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Monday, December 31, 2012

Bronchial thermoplasty-what is that?!

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I was reading a story in the newspaper last week, about a newer way to treat severe asthma. The patient in the story was waking up almost EVERY night for the past 42 years with an asthma attack. He has had asthma attacks so bad that on two occasions they have had to call the helicopter to fly him to the hospital. He's also been on a ventilator twice.

So how can doctors treat someone like him? Bronchial thermoplasty is an option. It's a technical sounding name but easy concept to understand. They put a small bronchoscope through the nose into the lungs. The bronchoscope zaps the smooth muscles in the airways. The heat softens the muscle and reduces the spasms that cause asthma attacks.

The article said that 80% of those treated with the heat have had a better quality of life. It has meant having to miss fewer days of work or school because of asthma attacks. It also meant fewer trips to the emergency room and fewer hospitalizations.

This patient had to a series of 3 bronchial thermoplasty treatments done in the hospital under local anesthesia. Each time, he was well enough to go home an hour later. It has made a dramatic in his life, before he would wake up and need his asthma medication. Now he can sleep through the night. Medicare will cover bronchial thermoplasty, but his insurance wouldn't cover it, so he paid $20,000 out of his own pocket. But to have such a change of life was worth it to him.

Bronchial thermoplasty is approved by the FDA for those 18 years or older. They are conducting studies to see if it can be used for children too.



Thursday, December 27, 2012

What's it like to be in the hospital?

(A Pink Sunset)

Angela Giaco, who manages Pink Sunset Blog contacted me while she was in the hospital for asthma. Angela was lucky enough to get out of the hospital just before Christmas! Asthma never picks a good time to hit, my kids have been in the hospital 12 times over the years, including the 4th of July, New Year's Eve and on their birthday. Angela's story is interesting, you can read what it's like to be in the hospital from her point of view.

So why do you need to be hospitalized for asthma? There comes a point when you can't do anything more at home and you are still having a hard time breathing. My kids already take daily asthma controller medicine, allergy medicine, a leukotriene modifier, and have had 5 years of allergy shots. When my kids start the horrible asthma cough and their peak flow meter  is in the yellow zone, they take oral steroids, prednisone  Sometimes that works for my kids, other times they continue to get worse, and we move to the next step, which is an steroid injection-decadron. 

If they are looking really pale and their lips are turning dark, we head to the Emergency Room as fast as we can. It also helps to have an oximeter to watch their oxygen saturation rate. I know that if their oxygen level dips to 91, it's time to head to the hospital. They usually admit the kids when their oxygen saturation rate is around 89. Once in the hospital, they start the kids on oxygen and give them an IV of corticosteroids. They take a chest x-ray to check for pneumonia and the respiratory therapist comes in every 4 hours to give them breathing treatments and listen to their lungs.

Here's more information from Webmd on when to go to the doctor of hospital

You may never end up in the hospital with your asthma, then again you might. Learning more about the emergency signs of an asthma attack can help you know if and when you need to head to the hospital. Better to learn now than when you are in the middle of a severe asthma attack. 
So stay healthy and keep taking your asthma medicine!

Monday, December 24, 2012

Over the river and thru the woods...

(Shutterstock image) Grandmother's house we go. It's supposed to be a fun time at grandma's, but I'm starting to think my in-laws have other motives. Are they trying to kill me off?!

It's scary traveling with food allergies, and grandma's house has everything we are allergic to. Son #2 is allergic to tree nuts, and what does she have? Almond milk and almond butter.  Same thing happened last time we were there, we had to go buy a gallon of milk and remind her that Son #2 is allergic to tree nuts, and that means he can't drink almond milk. He needs regular old cow's milk.

Then Hubby decided to make Clam Chowder for Christmas Eve dinner. I am allergic seafood, so I bought a can of chicken noodle soup at the store so I could have something to eat. I left the kitchen when he started cooking, and was watching TV in the area next to the kitchen. Suddenly, I felt a flushed feeling race through my body and my heart started pounding. My first thought was the seafood. Uh oh! I ran from the room into another part of the house, closed the door and opened the window. I started breathing in deeply to fill my body with fresh air. I grabbed my Epi pen just in case I needed to use it. Maybe I didn't breathe in enough of the cooking fumes, because it didn't get any worse.

Strange reaction? I was at a conference this spring when an allergy specialist was talking about seafood allergies. He said in rare cases, you can have anaphylaxis just from breathing in cooking vapors of seafood. I found an article about seafood allergies from American College of Allergy, Asthma & Immunology. Seafood has a protein that becomes airborne while you are cooking. If you are allergic to seafood, simply breathing in the same room while someone is cooking seafood can cause anaphylaxis! 

Did you also know that a seafood allergy can appear later in life? I remember eating seafood as a kid. I didn't like it, but I ate it. I developed an allergy to it about 20 years ago. My brother still thinks it's all in my head because I ate seafood as a kid. It's frustrating and dangerous when people don't believe you have a food allergy, or don't understand how scary it is to have a food allergy. Once you develop an allergy to seafood, it's usually there for the rest of your life.

So, we survived the weekend. For those of you who don't have food allergies, please take it seriously when someone is visiting your home and they say they have food allergies. It can be be the difference between life and death for that person. Asthma and Asthma Network, Mothers of Asthmatics has a great article about anaphylaxis. 

You should read it, it might help you save a life someday.

Thursday, December 20, 2012

Allergy shots for only 3 years?

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For those of you that have allergies, it can be a real pain. My college-aged son and teenage son and daughter are allergic to everything. Literally. Grass, trees, flowers, bushes, animals, dust and mold. You name it, they're allergic to it.

There comes a time when no matter how much medicine you take, you are still miserable. My kids would take Singulair and Zyrtec and still be miserable all the time. They would sneeze, their eyes would itch and water, and they would start wheezing. Asthma Doc told them to shower every night before bed (to wash all the pollen off their skin and hair.) That didn't help either. Daughter Kitty would sneeze all night long and wake us up. Then she would get a bloody nose. Fun times!

So all three of our kids have had to have allergy shots (immunotherapy) 
It's a long process, it usually takes 3 to 5 years. And it takes A LOT of time. You have to go to the doctor's office twice a week. Have one shot in each arm, then wait 20 minutes so you don't have anaphylaxis, then you can leave. After a while, you can go once a week. It's a pain to have to find a time every week to take kids to allergy shots. My two sons have already completed their 5 year's worth of allergy shots. Daughter Kitty is on year 4. I just read an article in the Winter edition of Coping with Allergies and Asthma Magazine.   

The article quoted a study from the Annals of Allergy, Asthma and Immunology. They are quoted as saying 
"Our research shows that three years is adequate duration for the treatment of childhood asthma associated with dust mites. An additional two years adds no clinical benefit." 
I wonder if that holds true for other allergens too? My kids are allergic to so many things. In fact, Son #2 may have to repeat the allergy shots because he is still having problems. For us, it's better to have the kids complete the 5 years worth of allergy shots. If you aren't allergic to that many things, maybe you only have to do it for 3 years. Check with your doctor and see what he says.
It's an exciting idea, but it never seems to be that easy for my kids. See what your doctor says, maybe you'll be lucky enough to shave off 2 years of the series of allergy shots.

Good luck!

Monday, December 17, 2012

Strong emotions can cause an asthma attack

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Did you know that strong emotions can cause asthma attacks? I have been thinking about the families of the school children in Connecticut. They're dealing with shock, panic, disbelief, anger and sadness.

When you experience any strong emotion (laughing, crying, fright, etc) it can cause an asthma attack. On Webmd's website, they have an article about asthma, stress and anxiety. The article says that asthma attacks can be caused from exposure to violence, public disasters, public speaking, school exams and family conflicts.

So how does that work? How can strong emotions cause an asthma attack?! Those of us with asthma, we know that our bodies over-react to situations. We can't help it. When we experience strong emotions, our bodies release histamine and leukotrienes, which makes our airways narrow. That's what makes it hard to breathe and causes an asthma attack.

It's important to make sure you always have your inhaler with you. Hopefully your doctor has told you when you need to use your inhaler. It's helpful to have an Asthma Action Plan, so you know what to do. It tells you step by step what to do if you have an asthma attack. I usually use my inhaler and then use some deep breathing exercises. It's common to panic when you can't breathe. So not only do your airways swell up and make it hard to breathe, but panicking when that happens makes it harder to breathe. It's a vicious cycle. Webmd recommends using relaxation techniques like muscle relaxation, deep breathing or clearing negative thoughts.

They also have other suggestions, it's worth taking the time to read the article entitled  Asthma, Stress, and Anxiety: Risky Cycle.

I know that the families in Connecticut have a lot more than asthma attacks to worry about. They are planning funerals for their children. I know that I have hugged my teenagers a little more lately (even if they hate it.) But at least my teenagers are still alive. And that's something to be grateful for. 

Friday, December 14, 2012

Ideas to avoid getting sick

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Yes, I am a germi-phobe. I've already been REALLY sick twice this fall. And colds and coughs are always worse when you have asthma.

My daughter, Kitty, is always careful about washing her hands. In fact, she washes them so much the skin is chapped. But she is still getting sick. She's had the stomach flu one week, sore throat the next, and last night had a blazing fever in the middle of her brother's Christmas band concert. So, we ducked out early.

So, what's the solution to staying healthy? Here are some ideas from Webmd website. 

  • Washing your hands frequently, using soap, for at least 15 seconds
  • Avoiding close contact with people who are sick
  • Cleaning the headsets of your telephones, and washing doorknobs, railings, and other frequently handled objects to keep them free of germs
  • Keeping your hands away from your eyes, nose, and mouth
  • Covering your mouth and nose when you cough or sneeze
 I like their ideas, especially about "keeping your hands away from your eyes, nose and mouth." If I have to scratch my nose or my eyes, I put my thumb inside my jacket or scarf and pull the fabric up to my nose and scratch it (that way my fingers don't touch my face). It looks a little strange, but at least I'm trying not to touch my face.

I also use my knuckle to press elevator keys. And I use a paper towel to open the bathroom door, or I use the bottom part of my jacket or coat.

A little much? Maybe. But it's better than being stuck in bed for 4 or 5 days while I have bronchitis. 

Webmd has other advice too, to read more, click here.

So, do what your mother told you growing up. Wash your hands (especially before eating) and don't touch your face! Maybe you can get through the holidays without getting sick!

Wednesday, December 12, 2012

Give your Christmas tree a shower!

Many of my friends are pulling out their Christmas tree to set up and finding out the tree is really dusty. Achoo! Achoo! Achoo! It can be especially dusty if you store it in the garage or attic.

You can try putting the tree in your shower to clean it off before you set it up. DON'T try this if you have a "pre-lit" tree! Our tree is about 20 years old (before they had pre-lit trees), but it still looks fine once I fill in all the bare parts with decorations!

If you live in an area that has mild winters, you could probably just spray the tree off with the hose, then let it dry before you put it up in the house. We do the same when we put our tree in the shower, we just let it drip dry before we put it up in the living room.

It probably sounds like a lot to bother with, you may be wondering why we don't use a real tree. Well, Hubby and I and all three of our kids are allergic to trees. We're also allergic to flowers, bushes, grass, animals and some foods. Too bad we had to pass on our defective genes to our kids! But it could always be worse, right?

Many of you may have already put your tree up. If not, consider spraying it off outside if it's warm enough-only if your tree isn't flocked and isn't pre-lit.) Or give it a shower.

Happy Holidays!

Monday, December 10, 2012

New talking Epi pen!!!


For those of you who have food allergies (or family members with food allergies) you may be interested in a new epinephrine injector. I usually carry Epi Pens, so it may take a while to get used to this new device. But watch-my insurance company will decide not to cover these!

I've never had to use my Epi-Pen (knock on wood!) The time Son #1 had anaphylaxis (after allergy shots) Asthma Nurse injected him with epinephrine and gave him a breathing treatment. Then she stayed with him for 2 hours, to make sure he didn't have a rebound anaphylaxis event. I will never forget how she saved my son's life.

Since that time, I've been nervous about using an Epi Pen. Watching someone having an anaphylaxis reaction is scary, can I keep my wits about me and use the Epi Pen if I needed to? Auvi-Q "talks" you through how to use one. You can watch the video that shows how to use it  here    

I've heard that it will be available in the first three months of 2013. Talk to your doctor about what's right for you. Make sure you always have an Epi Pen with you, I wouldn't wait until the new Auvi Q comes out. You never know when you might eat something that has been cross contaminated or has a hidden ingredient. My Epi Pen has gone to the Grand Canyon, Disneyland and Paris. It should have be getting frequent flier miles!

So keep checking your food, and make sure you always have an Epi Pen with you. The life you save could be your own.

Friday, December 7, 2012

Your home can affect your asthma

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Did you know that there are things in your home that can make your asthma worse?

The 2nd time my son was hospitalized, he wasn't responding to traditional treatment for his asthma flare up. My pediatrician called in an asthma specialist to confer. Asthma Doc asked us all sorts of questions about our home. Did we have pets? Did we have wall to wall carpet? Did we use scented candles? Did we have floral arrangements or silk trees? He went on and on.

That was my introduction to a sort of cause-and-effect for asthma.

12 hospitalizations later for my kids, we have tried to make a lot of changes on our home. Some of the things that are recommended through the EPA (Environmental Protection Agency). You can find information about controlling asthma triggers on the EPA asthma website.

Here's some of the things we do to make our home allergy and asthma friendly

  • Wood floors-easier to keep clean than carpet. I can actually see the dust and suck it up with my vacuum nozzle. Gotcha!
  • Vacuum twice a week-it helps reduce dust, which is a common asthma trigger
  • Remove shoes-I ask everyone to do that when they enter my home. This cuts down on the amount of dirt/bacteria/fungus, etc that we track in on the bottom of our shoes
  • Don't store anything under beds-it can be like excavating for dinosaur bones under beds sometimes. It's full of dust (and you're sleeping on top of it, breathing it in all night long!)
  • Limit stuffed animals on the end of the bed. I let daughter Kitty have her 2 favorites. The others get stored away.
  • Wash bedding weekly in hot water-kills dust mites and washes out the pollen
  • Use dust mite proof pillows, pillow covers and mattress covers
  • Use roll up shades or roman shades in the kid's rooms-I found that regular blinds catch a lot of dust. And I how often do you clean your blinds?! It's not on my list of favorite things to do.  When I switched to roll up shades, there's nothing for the dust to build up. And the kids are sneezing less, so it's working!
  • Use central air rather than a swamp cooler. Swamp coolers suck in pollen, air pollution and smoke from forest fires. They also make the house very humid which can lead to mold problems.
  • No pets! If you already have them, keep them off the bed and out of the bedrooms.  
This list may look a little overwhelming. Just pick a few things to begin with, then add one thing at a time. Many of these things don't cost money, but instead you will need to spend time cleaning. Break it down into small steps. Hubby and I both work full time and the kids are all in school. But if we all pitch in a little bit each day to help clean, it's worth it. We breathe easier and our asthma doesn't seem as bad when the house is clean. And the kids haven't been in the hospital in 5 years! Knock on wood.

A clean house is a healthy house. And it helps you breathe easier. Who wouldn't want to do that for their child?

Happy cleaning! And reward yourself with a pedicure, or manicure. Or watch a chick flick.

Wednesday, December 5, 2012

What happens to your lungs during an asthma attack?

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I found a short video that shows what happens to lungs during an asthma attack. It is from the American Lung Association.

There are actually 3 different things that happen during an asthma attack. The video from American Lung Association shows it better than this photo. (But this was all I had to put on the blog). You can see from the picture above that the left side is what all of you "normal" people get to breathe through. The right side it what those of with asthma try to breathe through.

On their video, they explain that:
  • 1st-you have swelling in the lungs (you can see the swelling on the right side of this photo). They said the swelling is always there, even if you aren't having any symptoms (or can't "feel it")
  • 2nd-bronchoconstriction which means that the bronchial tube is being constricted (or squeezed) by the bands on the outside of the bronchial tube. This picture doesn't show it that well, you should watch their video
  • 3rd-mucus is produced, yep-that fun stuff we all try to cough up during an asthma attack
Interesting, huh? I usually tell people that don't have asthma to try jogging in place for 30 seconds, then hold their nose and try to breathe through a straw. That's what it feels like for those of us with asthma. You can see it if you watch the video.

Make sure you have an inhaler handy. And it you are using it more than twice a week, that means your asthma is not in control. You may need a daily, controller medicine. Check with your doctor about that. Remember that the swelling in your lungs can always be there, even if you can't feel it. So if you have an asthma attack and your lungs are already swollen, your asthma attack can be really bad. And who wants to end up in the hospital? I've spent enough money there over the years for my kid's asthma hospitalizations. They should have named the corner wing of pediatrics after our family, I think we paid for it!

Have fun watching the video! It's not long enough to have a bag of popcorn while you watch it, but if you have the munchies.....why not?!

Monday, December 3, 2012

How can schools help during an asthma attack?

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I always worried when my kids were little that they would have an asthma attack at school, and I wouldn't be there to help. In fact, they did have asthma attacks and they would call me on my cell phone. I can't tell you how many times I have left a grocery cart in the middle of the aisle and took off for the kid's school. The school nurse was gone and the teacher and secretary didn't know what to do. In our area, school nurses are in charge of 5 or 6 schools, so the chance that they will be there when one of my kids has an asthma attack is zero. I used to joke that our Wonderful School Nurse will be at the school between 8:30-12:30 on Monday mornings, so if they're going to have an asthma attack, make sure it's during that time!

Are the teachers and staff in your school trained to handle an asthma attack if the school nurse is gone? I know that in our state, the state health department provides an Asthma Training for Schools. It takes 15 minute and it's called, "What To Do in Case of an Asthma Attack." The training talks about how many kids in our state have asthma, the signs and symptoms of asthma, and what to do if a student has an asthma attack.

The puzzling thing is that a lot of schools will tell the state health department that they don't have time for a training. I don't understand that. I know that schools nurses are taking care of students with asthma, diabetes, seizure disorders, autism, etc, etc. If the state can train the staff how to treat asthma attacks, wouldn't the nurse have more time to help students with other medical conditions? Wouldn't the staff feel more comfortable knowing they could help a student who was having an asthma attack?

If you have kids in school, check with the school nurse and ask if the staff has been trained. You can't be there with your kids all day at school, but it would be nice if the person taking care of them for 7 hours a day was trained to know what to do.

That's just my two cents worth today..