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Monday, December 31, 2018

Prepping for a long illness

(Shutterstock images)

I know it sounds weird to be prepping for a long illness, but I know what is coming up this week.

This morning, I woke up with my throat feeling funny and my lungs feel a little off. Not enough that I need my inhaler or nebulizer, but just enough to let me know that something isn't right.

People with asthma get a lot sicker than people without asthma (when it comes to colds and the flu.) 

In fact, it's not uncommon for a simple cold to morph into bronchitis or pneumonia. 
If I start with a cold, I know my cold will turn into bronchitis (as it did 4 times last year.) So, I am getting ready. I am stocking up on:

Tissues with lotion

Throat lozenges

Cough drops

Orange juice

Chicken Noodle Soup

I also make sure my Albuterol inhaler has plenty of puffs in it. And I check my boxes of Albuterol vials for my nebulizer to make sure I have enough.

Since I moved, I also need to find:

The closest Urgent Care (and the hours it is open.)
Nearest Emergency Room 
Open late/all night pharmacy

I know I need to rest and it will take a while for my lungs to recover. So, it will probably just be me with a snugly blanket and the TV remotes.

For those of you out there with asthma, I wish you luck if you get sick during the flu season. It could be a bumpy road for all of us!



Wednesday, December 26, 2018

Strong emotions triggering an asthma flare

(Shutterstock image)

This can be a tough time of year - holiday work parties, making treats for the neighbors, trying to take a family photo, being stuck in an airport, or in a long line of traffic trying to leave the city.

What are strong emotions anyway?

Anger, crying, laughter, yelling, fear, etc.

And there can be plenty of those emotions this time of year!  

So, what do you do? There's always going to be anger, especially if you commute to work (why do people insist on not using their blinker to change lanes? And they can't wait to merge but instead cut off other drivers?) I don't get it!

Crying can be common this time of year. It's hard to keep up with holiday expectations and you may be forced to spend time with family members who you didn't get along with as a kid, and you still don't.

Laughter - okay, there is nothing funner for me than watching a good movie. Or listening to The Hubby telling his dorky jokes or spouting one-liners from movies. A good laugh will start, but will quickly end up with coughing from an asthma attack.

Yelling - see above story about idiot drivers....

Fear. We had a series of faulty water heaters that flooded the basement a few times. Can I tell you the fear of walking down to the basement and stepping in water?? The last time The Hubby went to the home improvement store to replaced the water heater (still under warranty), the store said they were no longer carrying that brand because they had so many problems with it. Now they tell us?

Life can be a roller coaster. If know that strong emotions can trigger an asthma attack for you, make sure you still enjoy life - but keep your Albuterol inhaler or nebulizer handy!  




Friday, December 21, 2018

Death from asthma

During this holiday season, we have been dealing with the death of a beloved family member. For those of you who have lost a loved one, you know how hard it is to plan a funeral. 

Luckily, this family member had already planned their funeral years ago. But there were still plenty of last minute details to attend to since have changed since she planned her funeral. 

During one of our many meetings with the Funeral Director, I was curious about what he sees in his line of work. The death in our family was expected, yet still came quicker than we thought. I have had other deaths in my family where I got "The Phone Call" that no one ever wants to get. (Letting me know that a family member had died suddenly.)

Since my world revolves around allergies and asthma, I was curious if The Funeral Director had to deal with any deaths from asthma. His reply was a quick, "Oh yes, many over the years." 

Did you know that people can die from asthma? Most people say, "It's just asthma - use your inhaler and you'll be fine."

It's not fine. Inhalers can't always prevent death. In fact, each day in America, 10 people die from asthma.

How do you know if you or a loved one are at risk of dying from asthma? Very Well Health lists risk factors:

  • Previous history of a near-fatal asthma event
  • Recent poorly controlled asthma with increased shortness of breath, nocturnal awakenings, and rescue inhaler use
  • Prior severe asthma exacerbation where you were intubated or admitted to an intensive care unit.
  • Two or more asthma-related hospital admissions or three or more visits to the emergency room for asthma
  • Using two or more canisters of your short-acting bronchodilator  like albuterol in a month
  • If you have trouble identifying when your asthma symptoms are worsening or you are having an asthma attack
  • Being poor and from the inner city
  • Substance abuse
  • Significant psychiatric disease
  • Other significant medical problems like a heart attack and other lung diseases

How can you have a sudden death from asthma? Well, sometimes it's not sudden. Someone may be suffering for several hours, days or weeks before they decide they need help. Very Well Health says:

"Importantly, 80 to 85 percent who die from asthma develop progressive symptoms anywhere from 12 hours to several weeks before death. Only 15 to 20 percent die in less than 6 hours after developing symptoms."
How do you avoid dying from asthma? Very Well Health says:
  • Know that you are at risk
  • Know your asthma action plan
  • Make sure you understand your asthma action plan
  • Use your asthma action plan
  • Use your peak flow meter regularly
  • Do not delay seeking emergency care if your symptoms worsen
  • Tell your asthma care provider that you are at increased risk of an asthma-related death
  • Make sure you can effectively communicate with an asthma care provider

For me, I would trust my gut instinct as a mom. There were several times where I just felt like something wasn't right with my child, so I would take them to the pediatrician. The doc would diagnose my child with strep throat or pneumonia and send us to the pharmacy for an antibiotic. But later on that night, I would STILL feel like something wasn't right. 

So, I would bundle my child up and drive to the ER. My child would end up being admitted since their oxygen level was low and their asthma was flaring up. 

I remember feeling so grateful that I listened to my gut instinct that something was wrong! I feel like there were several times that my child's life was saved because I didn't wait to "see if they got better" but rushed them to the ER where my child was hospitalized for 3 days.

If something doesn't seem right, call your doctor or after hours - FAST. Or head to the ER. It might be an asthma flare up that the doctors can treat, but if you need more intense treatment in the hospital, and you wait.....

Your family might get "The Call" that no one wants to get. 


Tuesday, December 11, 2018

How do you comfort a child in the hospital?

This is one of those things you never want to happen - but it does. 

We had this scary and sad experience 12 times with our kids. I really hate pneumonia and smoke from forest fires.....those are my kid's enemies.

So, you have a child in the hospital for asthma, now what?

Well, you know your child better than anyone else. What would comfort them?

For us, we found a few things that helped and we packed them with every hospitalization.

Favorite blankie  

My kids would usually get a blanket from Project Linus, but it's not the same thing as having your favorite blankie at the hospital. The nurses would always remind us that when they come in to change the sheets on the kid's hospital bed, to make sure they didn't accidentally take blankie. Because once it went to the hospital laundry, we probably wouldn't get it back. 

Favorite stuffed animal 

Same thing here. They would get a stuffed animal that was donated to the hospital, but it's not the same as their favorite stuffed animal. 

Favorite music 

This is going to tell you how old I am.....we used to take a small CD player to the hospital with the kid's favorite CD's. And yes, I still have every Disney song memorized. Now kids have cell phones and other devices to play music, so take those. 


Our kids were all picky eaters, so we got the okay from the nursing staff and then brought the kid's favorite snacks to the hospital. And I brought along a lot of chocolate for myself. Because chocolate makes everything better.

The Child Life Specialist 

Did you know that hospitals hire Child Life Specialists to help families in the hospital? They are specially trained and certified, and can help in various ways. They can blow bubbles while the kids get IV's (to distract them), bring your kids toys, blankies, video games, art supplies, etc. They are really good listeners too if the kids want to talk (or the parents!)

Have you found anything that helps when your child is in the hospital?





Thursday, December 6, 2018

When you don't know what you're missing

(Shutterstock image)

Recently, one of my college aged sons was looking at a big clock on the wall in our living room. He said, "You know, I can see the number on the clock but not the letters." I could see him squinting, but he still couldn't see them.

I was a little surprised and wondered how long he was having trouble seeing?

I knew he would need a pair of glasses, so I told him to go to the eye doctor. Sure enough, he came back home with a prescription for glasses.

Once he had his glasses, he was walking around the house looking at things. I could tell that he was noticing things that he wasn't able to see before.

I told him I remembered what it was like when I got glasses. I didn't realize what I missing! I THOUGHT I could see okay, but once I got glasses, I realized I had been missing a lot!

That reminded me of families that get inhalers for the first time. They have NO idea that they aren't breathing as well as they could be. Most people are really surprised the first time they use an Albuterol inhaler or have a breathing treatment. 

They didn't realize that it should be easier to breathe. They struggle to breathe, can't keep up with the other kids at recess, or with the kids on the soccer team. That's normal for them.

And adults tell me they just thought they were out of shape! And that's why they couldn't keep up when the family went for a walk, rode bikes, etc.

Once they were on the right medicine, they couldn't believe how much better they felt! 

Hopefully all of you are on the right medicine and can feel the difference when you are taking it!

Friday, November 30, 2018

When to take a child to the emergency room

(Shutterstock image)

This is one of those scary decisions as a parent of a child with asthma. I should know - my kids were in the hospital 12 times.

Can I tell you how much I hate pneumonia? And smoke from forest fires? Those caused all of my kid's hospitalizations.

So, when do you know if it's time to take a child to the emergency room?

Nemours Hospital, says you should watch for these Emergency Signs:

"Your child has constant wheezing

Your child uses quick relief medicines (also called rescue or fast-acting medicines) repeatedly for severe flare-up symptoms that don't go away after 15-20 minutes or return again quickly

Your child has a lasting cough that doesn't respond to inhaled quick-relief medicine

There are changes in your child's color, like bluish or gray lips and fingernails

Your child has trouble talking and can't speak in full sentences

The area below the ribs, between the ribs, and in the neck visibly pull in during inhalation (called retractions)"

If you see any of those in your child, Nemours Hospital says to: 

".....see your doctor immediately, go to the ER, or call an ambulance"
I try to be prepared for an emergency by having an Asthma Action Plan for each of my kids. 

This one is from American Lung Association 

  It has green (good), yellow (warning/caution), and red (emergency) zones. Your doctor should work with you to help decide what to do in each zone. 
Talk to your doctor to let him know what you need to do in your red (emergency) zone.
It may help avoid a hospitalization or death from asthma.  

I can't tell you how many stories I have heard about people dying from asthma. One of the times when my daughter Kitty was being discharged from the hospital, the nurse who was pushing Kitty's  wheelchair said her brother died from asthma. Her brother's wife was rushing him to the hospital to get help, but he died in the car.

I have heard another story about a woman who found her son on the front lawn of the house. He had been hangout out with his buddies, but they all went home. He had an asthma attack and couldn't get into the house to get his inhaler. They found him dead on the lawn.

I tell you these stories to get you to see how FAST asthma can go from bad to worse. You may think you can handle it at home, but that's why we have hospitals. 

A couple of times, when my son was in the hospital, they had the "crash cart" outside his room. They weren't sure THEY could keep him alive - even with all of their hospital equipment. 

PLEASE do not "wait it out" to see if your child gets better.

After one hospitalization, the respiratory therapist said, "Don't let your son sleep through the night. Many parents are relieved that their child is finally sleeping. But - their oxygen level can drop, and drop, and they will stop breathing." That scared me!

After that, when the kids were really sick, Hubby and I would take turns staying awake and checking the kid's oxygen levels with an oximeter. 

Oxygen levels aren't the only thing to watch out for. Some people with asthma are able to compensate, so they don't seem that sick. 

Watch for the symptoms above - DO NOT be fooled by a high level of oxygen.    

This article, "Let's Talk Pulse Oximetry" may help explain it.

Decide now what you will do if your child is having any emergency symptoms. It helps to make a plan ahead of time (best route to the hospital vs calling 911.)

Monday, November 19, 2018

Bruises and asthma

I'm one of those really uncoordinated people. In fact, I joke that I can't walk and chew gum at the same time. 

I used to be graceful - I was a dancer and ice skater when I was young. But, the older I get the clumsier I am. Of course, that could be that my eyes are getting worse as I'm getting older!

These days, it's not uncommon for me to round a corner and hit my leg or toe on the kitchen cabinet or furniture. I also have fallen UP the stairs. Anyone can fall DOWN the stairs, but it takes talent to fall UP the stairs!

So, enter my bruise covered legs. Most of the time, I don't notice it. But sometimes if I wear a skirt at work, someone will say, "Where did you get those bruises?!" And most of the time - I have no idea!

Once in a while, it will really hurt when I hit my leg on something (like when I was trying to pull my suitcase off the conveyor belt at the airport before the cranky TSA agent yelled at me because I was taking too long to pick it up.) So I know something like that is going to leave a bruise.

But, how can I have so many other bruises and not know where they came from? I remember hearing that inhaled corticosteroids (the kind of inhaler you take every day) can cause bruising. 

 There are several studies that show that being female, older, and using a corticosteroid inhaler makes it more likely that you will have bruises.

There are other causes of bruising too, which could be a lot more serious. Like leukemia, Factor X Deficiency, hemophilia, etc. 
So be sure to talk to your doctor if you notice a lot of bruising.
Luckily, I had a physical recently, so I know my that my blood levels are okay. So, for me - my bruises on my legs are just a side effect of my inhaled corticosteroid. And me being clumsy.
If you notice bruises - talk to your doctor just to make sure there isn't anything more serious going on. And let them know if you are taking an inhaled corticosteroid.

Thursday, November 8, 2018

Yes or no to flu shots?

It's that time of year again, where the flu is making the rounds. I always worry about getting the flu, because it can be especially bad for people with asthma. 

Any cold or flu can be worse when you have asthma. 

And I am already hearing about people dying from the flu. In fact, a young (and I assume healthy) 29 year old female lawyer died of the flu in October. And there was no mention of that she had asthma.

Last year, The Hubby got the flu.

Even though I had quarantined The Hubby to our bedroom, was cleaning everything with bleach wipes, and I was sleeping on the couch to try to avoid the germs, I got sick anyway. 

I was at work and felt a little tickle in my throat, so I used my inhaler. As the day went on, my lungs started to burn. That was unusual because I didn't have a runny nose, and I wasn't coughing or sneezing. I didn't feel sick. But my lungs just started to burn-  and it quickly got worse. 

That's unusual for me, because my lungs don't burn unless I have been exposed to dogs, smokers, etc. They usually burn after an asthma attack. Or - from being sick for days at a time.

 I left the office and went home to use my nebulizer. At this point, I knew it that just using my inhaler wasn't going to cut it, I needed something stronger.

Even after using my nebulizer, my lungs kept getting worse. Then the chills and fever started. Great.

By now, it was early evening, and the doctor's office was closed. 

I knew this could not wait until morning. Since The Hubby was too sick to drive, I managed to drag myself to Urgent Care. I told Urgent Care Doc that my husband had the flu, I think I caught it, and I have asthma. 

That always changes how doctors treat a patient who comes in with problems breathing. They know that those of us with asthma get sicker than the average person (who doesn't have asthma.)

Urgent Care Doc said that there was a shortage of the anti-viral drug they use to treat the flu, but he was going to give me a prescription and to start it immediately.

I could barely drive myself to the closest 24 hour pharmacy to get my medicine and drive back home. This is the first time that I have been scared that I was going to end up in the hospital. 

The flu hit so hard and so fast, that I was worried. My kids had been in the hospital 12 times when they were younger (mostly for pneumonia and bad air quality).

But, this is the first time I was worried that I would end up in the hospital. 

As a Certified Asthma Educator, I knew how to treat myself at home, but I there were a few hours where I worried I was going to have to call one of my college aged kids to take me to the hospital.

I really feel that if I hadn't had my flu shot, it would have been worse. I know that it offered some protection. And that if I didn't have my flu shot, I would have ended up in the hospital.

So, if you are debating about getting the flu shot this year, and you have asthma, do you really want to take a chance? 

People do end up in the hospital or worse - die from the flu. 

Don't think it can happen to you? Neither did the 80,000 people who died from the flu last year.


Don't take a chance - if you can protect yourself, do it! Get your flu shot today!  


Wednesday, October 24, 2018

Getting help for asthma in rural areas

(shutterstock image)

I live in very large state with a lot of sparsely populated areas. To give you an idea of how big, you would have to drive for 8 hours to cross from the north to the south end of my state. And about 5 hours to drive from the west to the east.

We have several big cities, but also a lot of tiny towns - the kind of towns where they are so small that they don't have stop lights. 

Once, I was traveling on the interstate near a small town and I noticed the other drivers suddenly putting on their brakes. I couldn't see what was going on until I got closer, and then I saw that the farmer's cows had broken through the fence and were loose on the interstate. The highway patrol was trying to keep them out of the traffic lanes until they could get the rancher to come on horse back.

True story. 

So when we have these tiny towns that are far away from hospitals and clinics, how can they get help?

Enter Telemedicine and Telehealth. The FCC says:

"Telemedicine can be defined as using telecommunications technologies to support the delivery of all kinds of medical, diagnostic and treatment-related services usually by doctors. For example, this includes conducting diagnostic tests, closely monitoring a patient's progress after treatment or therapy and facilitating access to specialists that are not located in the same place as the patient."

Sounds a little confusing, but let's break it down. 

Maybe you had to drive several hours to see a specialist (which meant taking time off work), and spent a lot on gas money, and maybe even had to get a hotel to stay overnight. Or it's time for a follow up appointment, but you can't afford to take more time off work. 

But, you could go to your doctor's office, and they could have network set up where our regular doctor can communicate with a specialist. They have special medical equipment that allows the specialist to hear your lungs or heart - from your regular doctor's office! 

This video explains it a little better. It's using technology to connect you with a doctor.

There are also a lot of websites and apps that let you talk to a doctor over the computer, or on your phone.  You may be so sick that you can't drive yourself to the doctor's office. But, you can talk to them using the camera on your computer, or your phone camera. They can do a "virtual" visit, diagnose you, and even send a prescription to your pharmacy.

So, if you live in a rural area - or are too busy or sick to be able to drive to your doctor's office, check online and see what might be available for you.

You never know when it might come in handy! 

Monday, October 8, 2018

Teal colored pumpkins for Halloween!

I know teal is a really popular color for home decorations (and one of my personal favorites), but teal  pumpkins?


Teal pumpkins aren't made to color coordinate with your decor (although you could use them for that if you wanted to.)

The Teal Pumpkin Project (R) began in 2014 by Food Allergy Research & Education (FARE) to raise awareness of food allergies, and to make it safe for all kids to go trick-or-treating.

For all of you who have a child with food allergies, raise your hand! 

(I'm raising mine too)

Son #2 and I both have food allergies. 

He's WAY past the trick or treating age, but this would have been helpful for when he was a little kid. It's pretty hard to find candy without nuts.

The Teal Pumpkin project was organized to let kids with food allergies be able to safely trick or treat. 

Here's how you can help:

1. Buy "non-food treats" for your little trick - or - treaters
2. Put a teal pumpkin on your porch to let people know you have non-food treats (you can buy a teal pumpkin at the craft store, or paint your own!)
3. List your home on the Teal Pumpkin project map 
4. Let others know about it!

What are "non food treats"? FARE has a list of fun items you can buy for Halloween.  

FARE also has signs you can print out and put up in your windows to let people know you have non-food treats. 

They also have a few images you can download use for your Facebook, Instagram, or Twitter accounts.  

If you have kids with food allergies, please share this post so you can help them have a safe and fun Halloween too.

Now, about your kids changing their minds on costumes 6 different times....can't help you there!

Friday, September 28, 2018

What are you suffering because of asthma?

Is asthma holding you back from the things you would like to do? 

When I am teaching families about asthma, I help them to understand the Rules of 2's.  

Many times, they THINK their asthma is fine. But they're really not controlled. 

The Rules of 2's is from Baylor University in Texas and says:

If you:

  • Have symptoms/need your inhaler more than 2 times per week
  • Wake up due to asthma more than 2 times per month
  • Refill your rescue inhaler more than 2 times per year
They have also added a new measure, "Measure your peak flow at less than two times 10 (20%) from baseline with asthma symptoms?" That sounds a little confusing!

Why make a big deal about your asthma being under control? Well, are you missing out on things because of your asthma? 

Sometimes people may think, "I'm okay, I'm just having a little flare up."

So, another thing I ask families is:

 "Is asthma holding you back?"


"Are there things you CAN'T do because of your asthma?"

You can think about how often any of these things are happening:
  1. Waiting in a crowded emergency room
  2. Having sleepless nights
  3. Missing school or work
  4. Depression
  5. Bullying
  6. Losing a job because you were missing so much work due to asthma
  7. Hospitalizations
These ideas came from a video that a group of Community Health Workers created (along with other asthma education organizations). They wanted to help families see how much asthma is affecting their life. 

Sometimes, if you look at it that way, you may think, "Hmm. I didn't realize how much asthma is controlling my life."

We're all going to have flare ups. I had a crazy winter last year and had bronchitis 4 times! So yes, I was in Urgent care late at night (I knew it couldn't wait until morning.)

You can watch the video and see if you think your life is as good as it can be (with asthma.) It can take a while to find the right medication for your asthma. 

My 3 kids and I all have asthma, yet we are all on different medications. 

You need to find what's right for you.

And if you are missing out on a lot of things in life due to asthma, talk to your doc. You may be able to change your inhaler to a different one that can work better for you.

Life is wonderful! I would like to keep my asthma under control so I can enjoy life!  

Friday, September 14, 2018

Preparing for disasters when you have asthma


The weather has been a little crazy lately. 

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

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

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

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

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

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

Thursday, September 6, 2018

Nose spray for anaphylaxis?


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

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

The Fast Track is: 

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

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

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

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

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

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

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

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

I want to punch them!  Hard.

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

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

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

Thursday, August 30, 2018

Can you avoid the September Epidemic?

(Shutterstock image)

First of all, what IS the September Epidemic?

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

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

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

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

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

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

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

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

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

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

Thursday, August 23, 2018

How can I keep my child out of the hospital?

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

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

Often times, you aren't doing anything wrong! 

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

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

Using a peak flow meter 

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

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

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

After hours/Urgent Care

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

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

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

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

Emergency Room 

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

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

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

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



Friday, August 10, 2018

Define Your Asthma

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

Who is AAN?

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

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

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

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

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

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

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

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

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


Define Your Asthma. 

Wednesday, August 1, 2018

Fires and smoke, oh my!

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

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

It happened so fast.

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

What are the health effects of smoke?

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

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

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

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

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

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

Better to keep on breathing, right?! 

Friday, July 13, 2018

Pricey meds

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

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

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

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

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

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

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

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

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

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

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

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

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

Good luck!

Thursday, July 5, 2018

How does surgery effect asthma?

For anyone with an upcoming surgery, there are a few things to watch for (from my experience). You should have a detailed visit with your surgeon about your medical history (and family history.) Followed up by the Surgery Nurse who will usually called the week of surgery and repeat all of the same questions (so the hospital also has your medical history).

They usually ask if you have a family history (or personal history) of diabetes, kidney disease, heart problems, asthma, bad reactions to anesthesia, allergies to latex, etc. 

For asthma, they usually want to know:

  • What medications do you take?
  • Do you take a controller medicine? Or just a rescue inhaler?
  • Is your asthma under control?
It's helpful to keep a list of medications on your phone, so it you can easily tell them the names and doses of all of the medicine you take. Surgery Nurse will usually ask you to bring your inhaler to the hospital too.

So, now that they had all of their information about your medication and medical history, what about the surgery?

Some people find that your oxygen level can drop during the surgery. That can happen when they put the tube down your throat (intubate you) to help you breathe during surgery. It can help to keep your oxygen turned up during surgery.

Sometimes people are groggy after surgery and will pull off their oxygen mask without realizing it. That can be followed by a faint "Beep, beep, beep, beep" of the alarm going off for your oxygen monitor. You may hear a "Breathe! Breathe! Breathe!" from the nurse in the recovery room. You can ask them beforehand to put your mask back on if you pull it off in the recovery room.

After surgery, you may notice that your lungs don't "feel right." Sometimes people can start to breath really shallow and have a hard time taking a deep breathe. That can lead to pneumonia. 

And if you start coughing, you can pull the stitches out of the surgery site. They may have you use an "Incentive Spirometer" to help expand your lungs. If you aren't sure what an Incentive Spirometer is, you can watch a short video here to see how they work.

It may also help to use your nebulizer and have a breathing treatment. 

So, if you have a surgery day coming up, make sure you are prepared. It helps to keep taking your daily, controller inhaler and make sure you don't miss any doses after surgery either!

Keep your inhaler or nebulizer handy and make sure you call your doc if something doesn't feel right.