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Wednesday, September 2, 2015

Virtual doctor visits

(Shutterstock image)

I can't keep up with technology. Good thing I have two adult sons and one teenager who can help me with my new things (did you know you can use your thumbprint to access your iphone instead of trying to type in a 4 digit code every time?! Thanks to daughter Kitty for showing me that and setting up my phone. I LOVE IT!!!!)

Did you also know that in some states, if your child has Medicaid, they can see a doctor virtually from school? You don't have to leave work and your child doesn't have to leave school. I just read an article about a school district in Texas. Here's how they explain the program:

"They say adults shouldn’t have to take time off work and kids shouldn’t have to miss school to get routine health care, like when a child has an ear infection or skin rash, because modern technology allows a remote doctor to get high-quality, instantaneous information about patients. An electronic stethoscope allows the doctor to hear a child’s heartbeat, for example, and a digital otoscope offers a look into the child’s ear — all under the physical supervision of a school nurse."

I have never heard of an electronic (or digital) stethoscope until a few months ago. The Washington Post has a great article that explains how they work. Can you image the nurse using the stethoscope to on your child's lungs at school while the doctor listens from his office miles away? They can do the same thing with an otoscope to look in the ear. Welcome to modern technology!

If there's a problem, the doctor can call in a prescription and you can pick it up on your way home from work. Wow!

This would be really helpful for parents who can't leave work (because they don't have sick time). If they have to leave work and take their child to the doctor, they don't get paid. And the child misses school.

Here's how one doctor explains it. 

“Ninety percent of what you would see in a general pediatric clinic, we can handle it by telemedicine,” said Richard Lampe, chairman of the Department of Pediatrics at the Texas Tech University Health Science Center. He said that included sports injuries, strep throat — and among middle and high school students especially, mental illnesses like anxiety and depression."  

This may not work for everyone, but I think it's a good idea for some families. 

What will they think of next?!   

Thursday, August 27, 2015

Over reacting asthma cells

(Shutterstock image)

I love researchers! Unlike me, these people are REALLY smart! There are lots of Smart People, like my teenage daughter, Kitty - who drops her high school physics class because it's too easy. (Yeah, well I can't even spell physics - I had to use spell check for this blog entry.......) 

But these researchers are finding out new things all the time about asthma. The photo above shows a doctor looking at lungs, but the researchers are looking a lot deeper - at the cells that line the lungs (epithelial cells)

The newest research out shows that the cells that line the lungs in people with asthma are not like other people's lung cells. In "normal people's" lung cells, their cells just sit there in the lungs, like cars in a traffic jam. 

But people who have asthma have lungs cells that can be explained by  a study from Harvard Public Health 

“scramble around like there’s a fire drill going on”

I always tell people that asthma is like a "drama queen". (Those of you with teenagers know all about drama and over reacting.)  With asthma, your body over reacts to normal every day things - you know, like stress, animals, grass, trees, flowers, perfume, cleaning supplies, air pollution (these are "asthma triggers" - they trigger an asthma attack). Normal People can be around these things without thinking twice. But someone with asthma gets around any of those asthma triggers and our lungs over react and swell, make mucus, and the bands around the bronchial tubes tighten. 

Yeah, and we wonder why we suddenly start coughing or are short of breath?!

So, now we know that the cells in our lungs seem to over react (and they also have an unusual shape.) Check out the videos on the Harvard Public Health page. It's pretty interesting.

Now that the researchers have found this, it leads to more questions 

"Now that it’s known that epithelial cells in asthmatic airways are oddly shaped and are not jammed, scientists have to figure out why it’s happening—whether it’s asthma causing the cells to unjam, or if it’s the unjamming of these cells that causes asthma."  

That is kind of like "which came first, the chicken or the egg?"

Well, keep on working researchers! I would love to see the day when they find a CURE for asthma. They making great strides in finding out what causes asthma, let's find a cure you Smart People!  

Wednesday, August 19, 2015

Fires again!


I've been watching all of the stories on the news about the fires in California and Oregon. It's so hard to see the home owners on the news after their houses have burned. It shows families going back to what was their house, only to find ashes there now.

We live two states away, and our skies are filled with smoke from the fires.

Smoke and asthma are NOT a good mix. In fact, when I was watching the stories on the news, my first thought was "How can those people be there around all that smoke!?" I can't see how any of the reporters, government officials, home owners and fire fighters can stand it. It made me wonder if any of them have asthma?

The smoke is bad enough where I live, how can they stand being in the same area where the fire is burning? I have been having problems with my asthma and my throat is burning and my eyes are running. 

 I work in an office, so the air here is filtered. I also have air cleaners and a filter system on my air conditioning at home. And luckily, I have a button in my car where I can re-circulate the air, so it doesn't pull in smoke from outside. But I still don't feel well at all.

I shouldn't complain - when Son #2 was around 10 years old, he almost died from the smoke from a forest fire in our valley. He had been outside playing, and I didn't notice how far the smoke had spread. The fire was about 15 miles away, but the smoke filled the whole valley. 

(You would think kids would be smart enough to come inside when it's that smokey, but hey - that might interrupt any fun they are having hanging out with friends!)

By the time he came inside, he was really struggling to breathe. We used the nebulizer and gave him a breathing treatment, but he just got worse. He ended up in the Emergency Department, and they quickly admitted him to the Pediatrics ward of our hospital. He was in ICU, and they had the "crash cart" outside his room. (I found out later that they parked the cart there in case he stopped breathing so they could resuscitate him.)  

 I have learned SO much since then! We didn't know much about asthma, and what could make asthma worse. Smoke is high up there on the list for us. 

If you are having problems breathing, and aren't sure if you should treat it at home, or go to the emergency room, Nemours has a great webpage that may help.

As for me, I'm keeping my fingers crossed for rain. These fires are horrible! 


Wednesday, August 12, 2015

10 worst cities to live in if you have asthma

(Shutterstock image)

Have you ever wondered if there was a "safer" place to live if you have asthma? 

When my kids were younger and frequently in the hospital, I wondered the same thing. Out of desperation, I asked Asthma Doc, "Is there a better place to live for asthma?" He sort of chuckled and then said, "There are going to be asthma triggers wherever you go - cats, dogs, dust, plants, grass, etc. You could move to a new area that has new plants that you aren't used to - then that would cause more allergy and asthma problems."

Rats. I was hoping he would say that medically, the best place for us to live was Hawaii. A girl can try, can't she?!

Allergy and Asthma Foundation of America (AAFA) have released their list of the top 100 worst place to live if you have asthma. You can see the Top 10 on WebMd's site 

You can visit AAFA's website to see all 100 cities.This is how they decide which cities are the worst:

"2015 Rank - Rankings for the Allergy Capitals™ are based on analysis of data from factors including: Prevalence Data, Seasonal Pollen,
Allergy Medicine Utilization per Patient, and the number of Board Certified Allergists per patient. Weights were applied to each factor and a
composite final score was calculated for each Metropolitan Statistical Area (MSA)."
Sounds technical, but they are looking at how many people in that city have asthma, the pollen counts, how many people are taking allergy medicine, and if there is an asthma specialist in the city. 

I'm not sure how they gather their data - see how many bottles of Zyrtec, Allegra or Claritin the local Walgreens sells?!

Anyway, it's fun to look at the list and see if your city is on it. 

Happy viewing!

Tuesday, August 4, 2015

Back to school time!!

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I can't believe summer is coming to and end! We still have a few weeks until daughter Kitty starts school, but we are already planning ahead for her asthma.

School Nurse sent an Asthma Action Plan this summer. What is an Asthma Action Plan? The Centers for Disease Control,  CDC  explains it this way:

What is an asthma action plan?

The action plan is based on zones of asthma care defined by your peak expiratory flow (PEF) rate and symptoms. A PEF is a way to measure how much air you can blow out of your lungs in one second. Measuring your own PEF every day will help you track how well you are doing. Green Zone 
Green means go. You are in the green zone of the asthma action plan if your peak expiratory flow rate is 80% to 100% of your personal best measurement. You want to be in the green zone every day. You should have no asthma symptoms when you are in the green zone.
Yellow Zone
 Yellow means caution. You are in the yellow zone of the asthma action plan if your peak expiratory flow rate is 50% to 80% of your personal best measurement. Symptoms may not exist, may be mild to moderate, or may keep you from your usual activities or disturb your sleep. The yellow zone may mean that you are having an asthma episode or that your medicines need to be increased. The action plan should state what medications you need to take, how much to take, and when to take them. If you keep going into the yellow zone from the green zone, talk with your provider. Your regular medication may need to be changed.
Red Zone
Red means STOP. You are in the red zone of your asthma action plan if your peak expiratory flow rate is less than 50% of your personal best measurement. Your symptoms will be severe and you may have extreme shortness of breath and coughing or other symptoms that are specific only to you. If your symptoms and peak expiratory flow rate are in the red zone, seek medical help immediately. While you are seeking emergency help, follow your action plan and take your medications as directed. You may need emergency treatment, admission to a hospital, or to call 911.

There are a LOT of different types of Asthma Action Plans. Some schools like to use a certain version of the form, some doctor's offices have another form they like to use.

I just fill out whatever School Nurse sends me. In our case, it's an Asthma Action Plan from our state health department. Since daughter Kitty has to go to Asthma Doc every year to get a renewal on her asthma and allergy medicines, it's the perfect time for us to take the Asthma Action Plan and have him fill it out. (Believe me - she doesn't just go to Asthma Doc once a year - it seems like it's every other month.)

 Our Asthma Action Plan is a combination form - it also has a section where the doctor and I give permission for daughter Kitty to carry her inhaler with her at all times during school.

Did you know that it is legal in EVERY state in the country for students to carry their inhaler with them? However, you usually have to fill out a permission form at the beginning of every school year.

For us, it's not a problem - I just add it to the stack of all of the other forms I have to fill out!

So, while you are out shopping for school supplies to get ready for school - remember to also get ready by having an Asthma Action Plan on file at school. That way the teachers/lunch staff/recess guards will know what to do if your child has an asthma attack during school.   

Tuesday, July 28, 2015

This tween is amazing!

Susan Tatelli is one brave tween! She has life threatening allergies to peanuts, tree nuts and soy. Her mom recorded Susan using her Epi Pen and uploaded it to Youtube. She also interviews several allergy and asthma doctors who talk about when and how to use an Epi Pen. This tween does an AMAZING job using hers!!

Susan wanted to show other kids that it's not so scary - that others can use their Epi Pen if they need to. She has had a LOT of experience using her Epi Pen because she was part of a peanut allergy trial. While she was in the trial, she had 6 anaphylaxis reactions. She used her Epi Pen herself 5 out of the 6 times. Way to go!

I learned something from watching the doctors she interviewed. Dr. Sakina Bajowala of the Kaneland Allergy and Asthma Center shows how to hold the Epi Pen in your palm with your finger and thumb stretched out. 

Then she wraps her thumb around the Epi Pen first. Then she wraps her fingers around her thumb. 
She said that stops you from putting your thumb on the top of the Epi Pen (where the safety cap is) I didn't know that - and I have been carrying around an Epi Pen for years!  
You can watch the video here. You can see how red Susan's face is before she uses her Epi Pen. Scary stuff! What a brave tween to share her story with others to make it a little less scary.

She is going to do great things in this world!! 

Monday, July 20, 2015

Pacifier attached to a valved holding chamber and asthma inhaler?

I was at a conference and I saw a display from a company that makes a valved holding chamber that you can use with different age groups. (Basically, it's a tube that connects to your asthma inhaler. You spray the inhaler in to the tube, then you can inhale the asthma medicine out of the tube and it will go into your lungs.) 
You can use it:
  • as a valved holding chamber with an older child
  • add a mask for a younger child
  • add a mask and pacifier for an baby

Has anyone tried this yet? With the pacifier for a baby? It seems like companies are always coming up with something new!

I always used the nebulizer for my kids when they were little. I'm wondering if the valved holding chamber and pacifier would work just as well?

Any comments from anyone that has tried it?