Asthma Asthma Basics

Asthma and Adolescents

What are some difficulties in dealing with teens with asthma?
The unique part about asthma in adolescence is that adolescents are unique. It's challenging to have adolescent patients recognize their symptoms. They don't want to be different, and they're often less aware of physical symptoms than they are of what they might be doing on the weekend, or that they need to get their homework in on time. We have to be more aware of the more subtle cues such as coughing at night, exercise limitations, or colds or coughs that are lasting longer than normal.

Adolescents often don't tell me their symptoms or haven't even recognized themselves that when they tried to throw a Frisbee with their friend, they couldn't run very fast or very far. Or they might not notice that they're kind of sleepy because they've been coughing an asthma cough for several nights.

So it takes a unique relationship with a patient get to the truth. However, it's not impossible and once that can be achieved, it's very gratifying as a physician, because adolescents are great to work with and when they're healthier, they're active, they're feeling good, and they're very pleased with their quality of life.

The other difficulty with adolescents is they don't like it when adults tell them to do stuff. So trying to get them to do something like take an inhaler twice a day, or take certain pills, is additionally difficult.

Do the characteristics of asthma change during adolescence?
Asthma symptoms can be variable during adolescence, because there are so many great changes in the physiology of the body in general. Some adolescents, however, will have fewer asthma symptoms. Young males in their late adolescence and early adulthood will often notice fewer symptoms. That used to be thought of as growing out of asthma; we now know asthma is not something that goes away, but that the symptoms can lessen over time.

Female adolescents who are going through puberty can have hormonal influences, so they may have more asthma symptoms at different times of the month. Or their asthma may worsen as they go through puberty. Certainly young women can have changes in their asthma due to becoming pregnant, having a pregnancy and delivering a baby, followed by the fatigue of being a new parent.

All of these things are special issues that we need to be aware of and share with our patients, so we're customizing their therapy to best fit with their life.

Are there any special treatment issues in teens?
The treatment of asthma in adolescents is the same for the population in general. Good treatment of symptoms, good treatment of the underlying inflammation and good communication with the patient are key.

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