Published in Healthlines USAY, 1992. Author's permission required to reprint.
Do your parents make most of the decisions about your asthma care? Do school rules make you feel like a little kid? Do you wish your allergy shots could be scheduled so you don't miss soccer practice?
If you've had asthma since you were very young, you may be comfortable with your parents making most of the decisions. If you recently found out you have asthma, your parents may be telling you when to take your medicines and be doing most of the talking to doctors, teachers, and school nurses.
But gradually you realize that your parents and your doctors can not possibly understand all the decisions and conflicts you face in an ordinary day. Their priorities may not be your priorities. As you grow older, you need more flexibility and less adult involvement and direction. You know that having more control over your asthma decisions gives you more control over your life.
Would you like to be more in charge of your asthma? Your first step is to let your parents know! Speaking up for yourself is as much a part of good self-care as keeping peak flow charts or taking the right medicines. Let doctors and parents know your priorities and concerns. Tell them how their advice works in the "real world" at school or on the soccer field. You may not want adults to take over or boss you around, but you still need them on your support team as allies, coaches and advisers.
Managing asthma is a complicated process. It is made up of lots of different tasks, responsibilities and decisions. You and your parents need to agree on how to share them. Good communication is especially important when family roles and relationships are changing.
There are many good books and educational materials designed to support you with information and advice. Asthma education programs and support groups that emphasize self-care and decision-making can help you gain skills and confidence in yourself.
Charting peak flow trends takes a lot of the guess work out of asthma and helps shift the focus from illness to prevention. An individualized plan that tells you how to step up your medication to deal with triggers, viral infections or seasonal changes in weather and activities lets you avert serious asthma problems.
Remember that building responsibility is a learning process. It is not a test of character. One missed dose, a lost inhaler or an asthma flare should not be a reason for blame, recriminations or punishment. Even parents and health care professionals don't always remember every dose of their medicine.
Don't waste time and energy criticizing yourself for temporary setbacks. Avoid thinking: "I'm dumb. I should have known I couldn't do it." Taking risks is part of changing old patterns of behavior and facing new challenges. Mistakes are opportunities to analyze a problem and try new ways of doing things.
It helps, too, to know that being independent doesn't mean you are totally on your own. Being responsible doesn't mean hiding in your room and stewing about a problem all by yourself. Making good decisions sometimes means consulting others who may have more experience or expertise, people who know asthma and who know you.
Asking for advice or assistance may seem like a step backward when you are eager to prove that you can handle a situation on your own. But it is one way that you show others, especially parents, that you aren't just being reckless. You show that you still value their support and are smart enough to ask for it. Don't forget, knowing when to call your doctor is an important part of asthma safety.
An inhaler self-management plan at school can help you achieve better asthma control as well as to feel more confident and in charge of your life.
Where schools don't allow students to carry their inhalers, leaving class to use an inhaler may attract unwanted attention, create conflicts with teachers over time out of class, and frequently make students late for gym or lunch. The inconvenience and potential social discomfort discourages students from using their medication. Fortunately, most doctors and parents agree that students are better off when they manage their own inhalers.
If your school doesn't support inhaler self-management, write a letter to the principal or school board explaining why keeping medicine in the nurse's office creates problems for you.
Talk to other kids with asthma to see if they feel the same. Develop a strategy. Find examples of schools with successful self-management policies. Be prepared to provide information and respond to the concerns of school officials. Your goal is to convince school officials that the proper use of medication is as important to you as it is to them. You want them on your asthma control team.
Are they worried that students will lose or misuse their inhalers? Ask the pharmacist to put name labels on all your inhalers. Keep a backup inhaler in your locker or in the school office. Your physician's guidelines for medication should be specific and practical and avoid medical jargon and vague terms such as "as needed."
Are they worried that others students might try it and harm themselves? A doctor's letter might help convince them that your inhalers, unlike other types of medication, won't endanger anyone. Suggest that the school hold a health education session to discuss safety guidelines for prescribed and over-the-counter medications.
Locking up your inhalers may be the school staff's way of handling fears or mistaken beliefs that your medications can make you "addicted" or that taking it frequently makes the medication less effective. Especially if you have asthma under control, people may question if you "really need it." Some drug abuse prevention programs and "drug-free schools" campaigns convey the attitude that all drugs are bad creating confusion and negative feelings.
Role play with parents or friends how to respond to well-intentioned but misinformed people who try to discourage you from taking your medicine.
At home or at school, the job of managing asthma is an ongoing process of educating ourselves and educating others. At any age, the more active the role you play, the better you become at controlling asthma and taking charge of your life.
The world endures solely by virtue of the breath of school children. (Talmud)