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Wednesday, December 31, 2014

Happy New Year!!

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Have you ever celebrated New Year's Eve without fireworks? Salt Lake City, Utah is about to try it! Like several areas of the country, Salt Lake City can suffer from inversions . An inversion is when cold air is trapped in the valley with warmer air up above. That causes the air in the valley to become very polluted. Why? All of the exhaust from cars gets trapped in the valley. Unless a storm moves in with wind and snow, the air gets more and more polluted. 

Salt Lake City doesn't want to add to the pollution, so they are using a two story disco ball. for their annual New Year's Eve celebration.

For some people, air pollution isn't a big deal. But if you have asthma, it is a BIG DEAL!! To learn more about how air pollution affects asthma, visit the Utah Department of Health. 


It's nice to know Salt Lake City is trying to help with air pollution. It will be interesting to see what the two story disco ball looks like.I thank you, and my lungs thank you!!!

Happy New Year!!






Tuesday, December 23, 2014

Finding a cure for allergies?

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Billionaire Sean Parker is donating $24 million to finance research for allergies and asthma. (What would it be like to have 24 million "extra" dollars floating around to donate.....) 

Sean Parker has allergies and asthma. In fact, his allergies are so severe that he has lost track of how many times he's ended up in the emergency room - the last 14 times were with his wife. He now has two kids and is worried about the genetic tendency of allergies and asthma. 

Hubby and I worry too. We both have allergies, as do all three kids. Asthma runs on both sides of our family, and all three kids and I have asthma. I really worry about what it will be like if I ever become a grandma. Will my grand kids spend countless nights in the emergency room and hospital, like their parents? 

Sean Parker's money will fund the Sean N. Parker Center for Allergy Research at Stanford University. He is partnering with Dr. Kari Nadeau, one of the top specialist in the country for treatment of allergies. In clinical trials, she's been able to cure 680 out of 700 patients for multi food allergies. 

I never thought I would hear the word "cure" and "allergies"in the same sentence, but this gives me hope! There are brilliant researchers that just need the funding to be able to focus on their work.

Here's hoping for a better future for my kids and (someday) grandkids .......

Friday, December 19, 2014

Using your Epin Pen or Inhaler correctly?

Well, I'm having computer problems today, so this will be a short post. (Poor little laptop.....you have served me well, but I can see that you are ready for retirement.)

There was a story on Good Morning America this morning with Dr. Michael Besser. He said that most people are NOT using their Epi Pen or asthma inhaler correctly, and it can be deadly.

Sometimes, people may not be trained properly the first time they get an Epi Pen or asthma inhaler. Or, it may have been a long time since they were trained and they suddenly find that they need to use it - but can't remember how! Uh oh!

He said that most people who use their Epi Pens correctly administer it into the thigh (you swing your arm down and jab it into your thigh), but then it hurts- so they pull it out again. BUT - you have to leave it there for 10 seconds or all the medicine won't come out of the tiny needle. There is a short video here that shows how to use an Epi Pen. 

There is another option too - Auvi Q. It's another epinephrine injector, but it is about the size of a cell phone - and the helpful thing is that it "talks" you through using it. See the video here.

The other thing Dr. Besser talked about was how to use an asthma inhaler. He said it's important to breathe OUT all the way before you use your inhaler. Here's a video that shows how to properly use an inhaler.

These are good reminders to make sure you are using them correctly. When you have an asthma attack or see someone having an allergic reaction (anaphylaxis) it can be normal to panic and not remember what to do. It can be a scary thing to experience or watch happen to a loved one.

Watch the videos and book mark them - just in case you need them someday ....

 


Monday, December 15, 2014

Real or artificial Christmas tree?

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Well, I wish it looked like this where I lived. But, no such luck. We are in a drought! I have accepted the fact that we will NOT have a white Christmas. Sigh.

It's that time of year when people are putting up Christmas Trees. So - the age old battle starts.....is it better to have a real or artificial Christmas tree?

Everyone is different - so it depends on if you are allergic to trees. (Yes....many of us are allergic to various trees, flowers, bushes, grass, etc. ) I saw an interview with Dr. Michael Borts, from St. Louis, who specializes in asthma, allergies and sinus care.

He said some people may have problems with a real Christmas tree because the tree may have pollen and molds on the branches. Once you bring the tree inside your house, it may cause problems for anyone with allergies and asthma. 

However, with an artificial tree, if it's stored in the attic or basement, it might be dusty or have mold (if your basement is damp). And if you are allergic to mold or dust, you may have allergy and asthma problems.

In his video interview, he suggests several things to do, either for a real or artificial tree. 

Our teenagers are allergic to Christmas trees (how sad!!) So, we have had an artificial tree for years. I miss the smell of a fresh Christmas tree. But, it's not worth the running nose, sneezing, and asthma attacks. And for us - it would last the entire time the tree was in the house.

So, we just put up our artificial tree every year. Besides - we tell ourselves that we are also saving the environment by using the same tree over and over again every year.

For some reason, it's just not the same as having a real Christmas tree. Oh well. :(

 

Friday, December 12, 2014

Joking about kids with food allergies??!!

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I was a little shocked this week when I read a story online about a school board member who joked that students with food allergies "should be shot." I believe they were discussing food allergies in schools and how to handle them.

I COULD NOT BELIEVE WHAT I WAS READING. 

Anaphylaxis is no joking matter. I have a seafood allergy, and Son #2 has a tree nut allergy. I have actually witnessed a severe allergic reaction - anaphylaxis   in Son #1.

I never want to see that again as long as I live. I have shared this story before, but here goes....

Son #2 was in the hospital (one of 8 hospitalizations), thanks to pneumonia. Hubby came down for his turn at the hospital, so I went home to pick up Son #1 and daughter Kitty. Son #1 needed his weekly allergy shots. Our plan was to get shots, grab a pizza, and head back down to the hospital to have dinner and watch a movie as a family.

We ALWAYS wait 20 minutes after allergy shots. You are supposed to stay so just in case you have an allergic reaction. I told Shot Nurse that we weren't going to stay this one time, that we were going to grab a pizza and head back to the hospital. She said, "you'll be fine....what are the odds that anything will happen?"

So, we hopped in the car and were a block a way when Son #1 said, "Mom, I think something's wrong." I looked in my rear view mirror and saw a VERY red-faced son. His neck was bulging, his eyes were glassy and bulging, and he was coughing. I swerved over to the side of the road, flipped a U-turn, and headed back to the office. I called the office to let them know what was going on. 

Shot Nurse was ready for us when we RAN from the parking lot. She gave Son #1 a shot of epinephrine (what's normally in an Epi Pen) and started a breathing treatment. Daughter Kitty was wide eyed and clutching her stuffed animal. She knew something was REALLY wrong.

Shot Nurse was calm and talked to Son #1, all the while monitoring his oxygen level and symptoms. She stayed with us for 2 hours after the office closed. (They are located right next to a hospital!)

She also let us know that you can have a rebound effect , meaning that the anaphylaxis can come back after hours or even days later. WHAT??!!

So, she gave us a prescription for an Epi Pen. We stopped at the pharmacy to fill that. Thinking that if he DID have a rebound effect that night....at least we would already be at the hospital! 

Meanwhile, Hubby called and said, "Hey, where's the pizza??!!" He was unaware that anything was going on. He had no idea that Shot Nurse was saving our son's life.

I was so scared and shaky that I could barely drive back to the hospital. We ended up just getting pizza delivered to the hospital and watched a movie with the kids. All the while I was thinking how grateful I am for modern medicine and for Shot Nurse who just saved my son's life.

The same thing can happen with food allergies. I have to inspect any food that is not prepared by me - yep, office parties, church parties, family parties, restaurants. I am not afraid to ask, "does this have seafood in it?" I will ask the person who prepared it, and if I can't find them, then Hubby will try to the food first to see if it's safe for me to eat. We do the same thing for Son #2's tree nut allergy. Tree nuts are in soooo many desserts and ice creams, we have to be very careful.

To the school board member who said "just shoot them", I would like her to visit kids in the hospital who have experienced anaphylaxis. Or read any of the stories online about someone who has died from a food allergy.

It is no joking matter.  
  

Monday, December 8, 2014

Medication problems


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Sometimes it can be really hard to keep track of all the medicines that I use. Luckily, I go to one pharmacy (and I have blogged before about how EVERYONE in the pharmacy knows me.....which isn't necessarily a GOOD thing! It's kind of like being on a first name basis with my car mechanic.....it means I am there WAY too often!!)

Last week, I had to see my regular doctor, who prescribed an antibiotic to clear up an infection. When I went to the pharmacy, the pharmacist told me that there was a drug interaction - that my doctor didn't catch! I couldn't take the antibiotic with another medication that I was on.

Scary stuff!

It's helpful to get all of your medicines at the same pharmacy. The computer system they use will "flag" when there might be an interaction between two medications. If you are using different pharmacies, they won't have a complete list of all the medicines that you take.

I am VERY grateful that the pharmacist caught the problem. If you are worried about medications that you take interacting, you can try Drug Interaction Checker, from Drugs.com. You can type in the names of medications, and it will check to see if there is an interaction. There can be minor, moderate, or major drug interactions.

You can also make sure that your medicine doesn't interact with food. I have to wait 2 hours after I drink milk to take my antibiotic. I wouldn't have known that if I hadn't read the big LONG printout from the pharmacy. 

Sheesh. Some things are complicated!!

If I want my medicine to work, I need to take it the right way. And that may mean:

  • On an empty stomach
  • With food
  • With a full glass of water
  • Without certain foods

If you have any questions, ask your pharmacist. These people are very smart!!
You may not need this now, but remember it the next time you need a new prescription :)

Monday, December 1, 2014

College student dies after being exposed to peanuts

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My sister sent a story she read in the Washington Post titled "College student dies after severe allergic reaction to peanut butter." It was so sad, I could hardly finish reading the article. Sometimes things hit a little too close to home.

Son #1 experienced a severe allergic reaction (anaphylaxis) several years ago. Son #2  has a tree nut allergy - not to be confused with a peanut allergy. (Peanuts are actually from the legume -or bean family - and they grown in the ground.) Tree nuts grow on....... well....trees! Son #2 is allergic to pecans, walnuts, almonds, etc. I am allergic to seafood. We all carry epi pens - EVERYWHERE!!!!

Apparently, the college student, Chandler Swink, had visited an apartment where someone had made peanut butter cookies. Somehow, he came into contact with the cookies or some of the peanut residue. He started to feel symptoms of anaphylaxis and went out to his car to use his Epi Pen. 

The National Institutes of Health list these 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 
 Chandler then drove himself to the hospital. However, he was later found unconscious in the parking lot. He had suffered cardiac arrest and an asthma attack. He was taken off life support a week later. What a horrible thing for his family to have to experience. My heart hurts for them :(

The National Institutes of Health suggest: 

If you or someone you know is having an anaphylactic episode, health experts advise using an auto-injector, if available, to inject epinephrine (a hormone that increases heart rate, constricts the blood vessels, and opens the airways) into the thigh muscle, and calling 9-1-1 if you are not in a hospital. If you are in a hospital, summon a resuscitation team.

If epinephrine is not given promptly, rapid decline and death could occur within 30 to 60 minutes. Epinephrine acts immediately but does not last long in the body, so it may be necessary to give repeat doses. 

At the first sign of symptoms, give yourself epinephrine and then immediately call an ambulance or have someone else take you to the nearest emergency facility.

Unfortunately, Chandler drove himself to the hospital. Maybe he had used his Epi Pen before and then was treated at the hospital and survived? Maybe he thought it would be okay? Who knows. 

I know I am going to have a reminder talk with my sons. Use the Epi Pen and then call 911. 

My thoughts are with Chandler's family. 

   

 

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

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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

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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


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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!!

 

Monday, October 27, 2014

If your child ends up in the hospital



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I had to go to the hospital last week to meet with a colleague, and as soon as I walked in - there was "that smell." There is a certain scent that I recognize from having my kids hospitalized 14 times. Not a bad scent, just a familiar one! 

My kids were usually admitted to the hospital with pneumonia or from problems breathings smoke from forest fires. For me, having a child admitted to the hospital was actually a relief. There comes a point where I have done everything I can as a parent to try to help them breathe easier. To quote a line from Mall Cop "Backup! Backup!!" 

I need someone who knows more than I do to take over! I am NOT a respiratory therapist or a nurse, so sometimes I need the professionals to take care of my child.

I have all the preventative (or daily controller) medicine at home. When they get sick, I will start giving them Albuterol breathing treatments with the nebulizer. (The nebulizer machine turns the liquid medicine into a mist so it's easier to breathe in.) If you aren't sure how to use a nebulizer, here is a video from NationalChildrens 

If they are still getting worse, Asthma Doc will either give the kids a steroid shot of Decadron or a steroid pill like prednisone. If they have the steroid shot, they MUST have a "burst" - 3 or 5 days of taking the steroid pill and slowly tapering down the dose. It's definitely one of those medicines that you can't stop suddenly. (Steroids will take the swelling down in the lungs so it's easier to breathe, but you have to take them EXACTLY as prescribed or it can cause other problems.)

If they STILL aren't getting better, I head to the emergency room. My kids can get an even stronger steroid IV, plus oxygen, and be connected to breathing monitors. That way, the professionals can monitor their oxygen level around the clock and an alarm will go off if the child's breathing gets worse. Years later, I can still hear the sound of the alarm going off in my head......

I'm not going to lie - it is VERY scary and stressful to have a child in the hospital.

Watch what the nurses do and ask questions. If they have a heart monitor on your child, it's REALLY serious!! From my experience with my son, that means they are really worried that your child might stop breathing  - which will make their heart stop - and then they can die. It's rare - but you may need to know about it just in case...



Talk to your doctor about when to take your child to the emergency room. Here's some information from emedicine's website.  Sometimes kids with asthma can go from bad to worse very quickly, so keep a close eye on their breathing. 
 
Isn't it fun raising a child (or 3 children in my case) with asthma? Sigh....it's all part of My Life as an Asthma Mom!!






Friday, October 24, 2014

Is it asthma or something else?

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This is a LONG blog, but important, so PLEASE read the whole entry!! :)

Having problems with your lungs is annoying, you really take it for granted that you can breathe! And when you can't......well, it's no fun! So how do you know what lung disease you have?

 When daughter Kitty was little, she just didn't seem to be doing well, even with all of the asthma medications she was taking. She had been hospitalized 4 times for asthma, so Asthma Doc wanted to rule out any other lung disease. He ordered a sweat chloride test to check for Cystic Fibrosis.  I have tell you - that was the LONGEST weekend of my life!!! Waiting for test results was so hard, we couldn't eat or sleep.  Luckily, her test was negative. But some people aren't so lucky. 
So what is Cystic Fibrosis?

Here's a quote from the Cystic Fibrosis foundation:

"In people with CF, a defective gene and its protein product cause the body to produce unusually thick, sticky mucus that:
  • Clogs the lungs and leads to life-threatening lung infections.
  • Obstructs the pancreas and stops natural enzymes from helping the body break down food and absorb vital nutrients."
 Another possibility is Vocal Cord Dysfunction (VCD.) Son #2 was hospitalized 8 times (2 in ICU) and also didn't respond like he should have to asthma medications. Asthma Doc sent us to the hospital to test for VCD. VCD happens when the vocal cords don't open correctly. It can be confused with asthma because the symptoms can look the same. 

"In asthma, the airways (bronchial tubes) tighten, making breathing difficult. With VCD, the vocal cord muscles tighten, which also makes breathing difficult." 
  You can read more about VCD by clicking on the link from AAAAI above.

Another lung disease is Mesothelioma - it's actually cancer of the membrane that line the lungs and stomach. It's caused by exposure to asbestos. Asbestos was commonly used in all sorts of building materials for homes and businesses. I was contacted by Heather Von St. James, who was diagnosed with Mesothelioma shortly after her baby girl was born. Here's Heather's video about her journey. I'm helping her spread awareness about Mesothelioma!!

Last on the list is radon induced lung cancer. If you have heard of someone who has NEVER smoked, but developed lung cancer, radon might be to blame. The EPA radon site says:

"Exposure to Radon Causes Lung Cancer In Non-smokers and Smokers Alike"

What is radon? The EPA says:
"Radon is an odorless, tasteless and invisible gas produced by the decay of naturally occurring uranium in soil and water. Radon is a form of ionizing radiation and a proven carcinogen. Lung cancer is the only known effect on human health from exposure to radon in air."
 Some people confuse radon with carbon monoxide, but they are VERY different gases. So, how do you know if you have radon in your home? You can buy an inexpensive test kit (around $10) to test your home. You can check the EPA site to find the radon coordinator for your state to find help.

 So, lots of lung diseases to consider - Asthma, Cystic Fibrosis, Vocal Cord Dysfunction, Mesothelioma and Radon. If you have concerns about any symptoms and your lung health is not improving, talk to your doctor. They are MUCH smarter than I am and can run tests and rule out other causes. 

Stay healthy!!! :)


















Tuesday, October 21, 2014

Asthma and depression?

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American Lung Association has an email list where you can get updates about lung cancer, asthma, COPD, etc. Their latest "top story" (October 7, 2014) is about a link between depression and asthma.

They say that if you have any of the lung diseases listed above, it's not unusual to feel anxious, stressed, or even depressed.  They also say that 1/3 of people with chronic diseases may feel depressed. Here's a quote from the website:

"Sometimes you might notice you don’t feel like yourself but you are aren’t sure exactly what is bothering you. Undiagnosed depression can make it more difficult to manage your disease and has a large impact on your quality of life."

You can click here to find someone in your state that offers depression screenings. Of course talk to your doctor if you feel a "little off" or don't feel like yourself! :)

Most states (and also many foreign countries!) teach a 6 week workshop that helps you cope with having a chronic condition. The workshop was developed at Stanford University in California and is called Chronic Disease Self Management.  The class meets once a week for 6 weeks, and the instructors of the class MUST have a chronic condition (or a family member with a chronic condition) to be able to teach the class. That way, they "get it" - they understand what it's like to live with a chronic condition. They teach you to have the best quality of life you can! I felt so much better after I took the workshop! 

Subjects covered include: 
1) techniques to deal with problems such as frustration, fatigue, pain and isolation
 2) appropriate exercise for maintaining and improving strength, flexibility, and endurance
 3) appropriate use of medications
 4) communicating effectively with family, friends, and health professionals
 5) nutrition
 6) decision making
 7) how to evaluate new treatments


When I took the class, the book and CD were free, but you can also order a copy online if you wish.  

These workshops are taught ALL OVER THE WORDL!! If  you want to see if the free or low cost workshop is taught in your state or country, click here.

Help is out there, hopefully these ideas will be useful if you feel like you need help. :)

Thursday, October 16, 2014

Worrying about your job increases risk of developing asthma?

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I'm a little bit of a nerd, because I love research studies. I am always looking for new studies or articles about asthma. 

The latest study I read was from WebMD. The story was originally published in Healthday News. A study done in Europe showed that the worry of losing your job could increase your risk for developing asthma.

Hmmm.

The study interviewed 7,000 people in Germany in 2009-2011 and asked the employees questions "about the respiratory disorder and also on whether they thought they would lose their job within two years." During that time, there were 100 people that were diagnosed with asthma.

Here's a quote from the article:

The researchers noted that for every 25 percent jump in job-related stress, the risk for asthma also increased by 24 percent. The risk for asthma surged to 60 percent among those who thought it was highly likely they would lose their job.
The study did say that worrying about your job doesn't CAUSE asthma, but it can be a risk factor that can put you at increased risk for developing asthma. I guess they can't technically say that worrying can causes asthma, but it makes it more likely that you can develop asthma.

What to do about stress at work? Mayo Clinic has good information about dealing with stress. You can search for 'stress management' on your computer and come up with thousands of websites that offer ideas. 

Do a little research and find what it best for you. Some people use deep breathing exercise, and others use yoga. I wish I lived closer to a beach, because the sound of the waves really relax me.

I should book that trip to Hawaii now......

Monday, October 13, 2014

Teal pumpkins for Halloween? What?





Halloween can be a scary time of year - not because of scary costumes and spook alleys, but because I have a son with a tree nut allergy! There are a LOT of different kinds of candy out there with tree nuts. Every year at Halloween, I would have to carefully go through Son #2's candy and make sure his candy was safe for him to eat. (Mom bonus: if there WAS a candy bar that had tree nuts, I would have to "take it for safe keeping"........ya - I would eat it!)

The Food Allergy Research and Education website  (FARE) has a fun idea to help families of kids with food allergies. They are asking families to place teal colored pumpkins on their porch (and the sign pictured above) and hand out non-candy treats instead.

You can paint a real or plastic pumpkin teal, then print out the sign  to hang on the front door. You can also print out fliers to help spread the word.  

There are a lot of things you can hand out instead of candy, FARE suggests:


  • vampire teeth
  • spider rings
  • Halloween stickers
  • mini slinkies
  • mini bottles of bubbles
  • bouncy balls
  • glow bracelets
You can find lots of fun (and cheap) toys at your local party store or craft store. There are a few places online where you can order supplies too.

What a fun idea! :) Finally - a way to make Halloween safe for kids with food allergies!



Friday, October 10, 2014

Problems with Xolair


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I just read a story on Webmd (dated September 29th, 2014) about potential problems with omalizumab (Xolair). The makers of Xolair were conducting a safety test, and their study showed a "slightly increased but serious" risk for heart attack and mini-stroke (called TIA's or transient ischemic attacks.)

Uh oh!!

 Xolair is used for patients whose allergic asthma can't be controlled by using other asthma medications. Some doctors also use Xolair to treat chronic hives.

Son #2 has had Xolair injections for the last 7 years. He is one of the small percentage of people with asthma who has severe asthma.  Son #2 has been hospitalized 8 times, and two of those hospitalizations were ICU admissions. We did EVERYTHING the doctor would outline -what medications to take/when/how much - but he would still end up in the hospital. He would suddenly go from bad to worse.

I remember one time when Son #2 suddenly became worse in the Emergency Room - it even scared the doctor! He said, "I was right here, what happened??!!" I told him Son #2 has severe asthma and doesn't respond to asthma medication and treatments like most asthma patients. Patients with severe asthma are VERY difficult to treat.

For us, Xolair has kept our son out of the hospital. Shortly after starting Xolair injections, I noticed that when he would start to get sick, instead of thinking "Oh no! Here we go again!!", I could give him a breathing treatment - and he would actually get better!! Before he started Xolair, it didn't matter what we would do - nothing would seem to help. He would have to be hospitalized and monitored around the clock by a respiratory therapist, doctor and nurse. They would give him breathing treatments every 2-4 hours, give him an IV with powerful steroids, and monitor his breathing.

All that seemed to change once he started Xolair. BUT - every family is different. Son #2 has been slowly weaned off the Xolair injections over the last year. He seems to be doing well and his asthma doesn't seem as severe as it has been in the past.

I am VERY concerned about anything that can raise your risk of heart attack and mini stroke. 

This quote from WebMd article did catch me eye:

Because of certain "weaknesses" in the 5-year study, the FDA says it is "unable to definitively confirm or determine the exact increased level of these risks with Xolair." 

I wonder if the study was done correctly? Back in college, I took an epidemiology class, and we learned how to design a scientific study. It has to be done a certain way, or the results will be invalid. It makes me wonder what "weaknesses" they found in the study. I wonder if they will now have to repeat the study? 
 
I also noticed this quote from Webmd:

The safety study did not find that people taking omalizumab had a higher rate of death from ischemic stroke or heart disease compared to people not taking it, though. 

Hmm..... so maybe patients are having heart problems and mini strokes but recovering? The FDA report lists heart attacks and other heart problems too. It's worth taking the time to read.  It may be rare that these problems happen, but it's good to know what to watch for. 

Until then, if you are on Xolair, talk to your doctor about the risks. The FDA is adding the warning about heart problems and mini stroke to the Xolair label. In the past, the label has also had a warning about anaphylaxis and an increase in cancer.

As with any medication, it's important to weight the benefits with the risks. If you or your child is having Xolair injections, ask your doctor what they would recommend.

Monday, October 6, 2014

Maintenance inhaler VS Rescue inhaler

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All inhalers look the same, but are just different colors. How do you tell which one you should use every day (maintenance/controller inhaler), and which one you use if you are having a hard time breathing (rescue inhaler)? They may look the same, but the medicine inside is VERY different!

Here is a link from American Academy of Allergy Asthma and Immunology (AAAAI) to see lists of photos of maintenance medications (inhaled corticosteroids)

Examples of these are:
  • Qvar
  • Pulmicort
  • Alvesco
  • Aerobid
  • Aerospan
  • Asthmanex
  • Flovent
  • Azmacort 
(The medicines listed above are meant to be taken EVERY DAY!!!!!)

Here is a link from AAAAI for photos of  long-acting beta-agonists (LABA's) It's important to know that the FDA recommends that these medications (LABA's) must ALWAYS be taken with the inhaler corticosteroids (listed above) 

Examples of these are:

  • Foradil
  • Serevent
(These are also meant to be taken EVERY DAY!!!!!) 

OR.......You can use a combination medication that is both an inhaled corticosteroid AND a long-acting beta-agonist. Examples of these are:
  •  Advair (diskus or inhaler)
  •  Symbicort
  • Dulera
 (These are meant to be taken EVERY DAY!!!!!) 
 
(Be careful when looking at the photos in all of these links, because some of the photos are for medicines used to treat COPD, not asthma. Carefully read the "use" column to see if it's for asthma or COPD) 
  
It's hard keeping track of all of the different types of medicine! If you aren't sure what you should be taking, or WHEN, call your pharmacist! It's easier for me to get through on the phone to the pharmacist - and it's what he specializes in! He can always answer my questions.

I was talking to Neighbor this weekend, and she happened to mention something about one of her inhalers. She said she would take it as needed (like a rescue inhaler) but when she mentioned the name of the inhaler, I realized that it was actually a controller/maintenance medication! That can be dangerous, because using the wrong inhaler won't help you if you are short of breath or coughing from an asthma attack.  We called the pharmacist to have him explain the difference between controller and rescue inhalers.

  •  ProAir
  • Proventil
  • Ventolin
  • Xopenex

Rescue inhalers are designed for IMMEDIATE relief. Remember - you don't have to wait until it's "an emergency" to use it. Some people used to call rescue inhalers "emergency inhalers". But that was a bad idea because people would say "well....it's not really an emergency because I can still breathe...." and they wouldn't use their inhaler. You can end up in the hospital, or worse - die from an asthma attack!

Webmd has a section called "When Should I Use My Inhaler? "

I know this is a long post today, but it's SO important to make sure you are using the right asthma medicine at the right time. It can be dangerous if you don't. All of these website recommend:

  • Use your controller/maintenance medication EVERY DAY
  • Use your rescue inhaler if you are short of breath/wheezing/coughing/have tightness in the chest
If you have ANY questions about what medicine you should take and when, call your pharmacist or doctor to make sure you understand. I know that it can be confusing....when my kids were diagnosed with asthma, it took me a LONG TIME to understand the difference between controller and rescue medication and when I needed to use them.
 

Thursday, October 2, 2014

Paralysis with Enterovirus 68 cases??!! Yikes!!!!


I'm back to blogging! Have you ever had one of those HUGE projects due at work and you are really stressed out? Yeah, it's been one of THOSE kind of months. So I have neglected my asthma blog.  But I was always thinking about it - a story would be on the news, and I would think "I should blog about that!!"

 ABC News has had a few reports lately about how some kids who have the fast moving Enterovirus 68 have also had paralysis. Of course I am worried about my 3 kids because they all have asthma and have had repeated hospitalizations.  They are older now, so when they get sick, it's not as bad as when they were younger. But I still worry. I have seen my kids go from bad to worse in a few hours - it's VERY scary to watch them struggling to breathe.

Now there are kids who have contracted Enterovirus 68 and can't move their arms and legs. It affects a small number of kids. The report from ABC News last week said that there are 277 confirmed cases of the virus in the U.S., and only 9 of those kids have had paralysis in their arms and legs. BUT - if your child happens to be one of those that suddenly can't move, that's a big problem! In the video, Dr. William Shaffner (Vanderbilt University) said that the virus invades the spinal column and damages some of the cells and that's what causes some of the children to not be able to move their arms and legs.

The report also says that there are probably many, many more than the reported 277 cases, but in some people, the virus is mild and is nothing more than cold - like symptoms.

The CDC is tracking cases, so if your child has had a cold and suddenly can't move their arms and legs, call your doctor - FAST!! 

Doctors are also suggesting the basics - having kids wash their hands. We also avoid anyone that is sneezing or coughing. (It's not that we are paranoid....it's just that I don't want my kids catching the virus!! A cold to some people means pneumonia and another hospitalization for our family) 

We have already stocked up on chicken soup, orange juice, throat lozenges, asthma medicine and my favorite tissue that have lotion in them! Let's hope we don't need to use all of those!

 

 


 

Monday, September 22, 2014

Cold or sinus infection?


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So, it was only a matter of time until one of my teenagers came down with a cold. 

Colds are miserable enough, but with colds can come sinus infections. How do you know if you have a sinus infection? Well, it may feel like a cold, but Webmd explains it as:

Some of the primary symptoms of acute sinusitis include:

  • Facial pain/pressure
  • Nasal stuffiness
  • Nasal discharge
  • Loss of smell
  • Cough/congestion
Additional symptoms may include:
  • Fever
  • Bad breath
  • Fatigue
  • Dental pain
The Webmd page lists these symptoms for an acute infection (meaning it will only last for a short time.) It says if you have two or more of these symptoms, and also have a thick, yellow or green discharge - you may have a sinus infection. 

When that happens to us, we call asthma doc to see what he says. There are different ways to treat sinus infections  Some doctors will suggest you use a decongestant, steam inhalation, nasal sprays or antibiotics. Your doctor will decide what's best for you.

Some people swear by Netipots. If you have never used one, know that you have to follow the directions very carefully, especially making sure you have sterile water in your neti pot. (There have been some rare but creepy infections people got from using regular tap water.) 

Everyone has different symptoms, and may react differently to treatment plans, so ask your doctor what he wants you to do.

Until then, Teenager will be having LOTS of chicken soup and orange juice, and resting and watching some videos. 

After all, it's important to let your body heal. Hey, maybe Teenager will even let me hang out with her (as long as I keep my distance and try not to annoy her .....)

Monday, September 15, 2014

September Epidemic??


Yes, I am ALWAYS reading...anything and everything. The latest article I read was in Family Circle magazine's September issue. It's called "The September Epidemic." The website version is called "Everything You Need to Know About Asthma"


In the article, Dr. Stanley Szefler, director of the Pediatric Asthma Research Program at the Aurora's Children's Hospital Colorado said that:  "More schoolkids are admitted to the hospital for asthma attacks in September than in any other month."

Dr. Szefler says that it is known as the September Epidemic. There are a few reasons they mention:  
  • It could be because kids head back to school and share germs with all the other kids in school. 

  • It could also be because kids go on vacation during the summer, not just from school, but from using their maintenance medications. They are not in a school routine, so they forget about it. Or maybe Mom thinks she can keep an eye on the kids during the summer, so they don't need to take their maintenance medication. (Bad idea!!!!!! You should NEVER stop taking your asthma medicine without your doctor telling you to. We have made that mistake before and Son #2 ended up in the hospital because of it.) Sigh.The things you learn over the years about asthma....

  • It could also be due to fall allergies. The article says that, "Up to 80% of children with asthma also have allergies, with fall being especially problematic."  They say that "When breathing is constricted due to allergy congestion, the likelihood of asthma flare ups increases."

The article also talks about viral infections, the flu and obesity causing problems with asthma. 
 There's always so MUCH to worry about as a parent, if  any of these things seem to be a problem for your child, call your doctor. He/she is there to help!

Good luck with sending kids back to school and managing asthma :)