What are the costs of leaving asthma untreated?

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Dr. Christopher M. Webber, MD
Allergist & Immunologist

The health risks of not treating a child's asthma are increased fatigue and exercise problems, decreased oxygen to the muscles and brain, and decreased concentration and mental abilities. A lesser known risk of not treating asthma is a permanent loss of height. In addition to this, uncontrolled asthma may lead to an increased risk of lung infections such as bronchitis or pneumonias.

It is possible that if asthma goes untreated, it could lead to permanent lung problems such as chronic obstructive pulmonary disease (COPD).

Dr. Sande O. Okelo, MD
Pediatrician

The most severe health risk of not treating your child’s asthma is death, although this is very rare. Other risks include poor growth, premature decline in lung capacity (in older age) and poor general quality of life (e.g., not being able to participate in sports).

The consequences of not managing asthma are substantial. If the disease is not controlled, a child is likely to suffer long-term sleep problems due to breathing restriction, which can lead to a weakened immune system, reduced cognitive ability and learning difficulties. Over time, uncontrolled inflammation also is associated with loss of lung function and deterioration of lung health in adulthood.

From Good Kids, Bad Habits: The RealAge Guide to Raising Healthy Children by Jennifer Trachtenberg.

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Severe asthma attacks—the horror-movie sensation of an invisible force stealing your breath—hospitalize half a million Americans every year. Thousands die, often needlessly. New evidence just confirmed something all docs know: Many frightening or fatal asthma attacks result from people not taking their meds at all, not taking them the right way, or not using enough—even mid-crisis. Take asthma seriously. It's no joke.

Asthma can be a serious disease if not recognized and treated properly. We are lucky now to have many excellent new medications that can be used to control asthma. Every patient with asthma should have an asthma action plan that lays out the daily plan of care and then how to treat escalating symptoms. Also, each patient needs to be aware of their own early signs or symptoms of an asthma flare so they can step up their care as needed. It is the patient that ignores these early warning signs or does not even have a plan of action that ends up with asthma being serious.

Unfortunately, it seems that many physicians are reluctant to label someone "asthmatic". I think part of the reason for this is it illicits a lot of fear and questions in patient's minds. It is much better to make the correct diagnosis, answer the questions and allay fears. Also, the correct diagnosis leads to the proper treatment and takes much of the seriousness out of the disease. Diagnosing, treating and recognition of early warning signs of asthma exacerbations decreases the need for urgent care and emergency room visits as well as reducing the increasing number of asthma deaths.

Even a severe asthmatic patient with proper medication control can lead a normal life and be active. I am frequently asked if the diagnosis of asthma prevents a child's ability to play sports. I always answer with an emphatic "No" and go on to explain controller medications.  

If you think that you or a loved one has signs or symptoms of asthma, you should find a primary care physician that can work on properly treating and controlling your disease either alone or in combination with an allergist or pulmonologist.

Dr. Sam Pejham, MD
Pediatrician

Asthma can be very serious. It accounts for one-quarter of all emergency room visits each year, and 11 people die from asthma everyday in the US. It causes narrowing of the airways which leads to shortness of breath and wheezing. Uncontrolled Asthma can cause death. There are many medications available to help control symptoms of asthma.

Dr. Alice Wofsy, MD
Emergency Medicine Specialist

Although most asthma is controlled by medication taken at home, an asthma attack can be a life threatening breathing emergency requiring critical care. Asthma that is hard to control, or even usually mild asthma, can deteriorate into a severe attack of breathing difficulty requiring immediate emergency care, preferably via 911. Avoid delay in seeking treatment. A severe attack may need continuing critical care until it resolves.

Tameka White
Nursing Specialist

Asthma flare ups or exacerbations represent a time-threatening limiting airway disease that can progress quickly to an attack, warranting critical care either in the ER or admitted to an ICU setting. Having a personalized plan and adhering to maintenance medications or medications for flares up are usually helpful. A personalized plan may include recognition of what factors trigger an attack; knowing how to use correctly a metered dose inhaler, grading your symptoms and recognizing when these symptoms are getting worse requiring urgent care. Education and collaboration with primary care provider is essential. On the world wide web, there are distinct web sites that provides information and social connections for asthmatics to share their experiences.

When asthma attack becomes life threatening, the individual at this stage finds it very difficult to breathe, becomes tired easily, have frequent night-time awakenings, wheezes, uses inhaler daily or multiple times throughout the day and reduced daily activities are some warning signs that should not be ignored, requiring URGENT medical attention. 

In the ER, if symptoms persist without much improvement in airway flow, abnormal blood gas results, poor breathing mechanisms, the individual is then admitted to the critical care unit for intensive care. This care may involve mechanically ventilated, steroids medication, short acting beta agonists, fluids for hydration, antibiotics if pneumonia is suspected. Gradual improvement use of spirometer is used to promote lung function after mechanical ventilation is removed and blood oxygen levels are normal and asthma exacerbation is controlled.

Dr. Elif E. Oker, MD
Medical Toxicologist

People with poorly controlled asthma have a higher rate of emergency department use. Often they experience multiple or severe asthma exacerbations (asthma attacks). Asthma is generally controlled by inhaled or oral steroids. Sometimes these patients are not adequately prescribed controller medications. Other times patients fail to comply with their prescriptions. Patients whose asthma is poorly controlled are at risk for status asthmaticus, a severe asthma exacerbation that fails to respond to emergency treatment. These patients may require a mechanical ventilator to breath for them. Patients with this condition often require admission to the intensive care unit.

Dr. Paul M. Ehrlich, MD
Allergist & Immunologist

Treating asthma is often a question of in-between values, a kind of no-man's-land of conflicting physiological and psychological issues. Many general practitioners and pediatricians are experts at treating the overt, alarming aspects of the disease, but they fall short on the supposedly lesser ones, which is where the most damage is probably done. They are even reluctant to use the A-word, asthma, because it is alarming to parents. But denial is counterproductive. A wait-and-see attitude is a recipe for chronic inflammation and permanent damage to the airways. It does no good to call wheezing—or chronic coughing for that matter—bronchitis.

The indirect costs of untreated or undertreated asthma can be counted in days lost at school and work (asthma is the number-one cause of absenteeism), diminished performance, inactivity and poorer prospects for achievement through one's entire life. Nor are the bad effects confined to the individual. When one kid has uncontrolled asthma, the whole family gets sick. We realize we can't compensate for all the inequities that life deals these families, but where asthma is concerned, gains in quality of life and health for a single child can have exponential benefits for the child, the family and the classroom.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.