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Friday, September 14, 2018

Preparing for disasters when you have asthma





(Shutterstock) 

The weather has been a little crazy lately. 

Some parts of the U.S. are dry as a bone and plagued by wildfires and dangerous smoke.

Other areas of the U.S. are being battered by hurricanes, with crazy winds, rain and flooding.

No matter what part of the country you are in, how do you prepare when you have asthma?
I have been watching the national news stories on TV, showing empty shelves at the grocery store and long lines at the gas stations. 
Like my late father-in-law always used to say, "It costs just as much to fill up the top half of the gas tank as it does the bottom half!"
So, I try not to wait until my gas tank is on "empty" before I fill up. In fact, I know people that will fill up when their tank gets to the 1/2 way point.  

Allergy & Asthma Network has a list of things to help. 

  • Stay on your schedule for taking medicine (it's easy to miss a dose, but can cause problems if you do)
  • Medications - quick relief inhaler (Albuterol), daily controller inhaler (if you use one) and 2 epinephrine auto injectors (if you need those.)
  • Nebulizer - some need power and others run on batteries. I have an adapter so I can run my nebulizer from my car (it plugs into the cigarette lighter.) Find out what your nebulizer needs.
  • Bottled water, allergy free food (if you have food allergies) and cash to buy supplies  
  • Medical records and refill information - if your medicine is lost, it may help in getting refills. Sometimes, you may need to pay cash for a refill if it's "too soon" for your insurance to refill it. But don't go without your medicine!
  • N95 mask - can help protect your lungs 
  • Medical alert bracelet/tag - this will help rescuers to know if you have asthma, food allergies, diabetes, etc
  • Meeting place - where can you go if you need to evacuate? Do you have another family member's house you can go to? Church? School? If family members are split up, they will know where to meet. 
American Red Cross also has an Emergency Preparedness Checklist  
Remember to also keep calm (easier said than done - I know!) Since strong emotions are an asthma trigger, you could end up with an asthma attack on top of the stress of a natural disaster. 
Watch out for:
  • Crying
  • Fear
  • Anger  
  • Yelling
  • Laughter
  • Excitement

The weather can really surprise me sometimes, and it can catch you off guard. Make sure you are prepared for any sort of disaster that may come your way.

Thursday, September 6, 2018

Nose spray for anaphylaxis?

(https://www.empr.com/drugs-in-the-pipeline/epinephrine-nasal-spray-anaphylaxis-treatment-intranasal-bioavailability/article/792360/)

I was really excited to see a story on the Allergy & Asthma Facebook page about a nose spray for anaphylaxis.

The Food and Drug Administration (FDA), has given "Fast Track designation" to a Epinephrine Nasal Spray, which could be used to treat anaphylaxis.

The Fast Track is: 

"....a process designed to facilitate the development, and expedite the review of drugs to treat serious conditions and fill an unmet medical need. The purpose is to get important new drugs to the patient earlier. Fast Track addresses a broad range of serious conditions."

How do they decide if something is "serious"? It depends on if the FDA feels that the drug will:

 "have an impact on such factors as survival, day-to-day functioning, or the likelihood that the condition, if left untreated, will progress from a less severe condition to a more serious one."

For those of you with food allergies, you know that if "left untreated", our reaction will progress to a "serious condition". 

Son #2 and I have both had anaphylaxis in the last week due to cross contamination. And I would really rather use a nose spray any day over my epinephrine auto injector. 

It's SO frustrating. We always check our food, and as careful as we are, we may not know that someone has contaminated our food until we start to experience symptoms. Then we panic and wonder what happened?!

Someone must have used the same cutting board/knife/cookie tray etc for all of the food prepared.

It's frustrating that when we talk to the restaurant manager, and they say, "Really? Like that's a thing? Like it really can make you sick?"

I want to punch them!  Hard.

Yes, it can make me sick. And even kill me. 

Unless someone has a food allergy, they just don't understand how serious it is. So, we carry epinephrine auto injectors to protect ourselves.

And hopefully soon, we will be carrying a nose spray that does the same thing!  

Thursday, August 30, 2018

Can you avoid the September Epidemic?

(Shutterstock image)

First of all, what IS the September Epidemic?

Well, most parents worry about kids getting sick during cold and flu season (winter). It seems to make sense that winter is the most likely time to get sick and end up in the hospital. 

But - it's actually September! Asthma and Allergy Foundation of American (AAFA), says:

   "There is a September asthma hospitalization “epidemic.” Many more people are hospitalized for asthma shortly after school starts than at any other time of the year. The number of asthma hospitalizations peak first for school-age children, then preschool children, then adults."
 For those of you with school aged kids, that probably makes sense. I can remember being room parent for many years and helping out in my kid's classrooms. And the hygiene (or lack of) was shocking. I saw plenty of kids sneezing without covering their nose, coughing all over on their seatmate, and wiping their nose on their sleeve. 
Ugh.

That's how my kids would get sick, then their little brother or sister would get sick, then the Hubby and I would get sick. No matter how carefully I wiped down counters and door knobs, and no matter how often we washed our hands, we still picked up germs. 

The problem is that you can't control what goes on in school, especially when you have over 1,000 kids in a school. And they come to school with a cold because "Hey - it's just a cold, what's the big deal?"

Well, the big deal is that with asthma, a cold isn't "just a cold" - it can easily morph into bronchitis or pneumonia. Which for our family means another hospitalization.

So, what do you do? Short of coating everything with hand sanitizer?

There are some things we have found helpful when my kids were little. They are:

  1. Make sure you stay on your daily, controller inhaler (this will keep the swelling down in your lungs)
  2. Make sure each kid has their own rescue inhaler 
  3. Wash your hands (you should wash them for 20 seconds.) Wash them after you use the bathroom (seems obvious but you wouldn't believe how many people I see walk out of bathrooms without washing their hands.) Wash your hands or use hand sanitizer.
  4. Open the bathroom door with a paper towel (to protect yourself from those people who don't wash their hands and then touch the handle....ugh!)
  5. Sneeze into a tissue or your elbow (so you don't spread germs on everyone else).
  6.  Keep pop up hand wipes in the car to sanitize your hands after shopping
Keep an eye on your child if they get sick. They can go from bad to worse very quickly.  Nemours Hospital has a webpage that lets parents know "When to Go to the ER If Your Child Has Asthma".

So, stock up on hand sanitizer and tissues and let school begin!

Thursday, August 23, 2018

How can I keep my child out of the hospital?



(Shutterstock image)

I am asked this when I help families with asthma. And it's something I wrestled with myself when my kids were little.

I would wonder, "What a I doing wrong? My child is in the hospital AGAIN?!"

Often times, you aren't doing anything wrong! 

Some kids just have asthma that is hard to control. And sometimes kids can go from bad to worse VERY quickly. 

I found that close monitoring of their symptoms was helpful to me, including:

Using a peak flow meter 

This is an inexpensive little hand held device that you blow into as hard as you can for one second. It measures how much air you can push out of your lungs. The marker will end up on a number on the scale ( 0 - 600), which will be your "personal best". That's is YOUR number. It's pretty much the same every morning and every night (unless you start to get sick.)

What I like about the peak flow is that I knew each kid's personal best. They would use their peak flow meter every morning and every night and yell out their number. Hopefully, they were in their green zone. If it was lower than normal, I would ask them to do it again. If it was still too low, I would talk to them. I could actually hear a change in my kid's voices when they were sick. Their voices would get tighter and higher. 

A peak flow number that was dropping would give me several days warning that my child was getting sick and their lungs were getting worse. There are several things we could do (see below).



After hours/Urgent Care

Most pediatrician offices have an "after hours" network, where different doctors are on call after 5pm. Don't be afraid to use it! Kids with asthma can go downhill quickly. If you ever say to yourself, "I wonder if......" and if the next part of the question is "go to the doctor" - then GO! That's your gut telling you that something is wrong.

Many times the doctor would say, "It's just a virus." Well, pneumonia can be caused by a virus or bacterial - but it would still put my kid in the hospital. So even if it's a "virus", there are things Asthma Doc could do to help get the swelling down in my kid's lungs. He would have my child double up on their controller inhaler (depending on which one they were on).  They were usually just on a corticosteroid, not a combination inhaler, so they could safely double it for a few days. You can't always double up inhalers - it depends on which one you take. Because you can get too much of  a LABA (long acting beta agonist). 

 Sometimes the doctors would start my child on a 5 day "burst" of oral steroids (prednisone.) That would help reduce the swelling in their lungs. Other times doc would give them a steroid shot to get the medicine into their system even faster.  

We usually had a 50/50 chance of ending up in the ER after a steroid shot. But it was worth a try!

Emergency Room 

Our After Hours offices were usually open from 5 - 10pm. After that, we would go to the Emergency Room. I would always give them a quick history - this child had been hospitalized 6 times already for asthma. They seemed to take me more seriously when they knew my child had already been admitted for asthma. Keep your list of asthma medicines and doses on your phone so the ER staff can record them in your child's chart. 

Once one of my kids were admitted, did I feel like a failure? No. I had tried everything I could, but they needed more help than I was qualified to give them.  That's when I let the professionals take over and sigh in relief.

My kids needed around the clock care and needed to be hooked up to oxygen monitors so the staff can be alerted if they get worse. They have a respiratory therapist that comes in every few hours to give a breathing treatment. And they also have a nurse and doctor keeping an eye on them. That's more than I can do as a parent. 

So, hopefully the ideas above can help you monitor your child and try to keep them out of the hospital. But, if they do end up admitted - just know that you did the best you could!




 

  

Friday, August 10, 2018

Define Your Asthma

https://www.facebook.com/DefineYourAsthma/

I'm always on the lookout for new resources, and I learned about "Define Your Asthma" from (AAN) The Allergy & Asthma Network (AAN).

Who is AAN?

"Allergy & Asthma Network is the leading nonprofit organization whose mission is to end the needless death and suffering due to asthma, allergies and related conditions through outreach, education, advocacy and research."
Based in the U.S., AAN is known and trusted not just here, but internationally as well. Their CEO, Tonya Winders, is President of the Global Allergy and Asthma Patient Platform (GAAPP).

GAAPP is a global organization of allergy and asthma patient groups that was created to:


".....empowering the patient and supporting the patient voice so that decision makers in both the public and private sectors, in government and industry will be mindful of patient needs, patient desires and patient rights."

It's so important as a patient that you voice your opinion because you know your body and how your asthma responds. It helps to give feedback to your doctor, "This inhaler doesn't seem to work as well as the last one you prescribed. I'm needing to use my rescue inhaler more often now and my chest is tight all the time." 

GAAPP is one of many sponsors of Define Your Asthma. On Define Your Asthma's Facebook page, they say it was created for:

"......a severe asthma campaign with education at its heart. Its personal and inspirational approach aims to equip patients and physicians with the knowledge and confidence to start well-informed conversations.

They want to help you live your best life if you have a severe asthma diagnosis.   

Since asthma isn't a one-size-fits-all disease, it's important to know your body and what's best for you. In my family, all 3 kids and I use different inhalers for our asthma. We have daily controller inhalers and rescue inhalers for 4 people, so we have a big container with a jumble of brightly colored inhalers and spacers. We each have found one that works best for us.

So, know your body and what's right for you. 

And

Define Your Asthma. 
 

Wednesday, August 1, 2018

Fires and smoke, oh my!

(Shutterstock image)

Every summer I worry, and every summer we get forest fires and LOTS of smoke. 

Why do I worry? Well, because smoke from a forest fire almost killed my son 10 years ago. He ended up in the hospital in ICU with the "crash cart" outside his room. 

It happened so fast.

When you have asthma, smoke does a number on your lungs. 

What are the health effects of smoke?

You might have a cough and/or wheezing, a hard time breathing, and burning eyes and a runny nose.

Is it just people with asthma? AirNow says smoke can affect:

  • a person with heart or lung disease, such as heart failure, angina, ischemic heart disease, chronic obstructive pulmonary disease, emphysema or asthma.
  • an older adult, which makes you more likely to have heart or lung disease than younger people.
  • caring for children, including teenagers, because their respiratory systems are still developing, they breathe more air (and air pollution) per pound of body weight than adults, they’re more likely to be active outdoors, and they’re more likely to have asthma.
  • a person with diabetes, because you are more likely to have underlying cardiovascular disease.
  • a pregnant woman, because there could be potential health effects for both you and the developing fetus.
So now, I am VERY wary of fires and smoke. I keep the windows closed in the house and the car. And when I'm in my car, I also keep the "recirculating" air on so it doesn't pull smoke into my car when I drive. And luckily, my work has a great air filtration system and I am protected at my office.
 
So, I am lucky to be able to keep working and then heading home to a safe home environment. 

However, not everyone is so lucky. I have a friend in California that just drove 3 hours north to Oregon to be able to stay in a hotel in an area that is away from the fires and smoke. 

I had to do the same thing 10 years ago after my son was released from ICU. There was another forest fire and our valley filled with smoke again. This time the smoke was coming into my house and the kid's school. So I quickly packed things for myself and my kids and drove to family's house located 4 hours away.

It sounds drastic, but if you have asthma and are having problems breathing, and your home is filling with smoke, you may have to leave town. 

Better to keep on breathing, right?! 
 

Friday, July 13, 2018

Pricey meds


(Shutterstock image)

I just opened the bill for a simple surgery and was shocked to see that it was almost $6,000! Woah!

Luckily, it was the end of my insurance year, so I had already met my deductible and out of pocket limit. So I won't have to pay a copay on that bill.

That also tells me that I have spent a LOT of money on medical care over the last year.

If you are in the same boat, what can you do?
 
We use manufacturer's coupons for our inhalers. Son #2 and daughter Kitty and I are all on long term controller (maintenance) inhalers. Even thought insurance pays for most, we still have a $75 copay each month (for each of us.)  

Luckily, I have a really good pharmacy that knows us well (since we visit them so often.....) and they will search for manufacturer's coupons for us. So, instead of paying a $75 copay for my inhaler each month, I pay $25. In fact, when I renew my prescription each year, they search for a new coupon to apply to my copay. And they do that for my son and daughter's inhalers too. 

Years ago (in 2007), Son #2 was on a biologic injection to control his severe asthma. The medicine was given as a shot once a month, and his tiny vial of medicine was $1,000 per month. And he had monthly injections for 7 years. Insurance covered most of it, but we had a $125 copay each month. 

Which doesn't sound like much - but there are 4 of us with allergies and asthma, so monthly meds really add up. We found help on a website called Needymeds. They are a sort of website where you can go to find help with co-pays, find a low income/free clinic near you, etc,

Want to see if your drug has a copay help or coupon? Click here and select from the alphabet list of medicines.  

Want to find a clinic that is free/low incomes/or pay what you can afford? Click here.

They also have a list of mental health clinics, and even substance addiction clinics.


Want to attend a camp about asthma? You can find some listed here.  

Or you can search for camps or retreats for any other medical condition too.

So, you may have to do a little digging, but there are a lot of programs out there that can help.

Good luck!