Helping Asthma Patients Breathe Easier

It is said that no two asthma patients are quite the same. And that's no less true for the increasing numbers of kids developing this common allergic lung condition. What may be causing this narrowing and inflammation of the airways? And what can be done to relieve the wheezing, coughing and struggle to breathe freely? Kelsey McQuaid is an aspiring athlete, and a rival of her brother, Bobby, when it comes to sibling soccer fracases – often enacted in the house. The mostly friendly fights, however, might not have been possible in previous years, due to Kelsey's asthma being too severe. "I would have teachers call from school and say to me, 'Is she okay?' because she would just be black under the eyes. Her skin would be gray. The worst times are during the night, so there were nights where she was maybe getting two hours of sleep. She'd be up just hacking away," said her mother Kathleen. Kelsey agreed. "I'd just hack and hack and hack,” she said. “I'd want to go school, but I'd be so sick, it would be so hard to breathe, and we'd have to go to the emergency room. It'd be like horrible." The McQuaids had been through a slew of doctors until they found Dr. Cynthia Kelly, a pediatric asthma expert at Children's Hospital of the King's Daughters in Norfolk, Virginia. Dr. Kelly said, "We have no shortage of patients to see, unfortunately. And the children that we are seeing tend to have more severe symptoms." She's concerned because we don't know the reason for the increase. If we knew, we might have solutions more quickly. One hypothesis is the hygiene theory -- that vaccinations and antibiotics have taken the load off the immune system and caused it to produce more allergies and asthma. “It’s as if the immune system needed something to do while it wasn't fighting off infections,” Dr. Kelly explained. “There are people who think it may be related in certain areas, to ozone levels, pollution levels. Certainly there is a big genetic component and it will probably turn out to be a combination of genetics and environment." Neil Levin is a clinical nutritionist working at Now Natural Foods in the Chicago area. He says diet can help against all these possibilities. For instance, antibiotics kill off the good bacteria in the gut. “If an asthmatic child takes an antibiotic,” Levin says, "They should definitely be given the probiotic bacteria to replace what’s killed off that belongs in that system, and helps you to survive and thrive." And there's a case for prenatal vitamins fighting asthma. Levin said, "Deficiencies of vitamin E and zinc in the mothers is associated with increased asthma in the children and the babies." For Kelsey, genetics may play a role since her mom has a brother with serious asthma. But why Kelsey's case is so serious is hard to say. It is serious enough for her to have been on regular doses of a heavy oral medication called Prednisone. Although the medicine enabled her to breathe, it weakened her bones and ligaments. "First, I broke my left wrist and followed that at the same time by my right wrist and pinkie and hand,” said Kelsey. So I was double-casted in both arms." So how did Kelsey get off the Prednisone and get to breathing well without regular asthma attacks? A year ago, Dr. Kelly suggested experimental monthly injections of a drug called Zolair. "That is given subcutaneously, and attaches to the allergy molecule in your blood,” Dr. Kelly explained. “It has been a life-changing event for her. She now hardly misses school; she is very active in soccer and plays year around." Dr. Kelly emphasizes that Zolair targets Kelsey's specific physiology, and will likely work for other patients similar to her, yet may not work for others. Of course, Kelsey does take her daily medications, and keeps her room free of dust and mold that irritate the lungs. Kelsey said, "I have my air purifier. And my bed, it doesn't have any stuffed animals on it because they…can make me have a huge attack. Then I'll be at the hospital." Dr. Kelly says asthma is unique because kids play an active role in gauging asthma symptoms: She said, "We really work with families, as well as even young children, to recognize when they're having asthma symptoms. It may just be a cough; it may be some chest tightness. They need to recognize when their asthma is flaring." Another way to gauge asthma is the peak flow meter. When breathing is normal, you blow into the mouthpiece, get a reading, and compare that later to the level when breathing is labored. Levin says that in addition to gauging asthma accurately, nutrition should be considered. "Any time someone's on a medication,” he said, “you have to really work with a physician to be able to reduce that medication. And since nutrients are gentler, they take more time." For instance, the herb boswellia could take six weeks to show if it's going to help. "Of all the herbs in the world, that's the one with the best clinical evidence that it can actually reduce the incidence and severity of asthma attacks," said Levin. A child's dose would be about 500 milligrams: two tablets a day of this particular product. An adult dose would be about double. Levin has other suggestions, including magnesium. "Both injectable and supplemental magnesium is very effective at reducing the bronchial spasms,” Levin said, “which opens up the pathways for oxygen to get into the lungs." And there's beta carotene as well. 50,000 international units a day can help reduce childhood asthma symptoms (100,000 international units for an adult) and it repair cell damage from asthma itself. But whatever it takes, Dr. Kelly is hopeful about what the future holds for kids like Kelsey. And within those targeted therapies, there may well be targeted nutrition. "If you can help the repair of the lungs,” Levin said, “the ability of the body to digest food properly, to absorb nutrients, these are basic competencies of the human body…If you can give them back to a child, it's a great gift." With more understanding of nutritional benefits for the lungs and development of new medicines, the outlook for kids with asthma is improving. And with the addition of prevention strategies, the prognosis will be even better.