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The Asthma Section

Kids with Asthma Can Play Sports

From the Allergic Living magazine archives.

FORGET the stereotype of the wheezy, wimpy kid puffing on an inhaler. Young athletes prove that you can be a winner in sports – even with asthma.

Since being diagnosed with asthma when he was 4 years old, Brett Favaro has suffered pneumonia and bronchitis, asthma attacks, and been to numerous doctors. Now 22, he still has a nebulizer, a machine that delivers asthma medication in a fine mist through a facemask, in his bedroom.

But if you’re picturing a skinny kid, wheezing on the sidelines, you’ve got the wrong guy. Favaro was a competitive swimmer for 13 years, culminating with a stint as captain of the varsity swim team at Simon Fraser University in Vancouver. He’s also competed in cross-country running, taken tae kwon do lessons, and played basketball. Plus, he’s an avid weightlifter. Favaro says that with the support of his doctor, “I was able to do everything that everyone else did. I just had to be more mindful of my ability to breathe than other people.”

Growing up, Favaro achieved what experts say is possible for all asthmatic kids. “If they have good control, they can be competitive to any level,” says Dr. Brian Lyttle, a pediatric respirologist in London, Ontario. Good control usually means taking a corticosteroid (such as Flovent or Pulmicort) every day to reduce inflammation, minimizing exposure to triggers such as cigarette smoke and allergens, and having a fast-acting reliever puffer on hand in case of an asthma attack.

While exercise is important for everyone, it plays a special role for people who have asthma. “The better shape you’re in, the better your lungs function,” says Dr. Michael Clarfield, a sports medicine specialist and former team physician for the Toronto Maple Leafs. “When you’re getting diminished function from your asthma, the more function you had to start with, the better off you will be.”

Dr. Alan Kaplan, a doctor in Richmond Hill, Ontario who chairs the Family Physician Airways Group of Canada, looks at it this way: “Exercising will teach your muscles to learn to work with what you’ve got. So even if you do have lung impairment, it’s still important to exercise and to teach your muscles to be able to exercise even at lower oxygen levels.”

It’s not that asthmatic kids should ignore their symptoms and push themselves into respiratory distress; rather, with the right combination of medications, and in a supportive environment with minimal triggers, all kids with the disease should be able to reach their athletic goals.

Katherine Smith, 14, a Canadian whose family lives in Phoenix, has certainly not let asthma deter her athletic pursuits. A bout with pneumonia at age 1 left her with diminished lung function, and she also has bad seasonal allergies. When she was about 9 years old, her parents noticed she had difficulty breathing when she ran or played sports at school. “If she had to do anything that required any endurance, all of a sudden she was gasping for air,” says her dad, Doug Smith.

With the right medications and a good attitude, Katherine has thrived. She pitches for a competitive softball team that placed ninth out of 70 teams at last year’s U.S. national championships. “She treats the asthma meds as something ‘I’ve just got to do to prepare,’ ” says Smith, “like going to conditioning class, or to her trainer.”

But not every kid with asthma is a Brett or a Katherine. There is growing evidence that some young people with asthma shy away – not just from team sports – but from physical activity period. Researchers at John Hopkins Medicine conducted a telephone survey of 243 parents in 2004 and discovered that 20 per cent of asthmatic children were not getting enough exercise.

The lack of activity stemmed partly from misguided beliefs: 25 per cent of parents surveyed with an asthmatic child were afraid their child would get sick if he or she exercised. The kids’ attitudes toward exercising also played a role: 25 per cent of the parents responded that their child gets “upset with strenuous activity”.

A study published in the Journal of Asthma in March 2008 compared overweight status in adolescents with and without asthma; the study authors found that receiving an asthma diagnosis in early childhood may increase the likelihood of becoming overweight. Kaplan relates that he has been approached by parents asking him to write a note dismissing their child from gym class. “There are people who use asthma as an excuse not to exercise.”

For parents who don’t know a lot about the disease, hearing that their child has asthma can be alarming. There’s often a lack of understanding of both the disease and the level of control that should be attainable. When Jordan Stewart of Thornhill, Ontario, was diagnosed at age 3, his mother Tula Stewart was terrified. “My heart just dropped,” she says. “I was devastated. You hear stories of people dying from it; that was probably my biggest fear.”

The family doctor prescribed Jordan a puffer, but the asthma symptoms continued. At times of the year when Jordan had a cold, and during the spring and fall allergy seasons, he would cough and wheeze and become short of breath. At age 6, his parents enrolled him in soccer but that was short-lived.

As Stewart recalls, it just wasn’t worth the risk of having to rush him to the hospital. The Stewarts hadn’t yet learned enough about properly using medications to control Jordan’s asthma.

Next: Stereotypes about those with asthma

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