Asthma in Adolescents: Dealin... Video Transcript

Participants

, Ellen Crain MD, PhD, Philip Marcus MD, Nancy Ostrom MD, Nancy Sander

Summary

Being a teen can be difficult. Being a teen with asthma poses extra challenges. There may be changes in the characteristics of their symptoms due to puberty, and distractions may make them less aware. Listen as experts discuss how to help adolescents face asthma.

Webcast Transcript

ANNOUNCER: One problem in treating asthma among adolescents is that the course of the disease can change, sometimes unpredictably.

NANCY OSTROM, MD: Some adolescents will have less asthma symptoms. As a matter of fact, young males in their late adolescence and early adulthood can often have their symptoms become more quiescent or notice less symptoms. In female adolescents, again, going through puberty, they can have hormonal influences where at different times of the month they may have more asthma symptoms.

ANNOUNCER: Even if asthma symptoms remain unchanged, adolescents may refuse to pay attention.

NANCY SANDER: Teens with asthma are invincible. And they oftentimes think they can just discontinue their medications because they do believe they're invincible.

ANNOUNCER: Sometimes the problem is not "attitude." Instead, adolescents may just be too busy, or distracted.

NANCY OSTROM, MD: There's a challenge in adolescence of having the patients recognize their symptoms. They're often less aware of physical symptoms than they are of what they might be doing on the weekend or that they need to get their homework in on time. So we do have to be more aware of the more subtle cues that they're having cough at night, that they're having exercise limitations, that they are having colds or coughs that are lasting longer than normal.

ANNOUNCER: If teens don't pay attention to their asthma, they may put themselves at higher risk of serious attack.

ELLEN CRAIN, MD: The typical situation is that they get sicker than a younger child might get before they arrive at medical attention, because they don't do what their parents said, sometimes. They won't go to the doctor for checkups. They're going to a doctor who takes care of a lot of young children and may not be as comfortable seeing adolescents. And so all of these factors kind of work together to lead to under treatment, in general, of adolescents. So they're more at risk of serious problems.

ANNOUNCER: According to federal guidelines, the cornerstone of proper treatment for adolescents with persistent asthma is an inhaled corticosteroid, to reduce inflammation.

There are four inhaled steroids approved for use in adolescents: Aerobid, Azmacort, Flovent and Pulmicort Turbuhaler

Even when there's no debate about whether an adolescent has asthma and should be on medication, good communication about treatment can be difficult.

NANCY SANDER: They love to tell mom and dad that they did take their medications, when, in fact, they didn't. And mom and dad have to figure a way to give them just enough rope for them to learn their own lessons without them, you know, having a disastrous result at the end.

NANCY OSTROM, MD: Adolescents often don't tell me what's really going on, don't tell me their symptoms or haven't even recognized themselves that, when they tried to throw a Frisbee with their friend, they couldn't run very fast or very far. Or that they're kind of sleepy because they've been coughing through the night with asthma cough.

ANNOUNCER: Sometimes adolescents can't ignore their asthma, for it can have a real impact on their quality of life.

ELLEN CRAIN, MD: Sometimes they're really limited in their activities in lots of ways. Those who wish to participate in sports often can't participate up to their full capabilities because of their asthma. Others just get used to the limitations that asthma puts on them and don't even try anymore to run around, play with their friends, you know, do all kinds of activities. And some are really very incapacitated and stay home most of the time.