When I worked in a kindergarten-first grade school before becoming editor, I got to see first hand how many young kids were asthmatics and allergy sufferers.  Plastic bags of their inhalers and other medication would be stored in the nurse’s office, and every field trip meant that we had to make sure we had each child’s specific bag of meds.  To me it seemed like an almost epidemic.  When the book, “Beating Asthma” came into the office, I was very curious about any new findings on the issue.

The subtitle of the book, “Seven Simple Principles” caught my eye, and reminded me that sometimes the most perplexing problem can sometimes have common sense remedies.

Dr. Stephen Apaliski called me from his home state of Texas during a break from radio interviews.  He’s got a lot to say and has been waiting years to say it.

“The medical community has learned a lot about asthma,” he says, “but it’s time to quit educating the physicians, but educate the parents.”   The first question I asked is “why so much asthma?”

Dr. Apaliski faults the air quality for one thing, though while it’s cleaner than it was ten years ago, you still have poor air quality in the Hudson Valley (because we’re in a valley) and urban or industrial areas.  But also, he says, there is a “hygiene hypothesis,” which says that the more cleaner the environment, the less resistant our bodies have become to contaminants.  An example, Dr. Apaliski cited, had to do with some research done that says kids raised in environments with dirt, so to speak, and allergens have a higher tolerance for all kinds of air quality.  “Kids on a farm,” Dr. Apaliski notes, “tend to do better.”

In his book, Dr. Apaliski lists seven principles of asthma that parents, either for themselves or for their kids, should be aware of.  He refers to these as the “Seven P Principles.”

1. Understanding the Problem: Don’t view asthma as an episodic illness, which can give the patient the idea that they’re powerless to control it.  View it as a chronic problem with ways to manage it.

2. Prevention (by avoidance): Get to recognize the triggers of asthma, i.e., perfume,  days with high ozone alerts, and avoid them.  Parents should have their kids play indoors when the air quality for that day is poor.

3. Pulmonary Function Test: Having these test performed can greatly educate parents and their kids on the true state of lungs.  “Ironically, a person with asthma may report feeling well when in fact their lungs may not be doing well at all,” Dr. Apaliski writes.  Treatment plans may have to be adjusted, even when the patient feels well.

4. Pharmaceuticals: Find the right amount of medicine needed to control the asthma, nothing less and nothing more.  It’s a balancing act for the physician and patient, but good communication can get this to work.

5. Plan: Develop a plan with the physician so that parents know when to take action.  Relying on a “crises-driven” plan when only taking action when the asthma gets severe is not the way to go, but a daily monitoring of the patient feels.  If a cold is coming on, for instance, there should be steps taking right away to avoid a full-blown attack, requiring an ER visit.

6. Patient-Physician Relationship:  Engage in collaborative relationship with a physician, one built on mutual respect and open dialogue; find a physician who will listen and values your input.

7. Positive Mindset: While there is no research that asthma can be “beaten,” we know that having a positive mindset is key to its control.  A positive mindset includes optimism, ownership and something known as “grit,” or the persistence necessary to overcome denial, and maintain the positive actions needed keep asthma in check.

When I asked Dr. Apaliski about why he wrote this book, he told me about Sarah (name changed.)  “A typical pre-teenager…energetic, bright, and full of life.  But, beaten by asthma, she died on Father’s Day.”

To this day, Dr. Apaliski feels the loss, that her death left a “never-healing mark that is still there to this day.”

We concluded our conversation with this statistic: “Seventy-one percent [of those with asthma] could be described as poorly controlled….Patients are settling for less wellness than they deserve.”

Dr. Stephen Apaliski is Board Certified in Pediatrics as well as Allergy and Immunology. He’s a Fellow of the American College of Allergy and Immunology and a Board Member of the Allergy and Asthma Foundation of America-Texas Chapter.