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ASTHMA IN CHILDREN: STAYING AWAY FROM HOME
One of my patients, a little 5 year-old called Victoria, recently had to be admitted to a hospital in Italy with an asthma attack because her parents had not taken her nebulizer with them. I agree it is very bulky and difficult to fit into a suitcase but it does have a carrying handle. To me it is the most vital piece of luggage and must have top priority. Most people take far too many clothes away with them, so leave some behind and take the nebulizer instead.
Taking a nebulizer away with my own children has completely transformed our holidays, as it has taken all the anxiety away over the possibility of being unable to treat an attack. If it is combined with the use of a peak flow meter then it will be rarely necessary to use any local medical facilities. If there is any doubt before you leave about the power supply then it is wise to take a foot pump nebulizer rather than an electric one. These are cheap to buy or often your own doctor will lend you one to take with you. It is no use if your child has an asthma attack and there is nowhere to plug in the nebulizer!
Just one word of warning: always tell the customs office what the machine you are carrying is used for. Eleven year-old James arrived back at Gatwick from Florida with his father carrying the nebulizer. The customs officer must have thought he was a drug smuggler, because he completely stripped the machine down, causing all kinds of damage and rendering it completely unusable.
Equally important to take with you is a course of cortisone tablets, and I would recommend taking them very early in an attack. When you are away from home it is often difficult to tell how severe an attack is going to be and anyway you want to enjoy the holiday. The sooner the attack settles the better for everyone, so it is worth starting the cortisone as soon as the wheezing starts. Using 5mg tablets, a loading dose of two tablets followed by one tablet three times daily is quite adequate. Your own doctor will, I am certain, supply you with these before you go.
Should you by any chance forget to take any of the medication, and then do not despair. Most foreign countries have a much more relaxed approach to selling medicines than here and most are available over the counter. I remember going to Skiathos, a small Greek island, having forgotten to take any cortisone tablets with me. It was before the island had been developed for tourists so I was a little concerned when I sought out the local pharmacy. There was no cause for concern because their stock was larger than most chemists over here and there were several types of cortisone to choose from!
So, when you go on holiday try and keep calm and resist the urge to panic. This is not easy when you are in a foreign land and so many miles from home. If you go well prepared then management should be straightforward. Remember also that it is easy to ring home these days so take your doctor’s phone number with you. Last summer I had calls from Hong Kong and Brazil – unfortunately no one has so far offered to fly me out to treat them!
As a final note on holidays, I am often asked about air travel.
This will only cause problems in those with such severe and disabling asthma that oxygen levels in the blood are already low. A reduction in oxygen in the air in the aircraft cabin occurs at high altitude and at six thousand feet can be as much as 25 per cent. This could cause some embarrassment to the severe asthmatic and increase breathing difficulties. Fortunately oxygen is readily available. I must stress, however, that this will very rarely be needed and I would have no qualms about taking a child with asthma in an airplane.
*65/211/5*