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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. 
Ugh.

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

https://www.facebook.com/DefineYourAsthma/

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. 

And

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?!