It is important to be sure there are no other conditions presenting themselves as asthma. Usually a child shows asthmatic symptoms when experiencing an upper respiratory infection.

A family doctor often treats mild asthma, but more severe forms are probably better treated by physicians specializing in respiratory problems.

The most common treatment is with a bronchodilator, which may be used before exercise or when symptomatic. The inhaler is the most common route of administration, though tablets, capsules, and injections may be required. The medicine used is an agent that stimulates B2 receptors and relaxes the smooth muscles of the bronchi.

Some anti-inflammatory agents may be required if the bronchodilators are inefficient. Again, inhalation of a corticosteroid-like medication is usually effective. A recent study showed a 50 percent reduction in hospitalizations in people using prophylactic steroids. For children, a new group of medicines called "mastcell stabilizers" and "leukotriene modifiers" is showing promise.

Removing triggers from the environment can be very important: a dust-free environment, a pet-free house, damp dusting, hardwood floors, synthetic pillows and bedding. You should work out an asthma attack plan with your doctor. Understand what the medications you have been given are for and how they work. Be regular in giving the medication. Keep a list of everything you are using to show a doctor who may be unfamiliar with your problems.

Hopefully, with the growth of the airway, your little one will find that he or she is less significantly constricted and that the asthma becomes a problem of the past. Until then, follow your doctor's advice carefully.

I am trying to lower my cholesterol. I'm a vegan, I exercise, I have a normal weight, and I don't smoke or drink. Though my cholesterol readings have improved, the doctor is still not satisfied. I'm especially concerned because my father died at age 51 of a heart attack, even though he was apparently quite healthy until then. My doctor wants to put me on Zocor. What do you think?

Well, you seem to be doing all the things a person can do to live a healthy life. You definitely have taken care of the lifestyle component of health. One of the most difficult things for Adventists to realize is that we are broken; we can't work out all of our own health problems and live forever any more than we can work out our own salvation. That doesn't mean giving up. You are definitely better off than you would be if you lived a reckless lifestyle. I would recommend you take the Zocor your doctor has prescribed. If your lifestyle changes had worked sufficiently, you might not have needed it. However, it seems that at least part of your problem is very likely genetic.

Zocor belongs to the statin group of medications used principally to lower cholesterol levels (by inhibiting the production of cholesterol). A very strong base of evidence shows increased survival among patients using these statin medications. No medication is without potential side effects, and you need to discuss these with your doctor. However, some other interesting side effects have been reported about the statin medications.

In the November 11, 2000, Lancet, a large study on about 60,000 people found those on statin had a substantial reduction in the incidence of dementia and loss of memory. In fact, the group had better abstract thinking abilities than those not on statin. This effect was seen with the statin group of cholesterol-lowering medications, but not with other kinds of cholesterol-lowering medications. This lowering of risk amounted to 70 percent for Alzhei-mer's disease. This study was not a randomized study, so we await further evidence. If true, it is a nice additive effect to an already-proven benefit in regard to heart disease protection.

One of the statins-Baycol (cerivastatin)-was withdrawn from the market because of muscle breakdown and resultant kidney problems, but the other statins have not been shown to have side effects as significant. If the doctor feels you should take the medication, a vast body of compelling evidence exists to support its use.

I am concerned about the smallpox vaccination. How safe would it be? Is there any way to treat smallpox that would avoid vaccination if there were to be a terrorist attack using this germ?

Here we are, 25 years after we thought smallpox had become extinct, worrying about it again. The problem lies in the fact that stocks of the virus called "variola major" were held in "safe" keeping in laboratories in the U.S.A. and Russia. Concern centers on whether supplies of the virus have fallen into the hands of terrorists. How real such a scenario is we don't pretend to know. Nevertheless, a single case of smallpox would be far more dangerous and liable to spread than a case of anthrax.

The logistics of spreading the disease seem enormous, but willing "suicide" carriers could inoculate others they contacted. The disease causes severe morbidity, which might limit the ability of infected terrorists to interact with others, but epidemics were the norm in the days before immunization, and so epidemics could be expected in today's populations, which are currently not immune.

Smallpox has a 30 percent morbidity rate. The U.S.A. population is largely not immune, because the vaccination program stopped in 1971 for the general public and in 1990 for military personnel. There are 15.4 million doses of the old vaccine in stock. Vaccine production had stopped, so the call for vaccines for the entire population by 2003 likely will be of a virus cultured in human cell lines. The old method was to take lymph from cattle inoculated with the vaccinia virus and scratch some of it into the skin. The newer vaccines will not have had time for large-scale studies.

Smallpox vaccination is hazardous in those who are immuno-compromised, such as HIV-positive persons. People with skin disease such as eczema are also at increased risk of wide dissemination of the vaccine-produced pustules through the skin.

Rare but devastating is smallpox encephalopathy, which usually kills the unfortunate victim.

Though these complications are nasty, they are insignificant compared to the effects of a smallpox epidemic. For now, it's not wise to immunize the whole population, but should there be a terrorist attack, the best defense would be mass vaccination.

No dependable treatment exists. Those of us immunized years ago are probably quite susceptible and would need reimmunization. The U.S. government's expenditure of $428 million to produce a vaccine indicates a real concern on its part regarding the degree of risk. For now, all we can do is be alert and not get too anxious about matters we hope will not happen and over which we have no control.

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Allan R. Handysides, M.B., Ch.B., F.R.C.P.(c), F.R.C.S.(c), is director of the General Conference of Seventh-day Adventists Health Ministries Department;

Peter N. Landless, M.B., B.Ch., M.Med., F.C.P. (SA), is I.C.P.A. executive director and associate director of the General Conference Health Ministries Department.