For a child with asthma, triggers to another episode lurk in everyday things. Cold weather. Respiratory infection. Common allergens like animal dander and dust. Even laughing, for some, can cause an episode of asthma.
When asthmatic bronchitis strikes 16-month-old Ryan Groft, "his lungs get tied in knots," says his mother, Diane Groft. "The bronchial airways go into spasms. The air is trying to pass through the lungs, but there's this gross stuff, mucous, that produces high-pitched wheezing."
Medical treatment will restore Ryan's breathing. And, increasingly, families and children are learning how to control asthma under a physician's care.
Asthma is inherited; the Groft family traces it through four generations to their great-grandparents.
Asthma affects 5 percent to 10 percent of all children. With about 22,000 children in Carroll public schools, about 1,600 are likely to have some form of the disease. Each case is as individual as a fingerprint.
"No two asthma attacks are the same," says Mrs. Groft. " 'A' doesn't always lead to 'B,' which doesn't always lead to 'C.' " The causes and symptoms also may change as the child's bronchi grow larger, and he or she becomes less susceptible to childhood illnesses.
With individualized care, asthma can be controlled.
"Only 2 to 3 percent of kids with asthma cannot do what they want to do," said Barbara Wheeler, a researcher who's studied children for nine years in the Childhood Asthma Study at the Johns Hopkins University in Baltimore. She met with the Carroll County Asthma Support Group in Westminster last week.
The keys to controlling asthma, she said, are "education, compliance and communication."
The asthma sufferer and the family have to work together, she said, starting with understanding how the asthma might affect the child's behavior. Asthma attacks are often unpredictable, so the child could feel out of control. When activities are restricted, the happy child can become cranky. Siblings might fear they will get asthma, too.
Asthmatics must have good preventive medical care that becomes routine, she said. That means parents must learn the earliest symptoms and, with a doctor trained in treating asthma, create a treatment and maintenance program, she said. The child gains responsibility for care as he or she matures.
"The whole secret to changing family dynamics is to educate the family. If parents are not involved in a partnership way, it'll never work," said Mrs. Wheeler.
Diana Barbour's 10-year-old son, James Kenneth Jr., is this year's poster child for the Maryland Chapter of the Asthma and Allergy Foundation.
She says, "You just train yourself, and you have to share this with people who are part of your life, like your baby-sitter, the phys ed teacher, the principal, the teachers, the grandparents. You have to explain it to the family.
"When Kenny has difficulty, all activities stop for him and the family. We give a lot of TLC."
When Kenny is hospitalized, family members are there around the clock.
Support meetings such as the Carroll group are an invaluable tool, said Mrs. Wheeler.
"Look around the room. Everybody understands what they're going through. And when fathers are involved, and boys see fathers in a group like this, then they see it's OK" to air their feelings and concerns.
The Carroll support group "opens discussion," says Mrs. Groft. "We take on the needs of the community. We offer asthma care training, but our meetings are sometimes better attended when it's just to hear what other moms have to say."
"People are educated about asthma now," said Mrs. Barbour, recalling her own childhood asthma.
"When I was coming up, I basically stayed in the house. I'm absolutely sure my children are not deprived of any childhood activities."
Her decision met the test the day Kenny played soccer in the rain.
"I was scared to death, but I did not stop him," she said. "What I did say, was, 'I don't think you should play as long.'
"When we got home, I made him relax, take medicine and drink constantly. And he was fine."
For information about the Carroll Asthma Support Group, call Diane Groft at 848-6022.