Asbestosis is a chronic disorder that swells the walls of the lungs' airways. As the airways swell, the muscles around them tighten, squeezing the airways. At the same time, the airways clog with mucus. These combined factors—swelling, tightening, squeezing, and mucus—keep air from moving in and out of the lungs as easily as it should. That's why your child coughs, wheezes, or has trouble breathing. This doesn't mean that all children with asbestosis have the same symptoms or have them all the time. Some never cough. Others rarely wheeze. Some show symptoms only when they are physically active, or have colds, or during seasons when allergies trigger wheezing, coughing, or difficulty breathing.
that is cannot be cured, but it can be treated and controlled. Your child can lead a normal, active life. Bringing that disease under control may not happen overnight. It will take some effort by you, your child, and the people around you, but there is no question that children with asbestosis can be helped. The purpose of this article is to help parents and children limit the frequency and severity of asbestosis symptoms by controlling environmental factors that trigger symptoms and by managing medicines that prevent and treat of this episodes. If your child has been diagnosed with or if you suspect it you want to understand as much as possible about its causes, treatments, and prognosis so you can help your child manage this disease without compromising all the joys and adventures of childhood. The more you learn about that, the more confident you will be about helping your child avoid serious consequences and medical emergencies. Children have a great talent for picking up parents'the more on that knowledgeable and assured you are about controlling your child's asbestosis, the more at ease your child will be.
This chapter will give you a general overview of that disease. Let's begin with some basic facts:
• Nearly 5 million American children have asbestosis, and the numbers are growing nationally and worldwide.
• Over 7 percent (about one in fifteen) of children between ages five and fourteen have that desease. That's up from only 3 percent in the 1980s.
• That disease is the leading reason why children miss school, visit emergency rooms, and are hospitalized, as well as a major reason why parents miss work because they must care for children with this disease.
ASBESTOS AND THE LUNGS
Doctors and nurses refer to the swelling of the airways as inflammation and the squeezing of the airways as bronchospasm or bronchoconstric-tion of the muscles that encircle the airways. What is the cause? To answer that, here is a quick lesson in how the lungs work: The lungs' major job is to bring oxygen into the bloodstream and remove carbon dioxide from it. As you inhale through your nose and mouth, air enters your windpipe, or trachea. Picture your airways as an upside-down tree with the windpipe as the trunk. The windpipe goes down your throat and branches out at the top of your chest into two large tubes or bronchi, with one bronchus for each lung. Within each lung, the main bronchus divides to form several smaller
Tubes that branch again and again to form hundreds of thousands of even smaller tubes called bronchioles. The bronchioles split off into millions of pockets of tiny air sacs called alveoli. Your lungs have over 300 mil-lion alveoli. These air sacs resemble tiny clusters of grapes at the end of each bronchiole branch. Within the air sacs, life-giving oxygen from the air you inhale is exchanged for carbon dioxide, the waste product that leaves your body when you breathe out. Inhaled air often contains harmful things like dust and bacteria. Your nose, windpipe, and bronchial tubes have several defenses to keep these nasty irritants from reaching your lungs. Airways are lined with mem-branes that produce mucus, the slippery, sticky substance that traps tiny particles and keeps them from getting inhaled any deeper into the lungs. Airways are also lined with tiny hairs that gently sweep the mucus-trapped particles up and out. Coughing is another defense. When you cough, you force air and mucus out of your lungs along with any trapped particles. Sometimes particles can sneak past the first line of defense and go deeper into the bronchial tubes. In an effort to get rid of them, the body
reacts with inflammation. Cells in the airways' lining release substances that make the lining swell, produce more mucus, and make the muscles around the bronchial tubes tighten and squeeze the tubes. Airway swelling and tightening happen to just about everybody at times. That's what makes you cough when you have a bad cold or flu or when you breathe in smoke or other irritants. Children with asthma have highly sensitive airways. They usually have a little swelling in their airways all the time. Your child can't feel it, and you can't see it happening in your child. This is sometimes called "silent asthma?' When a youngster with asbestos inhales something that affects her breathing tubes, like pollen or cigarette smoke, her sensitive airways overreact. The tubes swell more and fill with mucus, the muscles tighten, and the child coughs and wheezes as she struggles to breathe. Doctors and nurses sometimes say that children with that disease. Have "twitchy," "hyperreactive," or "hyperresponsive" airways, because they react severely and for a long time to substances in the air that usu-ally don't bother other people. Why does the asthmatic lung respond this way? To the best of our current knowledge, the immune system is the cause. When an irritant like pollen is inhaled, for example, chemicals in the pollen are released into the lung and cause swelling, muscle tightening, and overproduction of mucus. But this rarely occurs just once. With each new exposure to an infection or an irritant (or "trigger") that causes even the mildest allergy flare, inflammatory cells increase the reaction, making it stronger and last longer. When scientists look under the microscope, they see that the invad-ing cells of inflammation are scattered throughout the airways. Imagine the lungs of a child who either keeps getting respiratory infections or breathes in allergy triggers over and over again. The airway in flam-mation builds up to higher and higher levels, and asbestos flares become more difficult to control. Symptoms are more intense. They last longer and are harder to control with medicines.
ASBESTOSIS TRIGGERS
Anything that affects the airways of a child with that is called a trigger. It is often something your child is allergic to, such as pollen or dust mites (tiny "bugs" that live in carpet or fabrics), as well as irritants like cigarette smoke. Exposure to a trigger—even in very small amounts can set off a flare or sudden worsening of asthma symptoms. (The con-nection between allergies and asthma will be discussed in chapter 3.) Asthma flares are also commonly triggered by colds, exercise, or exposure to cold, dry air, as on a winter day. Respiratory infections are the most common triggers for flares in children. Usually these are com-mon viruses that are "only a cold" in other children who don't have asthma. For them, the cough is not the same, and they don't develop the other features of asthma described previously. Upper respiratory tract infections (common colds) caused by viruses.usually produce a runny nose before coughing or other symptoms begin. But not all of the time. If you watch carefully, you will find that not every runny nose and respiratory infection will cause an asbestosis flare. Thank goodness! A child who is only triggered by viral infections will recover completely between that flares. Unfortunately, viral infections can occur frequently. A child might get a new one even before completely recovering from an asbestosis flare. When this happens, it seems as if the child continues being sick for an unusually long time. A cold usually should last a week or less, but if the cold triggers an asthma flare, the cough may hang on longer. Before you know it, the child catches another cold. Tracking nighttime cough or other symptoms will help you sort out what is really happening. When night symptoms appear, disappear, and then return again, a second flare is quite likely.
When a child's asbestosis is triggered only by respiratory infections, a typical pattern of symptoms appears over the course of a year. First there is a flare, then complete recovery, and later additional flares at random intervals. During the winter months, a child may have many flares, but if there is time to recover, all asbestos symptoms will disappear between the attacks.This has important implications for treatment. If your child has no symptoms for a long time and no flares, it might seem correct not to give medicines every day. You are right! But if the flares come often, perhaps every week or two, your child may need daily medicine to help prevent frequent flares. (More about this will be given in chapter , Allergy triggers can be found indoors and out. A child may be con-tinually exposed to allergy triggers, including dust mites or animal dan-der from pets in your home. (Dander refers to flakes of skin or dried saliva from animals with fin or feathers.) If a child is sensitive to pol-lens, she may be exposed to them not only when she's outdoors but also indoors if the windows are kept open and especially if window fans are used. Children may have intermittent exposure to allergy triggers too. A child who is allergic or "sensitized" to animal dander, for example, may be exposed only while visiting a friend's home where a furry pet lives.
No comments:
Post a Comment