Three top athletes join together to prove that living with asthma can be a win-win situation.

d06a.jpg (14008 bytes)Seventeen million asthma cases in the United States means respiratory care practitioners have their work cut out for them. However, the job of helping that sizable number of patients may have become a little easier thanks to the efforts of a national coalition of health care organizations to better educate Americans about ways to manage the pernicious and increasingly deadly airway disease.

The education effort is being conducted under the banner of a program called Asthma All-Stars, which revolves around a trio of asthmatic superstar athletes who have refused to allow their medical condition to in any way hamstring their success.

The three are football great Jerome Bettis of the Pittsburgh Steelers, Olympic track-and-field gold medalist Jackie Joyner-Kersee, and Olympic champion swimmer Amy Van Dyken.

The National Football League’s 1993 Rookie of the Year, Bettis was first diagnosed with asthma at age 15, although he had begun to experience symptoms years earlier. Like many asthma sufferers, he rationalized the breathing difficulties as merely a sign that he was out of shape. It was only after the wheezing refused to abate that he decided to see a physician. Throughout his college and professional football career, Bettis used an inhaler between plays to relieve his asthma symptoms. But his poorly controlled asthma caught up with him in 1997 when an attack struck during a nationally televised game and he had to be carried off the field.

Asthma surfaced in Joyner during her UCLA career in basketball and track. When she noticed herself breathing heavily and feeling winded after her workouts, Joyner sought a doctor’s help and was diagnosed with the lung disorder. Unfortunately, Joyner was slow to accept the finding and even slower to embrace a proper regimen of medications. It took a near-fatal episode in 1993 to change her thinking.

Van Dyken was just a baby when she was diagnosed with asthma. In fact, her pediatrician described Van Dyken’s case as the worst he had ever seen. But, by adopting sound asthma management practices, she was eventually able to gain the upper hand over the disease and go on to become a world-class swimmer, winning four gold medals in the course of the 1996 Summer Olympics in Atlanta (a first for an American woman).

Message of Hope
Now, as part of the Asthma All-Stars program, the three athletes travel the country and make personal appearances during which they offer tips about asthma management while sharing how they coped with and eventually overcame their asthmatic handicaps.

“The goal of Asthma All-Stars is to help people identify the signs of poorly controlled asthma and, at the same time, give them encouragement that this disease doesn’t have to hold them back because it certainly hasn’t held back Jackie, Jerome, and Amy,” says Veronica Grosshandler, program spokesperson. “Too many people in this country have asthma that is not controlled. The symptoms of asthma cause too many people to make late-night visits to the emergency department, to miss work, to miss school. We want to do something about that, and that’s what this program is all about.”

Asthma All-Stars came about after a pharmaceutical company-sponsored survey noted not only high rates of absenteeism and emergency department utilizations among the nation’s asthma patients but also a pattern of unnecessary limitations on activities of daily living. The survey concluded that these problems, coupled with information showing many asthma sufferers often lose sleep at night due to symptom flare-ups and resort to quick-relief medicine more than twice a week, were indicative of inadequate patient knowledge of how to self-manage the disease in accordance with asthma treatment guidelines developed by the National Heart, Lung, and Blood Institute, Grosshandler says.

Part of the problem has been the failure to adequately emphasize asthma prevention, suggests Gil D’Alonzo, DO, director of the Airways Disease Center at Temple University Hospital in Philadelphia and an active participant in the Asthma All-Stars program.

The Asthma All-Stars team—put together by the same pharmaceutical company that conducted the asthma absenteeism survey—includes the Allergy and Asthma Network-Mothers of Asthmatics (a nonprofit, community education, and outreach organization) based in Fairfax, Va; the American College of Allergy, Asthma and Immunology in Arlington Heights, Ill; the American College of Physicians’ CHEST Foundation in Northbrook, Ill; the American College of Sports Medicine in Indianapolis; and the National Association of School Nurses in Scarborough, Me.

Educational Tools
Besides the personal appearance tours of the athletes, two central components of the Asthma All-Stars program are a poster packet available to RCPs (among other health care professionals), and an information kit offered to the public.

d06a.jpg (14008 bytes)"The posters show each of the three sports figures engaged in the activities at which they excel,” Grosshandler says. “Each poster also gives a toll-free number that patients who see the posters can call for further information. These posters are meant to be displayed in areas where they will be seen by the public—in the doctor’s office, in the treatment room, in the waiting area.”

RCPs who order the set of Asthma All-Stars posters also automatically receive the information kit that is available to the public. The kit contains trading cards of the three sports figures, which, on the flip side, detail the superstar’s athletic record and career statistics. Also featured are motivational tips for beating asthma.

Along with the cards of the three personalities are five additional trading cards. One of the five cards covers asthma and exercise. Another one discusses asthma and school, offering parents tips for helping their children avoid asthma episodes. Then there is a card that offers an asthma fitness test to help patients assess whether their asthma is truly under control, Grosshandler says.

“Another card talks about the goals of asthma management, so people can know what to expect from their asthma care and be able to prevent asthma symptoms throughout the day and night,” she adds. “This same card also describes how patients can work with their doctors to make sure they’re meeting these goals.”

The kit also contains a brochure called “Asthma Control: What You Need to Know.” “This brochure offers what we consider to be the five most important things a person can do to control his or her asthma,” Grosshandler says.

One piece of advice urges asthma sufferers to consistently take their long-term control medications to help prevent symptoms.

“A problem,” Grosshandler asserts, “is that many people forget to take their long-term medications—their inhaled cortico-steroids and their long-acting bronchodilators, for example. We want them to know how important it is they take these drugs, even when they are feeling well, which is the time they are most likely to forget them.”

Another nugget of useful guidance found in the brochure admonishes patients to get in the habit of monitoring their asthma.

“Since asthma can change over time, we encourage patients to keep track of how well-controlled their asthma is and to be sure they share this information with their doctor at least every 6 months,” Grosshandler says. “Our recommendation is that patients should keep a written record of the frequency and severity of their asthma symptoms, as well as their use of quick-relief medicine. We also recommend they use a peak-flow meter to help measure how well air is flowing out of their lungs, which, of course, is a good marker of how well-controlled their asthma is.”

Countering the Critics
Asthma All-Stars was spawned from an earlier asthma education program that was conducted by the pharmaceutical company and involved the same three athletes. Grosshandler says the addition of the five national medical organizations that are partners in the Asthma All-Stars program was deemed vital for successful dissemination of the educational materials to the widest possible audience.

But, Grosshandler acknowledges, coordinating the participation of the various groups has not been easy, especially in light of the newness of the program (it debuted only last September). Moreover, what shape the program might take in the future is far from clear at this juncture.

Naturally, the program has come in for its share of criticism. The major complaint is that the use of athletes to promote asthma education will leave some asthmatics cold—especially the elderly and others who have no interest in sports.

“A complaint we’ve heard is that people in their 70s are not going to be able to relate to athlete superstars in their 20s and 30s, but we think that won’t be the case at all,” Grosshandler says. “The program is targeted toward people of all ages and what we are doing is giving people information that is easy to comprehend. We believe the best way to accomplish this is to give people information about the experiences of Jackie, Jerome, and Amy, which will motivate people of every age, whether or not they are sports fans.

“The underlying message of this program is that you can excel no matter what your goals are if you manage your asthma correctly and take steps to manage the symptoms and not wait for the symptoms to materialize.”

Some critics also worry that few RCPs will be able to spare the time or resources necessary to permit their participation in the program.

Grosshandler responds that the demands on RCPs who wish to participate are minimal. “The posters are free,” she says. “All it takes is the time necessary to order the posters and put them up on display.”

Posters can been requested by sending an email to [email protected] or by writing to the Asthma All-Stars program at PO Box 6187, West Caldwell, NJ 07007. Patients and interested members of the public can order information kits by calling toll-free (877) 425-5782.

Rich Smith is a contributing writer for RT Magazine.