Contrary to what my recent silence in the comments section may have you believe, I do actually read everything you guys post.
Here’s proof.
Last week, a new commenter left this message on a post about the American Lung Association’s 2008 State of the Air report:
Hi ~ I strongly suspect that our son has asthma. We live in Riverside, CA (yep, top of the lists up there) and yet I notice in this entry that you mention allergist-triggered versus intrinsic asthma. How can they tell the difference? Testing?
My main question is whether living in Riverside is contributing to our son developing asthma – he is only 3.
Let’s tackle these one at a time.
Allergic vs. Intrinsic Asthma
To be accurate, I guess that heading should read “extrinsic vs. intrinsic,” but whatever.
I like using “allergic asthma” better, and I think most other people do, too.
Allergy testing can definitely help you figure out the type of asthma your child has. If he does have asthma and also tests positive for multiple allergies, then you have a good idea of what may trigger his flares. My daughter, for example, tested positive only for dust mites, and that’s one of the most common asthma triggers. Since she didn’t prove allergic to any of the major tree or grass pollens, molds, or food categories, though, we started looking for intrinsic triggers.
Part two in telling the difference, then, is observation. When my kid was young and flaring pretty much everyday, we started keeping track of the things that made her lungs freak out, and they were all non-allergic triggers like these:
1. Respiratory illnesses
2. Heavy laughing or crying
3. Drinking cold beverages quickly (No, I’m not kidding.)
4. Very high humidity during hard exercise, like running
You get the idea. Intrinsic asthma involves any triggers that aren’t allergies–emotions, stress, airborne irritants like smoke or pollution, illness, and exercise are all examples. To make the whole issue even more complicated, plenty of asthma patients have a mixture of allergic and intrinsic triggers. My daughter is one of these because of her dust mite allergy, but she is mostly an intrinsic asthmatic.
Location and Asthma
This question’s a little thornier. No one understands asthma thoroughly yet, and right now dialogue is moving away from single-disease model and towards a more diverse concept of asthma as a collection of syndromes with a vast array of risk factors, symptoms, triggers, and possible treatments. Environment, genetics, immune system problems, and premature birth are all part of this landscape.
However, check out what National Jewish has to say about environmental pollution:
There are many non-allergic or non-immunologic exposures in the environment that can increase the chance of developing asthma. Exposure to irritants on a long-term basis, such as secondhand smoke in the home, is a major risk factor for developing asthma. Other exposures like this are indoor chemicals and air pollution.
The way I understand it, people who are susceptible to having asthma are probably going to develop it no matter where they live, since doctors have no way to turn off the tendency towards bronchial over-sensitivity yet. It appears that some things (like environment) can heighten or hasten development, but doctors don’t recommend moving to avoid asthma. As the Asthma and Allergy Foundation (AAFA) puts it,
If you are planning a move, you will take your allergies and asthma with you.
Either way, if you suspect your child has asthma, I’d ask the pediatrician about asthma testing and a referral to a specialist like a pediatric pulmonologist or an allergist. Then you can work with the specialist to pin down triggers to avoid and to create an asthma maintenance plan that will keep your child’s flares to a minimum, no matter where you live.
A great post! Drinking cold beverages too quickly gets me going too. Definitely a weird one!
Excellent info in this post.
Have you ever read anything about early lead exposure being connected to later development of asthma? My son, like your daughter, is allergic to dustmites, but that’s it. All his other triggers are intrinsic (mostly when he has a virus but also laughing or crying). He was breast fed for two years, was never around smoke, never had RSV, we have absolutely no family history of asthma or related respiratory issues, etc. It really seemed to have come out of nowhere.
BUT, he did have elevated lead levels when he was around 12-15 mos. from our 135 year old house (luckily we’ve moved since then). He has moderate persistent asthma now but is well maintained on a daily controller. I often wonder where it might have come from…
No, I’ve never heard of a lead/asthma connection, Jen–doesn’t mean one doesn’t exist, of course, just that I’ve never hard of one. I’ll check around, though, and let you know if I find any information. Thanks for stopping by!