Updated Advice For Asthma Sufferers

New NIH Standards Stress Preventive Therapy To Control Day-To-Day Symptoms

(CBS/AP)  Breathing easier without limiting activities is the goal of new government guidelines that urge more attention to asthma sufferers' day-to-day symptoms, not just their severe attacks.

Some 22 million Americans have asthma, and guidelines updated Wednesday by the National Institutes of Health stress the importance of adjusting therapy until their asthma is under good control.

"Asthma control is achievable for nearly every patient," said Dr. Elizabeth Nabel, director of NIH's National Heart, Lung and Blood Institute. "Patients really should accept nothing less."

The guidelines reflect a shift already under way, as specialists seek to teach patients that a flare-up isn't the only sign of trouble. Someone who only avoids an attack by giving up exercise, or who thinks it's normal to wake up at night coughing or wheeze while running, doesn't have asthma well-controlled.

The recommendations come at a key time: Asthma hospitalizations peak in September and October, said Dr. Homer Boushey of the University of California, San Francisco, a guideline co-author. Patients aren't as good at taking asthma-prevention medication during the summer and can be caught by surprise when schoolchildren start bringing home fall viruses.

The first time 11-year-old Deion Jones wheezed, it took his mother's breath away.

"He couldn't catch his breath," his mother Deirdre Miller told CBS News medical correspondent Dr. John LaPook. "I thought he was going to die."

When the doctor said that her son needed steroids, she was worried about potential side effects. New guidelines will tell patients and asthmatics not to be afraid of using inhaled steroids regularly, reports LaPook. They are the most effective longterm treatment and generally safe, even for children.

Asthma is a chronic lung disease caused by inflammation inside airways that in turn makes them super-sensitive, narrowing in response to irritants that wouldn't bother a healthy lung. Symptoms include wheezing, coughing, chest tightness and difficulty breathing.

There is no cure, but daily medications are very effective at reducing inflammation and preventing flareups. Yet asthma kills about 4,000 people a year and causes almost half a million hospitalizations.

The guidelines are aimed at doctors, but include some patient-friendly advice:

Give your doctor details about day-to-day symptoms and whether you've adjusted activities to avoid wheezing, to help him or her monitor both current impairment and future risk of a severe attack.

Every patient needs a written "action plan" with instructions for daily treatment and what to do is asthma worsens. Share that action plan with teachers and coaches.

Inhaled corticosteroids are the foundation of preventive treatment for all ages. Patients also need inhaled rescue medication. To ensure patients know how to use each, practice with "dummy" inhalers in the doctor's office.

Children ages 5 to 11 usually do very well on low doses of a single drug, the inhaled corticosteroid, instead of the combination treatments required by many adults. There are a variety of additional medications for more severe asthma, all with side effects to consider in picking the right cocktail.

CBS News correspondent Dr. Sean Kenniff spoke with pulmonary specialist Dr. Martin Baskin at St. Luke's-Roosevelt Hospital in New York who not only treats asthma patients... he has the condition himself.

Baskin says the most important lesson of the new NIH guidelines is patient education, "Patients need to be proactive in terms of managing their asthma."

Because Asthma is an ever-changing condition, it's important for patients to bring any changes in symptoms to their doctor's attention. It's also vital for asthma sufferers to always take their medication and avoid attack triggers like cigarette smoke, allergens and animals.

Dr. Baskin knows the importance of this advice from firsthand experience, "I used to have cats; I don't have cats anymore. If you follow the recommendations, you can lead a completely normal life."

---

For more information:

The National Heart, Lung and Blood Institute

American Lung Association

© MMVII, CBS Interactive Inc. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. The Associated Press contributed to this report.

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by patty706010 August 30, 2007 2:41 PM EDT

I find Dr. LaPook''s article/statement on steroids being safe for use by children to be totally irresponsible, criminal and deadly. I shutter to think that he has the gall to say what he''s saying about a product that is so harmful and deadly to some that it should be placed on a "watch patient carefully" list. As we know, no such list exists but certaily should. Steroids helps some, BUT NOT ALL. You are very reckless in your comments.

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[patty706010]

I find Dr. LaPook''s article/statement on steroids being safe for use by children to be totally irresponsible, criminal and deadly. I shutter to think that he has the gall to say what he''s saying about a product that is so harmful and deadly to some that it should be placed on a "watch patient carefully" list. As we know, no such list exists but certaily should. Steroids helps some, BUT NOT ALL. You are very reckless in your comments.