Madam Victoria Phua's sons, Idris (left) and Isa Baobid, both have asthma. Despite their condition, she encourages them to stay active. ST PHOTO: GIN TAY
SINGAPORE – How could what seemed like a simple cough turn into a life-or-death situation for a toddler?
Isa Baobid was 22 months old in January 2021 when he had a mild but persistent cough for about five days. His mum, Madam Victoria Phua, took him to a clinic where the paediatrician detected wheezing and advised close monitoring.
Isa’s condition improved that week – until one night when he kept crying and his cough worsened before bedtime.
As a precaution, Madam Phua took her son to KK Women’s and Children’s Hospital (KKH), where the boy was diagnosed with asthma after a weekend stay.
He was back to his happy self, but three weeks later, he was found breathing irregularly and crying non-stop.
Madam Phua, a 42-year-old public servant, says she instinctively knew her son was in an emergency situation and rushed him to KKH by car.
“The journey to the hospital was most agonising because I felt very helpless,” she recounts.
Upon arriving at the children’s emergency, she remembers shouting for help: “He can’t breathe, he’s blue!”
Isa was hooked up to breathing tubes in the high dependency ward before being transferred to the children’s intensive care unit.
“Reality hit home because what seemed like innocent coughing was now a life-or-death situation,” Madam Phua says.
Thankfully, Isa, now five, recovered after treatment and his asthma is now under control.
Asthma almost took his life too
Looking at seven-year-old Tyler Rodrigues Rui Yang, one would be hard-pressed to tell that the sporty boy was diagnosed with asthma at age two.
In 2022, Tyler Rodrigues Rui Yang, now seven, suffered an asthma attack so severe, it could have been fatal had his parents not rushed him to the hospital. PHOTO: REBECCA CHIA-RODRIGUES
In July 2022, he suffered an asthma attack so severe, it could have been fatal had his parents not sought prompt medical attention.
His mum, Mrs Rebecca Chia-Rodrigues, recalls taking him to a polyclinic because he had developed a cough the night before. He was also breathing deeply and had difficulty sleeping.
Recognising his low oxygen level and the severity of the asthma attack, the doctors immediately sent him to KKH in an ambulance, says the 42-year-old homemaker.
“Everything happened so quickly. When we got to the hospital, there was a team of doctors monitoring and administering him salbutamol every 10 minutes.” Salbutamol is a medication that helps relax and open up the airways in the lungs.
“A doctor told my husband that if we had not brought Tyler in to seek treatment that morning, he could have (died).”
Since then, Tyler’s family ensure he uses a preventer inhaler daily and attends regular health check-ups to manage his asthma effectively. They are also more vigilant when he is unwell.
“Initially, Tyler always felt he was different because we used to be afraid of him falling sick, as it could trigger an asthma attack,” says Mrs Chia-Rodrigues.
She would worry for him too, when his 11-year-old sister and five-year-old brother had a cough or cold, as he might catch the virus from them. His siblings do not have asthma.
However, she now feels more confident in recognising the signs of an asthma attack and at administering the necessary medication to manage his condition.
Tyler Rodrigues (right) with his mum Rebecca Chia-Rodrigues, dad Glendon Rodrigues, older sister Tara and younger brother Chase. PHOTO: COURTESY OF REBECCA CHIA-RODRIGUES
1 in 5 kids gets asthma
Asthma is a respiratory condition affecting one in five children in Singapore, according to Dr Ting Chun Yi, associate consultant at Respiratory Medicine Service at KKH.
In 2023, KKH’s children’s emergency department attended to about 2,800 asthma cases. Of these, about 1,000 required hospital admission.
Although some children – like Isa and Tyler – are diagnosed with asthma during their toddler years, others may not exhibit symptoms until they are in pre-school, primary school or even adulthood.
Common symptoms include coughing, wheezing, difficulty in breathing and chest tightness. Some kids may also have frequent coughing that is triggered by viral infections, exercise, cold drinks or cold air.
These signs can range from mild to severe, and may worsen at night for some children.
An interplay of various factors can contribute to the development of asthma in children, says Dr Ting.
Children with parents or family members who have asthma have a higher risk of developing the condition. However, asthma can also occur in kids without a family history of asthma.
Those with conditions such as eczema, allergic rhinitis or food allergies can be predisposed to asthma. Other risk factors include environmental exposures, such as cigarette smoke.
Asthma is more prevalent in young boys than young girls. However, after puberty, the trend reverses, with females experiencing a higher incidence of asthma compared with males.
Can childhood asthma go away?
There is no cure for asthma, says Dr Ting. However, with appropriate treatment, children with well-controlled asthma can lead normal and active lives.
While some may outgrow their asthma symptoms and do not need long-term inhaler use, others may experience symptoms into adulthood.
Some may even have a recurrence of asthma in adulthood, triggered by environmental factors, even after being symptom-free for years.
Dr Ting adds that it is important for children to understand their condition so they will take better care of themselves and not refuse medication.
Parents can explain to them that kids have sensitive airways and can react to triggers such as dust, pollen, pet fur and even the common cold.
These triggers cause the muscles around the airways to tighten and narrow, making breathing difficult. This is known as an asthma attack or exacerbation.
Parents can further illustrate the concept by using a straw. During an asthma attack, the airways narrow, similar to how the hole in a straw becomes smaller, making it harder to breathe.
Alternatively, read with them the asthma-themed picture book Wallace’s Song, written by Dr Ting and Dr Leon Tan Yuan Rui, her colleague from the Department of Paediatrics.
The title is part of the 12-book The Baby Bear Paediatric Care Series which addresses common childhood illnesses and conditions.
(From left) Dr Leon Tan Yuan Rui and Dr Ting Chun Yi wrote the asthma-themed picture book Wallace’s Song. They are seen here with other authors from The Baby Bear Paediatric Care Series: Dr Chong Kok Wee, Dr Catrin Kong Kar Yee, Dr Juliet Tan Sher Kit and Dr Christopher Seow Wen-Xing. PHOTO: KKH
In Wallace’s Song, a young whale neglects to use his prescribed inhalers as directed by his doctor, resulting in an asthma attack.
Dr Ting wants kids with asthma to know they are not alone.
“We hope this book will encourage them to use their preventer inhalers regularly, even if it feels like a chore, and to strive for good asthma control,” she says.
For children without asthma, she hopes the book will help foster empathy and understanding towards friends and family who have the condition.
Follow the action plan
Dr Ting emphasises the importance of having a written asthma action plan from healthcare providers.
This personalised plan includes details on the inhalers to use and specific steps for managing asthma daily and during an attack. When a child has an asthma attack, parents should follow the asthma action plan and administer the reliever inhaler as directed.
Dr Ting wants kids to understand that good asthma control can enable them to live unrestricted lives.
Tyler, who loves cycling and playing in the pool, attests to it. “Having asthma does not mean I cannot enjoy the same activities as other kids. I enjoy frequent play dates with my friends,” he says.
Likewise, Isa has been maintaining a healthy lifestyle with his four-year-old brother Idris, who also has asthma.
Madam Phua encourages her sons to keep active, but reminds them to stay away from smoke or dust particles, smokers and soft toys. ST PHOTO: GIN TAY
Madam Phua encourages her sons to keep active, but reminds them to stay away from smoke or dust particles, which can come from incense-burning, smokers and soft toys.
She adds: “Isa’s harrowing asthma attack, which led to his admission to the children’s intensive care unit, taught us that the condition can deteriorate rapidly if not treated promptly.”
5 myths about childhood asthma
Dr Ting addresses common misunderstandings about childhood asthma.
Myth 1: Kids with asthma cannot exercise
Fact: With well-managed asthma, children can and should enjoy an active lifestyle. Regular exercise offers numerous health benefits, including better lung function, which improves asthma control. Many successful athletes, even Olympic medallists such as American swimmer Amy Van Dyken and Japanese figure skater Hanyu Yuzuru, have asthma.
Myth 2: Children can outgrow asthma
Fact: While some children may experience fewer symptoms as they grow older, asthma is a chronic condition that cannot be outgrown.
Myth 3: Asthma inhalers are addictive and stunt growth
Fact: Preventer inhalers, essential for asthma management, are not addictive. They reduce airway inflammation to prevent asthma attacks. Consistent use, even when your child seems well, is crucial for good asthma control. Inhaled corticosteroids at normal doses do not significantly affect a child’s final height. Poorly controlled asthma poses a greater risk to growth.
Myth 4: Asthma is not life-threatening
Fact: Asthma attacks can be life-threatening, especially in a child with poorly controlled asthma. Taking medication regularly and avoiding triggers are vital for good asthma control and can reduce the chance of asthma attacks occurring.
Myth 5: No wheezing means no asthma
Fact: Wheezing is a common asthma symptom, but its absence does not rule out asthma. Symptoms vary among children and can include coughing – especially at night, triggered by exercise or cold food and drinks – difficulty breathing and chest tightness.
Source: The Straits Times © SPH Media Limited. Reproduced with permission.
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