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Tuesday, July 29, 2014

British study shows the majority of asthma deaths are preventable

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One of my colleagues (whose husband is a doctor) printed off an article for me that was titled "Two thirds of deaths from asthma are preventable, confidential inquiry finds." It's from the British Medical Journal. 

It's a little scary to think that people are dying from asthma attacks just because they aren't managing their disease. I think people don't realize that you can die from an asthma attack. It is rare, but if you or a family member die from asthma, it's a BIG deal. Most people think "I'll just take my inhaler - and I'll be fine."

This study found that 2 out of 3 deaths from asthma could have been prevented by:
  • better management including personal asthma plans for patients (asthma action plans)
  • timely reviews of asthma care
  • prescription of more appropriate drugs (too many are relying on a rescue inhaler)
The really scary part of the study says that of those who died from an asthma attack, 45% of them had not asked for medical help. The researchers said that the people who died didn't realize how sick they were until it was too late. When they looked at a group of youth ages 10 - 19, they found that 70% of children and 83% of youth died before they reached the hospital. 

The interesting thing about this study is that is showed that only 39% of the patients who died had severe asthma. The majority of people who died had mild or moderate asthma. Many of those people were only using a rescue (or reliever) inhaler to treat their asthma attack. They weren't using a daily maintenance medication.  

Asthma Doc has told us repeatedly that a rescue inhaler "will only buy you a little time." You have to find out WHY you are having asthma attacks (what is triggering or causing your asthma attacks?) And you may need a daily medication to keep the swelling down in your lungs. Allergy and Asthma Foundation of America explains that you shouldn't use your rescue/reliever inhaler more than twice a week. If you need it more often than that, your asthma is NOT controlled, and you will need a daily, maintenance medication. 

PLEASE call your pediatrician/family doctor/asthma specialist if you are not sure what to do about your asthma. And if you are relying on just a rescue/reliever inhaler, that could be a deadly mistake. 

Every day in America:
  • 44,000 people have an asthma attack.
  • 36,000 kids miss school due to asthma.
  • 27,000 adults miss work due to asthma.
  • 4,700 people visit the emergency room due to asthma.
  • 1,200 people are admitted to the hospital due to asthma.
  • 9 people die from asthma.
My youngest two teenagers are a little better now, but when they were younger, they were hospitalized 14 times for asthma. And Son #2 almost died twice. It can happen. I never want to experience that again as long as I live. I still have flashbacks about that time. :(

Please be careful and call your doctor for a check up to make sure you or your child are taking the right medication for you or your child's asthma. 

Friday, July 25, 2014

Ugh.....fires fires everywhere!!

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The thing I hate most about summer are fires. In my area, we are in the fourth year of a drought, so everything is very, VERY dry. Scary dry. Like if someone was driving down the highway and flipped their cigarette out the would start a fire. 

Yesterday, we spent the day on the lake, and as we were driving back home, we saw 3 different fires (in a half hour drive home.) Yikes!!

I am a little paranoid about forest fires and the smoke they cause. About 10 years ago, we had a big forest fire and smoke from the fire filled the valley. It was during the 4th of July holiday, so everyone was lighting fireworks too (which added more smoke to the neighborhood.) Son #2 was young at the time, and like most boys, he wanted to be outside and watch the neighborhood fireworks. He was struggling to breathe, so we brought him in and gave him a breathing treatment on the nebulizer. 

 It usually works. But this time, it didn't seem to help. He just "didn't look right." I was really worried, so I took him to the emergency room. He got worse and worse (even with all the medical equipment hooked up to him in the emergency room) and he almost died. From an asthma attack. Who knew that smoke could kill your child? It was an experience I will never forget. And we definitely learned from what we did wrong!

If you have asthma, and there is a forest fire nearby, be careful!! If the fire department or police come around the neighborhood to tell you to evacuate, get out-FAST!! 

I can buy a new house, a new car and new furniture. But I can't buy a new son. The smoke from the fire filled the valley so quickly, we didn't realize what was going on. Now we know better. We have evacuated one other time because of another fire. 

I hope they get the fires out here. The air doesn't look too bad, but I already used my inhaler this morning. If the air gets worse - I am outta here!!

Monday, July 21, 2014

Gross! No handwashing in the hospital?!

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I just read an article about how many doctors and nurses are NOT washing their hands when they visit patients in the hospital. Gross! Of the many times my kids were in the hospital due to asthma (14 times) I watched to make sure people were washing their hands.
My kids were REALLY sick when they were admitted to the hospital (usually because of pneumonia, RSV or smoke from forest fires.) In fact, Son #2 was in ICU twice. I can still remember how scary it was watching him struggling to breathe. 
You know your child is in REALLY bad shape when they have a heart monitor hooked up to their chest. The hospital wants to be able to monitor them because children can go into respiratory arrest (stop breathing) and die. From what I understand, if they stop breathing, then that causes their heart to stop beating (cardiac arrest) and they can die. The thought makes me shudder. We came so close to that several times with Son #2.......
The last thing you need is to have a nurse, doctor or respiratory therapist come into the room without washing their hands. I don't want germs from someone else!! If my child is in the hospital for pneumonia, I don't want them picking up the stomach flu, MRSA,  or some other nasty infection.
Read the article about how Vanderbilt University hospital started tracking hand washing. It's called "How a team of doctors at one hospital  boosted handwashing, cut infections and created a culture of safety."

A doctor's wife had knee surgery at Vanderbilt hospital, and he was shocked to see how many people coming into his wife's room weren't washing their hands. He was dressed in a t-shirt and shorts, so many people didn't realize he worked there. He asked everyone to wash their hands and decided they needed to make a change in their hospital. Over 5 years, their hand washing rates went from 58% - 96% and the number of infections also decreased (one of them by 80%!!)

If you are in the hospital with a loved one, make sure EVERYONE who comes into their room washes their hands. Don't be afraid to ask them to wash their hands. You (and your insurance company) are paying for your hospital stay. You have every right to ask people to wash your hands. 
Sometimes people just need a nice reminder....and we need to protect our loved ones any way we can.

Friday, July 18, 2014

Done with allergy shots!!!!!

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This is how I feel!!!! I am SO excited because the last of my three teenagers just finished allergy shots (immunotherapy.) We have been going to Asthma Doc's office weekly (or every other week) for the last 10 years!!! It's time for a we-are-done-with-shots-party!!

That's a LOT of time at Asthma Doc's office.....and that's just for allergy shots - that doesn't include all the sick visits or check ups.

For those of you who haven't had allergy shots, it's a LONG process. It takes anywhere from 3-5 years. Allergy shots are for people who are taking allergy medicine, and taking other precautions (keeping the windows closed in the car and house, showering before bed at night to remove pollen from their hair and skin, etc) and still being miserable from allergies. 

If you are doing all you can for your allergies, and you are STILL sneezing all day (and waking up your family because you are also sneezing all night long....) Or you're having itchy eyes and an itchy throat, talk to an allergy and asthma doc. There is help! He can do a blood test or a skin prick test to find out what allergens are causing problems for you. Then you get your very own bottle of serum that is mixed with allergens that cause problems for you. 

My teenagers started out going for allergy shots (one in each arm) twice a week - that's four shots a week! Shot Nurse will start out with a tiny amount of serum and gradually increase it. 

Everyone is different - some people have a tiny bump from the shot, other people can have an allergic reaction (anaphylaxis.)  It is VERY important that you stay at Asthma Doc's office for 20 minutes EVERY time you have shots!!  You can die from an allergic reaction, but Asthma Doc can quickly treat you and save your life if you are in the office. Believe me - it happened to Son #1. He experienced an allergic reaction after shots. I never want to see something like that for as long as I live. It was awful, luckily Shot Nurse was able to save my son's life.

 Anyway, at some point, they will tell you that you can come once a week for shots. (If the bumps on your arm stay small.) Then you will get to the point that you go in every other week.

Then, your body may finally be able to tolerate the allergens in your serum. You may go through several vials of allergy serum over the years. Ours is covered by insurance, we just pay a small co-pay for the serum. (We don't have to pay for an office visit each time.)

It's a long process, and all of my kids were going at different times. Son #2 was on year 3 of allergy shots (and going once a week) when Son #1 started allergy shots (so we had to take him twice a week.) 
As Son #2 was finishing his last year of shots, daughter Kitty started shots (so we were back to twice a week visits.) Sigh. I spent a LOT of time at Asthma Doc's office.

BUT - Kitty no longer wakes me up at night because she is sneezing. My teenagers can pet a dog or cat without having problems. Kitty can play soccer without having problems (from the grass.)

We're starting to feel like a normal family. But, as Hubby reminds me - "Normal is a relative term."  

Monday, July 14, 2014

Woah! My asthma symtoms changed!

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So Hubby and I decided to take a picnic dinner and go for a hike with daughter Kitty on Saturday. It was a beautiful night (but a little hot - it is the middle of summer!!) The trail wasn't very steep or very long, but I couldn't seem to catch my breathe.

I wondered if I was really out of shape. Or had I eaten too much? Maybe my pants were too tight? I didn't think I ate THAT much for dinner! I changed into loose fitting clothes when we came home, but that didn't see to make a difference.

I went outside to work in my flower bed, I was determined to get the weeds pulled out. But I was feeling miserable. I kept having a hard time breathing and was starting to sigh to catch my breath.

I went inside, where it was nice and cool. And suddenly I realized that I was having an asthma attack! Duh! It took me a while to figure that out, because an asthma attack for me is always a sudden, hard coughing spell. I might be exposed to perfume, smoke, cold air, etc and instantly start coughing. This time, I wasn't coughing at all, but felt short of breath.

I took two puffs of my inhaler (waiting 2 minutes between each puff so the pressurized air and medicine would have a chance to mix of course!) Then I propped my feet up and waiting for the medicine to work. 

It only took a few minute before I was breathing a little easier, but the shortness of breath stayed with me all night. It was a little scary.

So, what are the common symptoms of an asthma attack? Is it just coughing? Webmd lists the following symptoms of an asthma attack:

  • Coughing, especially at night
  • Wheezing
  • Shortness of breath
  • Chest tightness, pain, or pressure
 I also like one section from their web page that says:
"You may not have all of these symptoms, or you may have different symptoms at different times. Your asthma symptoms may also vary from one asthma attack to the next, being mild during one and severe during another."

Be aware of ALL of the symptoms of an asthma attack. And know that they can change over time. I knew all of the symptoms, but am used to the same thing - a sudden hard cough. If you are having other symptoms, check with your doctor or use your Asthma Action Plan. Your doctor should have instructions for what you need to do if you are having an asthma attack.

Make sure you are taking the right medicine at the right time. And remember that your symptoms can change when you have an attack. 

Keep that inhaler handy, you never know when you might need to use it!

Friday, July 11, 2014

Doctor's notes for students with asthma

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I was talking with a group of moms yesterday (who all have kids with asthma.) We were talking about problems with our kids missing school because of an asthma attack or from being sick.

Every school district is a little different, but most have rules for how many days the students can be absent during each quarter. For us, students can miss 4 days per quarter.

That can be a problem if you have asthma. Some students who have asthma may not have many symptoms or may not get sick that often. Other students with asthma can miss A LOT of school. 

Son #2 missed more than 4 days per quarter (he has been hospitalized 8 times because of asthma and has been in ICU twice.) The school staff knew he had severe asthma and I would call and let them know he was sick.

But they were stuck - the district level employees asked for a "formal" excuse letter. I guess letters from parents aren't good enough (in all fairness - I'm sure schools have had problems over the years with students forging excuse notes......)

So, we had to get Asthma Doc to sign a letter saying that Son #2 has severe asthma, that it is a chronic condition, and that he would be missing more than the 4 days allowed.

It's not that he WANTED to miss school. Sometimes with asthma, it's so hard to breathe, that you just concentrate on trying to breathe in and out. You can't pay attention to math or science if you can't breathe! And Son #2 was in the school band and played the french horn. Trying blowing into a musical instrument when you can't even get enough air to breathe! And then there's gym class...

Every year, I meet with all of his teachers and let them know that he has severe asthma. I tell them what his symptoms are like (everyone is different - some people cough, some wheeze, some feel like they can't catch their breathe, etc.)  I met with his teachers all the way up through high school. How embarrassing is that????!!! Mom is going to the school to talk to your teachers??!! But they needed to know what to watch out for. After all, he was there 8 hours a day!

If your child has asthma (or diabetes, or another medical problem) find out what the rules are at your school. You may need to have your doctor write a note at the beginning of the school year that lets the staff know your student may miss more days than are "allowed."

It's just one more part of the fun life of asthma....


Tuesday, July 8, 2014

Fun asthma books

Taking Asthma to School (from Amazon)

I'm always looking for fun things for kids who have allergies and asthma. I found a LOT of books on Amazon about allergies and asthma. There are other places that sell these books too, so do your own search and see who has the best prices.

Here's another one, The Day Jake Lost His Breath

Here's another one, The Lion Who Had Asthma

They also sell books about food allergies, this one is Taking Food Allergies to School

Another one I found is Allie the Allergic Elephant

 In fact, there's a whole section on books about allergies and asthma.

If you are REALLY worried about sending your child with allergies and asthma to school (who isn't??!!), you can also order different latex free wristbands for your kids to wear at school.

Here is one from Amazon for tree nut allergies, I wish they had this when my son was younger. He's in college now, but when he was younger, I worried all the time about him eating something that had tree nuts in it. He has had reactions from eating cookies made on the same assembly line as another food that had tree nuts in it. Sigh. Why can't we just be normal?

I know that reading labels and checking all the food we eat can be a chore. I am allergic to seafood and am always careful to check my food before I eat it. I always ask if there is seafood in a dish, I'm surprised at the foods I thought were "safe" to eat, only to find out there is seafood in it. Once I was at a catered dinner with a BBQ theme and was shocked to see shrimp in the baked beans. Why would you add shrimp to baked beans??!! AND that was after I had sent an RSVP for the dinner and listed seafood as an food allergy.

Amazon also has many other allergy wristbands for peanut, dairy, egg, fish, shellfish, gluten, latex and multiple food allergies.

There are so many fun books and wristbands for kids with food allergies and asthma. You can do your own search online and you may find some other fun things for your kids.

Even though it's the middle of summer, school will be starting before we know it. Talk to your school nurse and make sure your child has their Asthma Action Plan filled out. And talk to your child's teacher about your child's allergies and asthma. 

Maybe the teacher would let you bring in an allergy and asthma book and read it to the other kids in the class during story time. It could help the other kids to know how to protect your child from being exposed to allergies or to get help if your child is having an asthma attack.

Kids are capable of doing great things, sometimes they surprise us! 


Wednesday, July 2, 2014

Zyrtec, Claritin or Allegra?

There are so many choices out there for allergies. And since allergies can trigger an asthma attack, it's something our family likes to try to control.

I was reading the summer issue of Allergy & Asthma Today magazine, and found some interesting information under the 'comments to the editor' section about allergy medicine. Dr. Martha White wrote a column in the Spring issue where she said that Zyrtec was non sedating (it's not supposed to make you tired). However, another doctor - Dr. William Howland - wrote a comment to the editor saying that the Zyrtec label says some people may be so drowsy that they shouldn't be drive their car. Many people can probably take Zyrtec without feeling really tired. It doesn't seem to bother The Teenagers. But it makes me so tired that I can't get out of bed.

I'll include a photo of Dr.Martha White's comments (since I can't find that section of the magazine online.)


She lists the sedation rate of Claritin, Allegra and Zyrtec. (Sedation is what makes you REALLY tired! You know - the kind of tired where you just want to curl up on the couch and take a nap......)

From reading her comment, it looks like Claritin has a sedation rate of 8%, Allergra is 1.3%, and Zyrtec is 13.7%. Since everyone is different, you have to see what works for you. Asthma Doc has The Teenagers take their medicine at night, so they will sleep through the drowsy side effects. That seems to do the trick for them.

But talk to your doctor and see what works best for you. You can buy small bottles of different allergy medicines and see which one you like. Just don't drive if it makes you sleepy!! 

And stock up on boxes of tissues!!!