Meet the Asthma Team
- Anisa Hassan-Thabet, Clinical Nurse Specialist
- Kevin Farrell, Clinical Nurse Specialist
- Laura Hale, Clinical Nurse Specialist
- Laura King, Clinical Nurse Specialist
What do we do?
Here at the Children and Young People's Health Partnership (CYPHP), our specialist children's asthma nurses work with a children's pharmacist and emotional wellbeing professionals to make sure we are looking after your child and family as best we can. Emotional and behavioural issues are understandably common in children and young people with long-term or chronic conditions – no CYP wants to be "ill" or "different" in a way they don't choose. At CYPHP we're here to help you and your family with all that concerns you and your child.
We can see you at your home or at a nearby clinic, and we make sure other healthcare professionals,who are involved in your child's care, know what is going on.
We have just started so cannot yet offer our service to children with asthma across all of Lambeth and Southwark, but please do speak to your GP about us if you think you and your child could benefit from our service.
Check out our frequently asked questions section below:
Q1. What is asthma?
Asthma is a condition that affects the lungs
Over time, things ('triggers' or 'aeroallergens') in the air such as pollens, moulds, animal dander and dust can cause the breathing tubes in the lungs to become red, sore and swollen. Asthmatic breathing tubes are also quite twitchy, which means that they are very sensitive to other triggers like the weather, exercise, smoke or pollution, causing the breathing tubes to close.
This means there is then less room in the breathing tubes for the air to get through, causing wheezing, breathlessness and a cough.
For more information on ‘what is asthma?’ we recommend the following information resources:
- Asthma UK: https://www.asthma.org.uk/advice/understanding-asthma/what-is-asthma/
- Asthma UK: Easy read https://www.asthma.org.uk/globalassets/health-advice/resources/easy-read/easy_read_all_about_asthma_booklet.pdf
- Dr Ranj – ‘Get well soon’ describes asthma for younger children https://www.youtube.com/watch?v=q4re4hXbWGY
Q2. What are the symptoms of Asthma?
If someone has asthma they might have a dry cough, wheeze, feel breathless or tight chested. Most often these will be worse in the middle of the night and/or after exercise. However, every person is very different. Your doctor or nurse might ask you to fill in a questionnaire called an Asthma Control Test (ACT) which asks about you or your child's symptoms. This can be helpful to see how often and when you are having symptoms. The score from the test will tell your doctor or nurse how controlled your asthma is.
Q3. How does Asthma affect children and families?
Coming to terms with having Asthma takes time and can be tricky. Often the whole family is involved in the journey of adjustment to the diagnosis of asthma for individual patients; a range of reactions are common in siblings and parents including frustration, stress, worry, anger, jealousy (particularly for siblings). This is due to the physical symptoms of asthma but also to the emotional, social and psychological implication of having a chronic physical health condition as well as some of the behavioural/lifestyle changes related to the management of asthma symptoms.
Some children and young people will find the process of adjustment difficult but will be able to manage with support from family, school, friends and the health care professionals involved in the management of asthma symptoms. For other children and young people things might be more challenging and they might experience low mood, feelings of anxiety or anger and/or changes in behaviour.
Additional help for children/young people and their families is at hand to help with these emotions and behavioural changes - see FAQs below.
Q4. What are asthma triggers?
Triggers is a word to describe things which irritate the breathing tubes causing asthma symptoms. These can be pollens, moulds, animal dander, dust, exercise, cigarette smoke, pollution and perfumed products. There are lots of things that can trigger asthma. For some people, extreme emotions such as laughter or crying can also make the breathing tubes tighten and make breathing more difficult.
Avoiding triggers is difficult but it is good to know what triggers your asthma and how to reduce your exposure to them, if possible.
Have a look at the pollen calendar. Link: https://www.worcester.ac.uk/discover/pollen-calendar.html
This is a good tool for tracking if pollens are making your asthma worse, as well as which pollen in particular might be triggering your asthma, depending on the time of year you have most symptoms.
Other useful information about how to avoid or reduce triggers can be found on the Asthma UK website by following this link: https://www.asthma.org.uk/advice/triggers/
The London Air Quality website shows you what the air quality is like where you live. Follow link here: http://www.londonair.org.uk/london/asp/publicbulletin.asp?la_id=28
Q5. What is an asthma attack?
An asthma attack is when the breathing tubes become very tight in response to a trigger.
The signs of an asthma attack are:
- Persistent cough (when at rest)
- A wheezing sound coming from the chest (when at rest)
- Difficulty breathing (the child could be breathing fast and with effort, using all accessory muscles in the upper body)
- Nasal flaring
- Unable to talk or complete sentences. Some children will go very quiet.
- May try to tell you that their chest ‘feels tight’ (younger children may express this as tummy ache)
Q6. When to call an Ambulance?
CALL AN AMBULANCE IMMEDIATELY AND COMMENCE THE ASTHMA ATTACK PROCEDURE WITHOUT DELAY IF THE CHILD:
- Appears exhausted
- Has a blue/white tinge around lips
- Is going blue
- Has collapsed
- You have are following the child or young persons personalised asthma action plan and it directs you to call for an ambulance.
For more advice we recommend looking at the Asthma UK website. Follow this link: https://www.asthma.org.uk/advice/child/asthma-attacks/
Q7. What's an asthma action plan?
A personal asthma action plan should be given to you by your doctor or nurse. Everyone with asthma should have a plan, which clearly tells you or your parent/carer how much of your preventer medication/inhaler to take every day, as well as when to take your reliever ('rescue') inhaler.
The plan explains how much and how often you can have your reliever inhaler. This is so you stay safe and know when you may need to go and seen your GP or go to hospital.
It is really important to know what to do in an asthma attack and know how to recognise the signs. Having an asthma action plan, which is kept up-to-date by your doctor or nurse, is a great way to be prepare. Share this with friends/family, or places like schools, nurseries and clubs.
TOP TIP: Take a photograph of your asthma action plan on your phone so you can access/read it whenever you need it. It also makes it easier to share with other people who care for you.
There are lots of asthma action plans available. Here are the plans we use:
- Children aged 2 – 5 years: https://www.monkeywellbeing.com/wp-content/uploads/2014/09/asthma-plan-v3.pdf
- Children aged 6-11 years: https://www.asthma.org.uk/globalassets/health-advice/resources/children/child-asthma-action-plan.pdf
- Young people over 11 years: https://www.asthma.org.uk/globalassets/health-advice/resources/adults/adult-asthma-action-plan.pdf
Types of asthma medicines
There is no cure for asthma currently but there is a range of excellent medicines which help you manage your asthma; they can reduce the number and how bad your symptoms make you feel, reduce the number of asthma attacks and to keep your lungs healthy.
The healthcare team looking after your asthma will be following national guidance to support you to pick the best treatments to manage your asthma. As asthma symptoms and how ill you feel can change throughout the year and from year to year based on your triggers, your healthcare team will alter your medicines to try to help you manage these periods. Asthma treatments are like a ladder which are stepped up and stepped down based on how your or your children’s asthma is. It is important that you attend your asthma reviews and report to your healthcare team any changes in your symptoms or how often these occur.
Medicines used to treat asthma are broadly spilt into two groups; reliever inhalers and preventer medications.
These are usually blue inhalers and often salbutamol. They provide you with quick relief of symptoms such as breathlessness or a tight chest. They work by opening up your airways allowing you to breathe more easily. These inhalers should be kept on you or your child at all times in case they are needed.
These often inhaler and commonly brown or orange though some children take a tablet to help prevent their asthma. Unlike your reliever inhaler you will feel any difference after taking the medicine straight away; often people feel that this means they are not working and stop them. Preventer medications work in the background to help reduce inflammation, swelling and damage to the lungs. It is important to take them every day even when you are well to ensure that your lungs are healthy. By taking your preventer every day you should notice that you do not need your reliever (blue inhaler) as often.
For more information about the range of medicines used to treat asthma feel free to look at the Asthma UK website: https://www.asthma.org.uk/advice/inhalers-medicines-treatments/ or speak to your local pharmacist or team looking after your asthma.
If you go into hospital they may treat your asthma slightly differently so that can get on top of your symptoms and improve your breathing quicker.
Types of inhaler devices and how to use them.
The majority of medicines for managing asthma are inhalers. The most common type is using a multi-dosed inhaler (pMDI) with a spacer (tube device). Inhalers can be difficult to use and as such it is important that you know how to use these well to ensure you get the best of these. We recommend that someone checks your or your children’s inhaler technique at least annually but more frequently if possible to ensure your hard work is paying off. So why not pop on down to your local pharmacy or at your next asthma visit take your inhalers to see how you are doing.
In the mean time why not check out these handy videos on how to use your inhalers from Asthma UK: https://www.asthma.org.uk/advice/inhalers-medicines-treatments/using-inhalers/
I am worried about taking my medicines
As with all things medicines provide many benefits (good bits) but do have some bad bits too (side effects). If you have any worries about the side effects of your medicines or treatments the following information from Asthma UK website may answer your questions, if not feel free to speak to your pharmacist or healthcare team looking after your asthma:
Common concerns regarding asthma medicines: https://www.asthma.org.uk/advice/inhalers-medicines-treatments/common-concerns/
Information on steroids: https://www.asthma.org.uk/advice/inhalers-medicines-treatments/steroids/
Q8. What is an asthma review and why should I go?
Everyone with asthma should have a review with their GP or Practice Nurse at least every year. Contact your GP if you have not had a review.
The Practice Nurse or GP will assess your asthma control and make sure you are on the right medication.
Asthma UK Resource: Asthma and my child https://www.asthma.org.uk/globalassets/health-advice/resources/children/asthma-and-my-child-booklet.pdf
Q9. How do I ensure my child is safe in school?
Every child or young person with asthma will need their reliever inhaler and spacer in school in case they have symptoms. Schools will store your child's medication somewhere safe for you, such as in the school office or in your classroom. You will need to provide your child's medication to the school and ensure it is clearly labelled and in date. Speak with your child's school/nursery to find out what their asthma policy is.
It's important that in school or nursery your child has:
- Reliever inhaler
- Appropriately sized spacer
- Asthma action plan.
If you want to know more about how your school can support your child with asthma in school, we recommend looking at the information provided by Asthma UK: https://www.asthma.org.uk/advice/child/life/school/#essentials
Q10. Will I grow out of my asthma?
It is unlikely you will grow out of your asthma. Some people notice their symptoms becoming less frequent as they get older, however, everyone is different.
For lots more information on asthma, why don’t you check out the Healthy London Partnership Asthma Toolkit. Here you will find lots of useful information specifically aimed at parents and carers: https://www.healthylondon.org/children-and-young-people/london-asthma-toolkit/parents-and-carers
Q11. What should I do if I am worried about the impact of the diagnosis of Asthma on my child's/teenager's emotional wellbeing and/or behaviour?
Having a diagnosis of asthma and receiving treatment can bring additional emotional distress. Children/young people might feel angry, sad, worried, confused, frightened, lonely or embarrassed. These are very normal feelings but can be difficult to deal with. Asthma can at times be unpredictable and can impact lifestyle, peer and family relationships.
Asthma might also have a negative impact on school attendance and may result in getting behind on school work.
Here is a website highlighting some of the emotional and social effects of having asthma: https://hospital.uillinois.edu/primary-and-specialty-care/pulmonary/our-areas-of-expertise/asthma/emotional-and-social-effects
It can be hard for parents to start a conversation with their children/young people about how they are feeling. Parents might be worried about making whatever is bothering them worse by asking them about it – it won't - the most important thing is to start talking with your child/young person so that they can get the help they need.
Getting teenagers to talk openly about what is bothering them can be particularly difficult.
Try using some of the tips contained here to start the conversation: http://www.nhs.uk/livewell/mentalhealth/pages/talkingtoteens.aspx
Or go to the Young Minds parents helpline for advice, https://youngminds.org.uk/find-help/for-parents/parents-helpline/
Trying once is often not enough to get to the bottom of things so if you've tried several times and your child/teenager still isn't opening up, try talking to their teachers or close family members to see if they can shed any light.
You might be specifically concerned about the impact of the diagnosis of asthma on your child’s emotions, behaviour and general well-being. This is a relatively common situation as children/young people with chronic health conditions can be more prone to developing emotional/mental health issues for a number of reasons. This may include depression, anxiety but also a range of behavioural issues.
Depression can make children feel worthless, empty, tired or restless. They may have trouble sleeping, lose their appetite, feel confused and have no energy.
Anxiety can make children worry excessively about things, worry that something will happen to them or someone in the family. They may think about or talk more frequently about death.
It is important in the first instance to discuss your concerns about your child’s/teenager’s emotional wellbeing and/or behaviour with the heath professional/s looking after your child, in order to determine whether additional help would be needed.
Q12. How do I know if my child/teenager needs more help with their emotional wellbeing, mental health and/or behaviour?
It can be difficult to talk to health care professionals about your concerns. Think about:
- Being as open and honest as you possibly can. This might be difficult the first time around especially if you don't know your health care professional very well but say what you can. This video from the charity Mind has some useful tips on how to prepare: https://youtu.be/Dqb-n_L5hIA
- Don't worry if you don't really know what the problem is or that it might not seem important enough – your health care professional is there to help you with the emotional wellbeing of your child/teenager every bit as they are there to help you with their physical symptoms.
It can be helpful to get a baseline and track symptoms which can inform the conversation you have with a health care professional.
One way of tracking difficulties with sleeping is to do a sleep diary.
Here are some web links to help create a sleep diary which can then be shared with health care professionals:
A useful way of tracking changes with mood is a mood diary. This can help you keep track of any changes in your child’s mood, and you might find that there are more good days than you think. It can also help you notice if any activities, places or people make you child feel better or worse.
Go to this web link to create your own mood diary https://www.getselfhelp.co.uk/docs/MoodDiary2.pdf
Check with your child’s school if they have any concerns, noting any changes in their behaviour or academic achievement and see if this corresponds with what your child says and what you have noticed as a parent.
For situations where symptoms do not require specialist intervention but a little extra help would be useful see the following:
You might want to see if you are doing all that you can to ensure you get a good night’s sleep by checking out these web sites:
Here is web link for you to access an app which helps with anxiety: https://www.anxietybc.com/resources/mindshift-app
Here are videos of young people coping with anxiety: http://youth.anxietybc.com/video/teen-truths
Here is a web link which has information and exercises to help with depression: http://www.moodjuice.scot.nhs.uk/depression.asp
If you are not sure and would like to find out more about mental health difficulties, how they might present and what help is available these websites are helpful to access:
Here is some good information on how parents can support your child if they are struggling with their behaviour or mood: