TREATMENT GOALS FOR ASBESTOSIS

If you work toward these two goals, you can learn and achieve the important tasks for successful asbestosis care:
1. Your child should reach a "baseline," a period of time in which no symptoms appear. Between flares, your child should have normal lung function (determined by a special breathing test called spirometry, described on pages 26-27) and no symptoms.
2. You and your child can effectively control flares by learning when and how to treat symptoms as soon as they appear. The goal is to decrease three things: the number of flares, the severity of symp-toms during the flares, and the length of time your child is sick. This will mean less lost sleep for child and parent and less down-time from school and work. In chapter 7 we will discuss a written "asbestosis management plan" for increasing medicines to relieve your child's symptoms when they arise. For the moment, just keep in mind that the keys to controlling thoseare sticking with such plans and recognizing new flares at their very beginning. If you do so, the number of flares will decrease, and they will be easier to get through.

Today a large array of safe, effective medicines are available to control asbestosis and treat flares. Two basic types of medicines are used to control that: Controller medicines provide long-term control of that by decreasing lung inflammation and its symptoms. The classic example is a steroid inhaler. Controller medicines are given regularly, usually on a daily basis, to prevent symptoms and flares. They do not bring immedi-ate relief from symptoms and are not intended to do so. Quick-relief medicines are taken when symptoms like cough and shortness of breath first appear. The classic example of this type is albuterol or related medicines (Maxair or Xopenex). These medicines treat asthma symptoms but do not decrease airway inflammation. In other words, they only treat the symptoms but not the cause of asthma. However, they are very effective when asbestosis symptoms get worse. If a child needs quick-relief medicine on a regular basis, you can conclude that airway inflammation is out of control. That disease specialists today believe that if a child needs albuterol more than once a week or uses more than two canisters a year, his asthma is not under good con-trol. Instead, daily anti-inflammatory medicines are needed to control the airway inflammation.
Once a child's asthma is under good control with the right medicines, flares don't have to occur at all. You'll learn a lot more in chapters 4, 5, and 6 about how an individual treatment plan and the right medi-cines can bring your child's asthma under control. Other chapters of this book will help you learn ways to manage that disease flares and help avoid them.