Michael Marcus MD Ped Pulm DrMDK.com
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Male: It seems that a lot of people put a lot of time in saying “How to take care of asthma.” And some divide it, kids under five and over five and they talk about mild, moderate, and severe asthma. What does that mean? How do you judge these different types of conditions and how do you wish to treat that? Dr. Marcus: There has been over the years a number of different ways of judging the severity of asthma and it is very interesting that you asked that question because just this week the national asthma education program combined with the Global Initiative for Asthma, GINA have actually redefined the terms of asthma severity one more time. We originally for the last ten years have been using the terms mild-intermittent, mild-persistent, moderate persistent, and severe-persistent to define the degree of severity of asthma. And what we learned in using those terms is that they do not fit well every different instance. And so, we are not looking at asthma not in terms of that global severity index but rather with a more practical application of whether the asthma is being controlled or not. The new asthma evaluation were levels of severity are three. We can either have asthma that is controlled, partly controlled, or uncontrolled. The way we judge asthma to be considered controlled is that they must have their episodes of cough or difficulty breathing less than twice a week. They can use their pump twice a week or less. They must have no, night-time awakenings. They must have no symptoms with exercise or activity and their lung functions by lung function testing should be in the normal range. If your child does not fit under these categories then the child would be considered either partly controlled or uncontrolled and should be on daily therapy to decrease the chronic inflammation in the lungs and allow for lung function and the child’s general function which are back to a normal level.