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CNN SUNDAY MORNING

Interview with William Berger, Nancy Sander

Aired May 5, 2002 - 07:41   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
KYRA PHILLIPS, CNN ANCHOR: Well Congress got an earful about the danger of asthma this week. A non-profit group held its annual field hearing to educate members of Congress about a variety of issues facing asthmatics. We have two guests to talk about asthma and how to deal with it. Dr. William Berger, a pediatrician and allergist. He joins us from Dallas. And from Washington, Nancy Sander of the Allergy and Asthma. You can check out her organization's web site at breatherville.org.

Good morning to both of you.

WILLIAM BERGER, PEDIATRICIAN ALLERGIST: Good morning.

NANCY SANDER, ALLERGY & ASHTHMA NETWORK: Good morning.

PHILLIPS: Well, Bill, let's start off with the misconceptions about what asthma actually is. And let's clear some of that up. Describe the illness?

BERGER: Well, asthma is an inherited disease that very often will first show up as a cough, then wheezing, and shortness of breath. Very often, especially in childhood, it's thought of as being bronchitis and infectious process. But in reality, it is asthma. And it's a chronic inflammatory disease. And very often, people are aware of it when it's really gotten out of control. So the key to approaching asthma correctly is to making a correct diagnosis, which very often involves getting a good history, physical examination, doing lung function testing, and then instituting appropriate therapy.

And very often, that may mean anti-inflammatory therapy. Therapy that prevents the chronic inflammation that goes along with asthma.

PHILLIPS: And Nancy, why are more children and more adults continuing to get asthma? Why does it get worse versus better?

SANDER: That's the million dollar question that leaves many people scratching their head. Here in Washington, D.C., as well as around the country. But in Washington, D.C. what happens with asthma awareness, say on Capitol Hill, was that members of Congress heard that children in 17 states are not permitted, excuse me, in only 17 states are permitted to carry inhalers on their person. The rest are not. They also heard that clean indoor air in our schools is not a given. And the majority of our schools do not have a school nurse. And furthermore, if you show up in the emergency room with a broken leg, and I show up with asthma, you're more likely to get a referral to a specialist than I am.

When Congress heard these four things, they were shocked. And they committed to work with us over the next year, to develop legislation to ensure the protection of children with asthma.

PHILLIPS: All right, well, Nancy, you and Bill both talk about the number of -- so many cases that go undiagnosed. Bill, in your book, "Allergies and Asthma for Dummies," talk to us about this stepwise approach in the book?

BERGER: Well, as I mentioned before, the critical issue is diagnosing asthma, when very often that will involve getting good history and a physical, doing lung function testing, getting a history of how often patients need to use their rescue inhalers, the inhalers that give them that quick relief.

And we separate asthma into what we refer to as mild intermittent. And then in the persistent range, mild persistent, moderate persistent, and severe persistent. And again, those are based on the clinical evaluation of the patient's asthma, based on what category the asthma patient falls into, that determines the type of therapy that the patient needs.

As a result in the majority of patients who have persistent asthma, and that represents 70, 80 percent of all asthmatics, they need to be on regular medication therapy. Then as they improve, we can step down. We can decrease the amount of medication that they need. But the critical thing is to get their lung functions in the normal range, get them living a normal life. And in most cases, the vast majority of asthma patients can leave active lives, can be sports heroes. We actually had Jerome Bettis (ph), one of the top runningbacks in the NFL at Capitol Hill, an asthmatic who got proper care, and is now into very good control.

PHILLIPS: Nancy, why do so many schools not let kids bring inhalers to school? That's got to change, right?

SANDER: Right. And there's a lot of fear about oh, what happens if it gets lost on the playground and another child picks it up. Or in some cases, it's just a zero tolerance for medication. And there's a range -- excuse me, a zero tolerance for any kind of drug, if you will, at school. But there's a range of "reasons," all of which have more to do with lack of awareness than the health and safety needs of that child.

And we believe with education, that can make a difference. Remember that mild -- whether asthma is mild, moderate or severe, your chances are a child's chances of an asthma death are equal. And you know, as an organization, Allergy and Asthma Network, Mothers of Asthmatics, we are committed to helping schoolchildren have a safe experience at school every single year.

PHILLIPS: On that note of safety in school, Bill, maybe you can address this. I mean, I remember years ago as a reporter in other markets, doing these stories on the clean air. Is there clean air in our schools and all the issues of asbestos and all this stuff. How important is that? And is there a way you could test it yourself? If your child has asthma, do you have a right to bring something into the classroom and test the air? I know they sell the little testing devices at Home Depot and other places like this?

BERGER: Well, certainly...

PHILLIPS: Go ahead, both of you.

BERGER: OK, Nancy, why don't you go first?

PHILLIPS: Ladies first.

SANDER: Thanks, Bill. The EPA makes a wonderful indoor air quality kit, that is used in schools called Tools for Schools. And it helps identify common irritants and allegens and other kinds of contaminants that parents can work with their school principal, their PTA, with the building supervisor and make certain that the indoor air quality is as healthy as possible.

And just because a school is new doesn't necessarily mean that it is free of indoor air allergens.

PHILLIPS: Bill, go ahead.

BERGER: Oh, what I was going to say, and Nancy described it very well, is there are testing procedures that are available, but the key thing is to identify, not just the classroom triggers, but the different types of triggers that patients may not be aware of, things such as allergies, animal danders, dust, mold, pollens. We know, for example, exercise is a major trigger. Cold air is a trigger. And in children infections, especially viral infections are common triggers.

But again, it's important that a patient be able to review all of these triggers and identify them with their doctor. And very often, that requires an evaluation by a specialist. So the key thing is to be able to get a comprehensive overview of all of the triggers that can cause asthma symptoms.

PHILLIPS: All right, before we let you guys go, once again I want to mention Bill's book, "Allergies and Asthma for Dummies." Also, Nancy has a website, breatherville.org. Any other -- Bill, do you have a web site, too?

BERGER: We have a web site for our practice, but I think that Nancy's web site is the bet web site for information for patients. And I think one of the best books is "Allergies and Asthma for Dummies."

PHILLIPS: I love it. You're each other's fan club. Yes, Nancy?

SANDER: Well, I was going to say, "Allergies and Asthma" for dummies is a must have for ever person out there. And getting a clear understanding of your asthma and your allergy triggers from a board certified allergist is also extremely important. And it's a great shortcut to getting asthma under control.

PHILLIPS: Absolutely. Two experts and two good friends.

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