Common sense best remedy for respiratory issues

This is the third in a summer series on sports-related illnesses and injuries that affect scholastic and youth athletes.
It isn't uncommon for athletes to play despite suffering from asthma or, more particularly, exercise-induced asthma.

Those conditions are aggravated even more while playing an outdoor sport.

Managing asthmatic conditions is critical to being successful on the athletic fields, and not paying attention to the symptoms could be harmful and compound the problems.

As much of a problem as asthma can cause an athlete, few people realize it may be secondary to an ailment that gets far less concern, the common cold.

As simple as it might seem and as lightly an ailment as it is regarded, a cold or nasal congestion, whether caused by dust or allergies or whatever, could lead to greater difficulties that would surely diminish an athlete's performance level.

Dr. Michael Pardo, an Annapolis native and ear, nose and throat specialist on staff at the Anne Arundel Medical Center, assured that he can't stress enough the need for athletes, parents and coaches, the need for common sense when dealing with congestion.

"Pediatricians are more on the front line of dealing with asthma in kids in sports when they give physicals, but exercise induced asthma is a big problem … you have kids who have to use their inhalers and …

"But what also triggers that is their allergies during the outdoor seasons. If they're out there during the grass season, the summer, or when there's tree pollen, the spring, or when there are weeds, the fall, their allergies are aggravated," Pardo explained.

"Then they're sneezing and congested and their allergies lead to sinus infections and the more upper respiratory track infection you have, the more lower respiratory track infection you'll have," he said. "That's the biggest problem with colds: Once you get upper respiratory track infection it starts to affect your lower airways and your breathing."

He explained that if an athletes has exercise-induced asthma and he or she gets upper respiratory track infections the lower respiratory track becomes more agitated and the symptoms are exacerbated and breathing is affected.

Pardo leaned on his own lacrosse experience to recall that some players with exercise-induced asthma would often run to the sideline to use their inhalers but he doesn't remember any of them ever stopping or leaving the games.

"It's so hard to get kids to stop playing. It's hard to convince them that they might be having a problem from their asthma," he continued. "They want to play all the time so you have to be aggressive in treating their asthma and their allergies.

"The best way to monitor a kid with asthma is with a peak flow meter, which is a device you breathe into that takes the guesswork out of what's going on with someone's breathing. You don't have to judge for yourself how bad your asthma may be, the peak flow meter will tell you," Pardo said.

"You know when you're getting into the danger range because the peak flow meter tells you how your lung capacity is being affected," he explained. "You might say you're fine, but if you blow into the device and you're supposed to hit 300 but you only hit 100, you know you're in trouble.

"One of the things is that kids won't recognize problems like these by themselves because they want to play no matter what," Pardo said. "They may not realize that their athletic performance is being hindered and they'll play through it."

Certified athletic trainers would be educated enough to recognize such a problem but there are few schools that have trainers at practices or games. Another problem is that few asthmatics have peak flow meters at the fields with them.

Coaches aren't likely to recognize asthmatic or other respiratory symptoms, because they have a great deal to do and are working with a full team of youngsters, but it would be wise for them to learn a little bit about such problems. With that in mind, it behooves the parents of youngsters with asthma or other respiratory ailments to be vigilant during practices or games.

"It's got to be a parent who recognizes that if their kid has asthma is running around with a cold or a sinus infection they have to be concerned that the asthma will also be triggered or worsened by it," Pardo said. "Parent recognition is a key.

"However, there's no stopping kids from catching colds and for a kid who has asthma or allergies the cold tends to worsen things. It's all connected," Pardo said.

"Obviously, if a kid with asthma starts getting sick, getting sinus infections, run around coughing or are congested should be a tip-off for a coach that a kid is going to get worse," said Pardo. "Asthma can become crippling if a sinus infection starts kicking in.

"Almost anything can aggravate asthma; allergies, dirt, dust. If it's something that irritates a cold it makes the asthma worse," Pardo said. "There are lots of things out there that we call different things, but in the end they are all inflammation of the upper or lower airways."

He implied that it's paramount for parents to use common sense when it comes whether or not to allow their youngsters to participate in practices or play in games when they have a cold. If an athlete has chills, fever or bronchitis, they should not be playing.

Pardo explained that the common cold will run its course in five to seven days. If it goes beyond that, athletes should be more careful because it could manifest itself into a sinus infection to bronchitis to pneumonia, which would force the youngsters to sit out for two weeks or more.

"A lot of times an athletes will say he feels better when he's running or exercising, that their nasal congestion actually improves. During that time they may be clear but when they stop they'll congested again and when you get congested and your sinus passage gets blocked with mucous it can get infected," Pardo said.

He pointed out that such infections can become more serious to the point of contracting a Methicillin-Resistant Staphylococcus Aurous (MRSA) type infection.

While asthma can be controlled with inhalers and the like, the common cold is something that can become something worse and at that point athletes do have to take breaks. If a cold lingers beyond seven to 10 days it has done exactly that and the athlete has to be kept off the field.

"If you allow a common cold to progress to a sinus infection that could make you feel miserable it could take a month to get better and performance will be way down," Pardo said.

"The sinus infection, which includes headache, facial pressure, nasal congestion, thickened mucus, coughing that can cause fatigue, and that can turn into bronchitis and the bronchitis can turn into pneumonia and then you're in trouble," he explained.

The responsibility of keeping an athlete from becoming more ill falls mostly on parents. Practicing or competing with a common cold may not seem extreme, but there is a definite need for the athletes to be watched to be sure it runs its course and doesn't manifest itself to a worse illness.

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