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Monday, March 27, 2017

"Oh, is she a Dripper?"

You know, I've never heard of my daughter called that before, but.....okaaaaaaay. Apparently Instacare Doc didn't mean that in a BAD way.

We were at Instacare last fall because we were on vacation and didn't pack our nebulizer. It was a short 3 day trip to grandma's and my teenage daughter Kitty had packed her albuterol inhaler, so I wasn't too worried. 

But Kitty had a cold and we had a major change in elevation. Those two things combine must have made her feel that her albuterol inhaler just wasn't helping. 

So, Mean Mom that I am, I dragged her to the Instacare.

Instacare Doc could tell that she needed a breathing treatment and I sheepishly admitted that we hadn't packed our nebulizer and that's why we were there.

She was really nice about it and assured me that I wasn't a bad parent. She went off to get the nebulizer and brought one back with the canister and mouthpiece.


Sometimes people drip (or slobber) when they use a mouthpiece with the nebulizer. You can really taste the medication with the mouthpiece - it's sort of salty, which of course make your mouth salivate (or slobber/drip) a little bit. 

When Instacare Doc came back to check on Kitty, she could see that Kitty had wrapped a pile of tissues around the base of the canister kit. She said, "Oh - is she a Dripper?"

Never thought of it that way, but yes.

I should have told Instacare Doc when she first went to get the nebulizer that Kitty HATES the mouthpiece. She would much rather use the mask. But Instacare Doc was busy and I didn't want to bother her to hunt down a mask.

These is what we use at home. The big nebulizer is 17 years old, and the smaller one is new. Instacare Doc had home health care deliver a nebulizer to grandma's house so we didn't have to keep going back to the Instacare every 4 hours for a breathing treatment.

You can see a mask on each nebulizer. The mask on the smaller nebulizer is just like the mask you use when you get oxygen at the hospital. The one on the right is also works as an oxygen mask, but it's shaped like a dinosaur. We still have it from when the kids were little!  Some kids like the dinosaur shape because it's not so scary. I think we have one shaped like a fish somewhere too.

If you or your kids are using a nebulizer, you can try different options to see what you like. I'm not a big fan of the mouthpiece either, it is salty and I do drip. I would rather use a mask.

If your kids don't like using the nebulizer, that could be a reason why. Try a couple of different masks or a mouthpiece and see what they like best.

After all, who want to be called a Dripper?!

Wednesday, March 8, 2017

Stress in kids CAUSES asthma?!

(Shutterstock image)

Ever the science nerd, I love learning about new things. In fact, when my kids see me watching Frontline or another show on PBS, they say, "Looks like Mom is on Nerd Watch again."

I'll take that as a compliment!

My colleague is an epidemiologist in an asthma program and sent a link to a video from PBS News Hour.

The video talks about how stressful childhood experiences can actually CAUSE asthma.

Now, I knew that stress could cause (or trigger) an asthma attack 

But I didn't realize that stress could actually cause kids to develop asthma in the first place!

Experts at the National Institutes of Health say, 

"The exact cause of asthma isn't known. Researchers think some genetic and environmental factors interact to cause asthma, most often early in life."
 In our case, it's genetic. It runs on both sides of the family. I have allergies and asthma, as do all 3 of our kids. Many family members on Hubby's side of the family also have allergies and asthma.

The video is only 8 minutes, it's worth watching the PBS News Hour video, "Can stress trigger asthma in children?" 

It's sad to see the stress that these poor little kids are under. (Grab a tissue when you watch the video!) Some are homeless and others have witnessed trauma. The description of the videos says:

"Johns Hopkins Bloomberg School of Public Health found about 2 of every 3 Motor City children face “adverse childhood experiences,” such as household substance abuse, exposure to violence and extreme economic hardship that can trigger asthma."

The video says that too much stress can cause your cortisol and adrenaline glands to kick in to high gear. It also says that when your body is in overdrive like that, it can cause a variety of health problems, including obesity, heart disease, asthma and diabetes.
It sounds hopeless, but there are people trying to make a difference! The Henry Ford Health System has 2 mobile clinics (bright blue buses) that go into the neighborhood and offer health care through the Children's Health Project of Detroit. They also have school based health centers. 

After all, if the kids are living in poverty and experiencing trauma, they may not be able to have a car or money to go see the doctor. So, the doctors and nurses come to them!

It's worth your time to watch the video. I feel sad for all the kids in the video but I am glad that there are people out there trying to help them.

Although I already have asthma, stress can sometimes be a trigger for my asthma attacks. Today is one of those days at work. Guess I better eat some chocolate and do some deep breathing!


Thursday, March 2, 2017

Be Kind to the hospital staff!

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Having a child in the hospital can really rock your world. I should know - my kids were hospitalized 12 times when they were younger (including 2 times in ICU when my son almost died.)

It seems like my kids were ALWAYS sick when they were little. They would wake up with a runny nose and I would think, "Oh we go again!" Their runny nose would quickly turn into a nasty cough that required many breathing treatments with the nebulizer.

 And of course, the kids would always get worse at night! After carefully watching them for hours, there would come a point where we knew we were in over our heads and needed medical help. By then, we were sleep deprived parents driving one of the kids to the Emergency Department while Fabulous Neighbor stayed at home with the other kids.

(You can learn the warning signs of "When to Go to the ER if Your Child Has Asthma" from Nemour's hospital.)  

I have a hard time when I don't get enough sleep and I am very worried about my child not breathing well.

But, I was always kind to the hospital staff. After all, they are there to help us! 

Many families are scared and take it out on the hospital staff, yelling at them, being rude, etc.

A new study from The New York Times called "What Happens When Parents Are Rude in the Hospital" is a real eye - opener!

According to the article, if you are rude to the hospital staff, it can affect how your child is treated. And cause the hospital staff to make more mistakes. 

In the article, they had a "simulated crisis scenario" in a NICU (Newborn Intensive Care Unit) with rude "parents" (actors) worried about their baby (a plastic life like baby).  When the parent actors said something rude or unpleasant to the medical staff, they found:

"But even such mild unpleasantness was enough to affect doctors’ and nurses’ medical skills. Individual performance and teamwork deteriorated to the point where diagnostic skills, procedural skills and team communication were impaired and medical errors were more likely, compared to control scenarios in which the mother would just say something general about being worried. The team’s ability to perform in critical medical situations with sick babies was affected for the rest of the day, the findings suggest."

Woah! That's the last thing I want is for someone to make mistakes while they are caring for my child in the hospital! These doctors, nurses, respiratory therapist and CNA's are part of my team! I want to their help and I want to work with them. Part of being a team means treating everyone well and with respect. 

It's okay to disagree. I know the pattern my children follow with their asthma, and I know when they are getting worse. I have disagreed a few times with doctors who weren't listening to me. I would try to tell them that my son with severe asthma has a habit of "dropping" his oxygen levels - FAST! 

When the doctor came skidding into my son's room in the ER with wide eyes and a look of shock on his face, I would politely say, "This is what I trying to tell you would happen."  

Advocate for your child. You know your children better than anyone else and what typically happens with their asthma. As part of the team, you can KINDLY share that with the hospital staff. Be a good team player so you can all work together to make help your child get better. (Even if you are scared, worried, and have a horrible headache from lack of sleep.) 

Together, you can do great things for your child!

And remember the line from the live action Cinderella movie, "Have Courage and Be Kind." 

Wednesday, February 15, 2017

New medication for kids with uncontrolled asthma

These are a few of our "empties", not THOSE kind of empties! 

No beer bottles here!

These are some of the controller inhalers/discs we have used over the years. Controller medication is what you take EVERY day for your asthma to keep the swelling down in your lungs. It's important that you take it every day - whether you feel sick or not.

There are four in my family with asthma (myself and my 3 kiddos - 2 of whom are now grown.) All of us have different struggles with trying to control our asthma over the years.

So, we have tried almost every asthma medication that is on the market. In fact, when we saw a TV commercial for an asthma medicine, I asked daughter Kitty, "Hey - you had that one once, didn't you?" She didn't even look up from her homework, but said dryly "Yep, if they make it, I've tried it."

I always like to keep my eye open for anything new, so I follow the Allergy & Asthma Network Facebook page. Last week, they posted an article from Medscape that said "FDA Ok's Symbicort for Uncontrolled Asthma in Kids 6 to 12."

Symbicort (the bright red inhaler above with the grey cap) has been around for a while, but was only used for those 12 and older. A new study has shown that it can safely be used in kids 6-12.

I love my Asthma Doc because he is willing to try different medications, different doses, etc to find one that we feel controls our asthma. 

How do you know if your asthma is in control? GSK has an Asthma Control TestTM for those 12 and older. This is the Asthma Control Test for 4-11 year olds.

If your child's asthma is not in control, talk to your doc to see if they want your child to change a dose/try a new inhaler.

Life is short! Let's keep those lungs working!

Thursday, February 9, 2017

Asthma moms! Are you taking care of yourself?

With 25 years of parenting under my belt, you would think that I would have learned by now how to take care of myself AND my kids, but nope.

This photo is me in the hospital, having some tests run.

Apparently years of chronic stress have taken a toll on my poor little body.

As mom to 3 kids with asthma, we have had a LOT of stress over the years. My two youngest kids were hospitalized 12 times for asthma (2 were ICU.)

When my kids were little, it seemed like they were ALWAYS sick! If they would come home from school with a runny nose, I would start to panic. For us, it would just be a matter of time before all the other cold symptoms would start (sneezing, coughing and wheezing). 

We knew where to find all the after hours pediatrician offices!

But wait, there's more!

And for us, that would mean a 3 day hospital stay. But we also had two other kids at home, so how do we juggle all of that? Who could pick them up from school? Take them to scouts? Dance? Drive to Target at 10:30 at night (on the way home from my turn at the hospital) because the new semester was starting and my son needed shorts for gym class? True story by the way.......

Throw in a car accident or two, black mold in my house, six family members dying and the odd assortment of every day stress of being a mom, and it's no wonder my health suffers!

As part of the pre-flight announcements, the flight attendants will always tell you that if the cabin suddenly loses pressure, an oxygen mask will drop. They tell you to put your oxygen mask on first before you help your child.

How many of us do that? Our first instinct is to put on our child's oxygen mask first, then take care of ourselves. 

That sounds like the life of a mom in so many ways. We make sure everyone else is fed, dressed and off to school. We take kids to piano lessons, swimming lesson and attend their band concerts. In between we put in a full day at the office (or a full day of taking care of kids at home.)

With kids with a chronic illness like asthma, you throw in all of the medical stuff on top of that and its no wonder we have a hard time keeping up - let alone time to take care of ourselves.   

For all of you asthma moms - what have you found to help you handle stress?

Yoga? Funny movies? A bike ride or walk? Chocolate?

Comment below - maybe you can spark an idea for another asthma mom. And together, we can take a moment for ourselves! 



Thursday, February 2, 2017

Do I disagree with the experts? Well.....yes!

I feel that there is no one-size-fits-all approach to treating asthma. You can see from the picture above a small sample of what we have around the house for allergies and asthma.

My 3 kids and I all take different medication and different doses of allergy and asthma medicine.

Son #1 swears by Allegra, but daughter Kitty likes Zyrtec. I can't take either one because it makes me feel WAY too tired. So I use an over the counter nose spray .

The same is true for our asthma medicine, we all have different inhalers that we feel work best for us.

But with asthma medicines - what works best? Inhalers or nebulizers?

Do I think they are right? 


I get that they are researchers and they have their professional opinions and the science to back it up.....

But, I know my body, and I know what works best FOR ME. There are times when I am so sick that I am breathing really shallow (I can't take in a deep breathe). In fact, if I try to breathe deeply, I will start coughing so hard I can't seem to catch my breathe and I almost throw up.

So, when that happens, I CAN'T use my inhaler because I can't breathe in deep enough to inhale the medicine. But, I can sit on the couch and slowly breathe in the mist from the nebulizer while I try to stay calm. (Staying calm is not easy when you are desperately trying to breathe....)

Yes, I know that a nebulizer takes more time. But, if you can't breathe in deeply to use an inhaler, what choice do you have?!

I have noticed the same thing with my kids. When they were little and either headed to the hospital/or had just been discharged from the hospital, they were really weak and breathing was a BIG job. They couldn't breathe in deep enough to use an inhaler. So, we used the nebulizer.

I also liked being able to give them a breathing treatment while they were sleeping. We had an oxygen monitor, and I would check on them often during the night when they had pneumonia. If their oxygen level was low, I would plug in the nebulizer near their bed, strap the mask to their face while they slept and give them a breathing treatment.

We TRIED having them sit up during the night and breathe in deep enough to use their inhaler. Tried. No dice. Didn't work. They would start a really bad coughing spell, and sometimes they would throw up.

So, we learned to use the nebulizer when they were really sick.

We pack the nebulizer when we travel. It's been to the Grand Canyon, Disneyland, grandma's house, etc. We learned to never leave home without it.

Remember, everyone with asthma is different. Asthma flare ups (or attacks) can be different too. Some are mild and can easily be treated by an inhaler. Other times, only a nebulizer will do.

So, what works best for you? Inhaler or nebulizer? Talk to your doctor and she can help you decide what's best for you. Even if it's not what the researchers say you should be can be a rebel like me and disagree! 

Monday, January 23, 2017

Learnin' the lingo

(Shutterstock image)

If there's one thing I learned being a mom to 3 kids with asthma, is to know oxygen levels. When they were little, my kids were hospitalized 12 times for asthma (2 of those were ICU.) 

In addition to watching for their skin color, fingernails, or lip color to change, I checked their peak flow meter, listened for wheezing, and gave breathing treatments. I also learned how to use an oxygen monitor.

We had a hand held monitor we borrowed from a friend, similar to the photo above. (I just did a quick search online and found that you can buy a finger tip monitor for $20-$40!) Wow! The one we used back in 2000 - 2007 was about the size of a paperback book and cost $800.

Once you have a monitor, how do you know if your oxygen level is low?

"Normal pulse oximeter readings usually range from 95 to 100 percent. Values under 90 percent are considered low."
 When my kids would get REALLY sick, I always pulled out the oxygen monitor. They usually followed a pattern. They would start a cold and their oxygen level would be 94. Then it would steadily drop over the next day or two. Once it hit 90, we would head to the ER, because I knew the hospital would admit my kids and start oxygen and steroid IV's. That would also mean 3 days on the pediatrics floor. (Which was fine - I was more than happy to let the professionals take over!)

When I would get to the ER, I would "speak the lingo" or use the medical language so the doctor would know that I know what I'm talking about. I would let them know:

  • my child had been hospitalized before for asthma
  • all of the asthma medications my child was taking
  • how much my child's peak flow meter level had dropped
  • how often I was giving breathing treatments (and when I gave the last one)
  • we had already started oral steroids, but my child was not breathing better
  • I had an oxygen monitor at home, and what the level was 
I have noticed that some doctors or nurses call it the "sat level" (short for oxygen saturation level), while others call it the "02" level (oxygen level.)

If you are want more info about  "When to go to the ER if your child has asthma." 
 Nemours Hospital has a helpful section on their website.

Recently, I was in the hospital with a family member who had an accident, and I noticed their oxygen level was  VERY low. Remember the quote from Mayo Clinic that says "values under 90 percent are considered low?" Well, this family member had an O2 of 85. And at one point, they would drop to 73.

When the nurse was in the room, I would say that I was worried about my family member's oxygen, that I had been watching it while the nurse was gone, and family member's  O2 level was bouncing between 73 and 85. He said, "It sound like you know what you're talking about." 

I said, "Well.....I am a Certified Asthma Educator (AE-C)! I have asthma, and 3 kids with asthma, and they were hospitalized 12 times when they were little. So I have learned to REALLY watch O2 levels."

Now, you don't have to be a AE-C to know about oxygen levels. You can learn more from  John Hopkins  and your doctor. Work with your doc to learn more about asthma treatment plans, and how to know how sick your child is - and if you need to go to the ER.

Meanwhile, I will keep watching O2 levels anytime a loved one is in the hospital. It makes me REALLY nervous when the levels drop.