find a happy medium, except to be calm but insistent about doing what was needed to keep the disease under control.  We were fortunate to find our way to pediatricians who were good teachers, and we learned a number of things from them that turned out to be important for the long haul.  My first lesson came when I mentioned that I knew parents who seemed to rush to the emergency room an awful lot because of their child&amp;#039;s asthma attacks. Our normally mild-mannered pediatrician became irate and insisted there should be no need for emergency treatment \u2014 not if the asthma was being managed properly. His indignation made an impression on me. So did the idea that if we kept our wits about us, it might be possible to avoid trips to the emergency room. I paid attention when he explained that even though our sons&amp;#039; asthma attacks occurred mainly at night, it would take several doses of medicine during the day, every day \u2014 even when they were feeling fine \u2014 to prevent the attacks. Initially, I found that hard to accept. Why couldn&amp;#039;t they just take medicine at bedtime to get them through the night? I soon found out it wasn&amp;#039;t enough. Like most parents, I hated the idea of giving my children drugs day after day, with no end in sight. Although there didn&amp;#039;t seem to be immediate side effects, I wondered if problems might develop later, perhaps ones that hadn&amp;#039;t even been discovered yet.  But we didn&amp;#039;t really have a choice. Without the drugs, our sons had asthma attacks nearly every night. We followed all the crazy-making advice about buying special dust-mite-proof covers for mattresses and pillows, banishing pets, and getting rid of carpets and stuffed toys to keep dust away. But the only thing that clearly made a difference was asthma medicine.  There are two main classes of drugs. One is used only to prevent attacks, and works by treating the underlying cause of asthma, which is thought to be inflammation in the airways. Several medicines ease inflammation, including steroids related to cortisone and other drugs that act on the immune system.  Rescue medicines, or bronchodilators, are used to treat attacks in progress, or to help keep attacks at bay during colds or other respiratory infections. They work by relaxing muscles in the airways that go into spasm and make it hard to breathe. Albuterol, also called Ventolin, is a commonly used bronchodilator.  Guided by our doctors, we used various preventive drugs as the backbone of treatment. Most of the time, we used albuterol only to treat attacks. And if our sons needed it more than occasionally, we took that as a sign that they also needed more of the inflammation-fighting drugs.  Viral infections, sinus problems, and allergies seemed to bring on attacks. We also found out, the hard way, that the flu can play havoc with asthma, and at a pediatrician&amp;#039;s urging, we all started getting flu shots every year when the boys were in elementary school. It was one of the best decisions we ever made.  When the kids were young, we spent a lot of time showing them how to use inhalers and making sure they did it right. I don&amp;#039;t have asthma, but I practiced with an inhaler anyway so that I could help them learn. It&amp;#039;s amazingly easy to do it wrong and have the medicine land at the back of your throat or on the roof of your mouth instead of in your lungs. When the boys were younger, they used a device called a spacer, which attaches to the inhaler, captures the mist in a chamber, and makes the inhaler a bit easier to use.  All this practice turned out to be time well spent, because it helped make taking the medicine into a routine and a habit. The boys used inhalers at school or in public places if they needed to. We felt strongly that they had to carry their inhalers around, rather than stowing them in a teacher&amp;#039;s desk or a nurse&amp;#039;s office. Fortunately, the schools agreed.  Like most kids, our sons were always ready to argue, bargain, and negotiate over just about anything \u2014 bedtime, TV, sleepovers, computer games. But taking the medicine wasn&amp;#039;t an issue: It never even came up. I think it was clear that there was nothing to debate, and they were smart enough to know that the drugs were helping them.  They never missed school because of asthma, and we tried hard to keep the disease from interfering with their lives. When the boys wanted to play sports, we were delighted. They swam, played soccer and basketball, and in high school, both were track and cross-country runners. I can think of only one decision dictated by asthma: When Eric&amp;#039;s elementary school was starting band classes, I asked the teacher not to assign him a wind instrument, because he&amp;#039;d been ill and I didn&amp;#039;t think he had enough breath for a horn or a saxophone. We got lucky: Eric found out he loved percussion, and he still plays drums in a band in college.  Gradually, the asthma diminished for both of our sons, but Brian still has occasional attacks and can&amp;#039;t afford to ignore respiratory infections, even ones that seem minor; he had a bout with pneumonia during his freshman year in college and needed an inhaler for the first time in years. That illness was a sobering reminder to all of us that although asthma loosened its grip over time, it never did let go entirely. "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.goodhousekeeping.com/health/a1642/live-with-asthma-0807/?src=shelter_footer>