Asthma

I have been thinking about Asthma a fair amount lately.  When I was a child 40 years ago, I was one of only a few students in a large suburban school who had asthma.  Now, you can go to a soccer game and nearly the entire team has to stop for a medication break!

When I was a child, they blamed second hand smoke.  My mother was made to feel terribly guilty that she had caused my asthma.  Cigarette smoking has dramatically decreased while asthma has dramatically increased.  Then all the experts pointed to air pollution.  Not only has air pollution improved, but more importantly, think about when asthma symptoms are worse and when are they better?  For me (and now both my children), symptoms are worse in the winter and better in the summer.  Hmmmm.  The opposite of air pollution trends.  At least outdoor air pollution.

Another observation.  A physician friend of mine recommended we try my daughter on a steroid inhaler practically from her first episode.  That was an 'off label' use.  Guess what?  Rarely does she need more than two doses in the same day to clear her asthma, often for weeks at a time.  Works even better on myself and my younger son who rarely need more than one 'puff'.  Hmmmmm.  That is an odd treatment for the 'infectious agent'  theory.

The latest theory currently in vogue is that we keep our kids too clean and the immune system is looking for something to do.  Ok.  Maybe.  Blame it on Mom again.  But to me the steroid proves that in many cases, we are dealing with a low level inflammation caused by a relatively brief exposure to an inflammatory cause.  Perhaps the winter/summer paradox is caused by something the children inhale mostly at school during the school year? Like the so called 'sick building' syndrome.  Perhaps a disinfectant that has become ubiquitous in public buildings over the decades?  Perhaps one also used at home in typically smaller quantities, enough to make a connection with 'too clean a home'?  As studies go, this could be initially as easy as a challenge test.  Think ammonia, chlorine, and a host of newer ones. Somebody needs to find out.