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Monday, November 24, 2014

Spacers and holding chambers



Some of you may use your inhaler by itself. For me, I have found it to be MUCH more effective to use a spacer (pictured above) or a valved holding chamber. What are they?

American Lung Association (ALA) has a helpful web page that tells the difference between a spacer and a valved holding chamber. ALA says:

A spacer is a device that is placed on the mouthpiece of your quick relief inhaler. When used, a spacer creates “space” between your mouth and the medicine. This space helps the medicine break into smaller droplets. The smaller droplets can move easier and deeper into your lungs when you breathe in your medicine.

( Photo from ALA http://www.lung.org/lung-disease/asthma/living-with-asthma/making-treatment-decisions/holding-chambers-and-spacers.html)
A valved holding chamber is a type of spacer that includes a one-way valve at the mouthpiece. This device does more than provide “space” between your mouth and the medicine. It also traps and holds your medicine, which gives you time to take a slow, deep breath. This allows you to breathe in all of the medicine. 

Sometimes it's hard to "time" when you depress your inhaler, and when you breathe in. In fact, sometimes the medicine from the inhaler can go to the back of your throat instead of down into your lungs. My holding chamber helps me get the medicine into my lungs.

Asthma Doc has all of us use a holding chamber with ALL of our medications. I have one for my daily, maintenance medicine, and one for my rescue inhaler.

However, insurance will only cover ONE PER LIFETIME! Who's genius idea was that??!! So, when I need more than one, (since I have two different inhalers) Asthma Doc can still write a prescription for a holding chamber. BUT - I have to pay for one myself. I think my last one was about $20 or $30. You can call different pharmacies and ask for the "cash price" to get the best price.

They are made of plastic, so I don't know why my insurance company thinks one will last a lifetime..... big sigh.


Friday, November 21, 2014

If you have asthma, watch for heart attack

(shutterstock image)

I just read a surprising article, it was titled "Having Asthma Could Double Your Risk of a Heart Attack." What??!! The article says:

One study found that those with asthma who require daily controller medication are 60 percent more likely to have a cardiovascular event like a heart attack during a 10-year period. The other finding may be even more striking. Those with active asthma (meaning current asthma symptoms) or asthma medication use, and those who sought treatment for asthma within the previous year, are twice as likely to have a heart attack than those without active asthma.

So what does asthma have to do with your heart? How is that connected? 

The article says:

The tie between them could be inflammation, or swelling. Both asthma and heart disease are associated with higher levels of inflammation. Inflammation is the immune system’s attempt to heal body tissues after an injury, infection, or other damage. Some inflammation is good, but chronic inflammation, which occurs in many conditions like rheumatoid arthritis, nasal allergies, atherosclerosis, and asthma, can do permanent damage.

I want to learn more about this! I have asthma, as do all three of my teenagers. And we all take controller medication. So we could be at risk for a heart attack down the road. It looks like the study was presented at American Heart Association's Scientific Sessions 2014.  I don't see the study on the website yet, but I will be checking back to see if they post it.

This is one subject that I will definitely be following!

Monday, November 17, 2014

A pill for asthma?!


When you think asthma, you probably think of someone using their inhaler. BUT there is a pill that has been used for years to control asthma and allergies. Singulair (montelukast sodium) is a once a day pill that is used to treat asthma and allergies. 

Singulair is a leukotriene modifier. What does that mean? It was explained to me like this: leukotriene is what is released in the body during an asthma attack. Histamine is what is released in the body during an allergic reaction. So, people take antihistamines to block the histamine from being released into the body (and help control allergies). Think of Singulair like an "antileukotriene." It helps control the release of leukotriene (and can help control asthma.)

Still confused? Dr. Martha White wrote an article for Allergy and Asthma Network Mothers of Asthmatics (AANMA.)  

Singulair might be an option for some people to treat their asthma. Dr. White says it's available as sprinkles and as a chewable tablet. It's also available as a pill that you swallow (all of my teenagers take the pill form every day.) 

And, there is a generic pill available now! So instead of paying around $50 a month for EACH of my teenager's prescriptions (yep, $150 a month), we only pay about $10 a month now for EACH prescription ($30 a month). Much better!!

Yes, I did the happy dance when Singulair finally went generic! When you have 4 people in your family with asthma, (me and 3 teenagers) and we all have maintenance medications, rescue inhalers, medicine for the nebulizer, allergy medicine and singulair, it really adds up! Hubby has allergies too, so we have to add in his medicine and nose spray..

In fact, at one point I asked the pharmacist if I could just sign over my paycheck - just to make things easier! 

Talk to your doctor and see if Singulair would work for you or your kids. Everyone is different when it comes to treating asthma. Some kids with mild asthma can use Singulair. Other kids need Singulair plus an inhaled corticosteroid and allergy medicine. 

Until them, keep breathing!

Monday, November 10, 2014

Other stuff I learned in the hospital with my kids

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There are things we learned along the way of when our kids hospitalized 14 times for asthma (mostly thanks to pneumonia, sometimes it was the smoke from forest fires)

I'll share a few of the things we learned. Keep in mind that every hospital and every nurse are different. So, these may not be helpful to you OR you may find other things that help your kids.

1. A Bubble Humidifer. The picture above is an  "oxygen bubble humidifier." In hospitals, instead of using an oxygen tank, the oxygen comes out of the wall (there is some sort of system behind the wall......I don't know the science of how it works.) But the important thing to remember if your child is on oxygen is to have a bubble! The bubble is filled with water and adds a little moisture to the oxygen so your child's nose doesn't dry out and bleed. We had that happen - A LOT! It's not fun :(

2. Bring things from home. If there are things that help your kids feel better, bring them to the hospital. Our kids always had a favorite blanket and stuffed animal. BUT - we had to make sure we told the nurse on each shift that it was from home. Otherwise, blankie may end up in the laundry facility with the rest of the hospital sheets and you might not be able to find it again. We also brought a small CD player and would play our kid's favorite CD's that they listened to at night to get them to go to sleep.

3. Bring things for yourself. Since I didn't ever leave my child's bedside, I brought a bag with slippers, toothpaste and toothbrush, gum, snacks, a water bottle and magazines or a book to read. (Our nurses would also give us a toothbrush, toothpaste and comb if we forget to pack them.)


4. Bring favorite DVD's. Once again - make sure they are marked with your name on them. In our Pediatrics ward, we can check out DVD's for the kids to watch. But, my kids always had their favorites. In fact, Little Mermaid helped my daughter through more than one hospitalization! When we went to Disneyland, we stood in line to get a picture with Ariel. I told Ariel that my daughter watched our Little Mermaid DVD over and over again when she was in the hospital for asthma. Ariel said, "You are just like me! You must be half mermaid! I can't breathe very well when I'm on dry land either!"  I love you Ariel!! My daughter thought it was SO COOL that Ariel had a hard time breathing sometimes too!! I don't think Ariel had ANY idea how much that meant to us!

5. Ask for help I usually had one kid in the hospital and two more at home. So hubby and I would play "tag team." We would switch off who stayed at the hospital and who stayed at home with the other kids. When people ask how they can help - tell them!! Is there anyway you can pick up Son #1 from school today? Another neighbor would take my sons to scouts. Another would drive preschool carpool. Another brought warm chocolate chip cookies to the hospital. Mmmmm

Remember, just because your child is admitted to the hospital doesn't mean it is smooth sailing. We would have one step forward and two steps back. One of the kids would be doing well, then suddenly take a turn for the worse and the doctor would order the nurse to increase their oxygen, start a new antibiotic, change when they got their breathing treatments, etc. There were always good and bad days. Just know that it does get better!! 


Thursday, November 6, 2014

Cold temperatures can cause asthma attacks

(Shutterstock image)

We live in an area with a lot of mountains, and although it hasn't snowed in the valley yet, the mountain tops have been dusted in snow.

When it gets cold enough to snow, it causes problems for my asthma. Cold temperatures are one of my asthma triggers. It's important to know what triggers your asthma, (or causes an asthma attack) because then you can avoid those things. 

Asthma triggers can be different for everyone:

Animals (cats, dogs, horses, etc)
Pollen (flowers, trees, bushes)
Dust
Mold
Certain foods or medicines
Stress
Irritants (smoke, strong scents)
Colds or the flu
Exercise
Cold temperatures

 So, what do you do when you live in an area that is cold for most of the winter? Move to Hawaii of course!! Just kidding....although I would REALLY move to Hawaii if I could!

I pretend to be fashionable and wear a scarf. When I go outside, I can drape the scarf over my neck and mouth. That helps warm up the air before I breathe in. I also exercise indoors. For any of you that enjoy walking, many of the malls are open early for people to walk. 

If you are stuck outside and don't have a scarf, you can always do your "Darth Vader Impression." You can cup your hands over your mouth and warm up the air before you breathe in. I have actually done that until I could get back inside. 

Does anyone else have cold temperatures as an asthma trigger? I would be interested to know what anyone else has found that helps prevent asthma attacks from being out in the cold. 

Maybe a nice cup of hot chocolate......





Monday, November 3, 2014

Stock Epi pens in American schools, stockasthma inhalers in England?

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There are many schools in the U.S. that stock Epi Pens - just in case. There are students who have NEVER had an allergic reaction, but have their first one at school. Anaphylaxis is a medical emergency. Once anaphylaxis starts, death can happen in as little as 30 minutes. 

We are lucky because our school district stocks Epi Pens at EVERY school in the district. They can be used on anyone - a student, faculty member, even a visitor to the school.

I just read about how schools in England are stocking asthma inhalers - just in case. Most classes have at least 2 students with asthma (this is true in America too.) In England, the article says that:

 "Around 20 school children in England and Wales die every year from asthma, and most deaths occur before the child reaches hospital."

That just breaks my heart. It's my worst fear that one of my kids won't recognize the symptoms of an asthma attack and won't use their inhaler in time. :(

There is an English charity named Asthma UK that pushed for the inhaler rule change. They conducted a study that found that 64% of students couldn't use their inhaler because they either broke it, couldn't find it, forgot to bring it or it was empty. Having a stock rescue inhaler could help save the lives of many students there.

I know the panic of not being able to quickly find my inhaler! And let's face it - kids are kids. Half the time, they can't find their shoes, homework, cell phones, etc. They lose their inhalers too. 

How nice would it be to have a back up asthma inhaler in stock at the school - just in case?

Go England!! Let's get the same thing going here in the U.S.!!

 

Friday, October 31, 2014

allergic reactions


(Shutterstock image)

I was at the library listening to a presentation and overheard the woman behind me telling a friend that her daughter had an allergic reaction that day and had been in the emergency room.

I turned around and told her I didn't mean to be creepy and listen in on her conversation, but that my son had also experienced anaphylaxis, and it can be really scary as a parent to watch it.

She said, "Oh, it wasn't anaphylaxis. Her throat was just closing off, she was just having an allergic reaction." I said, "that IS anaphylaxis!!! You know she can have a re-bound effect, right?" (Even after you are treated for anaphylaxis, you can experience a "re-bound" - the symptoms can come back.)

I told the woman that she better check in on her daughter! An hour later, she tapped me on the shoulder and said, my daughter just sent a text and said it feels like her airway is closing off again. I think she saw the look of shock on my face, and I told her she needed to get her daughter to the emergency room - FAST!!

She said that her daughter was older and could drive herself. I told her, "not if she stops breathing!" I knew that death can happen in as little as 30 minutes. That scary fact has always stuck with me.

The National Institutes of Health lists symptoms of anaphylaxis: 
  • Skin—itching, hives, redness, swelling
  • Nose—sneezing, stuffy nose, runny nose
  • Mouth—itching, swelling of the lips or tongue
  • Throat—itching, tightness, difficulty swallowing, swelling of the back of the throat
  • Chest—shortness of breath, cough, wheeze, chest pain, tightness
  • Heart—weak pulse, passing out, shock
  • Gastrointestinal (GI) tract—vomiting, diarrhea, cramps
  • Nervous system—dizziness or fainting 
There are lots of things that can cause anaphylaxis, you need to let your family/friends and co-workers know if you have a food allergy or are allergic to medications or bees.

I would also wear an alert bracelet. There are cute bracelets for kids.  And there are a lot of companies that make allergy alert jewelry for adults too. You can do an internet search and find a LOT of options - bracelets, necklaces, stickers, etc.

Remember, anaphylaxis is a medical emergency! Get help fast!!