Blog - Active Healthcare

Albuterol to the Rescue


Rescue inhalers are a great comfort to anyone with Read more

Does Back to School Mean Back to Allergies?


Summer is coming to a close for students in Read more

Got Asthma or Allergies? There’s an App for That!


AllergyManager Geared towards helping those suffering with nasal allergies by Read more

The Double Threat of Vaping


Food industry workers at a microwave popcorn factory were Read more

Can Diabetes Give You The Blues?

Lisa Feierstein Children's Health, Diabetes, Men's Health, Women's Health Leave a comment   , , , , ,

diabetes depressionThe number of Americans that suffer from depression, also known as Major Depressive Disorder is increasing all the time. Depression is more than being sad or in a bad mood. This condition is a chemical imbalance in the brain.

Unfortunately, depression often goes undiagnosed and, therefore, untreated. As it turns out, diabetics are especially vulnerable to this condition.

Diabetics At Double the Risk of Depression

Several studies have found that diabetics are at double the risk of suffering from depression due to the physical and emotional stress of their chronic disease. A depressed diabetic is more likely to neglect his/her diet or medication plan, which is critical to their well-being. The cause is unclear, however if a patient’s depression is stress induced, a diabetic may be a greater risk because of a metabolic imbalance that already exists.

Managing a chronic condition like diabetes can be overwhelming, leaving less time and energy for dealing with life’s other challenges. The financial burden of treating diabetes may also be a contributing factor to higher rates of depression. The rising medical costs of their life sustaining treatment adds another burden.

Studies also suggest that diabetics who have a history of depression are at a higher risk of developing diabetic complications than those without. This is because depressed individuals have elevated levels of stress hormones such as cortisol, which can affect blood sugar metabolism and increase insulin resistance.

What to Watch for: Symptoms of Depression

People suffering from depression may not want to get out of bed in the morning. They neglect their diet and don’t exercise. Depressed people shun social gatherings and have trouble staying motivated at work or school.

Seek help if you are experiencing any of the following symptoms:

• Difficulty concentrating, forgetfulness and poor decision making
• Feelings of guilt, worthlessness and/or helplessness
• Insomnia or excessive sleep
• Irritability or restlessness
• Loss of interest in activities once enjoyed
• Overeating or not eating enough (dangerous for diabetics)
• Aches and pains including headaches, cramps, and digestive problems
• Persistent sadness, anxiety, and feelings of emptiness
• Thoughts of suicide or attempting suicide

Depression can be brought on by a number of factors including genetics, life circumstances, trauma, side effects of medication, stress, or other environmental factors. It is treatable with psychotherapy, as well as medication. As with most medications, anti-depressants (often called SSRIs, which stands for Selective Serotonin Reuptake Inhibitor) come with side effects including nausea, weight gain, fatigue, insomnia, dry mouth, dizziness, irritability, and anxiety.

You may have chalked your feelings of sadness up to the fact that you’re diabetic when you may also be depressed. Depression should be treated as a separate condition. Getting treatment for it can help you take better care of your diabetes, putting you in optimal health.

Additional Resources:

http://www.diabetes.org/living-with-diabetes/complications/mental-health/depression.html

https://www.childrensdiabetesfoundation.org/diabetes-and-depression/


Albuterol to the Rescue

Lisa Feierstein Asthma, Breathe EZ, Children's Health 1 , , , , ,

Rescue inhalers are a great comfort to anyone with asthma since the onset of symptoms can be sudden and frightening. Since 2004, Federal law allows children to carry rescue medication for emergencies at school.What happens when a child forgets their inhaler at home? New federal legislation may help address this concern.

School-Based Respiratory Health Management Act | House Resolution 2285

School Rescue MedicationFederal Bill House Resolution 2285 was introduced in the House of Representatives earlier this year. If passed, this bill would allow trained school personnel to administer rescue medications.

Eleven states already allow the most common rescue medication, albuterol, to be stocked at their schools. This medication can be administered by school nurses and other trained staff during a breathing emergency.

Unfortunately, North Carolina does not allow schools to supply albuterol. In most states, a child with asthma who forgets their rescue medication may be at increased risk of complications. The states with existing laws and guidelines to stock albuterol in schools include: Arizona, Colorado, Georgia, Missouri, Nebraska, New Jersey, New Mexico, New York, Ohio, and West Virginia.

The American Lung Association has developed a model policy for school districts. Schools can use this tool to create and implement rescue medication policies for their facility.

Wonder How Your State Ranks for Asthma and Allergy School Policies?

The Asthma and Allergy Foundation of America (AAF) releases a yearly state honor roll. This report card rates each state’s asthma and allergy policies. States are ranked in a number of categories. Ranking categories include Medication and Treatment policies, Awareness policies, and School Environment policies.

The 2016 state honor roll list includes North Carolina. Our state met 19 out of the 23 AAF core policy standards. There are, of course, areas for improvement. The AAF suggested that North Carolina add more full-time school nurses and provide additional training for school staff in asthma awareness. North Carolina can also improve their facility design standards to promote healthy school environments.

Additional Resources:

House Resolution 2285 – School-Based Respiratory Health Management Act

Asthma and Allergy Foundation of America – 2016 State Honor Roll

2014 EPI Pen Legislation


Monitoring Your Diabetes at School

Lisa Feierstein Children's Health, Diabetes Leave a comment   , , , , ,

Type 1 Diabetes requires continuous monitoring, regardless of the patient’s environment. In previous blogs, we’ve discussed carrying an emergency bag and other methods for managing your diabetes when away from home. However, one area we did not discuss is what to do at school.

Monitoring Diabetes at School - Communication is Key

Monitoring Diabetes at SchoolFirst and foremost, you cannot communicate enough with school staff including teachers, bus drivers, and health personnel about your child’s condition. Provide as much information as possible so they will know how to assist your child when the need arises.

A Diabetes Medical Management Plan (DMMP) should be completed and gone over with school administrators so everyone is on the same page. An example of this can be downloaded here.

This comprehensive and critical document should contain the following information:

  • Blood sugar target and testing times
  • Insulin schedule
  • List of supplies
  • Meal and snack plan
  • What aspects your child can handle on their own vs. what they might need help with
  • How to handle a low blood sugar or high blood sugar episode

ADA and IDEA

There are many laws that protect your diabetic child including the Americans with Disabilities Act (ADA) and the Individuals with Disabilities Education Act (IDEA). IDEA is a law that provides services to diabetic students. For more information about IDEA, click here. In addition, in a public school setting (or a private one that receives funding from the federal government), you are entitled to set up a Section 504 plan for your child.

This would require that the school make special accommodations for him or her including the following:

  • Allowing him or her to use the restroom and use the water fountain when they need to
  • Eating wherever and whenever necessary
  • Allowing extra absences
  • Scheduling exams at a time that will not cause your child to suffer from the hypo or hyperglycemia
  • Ensuring that a trained diabetes care personnel member be present during sports, extracurricular activities, and field trips

If your child is not currently using a Continuous Glucose Monitor (CGM) (more on this in our previous blog “The 411 on CGM”) or an insulin pump, the beginning of school is a great time to look into these options, as these devices provide peace of mind for the parent, school staff member, and child alike.


Does Back to School Mean Back to Allergies?

Lisa Feierstein Allergies, Asthma, Breathe EZ, Children's Health, Men's Health, Women's Health Leave a comment   , ,

Summer is coming to a close for students in North Carolina.  The change of seasons and environment can spell trouble for asthma and allergy sufferers.  They already know their at-home triggers and how to combat them, but have less control over their environment at school.  Common classroom triggers include pollen, dust mites, mold, chalk dust, and pet dander.  With the help of school administrators and parents, students can remain focused on their studies and less on their allergies.

Allergy and Asthma Preventative Measures for Back to School

  • Keep windows closed when pollen counts are high
  • Repair leaking water pipes and faucets
  • Install high efficiency air filters
  • If the classroom has a pet, position asthmatic and allergic students far away from it. In addition to the dander produced by the class pet, it is possible that a fellow student might also transport pet dander into the classroom from home.
  • Address any concerns that aren’t resolved by your administrators with county school officials, if necessary

 

Prepare for a Successful and Allergy-Free School Year

  • Make an appointment with an allergist
  • Make an appointment with your child’s teacher and/or school administrator and, if possible, perform a walk-through of the classroom to pinpoint potential triggers (this could be done at meet-the-teacher night, as well)
  • Share your child’s treatment plan with school staff and bus drivers
  • Discuss what to do in an emergency
  • Provide the school nurse with any medications the student needs, as well as the dosage and instructions
  • Also, have your child’s doctor complete your school district’s Medication Authorization form

 

Don’t Forget About Recess and Sports Activities in Your Planning

  • Use a short-acting inhaler 15 minutes before any activity, under your healthcare provider’s recommendations
  • Stay hydrated
  • Choose activities that are less intense
  • If it’s cold out, bundle up
  • Protect your eyes and lungs with a mask or bandanna

 

Going back to school is an exciting time and can be made less stressful for asthma and allergy sufferers by taking this advice into careful consideration.

 


Diabetic Tips: Making Sure It’s “In the Bag”

Lisa Feierstein Children's Health, Diabetes, Men's Health, Women's Health Leave a comment   , , ,

Emergency Diabetes BagAs a diabetic patient or parent, you are well aware that you need an emergency diabetes bag. This is one project that can’t be put off.

Advance planning is key to successful management of your diabetes. Don’t “live and learn,” coming up with a Plan B on the fly.

Here are some ideas for filling your emergency diabetes bag

Your Medical History and Contacts List

Take the necessary time to gather this information, which should include your health conditions, allergies, medications and dosages. Also, include contact information for your doctor, pharmacy, and emergency contact. Carry one in your wallet and smartphone.  Don’t forget to store a copy in an easy-to-locate area of your home, such as attached to the fridge.

Glucose tablets or gels are great to have in your bag in the event of a blood sugar nosedive.

But don’t forget a glucagon injection kit, you may need this depending on the severity of your episode. On that note, it would also be a good idea to keep a list of signs and symptoms at work and home so others can identify these and know how to assist.

Extra Medications – Include three days’ worth of your medications.

When you are ready to head out, keep your insulin cold with reusable frozen gel packs.

Snacks to keep blood sugar stable.

Always have some non-perishable snacks such as nuts, seeds, dried fruit, whole-grain crackers, trail mix, or dry cereal on hand.

Testing Supplies – so you can test as many times as you need to.

Being out and about can raise your stress level, causing your blood sugar to fluctuate more than usual. Therefore, it may be necessary to test a little more frequently.

Include the following:

  • Meter
  • Test Strips
  • Batteries
  • Lancing Device
  • Lancets
  • Needles
  • Alcohol Swabs
  • Hand Sanitizer

Let a Medical Alert Bracelet Speak For You When You Can’t

Always remember to wear a Diabetes ID bracelet. In the event you lose consciousness or cannot speak, bystanders and first responders will know that you are diabetic and can help accordingly. This bracelet should clearly state your diagnosis and any other key health information. You can find these at the American Diabetes Association’s (ADA) website at www.shopdiabetes.org.

Advanced Planning is the Key to Peace of Mind

Once you have your emergency bag packed, you can relax while on-the-go. For additional peace of mind, consider using a Continuous Glucose Monitoring (CGM) system or an insulin pump if you are not already benefiting from one of these devices.

More information about how CGM works can be found in our previous blog The 411 on CGM.


Got Asthma or Allergies? There’s an App for That!

Lisa Feierstein Allergies, Asthma, Breathe EZ Leave a comment   ,
Smartphone apps for both Android and iPhone are not just for shopping and social media. Most are free to download. We’ve blogged about asthma apps before. Here are a few new technology tools to better manage your asthma and allergy symptoms.

Five Free Apps for Asthmatics and Allergy sufferers to Download Now

Pick An App to Manage Your Asthma

AllergyManager

Geared towards helping those suffering with nasal allergies by allowing you to look up daily pollen counts. The app also provides 4-day allergy forecasts and coping tips. You can also use the symptom and severity tracker to report back to your doctor.

Asthma Ally

Pinpoints asthma and allergy triggers by tracking airborne irritants near you including pollen, dust, and the ozone. Allows you to log your daily symptoms before your next doctor’s appointment.

First Aid by American Red Cross

Offers step-by-step instructions on how to best handle an asthma or allergy attack in the form of safety tips and video demonstrations. It’s a good way to stay informed even when symptoms aren’t as bad so you can be prepared ahead of time for when an attack occurs.

WebMD Allergy

A lot of people turn to WebMD when they have symptoms they are unsure about, and now allergy sufferers can carry personalized allergy and weather forecasts with them, as well as tips. With this app, you can track how you feel on a particular day, as well as access an extensive library of articles and videos.

Zyrtec Allergycast

Yes, you may see some advertising for Zyrtec here, but the app also provides your local pollen index for the day and reports on how it might affect you. In addition, you are provided with alerts when the pollen level is high in your specific area, as well as a 10-day forecast so you can plan ahead.

Asthma can flare in any season. More flowers and plants are in bloom in the summer months; which worsen allergy symptoms. We hope that these apps along with your regular treatment regimen will have you enjoying your summer and worrying less about your asthma or allergies.


Pump, Don’t Fail Me Now!

Lisa Feierstein Children's Health, Diabetes, Men's Health, Women's Health Leave a comment   , , , ,

Check your blood sugarInsulin pumps are invaluable tools in managing diabetes. Most medical equipment is very reliable and the majority of the time everything works as it should. But what if it suddenly doesn’t?

Have you thought about what you would do if your insulin pump were to fail? It is important to have a plan in place for when and if this occurs. You can create a fail-safe plan for the rare event of a pump failure by following these four steps.

Pump Failure Action Plan

Step 1

First and foremost, call your pump manufacturer. Your pump’s warranty will cover repairs. The manufacturer may be able to troubleshoot the pump, arrange for repairs, or even a replacement.

Step 2

Next, call your endocrinologist. He/she can help you create a plan to manage your blood sugars in the interim and what warning signs to watch for.

Flu vaccine

Step 3

Keep the following items with you at all times, making sure all are within the prescription limits and not expired:

  • long-acting insulin (in case you will be without a pump overnight)
  • short-acting insulin (to inject and repeat for bolus and/or correction)
  • ketone strips
  • a list of 24-hour pharmacies

Step 4

Also, keep a record of your pump’s settings, as you may need to program a replacement or loaner pump. On this record, include the following:

  • Total basal
  • Your basal setting, which determines how much insulin you receive each hour
  • Insulin to Carbohydrates (I:C) ratio to help with adjusting pre-meal bolus insulin doses
  • Insulin Sensitivity Factor (ISF) — the number of points one unit of rapid acting insulin lowers your blood glucose
  • Insulin On Board (IOB) – the calculation telling you how much insulin is still in your body from previous bolus doses

The possibility of a pump failure may give you chills, but remember not to panic. With the help of your manufacturer and endocrinologist, you can be well equipped to deal with this unlikely event. Before you know it, you’ll be pumping again.


The Double Threat of Vaping

Lisa Feierstein Asthma, Breathe EZ, Children's Health, Men's Health, Women's Health Leave a comment   , , ,

Food industry workers at a microwave popcorn factory were the first to get sick from inhaling the vapors from artificial flavorings. The vapors caused symptoms such as coughing, wheezing, and shortness of breath, similar to those of chronic obstructive pulmonary disease (COPD).

Popcorn: Tasty Snack; Popcorn Lung: Deadly Disease

Dubbed popcorn lung, this condition (bronchiolitis obliterans) is a serious and irreversible lung disease. The culprit is the chemical diacetyl. When inhaled, it scars the tiny air sacs in the lungs resulting in the thickening and narrowing of one’s airways.

While many major popcorn manufacturers have removed this chemical from their manufacturing process, it still poses a threat. Diacetyl is also an ingredient in the flavorings for e-cigarettes. A Harvard study found that 39 of 51 e-cigarette brands contained the offending ingredient.

With flavors like ‘Cinnatoast Munch,’ ‘Cotton Candy,’ and ‘Kiwi Watermelon,’ teens are drawn to vaping. Not only do teens think vaping looks cool; they justify their new habit by saying it is better than smoking. Some e-cigarette ‘juices’ do not contain nicotine, but there is still a danger from the artificial flavorings.

As we discussed in our March blog vaping is often a method people choose for quitting tobacco, but can be very harmful to asthmatics. Vaping is not safe. Why put yourself at risk to develop ‘popcorn lung’? Don’t forget about the many other chemicals in e-cigarette vapor, like formaldehyde.

If you are a current smoker who desires to quit, there are better and healthier ways to accomplish this. A lot of people have trouble quitting because of an oral fixation. Below are some ideas to use as a substitute for smoking or vaping.

• Chew gum (some even contain nicotine) or eat hard candies.
• Get more exercise as this can reduce stress – which may lead smokers to crave a cigarette.
• Consider the nicotine patch which can curb your urge to smoke or vape.

The American Lung Association has many resources to help you quit smoking – or vaping.

Final Notes

Diacetyl has since been removed from the following brands of microwave popcorn: Orville Redenbacher, Act II, Pop Secret, and Jolly Time. So, don’t worry. Your favorite snack is safe now.

The FDA is closely monitoring this market and has begun to apply and enforce key provisions of the Family Smoking Prevention and Tobacco Control Act. This 2009 law gives the FDA authority to regulate the tobacco market and minimize the negative impacts of smoking on America’s youth and families.

Resources

2016 Surgeon General Report detailing the use of e-cigarettes among youth and young adults.

Quitline NC:  1-800-QUIT-NOW or En Espanol at 1-855-Dejelo-Ya


The Lowdown on Stress and Diabetes

Lisa Feierstein Children's Health, Diabetes, Men's Health, Women's Health Leave a comment   , , , ,

If you have diabetes, stress can take a larger toll on your body.  When the body is under stress, it acts as if it is under attack.  Cortisol (the stress hormone) levels rise, causing your body to store energy in the form of glucose and fat.  In diabetics, this process can be disrupted.  The glucose is released, and if it can’t be stored, it builds up in your bloodstream.

Stress hormones are scientifically proven to affect blood glucose levels.  Scientists who have been studying the effects of stress on these levels have found that when diabetic mice were under stress they had elevated glucose levels.  In Type 1 diabetics, studies produced mixed results with some patients experiencing a rise in blood glucose while others noticed a decline.  Type 2 diabetics more consistently experienced a rise than a decline.  This research confirms the importance of stress reduction.

Not All Coping Mechanisms Are Good

Everyone has different ways of coping with stress on the outside.  Some negative examples are below:

  • Drinking more alcohol
  • Not getting enough exercise
  • Neglecting nutrition (very important NOT to do if you’re diabetic)
  • Not getting adequate sleep

 

Diabetics have even more to think about during stressful times and stress may cause them to forget important tasks such as checking their blood glucose levels on a regular basis or planning their meals ahead of time.

Positive Coping Mechanisms

On the other hand, there are many positive ways to deal with stress.  Below are some methods anyone can implement to reduce stress:

  • Get regular exercise
  • Spend more time on your hobbies or learn a new one
  • Perform volunteer work in your community
  • When commuting, take the less stressful route to work if your drive is long
  • Patch up conflicts with your friends or family

 

Relaxation Therapy Techniques for Stress Reduction

  • Breathing exercises
  • Replace negative thoughts with positive ones
  • Progressive muscle relaxation therapy — an example of this is shown in the video below

 


The Good, The Bad, and The Ugly: How Houseplants Affect Asthma and Air Quality

Lisa Feierstein Allergies, Asthma, Breathe EZ Leave a comment   , , , , , , , , , , ,

We are all familiar with the usual suspects that trigger asthma including secondhand smoke, dust mites, mold, pests like cockroaches, and pets. Did you know that your houseplants can affect the air quality in your home and your asthma?

The Good: Many Common Houseplants Improve Indoor Air Quality

houseplants and air qualityPlants are frequently used to mediate the effects of pollution and toxins in our external environment. Our indoor environments can contain toxins such as volatile organic compounds (VOCs). Two common indoor VOC pollutants are benzene and formaldehyde. Benzene can be found in plastics, fabrics, pesticides, and cigarette smoke. Common household items such as dish detergent, fabric softener, and carpet cleaners all may contain formaldehyde.

VOCs have been linked to asthma and more serious conditions including respiratory illnesses and cancer. Plants act as filters to remove these harmful pollutants via their leaves and roots. In addition, the microorganisms living in the plant’s soil are a big help in neutralizing the air. Air-quality friendly plants include the Peace Lily, Golden Pothos, Red-Edged Dracaena, Snake Plant, and Asparagus Fern.

The Bad: These Houseplants are Indoor Irritants

Your friendly ficus that fills an empty corner has allergens in its sap. Palms, of the male variety, produce excess pollen. Check in with your local nursery to find a ‘female’ palm which is not a pollen offender. English ivy can cause skin irritations. African violets have beautiful flowers, but their leaves are dust catchers.

Don’t forget about cut flowers! If you home includes allergy sufferers, you may want to select flowers that generate less pollen like lilies, iris, roses and zinnias. Try to avoid daisies, chrysanthemums, and sunflowers in your table top bouquets.

Healthy Plants Mean Healthier Air: Avoid the Ugly Reality of Mold and Fungi

Over-watering your plants can lead to the development of a fungus and mold which are known asthma triggers. Remember that plants like ferns can be kept in rooms with higher humidity levels, such as your bathroom to keep them healthy and minimize over-watering.

Additional Resources

NASA Guide to Air-Filtering Houseplants
Houseplant Watering Guide


Leaving on a Jet Plane: Traveling with Diabetes

Lisa Feierstein Diabetes Leave a comment  

travel by airBelieve it or not, the upcoming travel season is upon us. If you’re diabetic and planning a trip, you may be a bit anxious about how best to manage your condition while away from home. You’re not alone.

Taking a trip will require more preparation, but can still be an enjoyable experience. Below are a few tips to help you with your trip planning:

Before You Travel: Get your documents together

  • Prescriptions from your doctor for any medications, as well as for your medical devices (CGM, insulin pump, etc.)
  • Documentation that specifies that you are a diabetic.
  • If traveling to a foreign country, make sure this document is translated to the language spoken in any of the countries on your itinerary.
  • Make a few copies of this document and distribute them to anyone traveling with you.

Packing Tips

Put medications in your carry-on bag

  1. Store medication in a quart-size plastic container or bag so that airport security can easily identify them at the checkpoint.
  2. Separate them from other liquids in your carry-on luggage.
  3. If possible, keep your insulin bottles or pens in their original packaging, as this will provide airport security staff with the prescriptions they will be asking for.
Packing Suitcase for Travel

Over pack your supplies

When packing your supplies, take twice as much as you think you will need.

Pack non-perishable snacks

Keep a few ready-to-eat snacks in your carry-on luggage for those blood sugar dips.


Additional Travel Resources

  • Visit the Transportation Safety Administration’s (TSA) website – Be sure to check out the requirements of the TSA ahead of time so you will know what to expect at the security checkpoint.
  • Look into loaner pumps – Many pump manufacturers offer loaner programs. Check with your specific pump manufacturer for details.


EpiPen® Recall Announced by Mylan N.V.

Lisa Feierstein Allergies, Asthma, Breathe EZ, Children's Health Leave a comment   , ,

EpiPen Recall - 2017Meridian Medical Technologies, a Pfizer company and Mylan’s manufacturing partner, has expanded a voluntary recall of select lots of EpiPen (epinephrine injection, USP) and EpiPen Jr® (epinephrine injection, USP) Auto-Injectors to now include additional lots distributed in the U.S. and other markets in consultation with the U.S. Food and Drug Administration (FDA).

Lots Effected by Recall

The recall impacts certain lots of the 0.3 mg and 0.15 mg strengths of EpiPen Auto-Injector. None of the recalled lots include the authorized generic for EpiPen Auto-Injector, which is also manufactured by Meridian Medical Technologies.

The manufacturer will be replacing the recalled devices at no cost.

Please visit Mylan’s website to read the Press Release with a list of the impacted lots that were sold in the United States and additional information on how to return effected devices.


Are You Asthma Aware?

Lisa Feierstein Allergies, Asthma, Breathe EZ 1 , ,

Did you know that May is Asthma Awareness Month?

Asthma Awareness MonthSpring is in the air, and as temperatures rise, an asthmatic’s symptoms reach their peak.

This is a perfect time to review some key points about asthma. With May quickly approaching, let’s have a refresher of some Frequently Asked Questions asked by asthmatics and their loved ones.

Question: Should I only take my controller medication if I’m having an attack?

Answer: No, controller medications are used to treat the underlying issue and not an attack. They do not immediately relieve symptoms such as wheezing, coughing, or chest tightness.

Question: Can I exercise and play sports even if I have asthma?

Answer: Yes, exercise is possible with asthma, but consult your doctor before starting a new exercise program or sport.

Question: Can I become addicted to my controller medication?

Answer: No, asthma medications are not considered addictive. With that said, it is important to understand them and to use them properly.

Question: Is it okay if I’m around smoke as long as I am outdoors?

Answer: No, secondhand smoke should always be avoided if you are an asthma sufferer because tobacco smoke is among the most common of asthma triggers.

Question: Does my controller medication stop working the longer I use it?

Answer: No, these medications are designed to work for the long haul and should be taken daily until your doctor suggests otherwise.

Question: Is it normal to use my rescue inhaler at least once per day?

Answer: No, this inhaler is not meant to be used every day, only in the instance of an asthma attack.

Question: Will using inhaled steroids/controller medication stunt my growth?

Answer: No, asthma drugs do not stunt growth, although one recent study did report a temporary stunt in childhood that disappears by adulthood.

To celebrate Asthma Awareness Month, the Triangle Asthma Coalition would like to make you aware of two upcoming events:

  1. 2017 Asthma Fair, May 6th, 9 AM to 12:30 PM, Raleigh, NC – Held at the Andrews Center at Wake Med and hosted by the Triangle Asthma Coalition, this educational event provides patients and their families with information about taking control of their asthma.
  2. 2017 Asthma Summit, May 24th, 8 AM to 4:15 PM, Burlington, NC – Held at St. Mark’s Church and hosted by the Asthma Alliance of North Carolina, the summit’s target audience includes nurses, respiratory therapists, registered environmental health specialists, and health educators.

For more information about the events, please visit the events page of the Triangle Asthma Coalition website.

Happy Asthma Awareness Month to all!

 


The 411 on CGM

Lisa Feierstein Diabetes Leave a comment   ,

The medical device market is always advancing technologically, as with most other industries. One new technological development, the Continuous Glucose Monitor (CGM), provides added peace of mind to diabetics by providing 24-7 information about blood sugar levels. This constant feedback provided by the device allows for better short and long term control of your diabetes, which will also improve your A1C levels.

The device is comfortable to wear and decreases the number of finger pricks you need to perform daily to check blood sugar. Patients who use a CGM often only need to test their blood sugar twice per day. Two finger pricks per day is much better than the typical number of ten times! This is a huge step forward in diabetes management.

CGM Components

A CGM system includes three components:  a sensor, transmitter, and receiver. The sensor inserts into your skin and uses the same enzyme as a test strip (glucose oxidase) to measure blood glucose. The glucose oxidase in the sensor converts the glucose in your blood to hydrogen peroxide, which reacts with the platinum in the sensor. This reaction sends a signal to the transmitter, which inserts into the sensor. The transmitter then communicates with the receiver (or other connected device), notifying you via alerts if your blood sugar is trending high or low. Sensors need to be replaced every seven days.

Here at Active Healthcare, we have a number of patients benefiting from CGM. Our patients appreciate the ability to analyze their blood glucose results and adjust their basal levels accordingly instead of guesstimating from multiple manual tests. We offer two Dexcom (www.dexcom.com) systems, the G4 Share and the G5.  The G5 is Dexcom’s newest model and pairs with a smartphone or any Apple device, eliminating the need to carry your receiver around. This is especially good for patients who already carry a lot of supplies and devices around to manage their diabetes, such as students. Both systems enable the patient to share device information with up to five other people.  We also provide the ongoing supplies for our CGM patients and can send these in the same shipment as your regular diabetic supplies.

Integration with Insulin Pumps

Many insulin pumps are now integrated with CGM including the Animas Vibe and Tandem G4.  The newest Tandem pump, the t-slim X2, will have compatibility with this feature later this year.  Because the CGM is a complex device, it is recommended that patients get as much information and training as possible both from their physician, diabetic educator, and the various manufacturers before beginning its use.


Vaping is Smoking, Too

Lisa Feierstein Allergies, Asthma, Breathe EZ, Children's Health Leave a comment   , ,

It’s no secret that tobacco is one of the most common asthma triggers. Tobacco smoke irritates the airways and causes your lungs to produce more mucus. In addition, it weakens the tiny hairs called cilia that sweep away mucus and other irritants that settle in your airways.

Quitting smoking is an excellent method of combating asthma, but you aren’t out of the woods yet. Another important risk factor to consider is secondhand smoke. It is especially harmful for children. If you are an asthmatic, tell your family and friends how tobacco smoke affects you. Have them smoke outside and far away from the doorway, if possible. Encourage them to quit for their own health, not just yours.

Vaping is Not Risk Free

Since it is common knowledge that tobacco smoke is very bad for one’s health, many nicotine addicts turn to electronic cigarettes and “vaping.” It gives many a false sense of security and the mindset of “at least I’m not smoking actual cigarettes.” Vaping is harmful, too, but in a different way. The vapor released by e-cigarettes contains formaldehyde, another asthma trigger. So, while people are on the right track with quitting tobacco, they need to know that vaping is not risk-free and may worsen their asthma symptoms. Vaping is a developing trend among teens because there are a number of flavors offered, some even tasting like candy and adult beverages.

Another thing to avoid is secondhand vapor. Since electronic cigarettes are a relatively new phenomenon, many businesses and workplaces do not have policies in place to keep employees and patrons from “vaping” indoors. In the same way you would tell your family and friends not to smoke around you, you should also ask them to vape elsewhere.

E-Cigarettes Pose Similar Risks

A recent National Jewish Health study links the liquid in e-cigarettes to an increase in respiratory infections. During the study, a test was performed on young, healthy non-smokers and it discovered that e-cigarette use damaged the cells in the airways that defend against harmful inhalants, such as viruses. “The cells showed a strong pro-inflammatory response within minutes and the risk of viral infection in those cells rose significantly,” said Hong Wei Chu, MD, who led the study.

If you are an asthmatic or have one in your life, remember to avoid both smoking and vaping for a healthier future.


Keeping You in the Loop About the Artificial Pancreas

Lisa Feierstein Diabetes Leave a comment  

If you have Type 1 diabetes, your entire day can be spent treating your condition. Over the past few decades, technology has advanced significantly, making life as a Type 1 diabetic easier than ever before. The FDA approval of a new medical device called the artificial pancreas in September 2016 will continue this trend. Derek Rapp, President and CEO for the Juvenile Diabetes Research Foundation (JDRF) says that the artificial pancreas “is a historical achievement for JDRF and the entire T1D community. After years of laying the ground work, this life-changing breakthrough is a true testament to the reason JDRF exists, which is to accelerate ways to cure, prevent, and treat this disease.”

Smart Phones and Diabetes Control: Mimicking the Pancreas

Researchers at the University of Virginia are developing and testing these devices. This device has two components: a smartphone and an implanted insulin pump. You may be asking yourself, but how does it work? The smartphone component uses an algorithm to deliver just the right amount of insulin into the body, as well as control blood levels. The insulin pump receives the patient’s blood sugar levels from the smartphone every five minutes in a process called “looping.” The device performs the same functions as a healthy pancreas.

Clinical Trials for Closed Loop Systems

Trials are being conducted all over the United States and Europe, the first of which is the International Diabetes Closed-Loop trial. This trial will be performed using the device developed by UVA and will be led by Boris Kovatchev, director of the UVA Center of Diabetes Technology. According to Kovatchev, the artificial pancreas is “not a single-function device; it is an adaptable, wearable network surrounding the patient in a digital treatment ecosystem.”

Les Hazelton, a 59 year old type 1 diabetic from Minnetonka, Minnesota, says that until he enrolled in a trial at Park Nicollet’s International Diabetes Center in Minneapolis, he was always chasing his blood sugar. “It was totally mind-blowing. I like being in better control of my body and my disease. The more I know about what’s happening right now, the better I can manage it,” he said.

You are likely wondering when such a device will be available on the market. Diabetes In Control www.diabetesincontrol.com says that with several trials having been conducted in 2016, we could see the first artificial pancreas available sometime this year.


When Valentine’s Day is Bittersweet

Lisa Feierstein Asthma, Breathe EZ, Children's Health Leave a comment   , , ,

Valentine's candy heartsMost people are aware of the most common asthma triggers which are referred to as the 3 Ps: pets, pollen, and pollution. Recent studies have brought a new one to light – sugar. The reason? Sugar causes inflammation of the airways. I bet you didn’t know that a little sugar could cause such a reaction.

In 2008, Dr. Sonja Kiersten, a researcher from the Nestle Institute in Lausanne, Switzerland, began to make this discovery. Dr. Kiersten and her colleagues at the University of Pennsylvania used mice to perform their research by feeding them sugar water. This experiment produced the following results.

  • The mice’s airways became inflamed, which made them more prone to developing asthma.
  • The mice fed the sugar water had airways that were twice as reactive as those that drank plain water.
  • The mice became addicted to the sugar water and wanted more.

Limiting your sugar intake is beneficial to everyone, as sugar can affect your body in a variety of ways including:

  • It can lead to an over-active pancreas, which can cause inflammation in various parts of the body. The pancreas is a small organ, so it can only take so much before it starts releasing hormones that affect your sugar levels.  It also produces insulin.  When you feed it with refined sugar like that in a can of soda, for example, your pancreas goes into overdrive and produces too much insulin. This will, in turn, inflame air passages.
  • Excess sugar leads to weight gain. Obesity aggravates asthma, as it does with many other chronic illnesses.

In addition to sugar, dairy can also worsen an asthmatic’s symptoms.  Many doctors tell their asthma patients to try to eliminate dairy from their diets because of the mucus milk and cheese produce, which clogs the airways and constricts air passages.  Even coffee can be harmful.  It is definitely important for asthmatics to stay hydrated and water is the best way for them to do so.

With Valentine’s Day approaching, here are some ideas on how you and your family can celebrate this popular holiday with minimal impact:

  • Have your child take Valentines to school with small toys attached instead (ex: a balloon).
  • Do a Valentine’s Day craft.
  • Make a special, heart-shaped breakfast using cookie cutters.
  • Take him/her out on a “date” not involving food such as a movie, walk, game night, etc.


Five Flu Myths Debunked Just in Time for Flu Season

Lisa Feierstein Breathe EZ, Children's Health, Men's Health, Women's Health 1 , ,

January is the height of flu season, and if you haven’t been vaccinated, it’s not too late to do so.

Influenza or “the flu,” as it more commonly known. This respiratory virus that can be fatal and causes severe symptoms including high fever, shaking chills, headache, body aches, cough, and tiredness.  If you haven’t ever contracted it, consider yourself lucky.

Here are five flu myths you might have heard about the flu that we will clear up for you.

Myth: You can catch the flu from the vaccine

Fact:  This is false

The vaccine contains a dead virus and cannot transmit infection. If you get sick around the time you got it, you were probably already going to get sick from exposure to the virus by an infected person.  In addition, it takes about two weeks for your body to build up the antibodies needed to fight the flu.

Myth: Vomiting and diarrhea are symptoms of Influenza.

Fact:  Influenza is strictly a respiratory illness.

Stomach flu or gastroenteritis is a completely different and separate virus. With stomach flu, you would experience vomiting and/or diarrhea in addition to stomach pain.

Myth:The vaccine is the only ammunition you need to fight the flu.

Fact:  In addition to the vaccine, you should wash your hands frequently, cough into your elbow, and drink lots of fluids.

Also, as with any illness, you will want to disinfect your surfaces such as phones, doorknobs, light switches, and remotes, as the germs can stay alive for up to 72 hours.

Myth: Young, healthy individuals cannot catch the flu.

Fact: Young and healthy individuals can catch the flu.

This group has a greater ability to fight complications of the flu, but it can still have an impact.  The 2014 flu season was particularly hard on this group of individuals.  Then, 61% of those hospitalized with influenza-like illnesses were adults aged 18-64.  In addition to reducing complications brought on by the flu, patients who are vaccinated also reduce the likelihood of transmission of the virus.

Myth: The flu vaccine causes Bell’s palsy.

Fact: No evidence has been found to support this.

One study from the Institute of Medicine reports that vaccines cause very few health problems.  “The findings should be reassuring to parents that few health problems are clearly connected to immunizations, and these effects occur relatively rarely.  The flu vaccine does not aggravate asthma, and the flu vaccine doesn’t cause Bell’s palsy,” explains Ellen Wright Clayton, MD, JD, director of the Center for Biomedical Ethics and Society at Vanderbilt University.

Everyone, male or female, young or old, healthy or sick, will benefit from receiving a flu vaccine.  Get yours today!


Five Misconceptions About Diabetes

Lisa Feierstein Children's Health, Diabetes, Men's Health, Women's Health Leave a comment   , ,

There are many misconceptions about diabetes. Below are a few of them followed by the truth.

Myth: People get Type 1 diabetes from eating too much sugar

Reality: No one really knows how someone gets the disease.

It does not mean that the patient eats too much sugar. “Type 1 is like being hit by lightning, and it’s not anybody’s fault,” says Steven Griffen, MD who is a vice president for the Juvenile Diabetes Research Foundation (JDRF). Researchers still can’t pin down the real cause of this disease, but it means that the patient’s pancreas is not processing insulin the way that it should.

Myth: It is dangerous for people with diabetes to exercise or participate in sports

Girls Walking for Exercise

Photo from Shutterstock.

participate in sports and even thrive as an athlete. Professional athletes such as tennis star Bill Talbert, boxer Jersey Joe Walcott, and golfer Sherri Turner are all Type 1 patients.

Myth: Diabetics should avoid all sugar and carbohydrates

Reality: Diabetics can and should have some sugar and carbohydrates. 

Did you know that diabetics also experience extreme lows in their blood sugar?  Yes, it’s true.  When a diabetic has a blood sugar nosedive, this is called hypoglycemia.  The highs are referred to as hyperglycemia.  Hypoglycemia can make the patient feel just as bad as if their sugar is too high. Hypoglycemia can be avoided by a regular intake of natural sugars. Diabetics can try eating fruit and complex carbohydrates like whole grain bread and pasta to prevent hypoglycemia.

Myth: Diabetes is caused by being overweight

Reality: There are two very different types of diabetes.

Type 1 is an autoimmune disease that never goes away. Type 2 symptoms can diminish with weight management and dietary changes.  Being overweight puts you at risk for Type 2 diabetes, but Type 1 patients often find it difficult to gain weight.

Myth: Diabetes is easy to control.

Check your blood sugarReality: Diabetes is hard to control, no matter how diligent one is with sticking to his/her meal plan and treatment schedule.

Treatment is ongoing. People often assume that the patient “has it all figured out.”  Stress, hormone changes, growth spurts, and illnesses can all cause a diabetic’s blood sugar to swing.

On the upside, there are so many more ways to combat Type 1 diabetes now than ever before. Patients now have many options available to them to make life with Type 1 diabetes more manageable including insulin pumps, continuous glucose monitors, and even an artificial pancreas.


It’s Beginning to Look A Lot Like Asthma Season

Lisa Feierstein Asthma, Breathe EZ, Children's Health, Men's Health, Women's Health Leave a comment   ,

The holidays may be the most wonderful time of the year, but not so much for asthma sufferers. While in the midst of the flurry of activity the season brings, it can be hard for asthmatics to enjoy themselves, especially when away from home.

Here are some things that you can do to make your holiday travel and festivities more enjoyable!

Before Your Trip

airplane

First, if you know you are going to be traveling anywhere this holiday season, make an appointment as soon as possible with your doctor. This will give you the opportunity to update medications, obtain new prescriptions, and get necessary information you need for your specific asthma case to help you in your travels.

  • Ask your doctor to provide you with a copy of your personal medical records to carry with you.
  • Refill as many prescriptions as you can that you think you could potentially use up while away from home a few days before your trip.

Packing Tips

car

  • When packing your bags, remember there are some critical things to leave out of your checked baggage such as your inhaler and medical record.
  • For your remaining medications, use a re-sealable plastic bag with all of the prescription labels visible so that you can move quickly through the security checkpoint at the airport.
  • Packing a pillowcase (and a pillow and mattress pad if you have the space) from home will help eliminate the possibility of inhaling dander from the pillowcases at your destination that could bring on an attack.
  • Tell a fellow traveler that you have asthma and how they can help you if you begin to have an attack. Make sure they know where to find your inhaler in your carry-on.

 

At Your Destination

  • If you will be staying in a hotel, be sure to request a non-smoking room. Look for pet-free hotels.
  • Before you go, search for the nearest emergency room or urgent care to your destination.


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