3-year-old timeline: Facing Fears

Your 3-year-old now
Bedtime fears are common for preschoolers. But children can be frightened of anything from loud noises to the idea of being abandoned by Mom and Dad. This makes sense: Now that they're more independent and can leave you, they also begin to realize that you can leave them.

Parents must walk a fine line here. You want to calm your child. But you don't want to fuel the fear. How to tread depends a bit on your child's personality. Some kids may be soothed if you check under the bed for monsters or squirt special "monster spray" (air freshener or water). Those with a scientific bent may see your monster hunt as proof that the creatures exist, so if your child only seems more upset, back off and try talking more directly about the fear: "I know a dark room can be scary. I was scared when I was your age, too." Offer a practical solution such as a night-light or a special back rub to calm her.

However you proceed, don't minimize your child's fears. Bluntly stating there's "no such thing" or "nothing to be afraid of" isn't logic she's going to buy into. Those monsters are very real to her. Your job is to help her cope, reassure her, and make sure she feels comfortable confiding in you.

Some don'ts:

• Don't threaten that a monster will get her if she doesn't behave. Her literal little brain will believe you.
• Don't force her to confront her fears. She isn't equipped to do that at this age.
• Don't tell her that "big kids aren't afraid." That doesn't take the fear away. It just adds pressure and makes it more difficult for her to come to you.
  

Your life now
When your child throws a tantrum, don't automatically assume she's tired. Other common triggers for 3-year-olds: Hunger, sickness, frustration over being unable to do something physical, and wilting from expectations that are too mature for her. Often the best response is no response: Give the tantrum a little time to burn itself out or, if you feel like you have to respond, hold your child (if you can) or rub her back. Realize, though, that her emotional state is much too primitive during a tantrum to respond to logical arguments or much other conversation.

source www.parentcenter.babycenter.com

3-year-old timeline: Your Little Storyteller

Your 3-year-old now
As your child's language skills evolve, he'll start to tell you more elaborate stories. Hooray! Storytelling is a great step in a preschooler's development.

It's happening now because at 3, your child is capable of a complex chain of events: He can experience something, think about it, and then tell a story about it. These stories — real or fictional or a mix of both — help little kids make sense of everyday events and the people they meet.

You may see your child telling stories to himself or his toys. They can be completely fantastical, or they can combine several real-life events into one narrative. If you're the audience, listen appreciatively. Encourage him with questions as he spins yarns about the picture he drew or the book he's reading. Invite him to add details to stories you tell.

To help keep the creative juices flowing, make sure your child hears stories of all kinds — fairy tales, anecdotes from your own life, fables, picture-book tales. Acting these stories out will also strengthen his imagination and storytelling abilities.

Your life now
Ever urge your child to hurry, only to see it have the opposite effect, as if molasses had just been poured over his head? Badgering a child to move faster can make him anxious. Better to try cajoling with a game or a race: "Let's see who can put on their shoes faster, me or you?" Or, "I'll race you to the car, ready, set, go!"

source www.parentcenter.babycenter.com

Asthma (Part 3 of 3)

What are the treatments for asthma?

For most people with asthma, most of the symptoms can be prevented with treatment. So, you are able to get on with normal life, school, work, sport, etc.

Inhalers
Most people with asthma are treated with inhalers. Inhalers deliver a small dose of drug directly to the airways. The dose is enough to treat the airways. However, the amount of drug that gets into the rest of your body is small so side-effects are unlikely, or minor. There are various inhaler devices made by different companies. Different ones suit different people. A doctor or nurse will advise on the different types. See a separate leaflet called ‘Asthma - Inhalers‘.

Inhalers can be grouped into ‘relievers’, ‘preventers’ and ‘long acting bronchodilators’.

• A reliever inhaler is taken ‘as required’ to ease symptoms. The drug in a reliever inhaler relaxes the muscle in the airways. This makes the airways open wider, and symptoms usually quickly ease. These drugs are also called ‘bronchodilators’ as they dilate (widen) the bronchi (airways). There are several different reliever drugs. For example, salbutamol and terbutaline. These come in various brands made by different companies. If you only have symptoms every ‘now and then’, then the occasional use of a reliever inhaler may be all that you need. However, if you need a reliever inhaler three times a week or more to ease symptoms, a preventer inhaler is usually advised.
  
• A preventer inhaler is taken every day to prevent symptoms from developing. The drug commonly used in preventer inhalers is a steroid. There are various brands. Steroids work by reducing the inflammation in the airways. When the inflammation has gone, the airways are much less likely to become narrow and cause symptoms. It takes 7-14 days for the steroid in a preventer inhaler to build up it’s effect. Therefore, it will not give any immediate relief of symptoms. However, after a week or so of treatment, the symptoms have often gone, or are much reduced. It can take up to six weeks for maximum benefit. You should then not need to use a reliever inhaler very often, (if at all).
  
• A long acting bronchodilator may be advised in addition to a steroid inhaler. One may be needed if symptoms are not fully controlled by the steroid inhaler alone. The drugs in these inhalers work in a similar way to ‘relievers’, but work for up to 12 hours after taking each dose. They include salmeterol and formoterol. (Some brands of inhaler contain a steroid plus a long acting bronchodilator for convenience.)

Tablets to open up the airways
Most people do not need tablets as inhalers usually work well. However, in some cases a tablet (or in liquid form for children) is prescribed in addition to inhalers if symptoms are not fully eased by inhalers alone. Some young children use liquid medication instead of inhalers.

Steroid tablets
A short course of steroid tablets (such as prednisolone) is sometimes needed to ease a severe or prolonged attack of asthma. Steroid tablets are good at reducing the inflammation in the airways. For example, a severe attack may occur if you have a cold or chest infection.

Some people worry about taking steroid tablets. However, a short course of steroid tablets (for a week or so) usually works very well, and is unlikely to cause side-effects. Most of the side-effects caused by steroid tablets occur if you take them for a long time (more than several months), or if you take frequent short courses of high doses.

What are the dosages of treatment?

Everyone is different. The correct dose of a preventer inhaler is the lowest dose that prevents symptoms. A doctor may prescribe a high dose of a preventer inhaler at first, to quickly “get on top of symptoms”. When symptoms have gone, the dose may then be reduced by a little every few weeks. The aim is to find the lowest regular dose that keeps symptoms away.

Some people with asthma put up with symptoms. They may think that it is normal to still have some symptoms even when they are on treatment. A common example is a night time cough which can cause disturbed sleep. But if this occurs and your symptoms are not fully controlled - tell your doctor or nurse. Symptoms can often be prevented. For example, by adjusting the dose of your preventer inhaler, or by adding in a long acting bronchodilator.

A ‘typical’ treatment plan

A common treatment plan for a ‘typical’ person with moderate asthma is:

• A preventer inhaler (usually a steroid inhaler), taken each morning and at bedtime. This usually prevents symptoms throughout the day and night.
• A reliever inhaler may be needed now and then if breakthrough symptoms occur. For example, if symptoms flare up when you have a cough or cold.
• If exercise or sport causes symptoms, then a dose of a reliever inhaler just before the exercise usually prevents symptoms.
• The dose of the preventer inhaler may need to be increased for a while if you have a cough or cold, or during the hay fever season.
• Some people may need to add in a long acting bronchodilator, or tablets, if symptoms are not controlled with the above.

At first, adjusting doses of inhalers is usually done on the advice of a doctor or nurse. In time, you may agree an ‘asthma action plan’ with your doctor or nurse. This means that you make adjustments to the dose of your inhalers, depending on your symptoms and/or peak flow readings.

Does asthma go away?

There is no once-and-for-all cure. However, about half of the children who develop asthma ‘grow out of it’ by the time they are adults. For many adults, asthma is variable with some good spells and some spells that are not so good. Some people are worse in the winter months, and some worse in the hay fever season. Although not curable, asthma is treatable. Stepping up the treatment for a while during bad spells will often control symptoms.

Some other general points about asthma

• It is vital that you learn how to use your inhalers correctly. In some people, symptoms persist simply because they do not use their inhaler properly, and the drug from the inhaler does not get into the airways properly. See your practice nurse or doctor if you are not sure if you are using your inhaler properly.
• See a doctor or nurse if symptoms are not fully controlled, or if they are getting worse. For example, if:
  • a night time cough or wheeze is troublesome.
  • sport is being affected by symptoms.
  • your peak flow readings are lower than normal.
  • you need a reliever inhaler more often than usual.

  An adjustment in inhaler timings or doses may control these symptoms.

• See a doctor urgently if you develop severe symptoms that are not eased by a reliever inhaler. In particular, if you have difficulty talking due to shortness of breath. You may need emergency treatment with high dose reliever drugs and other treatments, sometimes in hospital. A severe asthma attack can be life-threatening.
• You should have an influenza immunisation every autumn (the annual ‘flu jab’) if you require regular treatment for asthma or if you have had a previous severe episode of asthma. Flu tends to be more serious if you have asthma.

Source www.patient.co.uk

Asthma (Part 2 of 3)

How is asthma diagnosed?

Sometimes symptoms are typical, and the diagnosis is easily made by a doctor. If there is doubt then some simple tests may be arranged. A peak flow meter is commonly used to help confirm that symptoms are due to asthma (see below). Sometimes a test called spirometry may be done to confirm the diagnosis. This involves breathing into a machine that measures the rate and volume of airflow in and out of your lungs.

What is the the peak flow meter?

This is a small device that you blow into. A doctor or nurse will show you how. It measures the speed of air that you can blow out of your lungs. No matter how strong you are, if your airways are narrowed, your peak flow reading will be lower than expected for your age, size, and sex. If you have untreated asthma, then you will normally have low and variable peak flow readings. Also, peak flow readings in the morning are usually lower than the evening if you have asthma.

You may be asked to keep a diary over two weeks or so of peak flow readings. Asthma is usually confirmed if you have low and variable peak flow readings over several days. Peak flow readings improve when the narrowed airways are opened up with treatment. Regular peak flow readings can be used to help assess how well treatment is working.

What are the treatments for asthma?

For most people with asthma, most of the symptoms can be prevented with treatment. So, you are able to get on with normal life, school, work, sport, etc.

Inhalers
Most people with asthma are treated with inhalers. Inhalers deliver a small dose of drug directly to the airways. The dose is enough to treat the airways. However, the amount of drug that gets into the rest of your body is small so side-effects are unlikely, or minor. There are various inhaler devices made by different companies. Different ones suit different people. A doctor or nurse will advise on the different types. See a separate leaflet called ‘Asthma - Inhalers‘.

Inhalers can be grouped into ‘relievers’, ‘preventers’ and ‘long acting bronchodilators’.

• A reliever inhaler is taken ‘as required’ to ease symptoms. The drug in a reliever inhaler relaxes the muscle in the airways. This makes the airways open wider, and symptoms usually quickly ease. These drugs are also called ‘bronchodilators’ as they dilate (widen) the bronchi (airways). There are several different reliever drugs. For example, salbutamol and terbutaline. These come in various brands made by different companies. If you only have symptoms every ‘now and then’, then the occasional use of a reliever inhaler may be all that you need. However, if you need a reliever inhaler three times a week or more to ease symptoms, a preventer inhaler is usually advised.
  
• A preventer inhaler is taken every day to prevent symptoms from developing. The drug commonly used in preventer inhalers is a steroid. There are various brands. Steroids work by reducing the inflammation in the airways. When the inflammation has gone, the airways are much less likely to become narrow and cause symptoms. It takes 7-14 days for the steroid in a preventer inhaler to build up it’s effect. Therefore, it will not give any immediate relief of symptoms. However, after a week or so of treatment, the symptoms have often gone, or are much reduced. It can take up to six weeks for maximum benefit. You should then not need to use a reliever inhaler very often, (if at all).
  
• A long acting bronchodilator may be advised in addition to a steroid inhaler. One may be needed if symptoms are not fully controlled by the steroid inhaler alone. The drugs in these inhalers work in a similar way to ‘relievers’, but work for up to 12 hours after taking each dose. They include salmeterol and formoterol. (Some brands of inhaler contain a steroid plus a long acting bronchodilator for convenience.)

Tablets to open up the airways
Most people do not need tablets as inhalers usually work well. However, in some cases a tablet (or in liquid form for children) is prescribed in addition to inhalers if symptoms are not fully eased by inhalers alone. Some young children use liquid medication instead of inhalers.

Steroid tablets
A short course of steroid tablets (such as prednisolone) is sometimes needed to ease a severe or prolonged attack of asthma. Steroid tablets are good at reducing the inflammation in the airways. For example, a severe attack may occur if you have a cold or chest infection.

Some people worry about taking steroid tablets. However, a short course of steroid tablets (for a week or so) usually works very well, and is unlikely to cause side-effects. Most of the side-effects caused by steroid tablets occur if you take them for a long time (more than several months), or if you take frequent short courses of high doses.

Asthma (Part 1 of 3)

Asthma is a common condition that affects the airways. The typical symptoms are wheeze, cough, chest tightness, and shortness of breath. Symptoms can range from mild to severe. Asthma cannot be ‘cured’, but treatment usually works well to ease and prevent symptoms. Treatment is usually with inhalers.

This leaflet gives a general overview of asthma. There are other leaflets in this series called ‘Inhalers for Asthma‘, ‘Peak Flow Meters‘ and ‘Asthma - a Picture Summary‘.

What is asthma and who does it affect?

Asthma is a condition that affects the airways (bronchi) of the lungs. From time to time the airways constrict (become narrow) in people who have asthma. This causes the typical symptoms. The extent of the narrowing, and how long each episode lasts, can vary greatly.

Asthma can start at any age, but it most commonly starts in childhood. At least 1 in 10 children, and 1 in 20 adults, have asthma. Asthma runs in some families, but many people with asthma have no other family members affected.

What are the symptoms of untreated asthma?

The common symptoms are cough and wheeze. You may also become breathless, and develop a feeling of chest tightness. Symptoms can range from mild to severe between different people, and at different times in the same person. Each episode of symptoms may last just an hour or so, or persist for days or weeks unless treated.

What are the typical symptoms if you have mild (untreated) asthma?
You tend to develop mild symptoms from time to time. For example, you may develop a mild wheeze and a cough if you have: a cold, a chest infection, in the hay fever season, or when you exercise. For most of the time you have no symptoms. A child with mild asthma may have an irritating cough each night, but is often fine during the day.

What are the typical symptoms if you have moderate (untreated) asthma?
Without treatment: you typically have episodes of wheezing and coughing from time to time. Sometimes you become breathless. You may have spells, sometimes long spells, without symptoms. However, you tend to be wheezy for some of the time on most days. Symptoms are typically worse at night, or first thing in the morning. You may wake up some nights coughing or with a tight chest. Young children may not have typical symptoms. It may be difficult to tell the difference between asthma and recurring viral chest infections in young children.

What are the typical symptoms of a severe attack of asthma?
You become very wheezy, have a ‘tight’ chest, and have difficulty in breathing. You may find it difficult to talk because you are so breathless. Severe symptoms may develop from time to time if you normally have moderate symptoms. Occasionally, severe symptoms develop ‘out of the blue’ in some people who normally have just mild symptoms.

What causes asthma?

Asthma is caused by inflammation in the airways. It is not known why the inflammation occurs. The inflammation irritates the muscles around the airways, and causes them to squeeze (constrict). This causes narrowing of the airways. It is then more difficult for air to get in and out of the lungs. This leads to wheezing and breathlessness. The inflammation also causes the lining of the airways to make extra mucus which causes cough and further obstruction to airflow.

The following diagram aims to illustrate how an episode of asthma develops.

What can make asthma symptoms worse?

Asthma symptoms may flare up from time to time. There is often no apparent reason why symptoms flare up. However, some people find that symptoms are triggered, or made worse, in certain situations. It may be possible to avoid certain triggers which may help to reduce symptoms. Things that may trigger asthma symptoms include the following.

• Infections. Particularly colds, coughs, and chest infections.
• Pollens and moulds. The hay fever season is a common time for asthma to get worse.
• Exercise. However, sport and exercise are good for you if you have asthma. If necessary, you can use an inhaler before exercise to prevent symptoms from developing.
• Certain drugs. For example, about 1 in 50 people with asthma are allergic to aspirin which can trigger symptoms. Other drugs that may cause asthma symptoms include: anti-inflammatory painkillers, and beta-blockers such as propranolol, atenolol, or timolol. This includes beta-blocker eye-drops used to treat glaucoma.
• Smoking and cigarette fumes. If you smoke and have asthma, you should make every effort to stop. See a practice nurse for help if you find it difficult. ‘Passive’ smoking can make asthma worse too. All children deserve to live in a smoke-free home, in particular children with asthma.
• Other fumes and chemicals. For example, fumes from paints, solvents and pollution. The increase in air pollution may be a reason why asthma is becoming more common.
• Emotion. Asthma is not due to ‘nerves’, but such things as stress, emotional upset, or laughing may trigger symptoms.
• Allergies to animals. Such as pet cats, dogs, and horses. Animals do not trigger symptoms in most cases, but some people notice that their symptoms become worse when close to certain animals.
• House dust mite. This is a tiny creature that lives in mattresses and other fabrics around the home. If you are allergic to it, it may make symptoms worse. It is impossible to get rid of house dust mite completely. To greatly reduce their number takes a lot of time and effort and involves: using special mattress covers, removing carpets, removing or treating soft toys, etc. However, if symptoms are difficult to control with treatment, and you are confirmed to be allergic to house dust mite, then it may be worth considering trying to reduce their number. See separate leaflet called ‘Allergy to House Dust Mite and Pets‘.
• Certain foods. This is uncommon, and food is not thought to be a trigger in most cases.

Some people only develop symptoms when exposed to a certain ‘trigger’. Two examples are:

• Occupational asthma. Some people only develop symptoms when exposed to specific substances at work. They have no symptoms at other times.
• Exercise-induced asthma. As mentioned above, exercise can make symptoms worse for many people with asthma. But, some people only develop symptoms when they exercise, and are fine the rest of the time.

Obat Asma Hirupan

Meski layanan kesehatan dewasa ini sudah tersebar cukup merata, patut diketahui masih banyak penderita serangan asma yang datang ke rumah sakit dalam keadaan terlambat. Bahkan ada juga penderita yang meninggal dalam perjalanan ke rumah sakit. Karena itu, amat penting untuk mengenal faktor pencetus serta apa yang harus dilakukan jika ada serangan asma.

Pada penyakit asma terjadi proses radang kronis di pipa saluran napas. Peradangan kronis ini dapat menyebabkan pipa saluran napas menjadi sensitif, mudah terangsang oleh alergen maupun iritan. Sebagai contoh, jika sekelompok siswa masuk ke gudang sekolah, maka siswa yang mempunyai penyakit asma mungkin akan mengalami bersin, batuk, bahkan sesak karena terpajan oleh debu yang merangsang pipa saluran napas. Siswa lain juga terpajan, tetapi karena pipa saluran napasnya tidak peka (normal), mereka tidak mengalami serangan.

Akibat peradangan kronis, pipa saluran napas penderita asma mudah terangsang dan menyempit. Selain itu, pada pipa saluran napas penderita asma sering terbentuk sekret yang menyebabkan udara yang masuk dan keluar pipa saluran napas terhalang sehingga penderita menjadi sesak.

Nah, pengobatan asma ditujukan untuk melebarkan kembali pipa saluran napas yang menyempit (untuk ini digunakan obat bronkodilator) dan obat untuk menghentikan inflamasi kronis (untuk tujuan ini digunakan obat anti-inflamasi berupa steroid). Sekarang tersedia baik obat bronkodilator maupun obat anti-inflamasi dalam bentuk hirupan. Keunggulan obat hirupan adalah masa mulai kerjanya (onset) cepat karena obat ditujukan langsung ke pipa saluran napas serta pada umumnya kurang berpengaruh pada organ tubuh lain seperti jantung.

Pada obat asma yang diminum, setelah diserap usus, obat akan masuk ke sirkulasi dan beredar di sirkulasi terlebih dahulu baru sampai ke pipa saluran napas sehingga masa mulai kerjanya lebih lama. Selain itu, karena bersifat sistemik, maka dapat menimbulkan berbagai efek samping.

Salah satu efek samping yang perlu diperhatikan pada penggunaan obat secara sistemik ini adalah efek samping steroid. Obat steroid merupakan obat anti-inflamasi yang ampuh, tetapi penggunaan jangka panjang dapat menimbulkan beberapa kerugian pada pemakai. Kelainan pada kulit dapat berupa jerawat, muka dapat sembab, tekanan darah dapat meningkat, juga gula darah dapat meninggi. Selain itu juga dapat timbul katarak pada mata. Pada penggunaan lama tulang juga dapat menipis (osteoporosis). Karena itulah jika dapat digunakan obat steroid topikal dalam bentuk hirupan akan lebih aman bagi penderita.

Jadi, penggunaan obat asma dalam bentuk hirupan mempunyai beberapa keuntungan. Tetapi, untuk menggunakan obat asma dalam bentuk hirupan ini perlu penjelasan cara menggunakannya dengan baik. Bahkan diperlukan latihan agar obat dapat masuk pipa saluran napas secara benar. Selain itu, yang agak memberatkan untuk pasien adalah obat ini tersedia dalam jumlah yang cukup banyak, yaitu 100 atau 200 hirupan (sekitar penggunaan sebulan) sehingga harganya mahal. Namun, sebenarnya jika dihitung per kali pengobatan, harganya menjadi lebih murah.

Sekarang bahkan obat asma hirupan tidak hanya mengandung obat bronkodilator atau steroid topikal saja, tetapi juga sudah ada dalam bentuk campuran bronkodilator dan steroid topikal sehingga lebih hemat dan nyaman. Penggunaan obat hirupan asma tidak hanya digunakan pada asma yang telah berat, bahkan sekarang digunakan juga pada asma dini.

dr Samsuridjal Djauzi

Sumber : Kompas Cybers Media

Alergi Penyebab Utama Asma pada Anak

Jumat, 6 Februari, 2004 oleh: Siswono

Saat ini alergi merupakan salah satu faktor penting penyebab berkembangnya penyakit asma. Terbukti, 75%-90% anak dengan asma di dunia mengidap alergi.

“Oleh karena itu, pengendalian lingkungan harus dilakukan untuk setiap anak asma,” kata dr Rina Triasih, pada seminar Diagnosis dan Tata Laksana Asma pada Anak di RS Cakra Husada, Klaten (Jateng), kemarin.

Untuk itu, lanjut Rina, menghindari asap rokok juga merupakan rekomendasi penting dari bagian pengendalian lingkungan. Dianjurkan pula keluarga yang memiliki anak dengan asma tidak memelihara binatang berbulu, seperti kucing, anjing, dan burung.

Satu hal penting yang juga perlu mendapat perhatian dari kalangan orang tua, menurut spesialis anak dari Bagian Ilmu Kesehatan Anak FK Universitas Gadjah Mada/RS dr Sardjito, Yogyakarta, ini adalah perbaikan ventilasi ruangan dan penghindaran kelembaban kamar. Kondisi ruangan yang sehat itu mutlak dijaga, terutama bagi keluarga dengan anak asma yang sensitif terhadap debu rumah dan tungaunya.

“Perlu diingat, anak asma acapkali menderita rinitis alergika atau sinusitis yang membuat asma sulit dikendalikan. Deteksi dan diagnosis kedua kelainan itu, yang diikuti dengan terapi adekuat akan memperbaiki gejala asma anak,” ujar Rina Triasih.

Kurangnya pengetahuan tentang asma dan tata laksananya, tambah Rina, berpengaruh terhadap peningkatan morbiditas dan mortalitas penyakit tersebut. Hal ini bukan saja terjadi pada pasien dan keluarganya, tapi juga pada tenaga kesehatan, bahkan dokternya.

Sebab, banyak dokter tidak mengikuti perkembangan dan perubahan konsep tentang asma dan tata laksananya. Lebih jauh lagi mereka tidak mempunyai keterampilan praktis penggunaan alat-alat inhalasi. Sehingga, bahkan, ada dokter yang sampai melarang pasien yang sudah menggunakannya.

“Di banyak tempat di dunia, baik negara berkembang maupun negara maju, asma anak masih banyak yang underdiagnosed dan undertreatment,” tegasnya.

Dengan demikian, lanjut Rina, pendidikan asma sangat perlu dilakukan terhadap tenaga kesehatan, pasien, dan keluarganya serta guru sekolah. Selain kemitraan keluarga dan gurunya, keterlibatan unsur lain juga penting, misalnya lembaga swadaya masyarakat (LSM) dan media massa.

Menurut dia, media massa dapat berperan konstruktif dalam menyebarkan informasi tentang asma dan penanggulangannya kepada masyarakat luas. Sedangkan peran orang tua dalam penanggulangan asma anak cukup penting dibandingkan peran orang lain termasuk dokter. (JS/V-4)

Sumber: Media Indonesia, Kamis, 05 Februari 2004

Apakah Anak saya Asma?

Penulis: Darmawan Budi S

Banyak anak asma yang tak terdiagnosis penyakitnya sehingga ditangani sebagai penyakit lain dan keluhannya tak kunjung reda. Mengapa ? Dalam hal kesehatan dan penyakit, banyak di antara kita menilai anak seperti orang dewasa. Inilah pangkal masalahnya. Anak bukan orang dewasa dalam ukuran kecil, jadi berbeda dengan orang dewasa. Banyak aspek kesehatan dan penyakit yang berbeda pada anak dibanding orang dewasa.

Untuk penyakit sama, gejalanya yang menonjol bisa berbeda antara pasien anak dan dewasa. Sebaliknya, gejala yang sama, misalnya batuk, bisa mengarah ke penyakit yang berbeda anatara anak dan dewasa. Karena itu, orang tua perlu memahami gejala pada anak yang patut dipikirkan kemungkinan ke arah asma.

Asma pada anak tidak selalu memberi gejala sesak dan napas berbunyi (mengi) seperti orang dewasa. Sering kali gejala yang menonjol hanya batuk, tapi bukan sembarang batuk. Lalu, batuk seperti apa yang patut diduga asma? Batuk yang “bandel”.

Pengertian “bandel” mencakup beberapa keadaan yang mirip, yaitu batuk berlangsung lama (dua minggu lebih), sulit sembuh, timbul berulang dalam jangka pendek, atau membaik sebentar namun timbul lagi. Biasanya pasien dengan batuk bandel sudah berkeliling berobat ke banyak dokter umum maupun spesialis.

Pada orang dewasa, jika ditemukan gejala batuk yang bandel, dugaan penyakit penyebab pertama adalah tuberkulosis (tb). Dugaan ini sering diterapkan pada anak juga.

Pemeriksaannya berupa foto rontgen dengan penafsiran sangat subyektif. Kemudian, bisa diduga ada “flek” dalam parunya sehingga diterapi tb. Jika ternyata asma, maka usia pengobatan tb, batuknya akan tetap ada.

Perlu mengubah paradigma pemikiran jika menemui anak dengan batuk yang bandel. Pertama, pikirkan kemungkinan ke arah asma, bukan Tb. Tb. pada anak bisa memberi gejala batuk, namun bukan utama. Hal yang mendukung ke arah asma diantaranya :

Batuk timbul jika terpajan dengan faktor pencetus yang banyak sekali bentuk dan macamnya. Ada yang dari lingkungan rumah, berupa debu, asap rokok, kapuk, atau bulu binatang. Faktor lain yang biasanya teramati orang tua berbentuk makanan, misalnya permen, cokelat, makanan ringan mengandung vetsin, gorengan, es, atau kacang. Pencetus lainnya adalah flu, aktivitas fisik berlebihan hingga lelah, atau perubahan cuaca.

Batuk asma pada anak memberikan ciri lain yang lebih berat pada malam atau dini hari. Terkadang, perbedaan intensitas batuk pada siang dan malam hari, demikian ekstrem. Siang, tanpa batuk sama sekali, lalu malam justru hebat sampai anak tidak bisa tidur. Tentu orang tua ikut terganggu tidurnya. Akibatnya anak mengantuk di sekolah, dan orang tuanya mengantuk saat bekerja.

Sebagian besar asma didasari faktor alergi. Jadi, asma merupakan satu bentuk penyakit alergi. Dalam riwayat keluarga, biasanya ditemui asma, serta bentuk lain penyakit alergi, seperti eksim, pilek alergi, atau alergi obat maupun makanan. Kalau perlu, ditelusuri riwayat keluarga besar sampai buyut, kakek, paman, sepupu, dan seterusnya.

Hal yang diturunkan adalah bakat alerginya, namun manifestasinya bisa berbeda. Warisan bakat ini pun bisa lompat generasi. Misalnya, kakek mengidap alergi obat, anaknya mungkin tak memiliki manifestasi alergi, baru pada cucunya timbul penyakit tersebut.

Hal lain yang memperkuat diagnosis asma ialah respons yang baik dengan obat asma. Sering karena tidak terdiagnosis asma, pasien dengan batuk bandel diberikan obat penekan batuk, tapi bentuknya malah kian menjadi. Pasien asma memang tidak boleh diberikan obat tadi. Pasien akan mereda batuknya jika diberikan obat asma.

Untuk mengonfirmasi diagnosis asma, perlu dilakukan pemeriksaan khusus berupa uji fungsi paru. Untuk melaksanakannya, pasien perlu melakukan jurus yang cukup kompleks. Biasanya, anak berusia dibawah tujuh tahun belum mampu melakukannya sehingga pemerikssaan ini terbatas digunakan pada anak kecil.

Apabila ditemukan anak dengan batuk yang bandel disertai beragam fakta yang menunjang seperti di atas, anak dapat didiagnosis sebagai asma. Jika diagnosisnya tepat, tinggal masalah manajemennya.

Sumber www.idai.or.id/

Apakah Anak saya Asma?

Penulis: Darmawan Budi S

Banyak anak asma yang tak terdiagnosis penyakitnya sehingga ditangani sebagai penyakit lain dan keluhannya tak kunjung reda. Mengapa ? Dalam hal kesehatan dan penyakit, banyak di antara kita menilai anak seperti orang dewasa. Inilah pangkal masalahnya. Anak bukan orang dewasa dalam ukuran kecil, jadi berbeda dengan orang dewasa. Banyak aspek kesehatan dan penyakit yang berbeda pada anak dibanding orang dewasa.

Untuk penyakit sama, gejalanya yang menonjol bisa berbeda antara pasien anak dan dewasa. Sebaliknya, gejala yang sama, misalnya batuk, bisa mengarah ke penyakit yang berbeda anatara anak dan dewasa. Karena itu, orang tua perlu memahami gejala pada anak yang patut dipikirkan kemungkinan ke arah asma.

Asma pada anak tidak selalu memberi gejala sesak dan napas berbunyi (mengi) seperti orang dewasa. Sering kali gejala yang menonjol hanya batuk, tapi bukan sembarang batuk. Lalu, batuk seperti apa yang patut diduga asma? Batuk yang “bandel”.

Pengertian “bandel” mencakup beberapa keadaan yang mirip, yaitu batuk berlangsung lama (dua minggu lebih), sulit sembuh, timbul berulang dalam jangka pendek, atau membaik sebentar namun timbul lagi. Biasanya pasien dengan batuk bandel sudah berkeliling berobat ke banyak dokter umum maupun spesialis.

Pada orang dewasa, jika ditemukan gejala batuk yang bandel, dugaan penyakit penyebab pertama adalah tuberkulosis (tb). Dugaan ini sering diterapkan pada anak juga.

Pemeriksaannya berupa foto rontgen dengan penafsiran sangat subyektif. Kemudian, bisa diduga ada “flek” dalam parunya sehingga diterapi tb. Jika ternyata asma, maka usia pengobatan tb, batuknya akan tetap ada.

Perlu mengubah paradigma pemikiran jika menemui anak dengan batuk yang bandel. Pertama, pikirkan kemungkinan ke arah asma, bukan Tb. Tb. pada anak bisa memberi gejala batuk, namun bukan utama. Hal yang mendukung ke arah asma diantaranya :

Batuk timbul jika terpajan dengan faktor pencetus yang banyak sekali bentuk dan macamnya. Ada yang dari lingkungan rumah, berupa debu, asap rokok, kapuk, atau bulu binatang. Faktor lain yang biasanya teramati orang tua berbentuk makanan, misalnya permen, cokelat, makanan ringan mengandung vetsin, gorengan, es, atau kacang. Pencetus lainnya adalah flu, aktivitas fisik berlebihan hingga lelah, atau perubahan cuaca.

Batuk asma pada anak memberikan ciri lain yang lebih berat pada malam atau dini hari. Terkadang, perbedaan intensitas batuk pada siang dan malam hari, demikian ekstrem. Siang, tanpa batuk sama sekali, lalu malam justru hebat sampai anak tidak bisa tidur. Tentu orang tua ikut terganggu tidurnya. Akibatnya anak mengantuk di sekolah, dan orang tuanya mengantuk saat bekerja.

Sebagian besar asma didasari faktor alergi. Jadi, asma merupakan satu bentuk penyakit alergi. Dalam riwayat keluarga, biasanya ditemui asma, serta bentuk lain penyakit alergi, seperti eksim, pilek alergi, atau alergi obat maupun makanan. Kalau perlu, ditelusuri riwayat keluarga besar sampai buyut, kakek, paman, sepupu, dan seterusnya.

Hal yang diturunkan adalah bakat alerginya, namun manifestasinya bisa berbeda. Warisan bakat ini pun bisa lompat generasi. Misalnya, kakek mengidap alergi obat, anaknya mungkin tak memiliki manifestasi alergi, baru pada cucunya timbul penyakit tersebut.

Hal lain yang memperkuat diagnosis asma ialah respons yang baik dengan obat asma. Sering karena tidak terdiagnosis asma, pasien dengan batuk bandel diberikan obat penekan batuk, tapi bentuknya malah kian menjadi. Pasien asma memang tidak boleh diberikan obat tadi. Pasien akan mereda batuknya jika diberikan obat asma.

Untuk mengonfirmasi diagnosis asma, perlu dilakukan pemeriksaan khusus berupa uji fungsi paru. Untuk melaksanakannya, pasien perlu melakukan jurus yang cukup kompleks. Biasanya, anak berusia dibawah tujuh tahun belum mampu melakukannya sehingga pemerikssaan ini terbatas digunakan pada anak kecil.

Apabila ditemukan anak dengan batuk yang bandel disertai beragam fakta yang menunjang seperti di atas, anak dapat didiagnosis sebagai asma. Jika diagnosisnya tepat, tinggal masalah manajemennya.

Sumber www.idai.or.id/

Asma

Asma adalah suatu gejala yang ditimbulkan oleh kelainan saluran nafas yang berupa kepekaan yang meningkat terhadap rangsangan dari lingkungan sebagai pemicu.

Pemicu gejala ini dapat berupa kelelahan pikiran (gangguan emosi), kelelahan jasmani, perubahan lingkungan hidup yang tidak diharapkan (cuaca, kelembaban, temperatur, asap (terutama rokok) dan bau-bauan yang merangsang), infeksi saluran nafas terutama penyakit influenza tertentu, dan reaksi alergi dari bahan yang terhirup atau dimakan.

Tingkat gejala kepekaan saluran nafas ini diawali dari gejala yang ringan (berupa pilek/bersin atau batuk yang sering berulang/kambuh) sampai dengan gejala yang berat berupa serangan asma (kesulitan bernafas). Keadaan ini sebenarnya ditandai adanya latar belakang reaksi alergi.

Timbulnya beberapa tingkatan gejala kepekaan yang terekam/bisa diutarakan oleh penderita biasanya diawali sejak masa kanak. Sekitar 50% gejala akan sembuh dengan sendirinya, walaupun pada suatu saat gejala ini akan muncul lagi pada tingkat gejala yang lebih berat yang sering diberi istilah asma. Sekitar 55-6-% penyakit alergi pernafasan in dapat diturunkan ke anak atau cucu dan sisanya diakibatkan karena adanya polusi lingkungan hidup yang kurang atau masih belum mendapatkan perhatian, karena itu gejala baru muncul setelah dewasa bukan karena merupakan hal yang aneh.

Penyebab

Dasar permasalah pada penyakit asma terletak pada kelainan saluran nafas yang berpa proses reaksi/keradangan (akibat reaksi alergi) yang disebabkan oleh paparan bahan-bahan antara lain:

• Debu yang ada di dalam rumah yaitu debu yang berasal dari kasur kapuk (terutama yang sudah lama), karpet, sofa, pakaian yang disimpan lama di dalam lemari, langit-langit atap rumah, buku-buku/kertas arsip yang lama, dll.
• Bahan makanan terutama jenis ikan laut, susu sapi, telur, coklat, kacang-kacangan, dll. (sedang kelompok bahan makann yang mempunyai ciri yang mengiritasi a.l. pedas, dingin, bergetah, rasa manis/asam, asin, dll. bukan penyebab tapi pemicu).
• Lingkungan hidup antara lain bulu yang berasal dari bahan pertanian (tepung sari, jerami, rumput-rumputan, ampas tebu, dll.), bahan yang berasal dari bulu dan kotoran unggas serta binatang piaraan.

Sumber http://nusaindah.tripod.com/tipsasma.htm

Gejala Asma

June 17, 2008 at 1:58 pm

Batuk-batuk tertama pada malam dan dini hari memang biasa ditemukan pada penderita alergi. alergi atau atopi merupakan penyakit gen sehingga diturunkan. Umumnya penderita atopi, alergi terhadap debu rumah atau udara dingin.

Di luar negeri yang mempunyai 4 musim, alergi biasanya terjadi pada musim semi saat bunga berkembang dan banyak banyak tepung sari yang beterbangan. Penelitian di luar negeri menyebutkan bahwa alergi pada anak paling banyak disebabkan oleh zat tambahan atau pengawet pada makanan.

Gejala alergi bermacam-macam, mulai dari bersin-bersin, pilek dengan ingus encer, gatal-gatal, sesak napas sampai mengancam jiwa. Anak-anak penderita alergi besar kemungkinan untuk menderita asma. Pada malam dan dini hari merupakan saat paling sering seorang penderita alergi atau asma mendapat serangan bisa sesak atau batuk-batuk.

Hal ini disebabkan karena pada saat itu, kadar kortisol (semacam hormone yang menjaga supaya tidak terjadi peradangan pada saluran napas) berada pada nilai terendah. Pada penderita asma hal ini tidak dapat ditoleransi sehingga mereka akan sering mendapat serangan pada waktu-waktu tersebut.

Pemeriksaan untuk mengetahui apakah anak ibu asma atau tidak bisa dengan pemeriksaan fungsi paru melalui alat spirometer atau dengan uji provokasi bronkus. Asma bukan penyakit menular sehingga ibu tidak perlu khawatir anak ibu akan menularkan penyakitnya pada orang lain. Apakah asma bisa sembuh?

Asma hanya dapat dikontrol, yaitu dengan pengobatan dan menghindari faktor yang mencetuskan serangan asma. Obat asma yang saat ini dianjurkan adalah obat semprot atau hisap karena mempunyai efek samping relative lebih kecil dibandingkan obat makan atau suntik.

dr. Risa F Musawaris

Sumber : Pontianak Post Online

Nortel ditches WiMax to focus on G4

Telecom equipment maker Nortel Networks is dumping its WiMax business to focus on a more popular 4G wireless technology.

The company said earlier this week that it’s focusing its money and development efforts on long-term evolution or LTE. Even though LTE hasn’t yet been standardized, it has more support from major carriers around the world than WiMax. The two largest U.S. operators, AT&T and Verizon Wireless, have already announced they plan to use LTE to build their 4G wireless networks. Vodafone, the largest worldwide wireless operator, also plans to use LTE for its next generation network.

Sprint Nextel is the only major U.S. operator using WiMax. The company earlier this year joined forces with Clearwire and several other companies including Comcast, Time Warner Cable and Intel in a $12 billion joint venture to build a nationwide WiMax network.

Sprint, which has already been testing its WiMax network in some places, did not choose Nortel as one of its major vendors to build the new network. This was a major blow for the telco equipment maker, which instead has been forced to focus on carriers in emerging markets. Relative to LTE, this WiMax opportunity is much smaller, which likely contributed to the company’s decision to ditch it.

Instead of sinking a lot of research and development into WiMax, Nortel plans to address this market through a relationship with Alvarion.

Source : http://news.cnet.com

Is this actually mean that 4G have better bussiness prospect than wimax?

No- Key Keyboard

Typing on a flat surface is one of those ideas for future computing that never seems to completely go away. Currently there’s Bluetooth laser virtual keyboards, which project “keys” onto any flat surface. Recently the X0 model 2.0 (the next One Laptop Per Child) coming in 2010 was revealed to have two touch screens, one where the keyboard would usually be.

The latest is the No-Key Keyboard designed by Kong Fanwen. It features flat “keys” on flat glass. It’s probably useless for real typing, but who cares? It looks cool.

The only details known are that it’s made of glass, uses cameras and motion capture to figure out what keys you’re pushing, and has some lights in it. You may be able to run it through the dishwasher, top rack only I assume. (Sadly, all the pictures show a connection cable… no Bluetooth?) No idea what it would cost or if it will ever even come to market in the U.S., or even elsewhere.

Considering the reports on how much creeping crud we all store under the keys of our existing keyboards maybe it’s a design worth considering. But without tactile feedback - a response for each key touched - it will likely remain an oddity for us touch-typists. Though it’s an oddity I’m willing to try.

Source : Gearlog.com

Nenen malem tdk bikin gigi bolong

Hohohoho… kayanya yang bikin statement “nenen bikin gigi bolong” gak pernah nenenin anaknya deh…

“Lho kan ASI juga mengandung laktosa dok?? laktosa kan salah satu karbohidrat?? jadi memiliki sifat kariogenik dong??

“Ya ya ya…. so please check this out”
1. ASI baru akan keluar dari payudara ibu bila dihisap (eh, kecuali kalo lagi LDR ya?)
2. Tuhan telah menciptakan air ludah yang mampu menetralkan asam hasil fermentasi karbohidrat setelah 1-2jam

Nah, asal giginya rajin dibersihkan… jarang deh sampe karies
Kalopun sampe karies, pasti ada sebab lain…

Saya sendiri BELOM PERNAH denger “breastfed caries…”
Tapi kalo “bottle caries…” SERING!!

So…. “nenen yuk nak!!!”

sumber http://hprimaywati.multiply.com/reviews/item/11

Obat Semprot Bikin Ketagihan?

Asma adalah penyakit radang kronik saluran napas yang menyebabkan saluran napas hipersensitif terhadap berbagai allergen (zat/bahan yang menyebabkan alergi). Asma bukan penyakit menular dan asma terjadi karena faktor keturunan yang disebabkan oleh gen yang jumlahnya ratusan. Alergen atau zat yang mencetuskan asma bervariasi tiap individu.

Gejala serangan asma yaitu sesak napas, rasa berat di dada, batuk dan napas yang berbunyi (mengi, bengek). Frekuensi dan beratnya serangan asma bervariasi. Beberapa penderita lebih sering terbebas dari gejala dan hanya mengalami serangan serangan sesak nafas yang singkat dan ringan, yang terjadi sewaktu-waktu.

Tujuan pengobatan penyakit asma adalah membebaskan penderita dari serangan penyakit asma. Hal ini dapat dicapai dengan jalan mengobati serangan penyakit asma yang sedang terjadi atau mencegah serangan penyakit asma jangan sampai terjadi.

Mengobati disini bukan berarti menyembuhkan penyakitnya, melainkan menghilangkan gejala-gejala yang berupa sesak, batuk, atau mengi. Keadaan yang sudah bebas gejala penyakit asma ini selanjutnya harus dipertahankan agar serangan penyakit asma tidak sering kambuh. Obat-obatan bisa membuat penderita penyakit asma menjalani kehidupan normal.

Obat obat asma terbagi 2 yaitu pelega yang bertujuan untuk mengendalikan serangan penyakit asma segera dan obat yang berfungsi untuk mengontrol supaya serangan asma tidak sering terjadi. Pengobatan berbeda tergantung beratnya, biasanya obat semprot lebih cepat. Obat golongan Beta-2 Agonis (bronkodilator) dan steroid lebih kuat.

Sebaiknya gunakan obat semprot karena lebih aman bila dibandingkan obat minum atau suntik. Cuma karena kurangnya informasi dari dokter, banyak informasi salah yang menyebutkan bahwa obat semprot malah membuat ketagihan.

Obat semprot atau hirup relative lebih aman karena dosisnya lebih kecil dibandingkan obat minum atau suntik serta langsung ke saluran napas si penderita. Selain itu karena dosis kecil jadi efek samping juga relative lebih kecil dibandingkan obat minum atau suntik. Bila serangan asma hampir tiap hari, obat yang dipergunakan adalah kombinasi obat pelega dan pengontrol. Sebagian besar bronkodilator bekerja dalam beberapa menit, tetapi efeknya hanya berlangsung selama 4-6 jam.

Bronkodilator per-oral (ditelan) dan dipergunakan bila serangan asma tidak dapat diatasi dengan obat semprot atau hirup dan memiliki efek samping dan mula kerjanya cenderung lebih lambat. Pada serangan penyakit asma yang berat, bisa diberikan secara intravena (melalui pembuluh darah). Hal lain untuk mengontrol serangan asma anda adalah dengan mengenal pencetus yang menyebabkan timbulnya serangan asma serta hindari pencetus tersebut.

Pasien asma juga dianjurkan untuk memeriksakan diri secara teratur ke dokter. Karena bisa saja kondisi penyakit bertambah ringan atau sebaliknya sehingga baik obat maupun cara hidup perlu disesuaikan. Selain itu untuk menjaga kebugaran tubuh, anda dapat juga mengikuti senam asma yang bertujuan untuk melatih otot-otot pernapasan.

Team Pengasuh

Sumber : Pontianak Post Online

World’s fastest internet connection ‘used to dry laundry’

Last summer a 75-year-old woman from Karlstad became the envy of internet users worldwide.

With her blistering 40 gigabits per second connection, Sigbritt Löthberg had the world’s fastest internet connection - many thousands of times faster than the average residential link and the first time ever that a home user had experienced such a high speed.

So, after nine months with the ability to download a full high definition DVD in just two seconds or access 1,500 high definition HDTV channels simultaneously, how has Sigbritt’s life changed?

Not much, according to Hafsteinn Jonsson, who is heading up the fibre network operation for Karlstad Stadsnät.

“She mostly used it to dry her laundry,” he told The Local.

“It was a big bit of gear and it got pretty warm.”

Sigbritt’s son, Swedish internet legend Peter Löthberg, was behind the project, which was intended to demonstrate how a low price, high capacity fibre line could be built over long distances. Löthberg has now taken the equipment up to Luleå, in the north of Sweden, for further testing.

“The project was a huge success,” said Hafsteinn Jonsson, who explained that his department now measures its history in terms of ‘Before Sigbritt and After Sigbritt’.

“Apart from the death of Ingmar Bergman, this was the biggest story to come out of Sweden in 2007. We used to get all these detailed questions about what we’re working on - now we just mention Sigbritt and everybody understands.”

The secret behind the ultra-fast connection is a new modulation technique which allows data to be transferred directly between two routers up to 2,000 kilometres apart, with no intermediary transponders.

According to Karlstad Stadsnät the distance is, in theory, unlimited - there is no data loss as long as the fibre is in place.

Sigbritt may have been denied her world-beating internet link but she still has an admirable 10 gigabits per second connection. And there may be another surprise in store for her.

“We’re considering giving her a 100 gigabits per second connection in the summer,” said Hafsteinn Jonsson.

“Then she’ll be able to dry all her neighbours’ laundry too.”

Source : http://www.thelocal.se/