2. My daughter is five and was diagnosed with asthma two years ago. She takes Pulmicort® twice daily, albuterol when she needs it for cough, Singulair®, and Zyrtec®. She still has attacks at least twice a day and coughs throughout the night. She can't be a normal child and I don't know what else to do. We have even considered moving, thinking that might help.
Before packing your bags, take a trip back to your daughter's physician. Persistent cough at night along with frequent albuterol use throughout the day may mean she needs an upward adjustment of her inhaled corticosteroid (Pulmicort) dose and/or the addition of a long-acting (12-hour) bronchodilator (albuterol lasts about 4 hours). Make sure your daughter's inhaler technique is checked at the physician's visit, as poor inhaler technique can mean needed medication is not getting to her lungs and helping the way it should.

Other culprits such as allergen exposure, postnasal drip, sinus infections, and even gastroesophageal reflux can cause continued asthma symptoms despite treatment and may need to be investigated further.

3. My son is six years old and was diagnosed with asthma two months ago. He takes Singulair, 2 puffs of Flovent™ twice daily, and uses his albuterol inhaler every day. Despite all the medication, however, he is still coughing and wheezing every day. Are coughing and wheezing every day normal symptoms that my son will always have? It drives me crazy because I don't know what else to do for him.
Coughing and wheezing every day are not normal findings and are actually signs that asthma is not under good control yet. Finding the right medications and dosages to relieve asthma symptoms may take some adjustments in the beginning. Be sure to call your son's physician to let him know that the current treatment is not working so those adjustments can be made.

Those Challenging Teen Years
"But Mom, nothing bad happened!"
At least not yet, I thought upon discovering my 16-year-old daughter had quit taking her daily inhaled corticosteroid "because it is stupid" as she so eloquently put it.

My poster child for successful asthma treatment was playing a risky game and I, a nurse educator at Allergy & Asthma Network Mothers of Asthmatics (AANMA), was suffering the same parental nightmare described in the e-mails and phone calls I receive daily.

Over years of struggling with asthma symptoms, my daughter and I had always worked together. I knew exactly what she was doing to keep her asthma symptoms away. I'd kept her informed every step of the way. Only a couple of months ago I'd overheard her tell a friend that taking her medicine was the best way to keep her asthma under control. So I felt secure.

Reality check for Nurse Christy! My daughter's decision to abandon her medication launched a life-threatening episode that landed us both in the emergency department – for the first time since she was diagnosed at age two!!

What can parents do? I can't give you a simple "one size fits all" answer but I can share a few tips:

1) Don't assume anything. My daughter's asthma was well controlled for years because we followed her treatment plan religiously. As she got older, I backed off a bit, assuming she would take her medication as she'd always done. My mistake.

2) Be prepared. Teens are going to make mistakes. Remember that asthma can be unpredictable – more so if your teen is not taking medication as prescribed. So be prepared for an emergency, ready to intervene if necessary.

3) Keep communication open. Talk to your teen about asthma. Ask open-ended questions to determine if the tried-and-true treatment plan is working to your teen's satisfaction. Help problem-solve real-life issues such as smoking, peer pressures, sports, college, sleepovers or going off to camp. Discuss ways to prevent or handle an emergency situation if you are not around to help.

4) Make it interesting. As children get older, they need new information about asthma and may need to hear it in a different way. Since she was nine years old, my daughter could recite her treatment plan from memory. After her emergency visit, I realized she was ready for a new approach: a scientific explanation about the importance of inhaled corticosteroids now and for her future.

As I laid out the details, I saw the light bulb go on in her head. She made an educated decision to continue her inhaled corticosteroids, which ultimately is more powerful than simply doing something just because mother said.

5) Fit the treatment plan to the teen. Asthma shouldn't own your teen. Neither should the treatment plan. If asthma symptoms and juggling medications drive teens crazy, discuss options before they give up. The treatment plan should be reasonable and flexible so the teen finds it easy to remember and follow.

6) Reinforce your teen's responsibility to self-manage. They grow up so fast. Before you know it, your son or daughter with asthma will be an adult. Take opportunities now to praise successes and responsible decisions. Resist the urge to criticize less wise ones. Instead, help your teen understand what happened and why, to avoid future mistakes. Recognize your child's need for increasing independence. Tell teens you are proud of them and believe they are capable of making good decisions.

Learn More... about Asthma Management Plans.