Claire McCarthy, M.D., is a senior medical editor for Harvard Health Publications. She is an instructor in pediatrics at Harvard Medical School, an attending physician at Children's Hospital of Boston, and co-director of the pediatrics department at Martha Eliot Health Center, a neighborhood health service of Children's Hospital. The author of two books, "Learning How the Heart Beats" and "Everyone's Children", Dr. McCarthy was a regular columnist for "Sesame Street Parents Magazine" from 1995 to 1998 and is currently a contributing editor for "Parenting Magazine".

Question:

My son has been diagnosed with exercise-induced asthma. He's been on Singulair for six weeks, and uses an albuterol inhaler when needed. But the other day he had one of his worst attacks ever. The inhaler eventually brought it under control, but before that, he and I were both in a panic. What do we do while the attack is happening?

Answer:

Being short of breath is a very scary feeling. That must have been a terrible moment for both of you.

Today, the main goal of asthma treatment is to prevent attacks like the one you describe. There are three things that might help in your case:

1. Have your son use his albuterol inhaler before vigorous exercise. This may ward off attacks.

2. Think more about the episode. Were there other triggers for the wheezing besides the exercise? Had he just been playing with a cat, for example, or was there a lot of pollen or freshly cut grass around? Knowing the all the triggers or the true trigger can help prevent future attacks.

3. Talk to your doctor about changing your son's prevention medication. Six weeks is long enough for Singulair to take effect, and it doesn't seem to be doing the trick. Adding an inhaled steroid or allergy medication might make a difference.

But to answer your question about what to do when he's in the midst of an attack, try to have him (and you) relax as much as possible. Panic, as you've seen, only makes things worse. Make sure he uses the inhaler correctly. (Talk to your doctor if you have any questions about that.) Get your son in an uncrowded, quiet place if you can. Have him cough to loosen and bring up any mucous that might be blocking his airways. Breathing through pursed lips may help.

If things aren't getting better within a few minutes, especially if he looks very pale or blue, can't speak or is getting sleepy, you should call 911.