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Douglas Burr is a Licensed Acupuncturist,
with a Masters of Science in Traditional Oriental Medicine.
He was a Respiratory Therapist for 20 years before studying
Oriental Medicine. He practices in San Diego, CA at
the West Coast Center for Integrative Medicine.
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As a Respiratory Therapist for some 20
years, most of which have been in pediatrics, I have witnessed
first hand how frightening an asthma attack can be for both
parent and child.
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Luckily the medications available are many times able to reverse
an attack. Still some patients experience frequent trips to the
ER, which is frustrating and disheartening.
Acupuncture can minimize and sometimes eliminate asthma attacks
and those "middle of the night" trips to the ER. Painless
and needle free treatment is common for children. What you can
expect when talking to an acupuncturist about treatment for your
child will be discussed but first let us cover important information
concerning allopathic treatment.
The most important aspect of Western treatment is to understand
terms and have clear, up-to-date knowledge of the drugs commonly
used.
· Asthma- a reversible, obstructive lung disease,
resulting from bronchial (airway) spasms and inflammation of the
airway lining.
· Status asthmaticus- the state of an asthmatic
patient not responding to repeated doses of bronchodilators and
in progressive respiratory failure. Requires aggressive treatment
in an emergency room setting.
· Triggers- sensitivity to an irritant or an event
that can set off or "trigger" an asthma attack.
Dealing with Asthma Triggers
It is important to be able to identify and attempt to avoid your
child's asthma triggers. These could be one or more of the following:
· Allergens- pollen, grass, dust, pet dander, foods,
etc.
· Environmental irritants- chemicals, household
cleaners, fresh paint, new carpets, new cars, exhaust, second-hand
smoke (even residual smoke in clothes and car interiors).
· Exercise and emotional triggers
These triggers may induce different levels of severity of asthma;
mild intermittent, mild persistent, moderate persistent and severe.
Some triggers may induce a mild asthma attack while another may
cause a severe or status attack. Here are some tips:
- First line treatment is the avoidance of allergens and irritants
in the home.
- Using bed and pillow covers can significantly reduce dust
mites.
- Eliminate chemical cleaners; natural citrus-based cleaners
are widely available.
- Regular cleaning of carpets or removal of carpets is recommended
if possible.
- Using air purifiers can also be beneficial.
- Check for mold in any area where water damage is suspected.
Foods may play a roll in inducing an asthma attack or preventing
an attack by boosting the immune system. So monitoring your child's
diet is very important.
Try eliminating certain foods one at a time for a few weeks,
and then slowly add that food back into the diet and watch for
any reactions. Dairy products, wheat or wheat gluten, nuts and
highly processed foods are potential offenders. It's always a
good idea to restrict or eliminate over used food additives such
as high fructose corn syrup and artificial sweeteners.
Teach your child good hand washing habits! Reducing the chance
of colds, flu and any bacteria related illnesses would decrease
asthma attacks and maintain a healthy immune system.
Medications for Asthma Attacks
In case of an asthma attack, both parent and child must be absolutely
clear on which medications treat acute attacks and which are used
for maintenance. Today most asthma sufferers have 2 or 3 medications
to take at different times, which may be confusing especially
during a crisis.
Some of the most common medications in use are:
1. Albuterol Sulfate- brand names: Proventil, Ventolin
Bronchodilator- for acute or sudden episodes of asthma (inhaler
only)
- Daily maintenance and taken before exercise
- comes in inhaler, syrup and tablets
Effectiveness of inhaler is dependant upon proper usage, instructions
should be given when prescription is written and periodically
thereafter. Rinse mouth after use to reduce mouth and throat dryness.
Repeated use may cause paradoxical or rebound bronchospasm, if
breathing problems persist or worsen your contact health care
provider immediately!
2. Ipratropium Bromide- brand name: Atrovent
bronchodilator- has delayed onset, not for acute asthma!
- comes in inhaler only
Commonly used with albuterol, a 5-minute interval is recommended
between uses. Contraindicated for patients with a hypersensitivity
to soybeans or peanuts. Safety and efficacy in children under
12 have not been established. The herbs jaborandi tree and pill-bearing
spurge may decrease the therapeutic effect. Effectiveness of inhaler
is dependant upon proper use.
3. Budesonide- brand name: Pulmocort, and fluticasone propionate-
brand name: Flovent
- corticosteroids, anti-inflammatory- not for acute asthma!, maintenance
treatment only
A reduction of growth in children and teenagers may occur as
a result of the use of corticosteroids. Instructions must be given
for proper use. Rinse mouth after use. Avoid exposure to chicken
pox or measles and report immediately any exposure to your health
care provider.
4. Salmeterol Xinafoate- brand name: Serevent
bronchodilator- long-term maintenance treatment of asthma
May cause bronchospasm in some patients. Safety and efficacy has
not been established in children under 12. Patient must be instructed
on proper use
5. Advair- combination of Flovent and Serevent, use is
currently under review by the FDA due to its potential to cause
bronchospasm.
The Chinese Medicine Perspective on Asthma
In Chinese medicine asthma is not only a problem with the Lungs
but can also be related to a problem or deficiency with the Spleen
and/ or the Kidneys. The Organs in Chinese medicine have much
similar functions as Western medicine but also take on roles that
are much broader and interact with each other to create balance
in a completely healthy state of both body and mind.
The Lungs are considered the most exterior organ because of their
direct connection to the outside. They can be easily influenced
by exterior "pathogens." The Lungs govern and control
the dispersal of "Qi" and regulate the opening and closing
of skin pores. The skin is considered the exterior Lung. Like
the Lungs, the skin "breathes" to control body temperature
and sweat. This relationship between Lungs and skin is betrayed
by the common occurrence of both eczema and asthma in the same
patient. Many patients find their eczema clears up as the asthma
resolves. The balance between Lungs and skin promotes Protective
Qi or Wei Qi. This ancient idea of a protective and defense mechanism
of the body is today called our immune system.
The Spleen is where food and fluids are transformed and then
the refined material is transported to the appropriate areas of
the body. If the Spleen is deficient and unable to do its job,
then the proper transformation of food and fluids cannot take
place. This is when phlegm and dampness can collect in the Lungs
instead of the refined "mist" that is normally transported
to the Lungs to keep them moist.
In Western medicine the lungs and kidneys have a relationship
in maintaining pH (acid-base) balance in blood. Similarly a relationship
in Chinese medicine is essential between the Lungs and Kidneys
in order to maintain the proper movement of air into and out of
the lungs. If his relationship is out of balance then wheezing
occurs.
Acupuncture and Asthma
When the underlying problem is addressed, acupuncture treatment
can minimize severity and frequency of asthma attacks in children
and adults. In some cases treatment can resolve asthma altogether.
Acupuncture can treat not only the symptoms of asthma (coughing,
wheezing, increased work of breathing), but also the root of the
problem. This is why the problem exists in the first place. The
root problem is usually an underlying deficiency or a lingering
pathogenic factor. Lingering pathogens result from unresolved
illness and result in a chronic cough, getting sick easily, becoming
tired easily, decreased appetite, etc. Lingering pathogens can
become deeply ingrained in the body if they aren't treated. This
is sometimes where asthma starts. Many parents have had their
child diagnosed with asthma after a bout with bronchitis that
never seems to be completely resolved. Acupuncture is effective
in treating asthma from emotional triggers as well.
Your Child's Acupuncture Visits
What your child can expect at an acupuncture clinic is first
an in-depth history is taken by the practitioner including: frequency
and severity of attacks, what triggers set off attacks, and questions
about overall health. The treatment depends on the age of the
child but may consist of using shoni shin, small instruments used
for rubbing or pressing the skin along acupuncture channels and
points, and Electric stim or E-stim. This creates a tapping sensation
on selected acupuncture points. In our clinic we refer to it as
the "tickle machine". Most children enjoy treatment
and tolerate it very well. Treatments may last 30-45 minutes on
average.
The number of treatments required depends on your child's constitution,
age and severity of condition. A weekly treatment for 6-8 weeks
and then spacing treatments every 2-4 weeks depending on results
is common. In severe cases, 2 or 3 treatments may be recommended
in the first week or so depending on results. It is common to
see results of decreasing frequency or severity of attacks after
the first couple to treatments.
Emergencies
It is important to remember that Western treatment can be lifesaving
and any asthma attack is not to be taken lightly. Always watch
for signs of increasing asthma severity and keep medications available
for emergencies. Our goal is to minimize or eliminate the need
for medications and the multiple side affects associated with
each of them. Find an acupuncturist who can work with your family
medical doctor to answer questions and be an integrative resource
for your child's health and well being.
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