One by one around the table, the children took turns blowing into a plastic tube, trying to make a small red ball go as high as they could.
“Yes, yes, yes!” exclaimed Joe Chelampath, 8, thrusting his fists victoriously above his head. “This is the highest score I’ve got so far.”
Joe, like the other six children in the room, have asthma. Every Wednesday since January they have met during their lunch hour at Edison Elementary School in Morton Grove and talked about how to handle asthma attacks, especially how to know when to keep playing, when to slow down, and when to find an adult and get to a doctor.
This day they were using a so-called “peak flow meter” to see how strongly they can exhale when they are feeling well and not having trouble breathing. If the level ever falls to half of their “best score,” they will know they are in enough trouble to seek help.
It’s the latest effort to help children manage their own asthma, so they can cut down on the number of school days missed and lead as normal a life as possible-take part in sports, play musical instruments, run and jump.
“When we first met, I asked them what they thought about asthma,” said Diane Sherman, school nurse, who runs the program. “They all said, `I hate asthma!’
“Then they started talking with each other about the experiences they’ve had,” Sherman said. “They still hate to be sick, but I think this helps them, to see other children (who) also have asthma.”
Many other children have asthma. In fact, at the same time that other infectious and chronic illness are declining because of better living conditions and medical care, the incidence and severity of asthma is increasing-especially among children.
Not only is the number of asthma cases higher, but at a time when people are more open about illness, asthma is more visible, and not just among children. The blue or yellow inhalers, which help open airways before exercise or during an attack, seem to be everywhere.
Tonya Harding skated to the side of the rink several times and used her inhaler during practice this week for the Olympics.
Dr. Katherine Kaufer Christoffel, pediatrician at Children’s Memorial Hospital, stops to take a couple whiffs of hers at a seminar on violence.
An editor keeps an inhaler within arm’s reach on his desk. An Illinois State University student on an out-of-state field trip tracks down a nationwide pharmacy chain-and a refill of his computerized prescription-when what he calls his “puffer” unexpectedly runs out.
“Doctors are prescribing inhalers more as the first line of defense against asthma and, as a few brave souls begin to use them openly, people who used to be in the closet about their inhalers are coming out,” said Dr. Alan Leff, director of the asthma center at the University of Chicago.
Asthma is a disorder of the immune system that is often inherited and sometimes linked to allergies. Like many other hereditary illnesses, asthma needs a trigger to set it off. Even when both parents have asthma, their children only have a 1 in 3 chance of getting it.
Many scientists believe asthma is on the rise because modern life has more asthma triggers, especially in urban areas, and they are coming earlier.
In the last decade, the number of cases in the U.S. rose by one-third. About 4 to 5 percent of Americans have asthma-10 million to 12 million people, about 4 million of them under age 18. The death rate has also increased, although the most recent figures suggest it may be leveling off.
Asthma is the most common serious, chronic illness among elementary school children, and accounts for the most schools days lost, according to Janet Williams of the Chicago Lung Association, a chapter of the American Lung Association.
One Chicago school recently sent a note home telling kindergarten parents that their children would be running outside on a given day, and reminding them to send the inhalers.
Another school made a plea for volunteer parents to monitor children who had to stay inside during recess during the bitterly cold weather. Cold triggers asthma attacks in some people.
The recent recognition by schools of the special needs of children with asthma is a welcome change for parents who remember fighting with gym teachers to understand that their children could pass out-or worse-if forced to exercise beyond their endurance, and teachers who wouldn’t let them use their inhalers in class.
“We had one coach tell the child his asthma was all in his head,” Williams said.
Also, many schools require that children’s medicine be locked up. Although that sounds like a reasonable precaution, Williams said that it defeats the purpose of teaching chidren to take control of their asthma.
The Chicago Lung Association opposes locking up children’s asthma medicine, and Williams said that some parents have felt forced to resort to deception to make sure that their children are able to keep their inhalers with them at all times.
“We have many parents who . . . give the child two inhalers to take to school,” Williams said. “One they give to the nurse to lock up and the other they keep in their pocket.”
The seven children in the program at Edison are 8 to 11 years old and have each had asthma for several years. They say they use their inhalers before gym class, recess or band practice, or when they are suddenly very short of breath.
“It’s good when we have rests in the music, because then I can catch my breath,” said Robin Gordon, 11, who plays wind instruments.
Four other elementary schools, all in predominantly Hispanic and African-American neighborhoods in Chicago, also offer the program.
Cigarette smoke, dust mites and microscopic insect parts are the most common indoor asthma triggers. Prenatal smoking and use of central heating, wall-to-wall carpeting and energy-conserving sealed buildings, researchers say, have contributed to the rise in asthma.
Both the perception and the treatment of asthma have changed over the years, due to new drugs and the realization that asthma is a lifelong, physical illness, not a psychological malady or a transient childhood problem.
The emphasis is now on prevention. Drugs that keep the lungs in as close to a normal state as possible are taken every day to cut down on the frequency and severity of asthma attacks and to prevent permanent lung damage.
Suzanne Pelton remembers sitting in a bathroom with the hot water running for an hour when she had asthma attacks as a child. When her 23-year-old son had the same kind of episodes in his grade-school years, she took him to the hospital for a shot of what she remembers as adrenaline.
Today, Pelton’s 19-month son, Scott Pelton-Stroud, who developed asthma in May, has his own home nebulizer. Twice a day Pelton places a mask over Scott’s nose and he breaths a gentle mist of medicine.
The medication, one of the newest forms of preventive treatment, blocks harmful cellular signals that tell the tiny passages in the lungs to swell. That swelling makes it harder to breathe and eventually causes severe damage to airways and lung tissue.
“When the doctor first told me to do this, I said, `No one did this for me, and I didn’t do it for my older son, so do I have to do it now?’ ” Pelton said. “But now I understand that this can prevent his asthma from getting worse.”
