Susie remembers when she was 6 and at her friend Jessica's house. They were playing with Jessica's new puppy, Jack. All of a sudden Susie felt like she couldn't breathe. "My chest felt funny, and I made a whistling sound every time I breathed out. It really scared me at first, and it scared Jessica too. Jessica ran and got her mother. After awhile I was ok. Now I understand that I have Asthma."

What is asthma?

Asthma is a condition that affects your respiratory system, which includes your nose, mouth, windpipe (also bronchial tubes or trachea), your lungs and a bunch of air tubes that connect your nose and mouth with your lungs. For most kids, breathing is easy: you breathe in through your nose or mouth and the air goes into your windpipe, then it goes through your airways and into your lungs, then back out the same way. But for kids with asthma, breathing can be a lot more difficult, because their airways are very sensitive, and sometimes swell up and get clogged with mucus so it is hard for the air to get in and out of the lungs.

When Susie has an asthma attack she wheezes (a whistling sound when she breathes), coughs, and feels a tightness in her chest. Susie's asthma attacks can last up to two hours or more if she doesn't use her asthma medicine. It feels like she is breathing through a straw. After an attack, Susie's airways return to the way they were before, although it can take a few days.

Everybody doesn't feel the same things when they have an asthma attack. If you have an Asthma attack, you may:

• cough and cough and cough
• feel like you can't catch your breath
• feel like air is trapped in your lungs and it can't get it out
• have pain in your chest
• have very noisy breathing, called wheezing

What causes an asthma Attack?

Susie has asthma attacks when she is near Dogs or Cats, and when she is outside with lots of tree pollen. But, different kids are sensitive to different allergens, substances that cause allergic reactions in the airways. A lot of kids have asthma attacks when they are near furry animals that have dander. Some substances like smoke and smog can be triggers because they are very irritating to the airways and can act just like allergens.

Common triggers for kids with asthma are:

• dust mites (mites are tiny bugs that live in dust)
• mold (if you've ever been in a damp basement and smelled something funny, it was probably mold)
• pollen (from trees, grass, flowers and weeds)
• Cats and dogs both have what's called animal dander in their fur. This is sort of like dandruff, and it's a trigger that can cause a powerful reaction in the airways
• perfume
• chalk dust
• cigarette smoke (Smoking is always a bad idea, and especially around someone who has asthma)
• pollution or smog

Sometimes an infection can be a trigger and set off an asthma attack- if someone has a cold or the flu, their airways can become more sensitive than usual. In some kids, even really cold air can cause an asthma attack. Other kids have what's called exercise-induced asthma, which means that their airways are sensitive to exercise only - they could pet a dog and smell cut grass without a problem, but if they run around a playground or play tag, they may have an asthma attack.

What happens when I have an asthma attack?

When most of us breathe, the muscles that are wrapped around the air tubes are very loose and relaxed, and the lining inside the airways is very thin. This lets the airways open up very wide so that it is easy to get air in and out of the small air sacs that make up your lungs. When air moves in and out of your lungs, we call it breathing.

During an asthma attack, the muscles around the airways tighten, and the lining inside the airways swells up and becomes thicker, and gets clogged with lots of thick mucous. This makes the airways much skinnier than usual so it is harder to move air in and out of the air tubes.

During an asthma attack, it is actually harder to breathe out than it is to breathe in. This means that during an asthma attack, it takes much longer to breathe out (expire) than it does to breathe in (inspire). Since it is so hard to breathe out during an asthma attack, more and more air gets trapped inside the lungs making it feel like you can't breathe in or out!

How is asthma treated?

Kids with asthma need to try to stay away from things that cause their airways to tighten. But some things like cats, colds, and chalk dust, can't always be avoided, so these kids must manage their asthma by taking medication. There are different medicines for treating Asthma, and every case of asthma is different. Your doctor will talk to you about what causes the asthma attacks, how fast they happen and how serious the they are. Then your doctor will decide on the best kind of treatment.

Some kids only need to take asthma medicine when they have an attack which makes the muscles around the airways relax, these medicines are called bronchodilators. Other kids will need to take preventive asthma medication every day to keep the asthma attacks from happening (cromolyn sodium). A person who knows in advance that she'll be exposed to allergens or other triggers may need to take a different kind of medication that will keep their airways relaxed. A person who has exercise-induced asthma can take medication before exercise and play just like all the other kids. Other medicines reduce the swelling and irritation in the airways. These medicines are called anti-inflammatory agents (corticosteroids or steroids).

Some medicines are swallowed (pills or liquids), some medicines are inhaled (breathed in through your mouth or nose), and some medicines are injected (given as a shot in one of your muscles or veins). For most people, inhaled medicines are used first because they start working very fast (usually in less than five minutes!) and they don't have many side effects. This is because inhaled medicines go directly into the lungs and not into other parts of the body.

A common inhaled medication is called a bronchodilators, which relaxes your airways, or bronchial tubes. You may have seen a someone you know using an inhaler: it's a plastic container that is a little shorter and skinnier than a cardboard toilet-paper tube, and it holds a container filled with medicine. You hold the inhaler up to your mouth, breathe in, and a mist of medicine is released so that you breath it through your windpipe, and into your bronchial tubes. The medicine in the mist relaxes the airways, so you can breathe easier. Whatever type of medications a kid takes, the goal is always the same: to bring the asthma attacks under total control.

A lot of kids notice that their asthma goes away or becomes less serious as they get older. Some doctors think this happens because their airways grow wider as they grow up and get bigger. With more room in the airways, the air has an easier time getting in and out.

Who gets asthma? And why?

Ask your parents if they had asthma when they were young. Most asthma is hereditary, which means you have a better chance of getting asthma if your mom or dad or other relatives have it. But, even if your parents don't have asthma, you can still get it, just because of the way you are made.

Asthma is very common in kids, in fact there are as many as five million kids in the US who have it. Asthma affects one or two kids out of ten - that means if you have 30 kids in your class, four or five of them might have asthma. Asthma can start at any age, even in a babies or adults - but it's most common in elementary school-age kids. Do you know anyone in your class with Asthma?

Even though an asthma flare sometimes sounds like a cold, with coughing and wheezing, asthma isn't contagious. You can't catch it from someone like you can catch the flu or a cold. And kids with asthma are just like other kids. They like to run and play, but just have to be careful if they feel like they are having an asthma attack.

Asthma Facts

• Asthma is very common in the United States and Europe, while Children in Asia, Africa and South America are less likely to have asthma.
• More than five million children in the United States suffer from asthma.
• Asthma the most common chronic medical problem in children in the USA.
• African-Americans, Hispanics, and people living in cities are at the greatest risk for asthma.
• Asthma is the leading cause of being absent from school. Infact, children with asthma miss twice as many school days as other children.
• The number of cases of asthma in children under age five has been increasing, and the number of children who are hospitalized each year from asthma has increased five times in the last 20 years.

Are kids with asthma different?

Kids with asthma are just like all other kids. When a person with asthma takes their medication properly, they can do everything that other kids can do - from playing the horn to running around the park!

If you know have a friend who has asthma, or you see a someone using an inhaler, remember that it doesn't make them weird or different from you. It just means that their breathing tubes are very sensitive. They probably has a lot in common with you and like to do the same stuff you do!

How can I help someone having an asthma attack?

• get their inhaler for them
• go find an adult
• call 911 if it is a really bad attack and their breathing doesn't get better
• don't hit them on the back!

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