When Cole Fayemi had his first major asthma attack at the age of 18 months, his father, paediatrician Olutoyin Fayemi, had to hold him down for the medicine to be administered. Cole's oxygen levels were dangerously low, and he had to be hospitalised.

“It was a pretty frightening experience,” said Dr. Fayemi who works at Edgewood Paediatrics on Point Finger Road in Paget. He moved to Bermuda from Boston last year. “You don't know how your child is going to act until they put this thing in front of them with the steam coming out. He went ballistic. We had to do him. I had to really, really hold him.”

Today Cole is three years old. When he had his photograph taken for the Royal Gazette, he calmly helped his mother hold the inhaler to his mouth and counted to ten. When the inhaler was removed he took a deep breath and then smiled.

Asthma is a disease of the lungs. Lungs are made up of a number of hollow tubes. Asthma has two components. One of the muscles that surround the tubes are very twitchy so they punch the tube down and make the tube smaller and also produce a lot of mucus in the tubes to make the tubes even smaller.

Symptoms of an asthma attack vary, but for children can include a cough, especially a cough at night; a tight chest, wheezing, and breathlessness.

“We were at someone's birthday party and he got sick,” said Dr. Fayemi. “Cole started acting weird. I took him home and he was getting more and more cranky and wouldn't go to sleep. He started having trouble breathing. He vomited once or twice. We had the little puffers because we thought he had wheezed before. We tried that and it didn't work. We ended up in the emergency room at Boston Children's Hospital. He was admitted because his oxygen levels were really low and he was having a lot of trouble breathing.”

Dr. Fayemi said even for a paediatrician there was only so much a parent can handle at home.

“His oxygen level was 88 percent,” he said. “It is supposed to be 100 percent. He couldn't go home. They gave him a whole bunch of nebuliser treatments, that did nothing. He didn't improve. Then he was admitted. It was a pretty frightening experience.

“You don't know how your child is going to act until they put this thing in front of them with the steam coming out. He went ballistic. We had to hold him. I had to really, really hold him. He was out of control.”

But Cole did eventually get to use his asthma treatments.

Although Dr. Fayemi is not a specialist in asthma, he said his son's condition has given him a particular interest in asthma. On Friday May 6 he will be giving a one-hour presentation at the Bermuda Chamber of Commerce called ‘Childhood With Asthma'. The talk is being sponsored by the local asthma charity Open Airways.

Although there is no cure for asthma, the symptoms can be controlled with the right treatment regimen.

Dr. Fayemi said that some parents whose children react to the medication the way Cole first did, go into a period of denial, and don't give their children their medications.

“Asthma medications are not like Tylenol or Advil or cough medicine that is optional,” he said. “It is one of those things that you need to give to your child. They do get use to it. It doesn't hurt them. They will eventually be like Cole and want it when they get sick.”

He said that when a child had an asthmatic attack it was crucial that they had their medication every four hours.

Not treating asthma properly can have long-term consequences on the body.

“Poorly controlled asthma will lead to chronic lung disease later on in life,” said Dr. Fayemi. “It is more important to treat it aggressively early, instead of waiting and seeing what happens.”

And he said that asthma doesn't have to be a prison sentence for a child. In fact, he said there have been a few studies shown that suggest a slight amount of asthma can actually improve athletic performance.

“Some people theorise that people with a mild bit of asthma are used to having oxygen levels that are a little lower so they can run longer and can get use to being tired,” he said. “They can participate in sports. I haven't seen an asthmatic in Bermuda that was so severe they couldn't participate and do what they usually do.

“Many people also think that asthma means they are going to be on a respirator and not be able to go out and do what they want. You can still go out and do all the things you used to, it is just very important to know when your child is having an asthma attack, know the symptoms and how to treat it appropriately.”

He said asthma had a number of causes including allergies and genetic history.

“There are a lot of things that can cause it,” he said. “Any kind of chemical or inhalant can irritate your lungs. Every asthmatic is different as far as what effects their asthma. But smoke is probably one of the more common inhalants that are preventable. Exposure to second hand smoke is awful for asthma.

“There is a very strong connection between asthma and allergies. People who have eczema which is allergy of skin have higher instances of asthma. When you have allergies there is a higher chance of having asthma.

“It is genetic - if a parent, uncle or cousin has asthma you are more likely to have asthma, but you can have no family history of asthma and develop asthma.”

He said Bermuda's humid, mould-friendly climate also encouraged asthma.

“Although, my son's asthma has actually been very good here. It was a lot worse in Boston. When we went back to Boston recently he had a cold and got a bad asthma exacerbation. I don't think he has had a real asthma attack here as far as colds.

“It could be the air quality, dryness. He has allergies to peanuts and other things. It might be something about where we go that irritates him.”

The main medicines for asthma include Ventolin in a syrup or through an inhaler, inhaled steroids, and non-steroidal drugs such as Singulair.

“Any medicine has side effects,” said Dr. Fayemi. “Ventolin helps with the twitchiness of the airways. Through an inhaler it can cause you to have a fast heart rate and be a little jittery. The Ventolin syrup can make you bounce off the walls.”

He recommended that children with asthma be taught to look out for symptoms of an impending asthma attack, and be taught to use an inhaler.

“The talk I am giving will be on the basics of asthma,” said Dr. Fayemi. “Does your child have asthma and more important, is your child's asthma controlled? I will also look at what we mean by controlled. “Controlled means having not that many symptoms. We consider asthma not under control if you are having symptoms more than twice a week during the day and twice a month at night.”If your child's asthma is not under good control then the asthma treatment should be stepped up.”

Dr. Fayemi said that if you think your child has asthma you should take them to a paediatrician or family doctor. If they are having acute distress or trouble breathing they may need to go to the emergency room.

He said that most cases of asthma develop at four or five years of age.

“I don't know the exact numbers,” he said, “But it is around 80 to 90 percent before the age of five. There is an entity called childhood asthma. With asthma that is diagnosed very early in life most children outgrow it by age three or four.

“Eighty percent of kids who have asthma, will not have it when they are school age children. A fair number of those where it goes away will come back in their adolescence.”

In addition to Dr. Fayemi's talk on May 6 at 12 noon at the Chamber of Commerce, Open Airways will be providing information in Dockyard at the End to End Walk from 10 a.m. to 4 p.m. and they will be at Harbour Nights on Front Street. They are also having a talk for seniors and older adults with asthma and other breathing problems such as emphysema at the Peace Lutheran Church Hall on May 12 at 10 a.m. Call 232-0264 for more information or email lizbodenlogic.bm .