Children's Health Archives - Active Healthcare

Teen Focus: Dangerous Duo – Type 1 Diabetes and Drinking

Lisa Feierstein Children's Health, Diabetes 2 Comments , , ,

Drinks in GlassesYou might suspect that drinking alcohol would cause your body to react similarly to consuming other carbohydrates. Alcohol is filled with calories. The surprising difference is that alcohol needs to be processed by the liver. Teen type 1 diabetics who drink can actually experience a drop in their blood glucose (BG) levels as their liver focuses on processing the alcohol and doesn’t work on its other function – releasing glycogen into the blood stream.

Another worry is the length of time it takes the liver to process alcohol. Did you know that your liver can be busy for one to one and a half hours handling just one alcoholic drink? Teens who drink multiple alcoholic beverages risk a low blood sugar event.

The symptoms of inebriation are similar to those of low blood sugar – sweating, lightheadedness, shakiness, weakness, anxiety, hunger, headache, problems concentrating, and confusion – which can make it more difficult for teens to sense that their blood sugar is trending too low. The best answer is to test BG levels.

Top Tips for Teens

If your teen decides to attend a party or share a drink with friends, they can minimize the negative impacts by heeding these ideas:

  • Make Moderation your Mantra – alternate alcoholic drinks with water or other non-sugary beverages to prevent dehydration. Wait between drinks to allow your body to catch up.
  • Food is Your Friend – Eat healthy snacks including fats and protein before, during and after drinking. Consider enjoying a drink along with a meal instead. Eating prior to bedtime will also help prevent hypoglycemic events during sleep.
  • Don’t Guess -Test – Bring along testing supplies – don’t rely on how you feel as an accurate gauge of your BG level, test to confirm. A Continuous Glucose Monitor can be a great tool to monitor BG levels.
  • Alert your Friends – Educate your friends on the symptoms of low and high BG level events. Have a buddy that can help just like a designated driver to watch for worrisome symptoms. They can remind you to test and eat snacks. Consider wearing a diabetic alert bracelet or necklace.

If you vomit it is even more important to test BG levels and consume non-alcoholic drinks to rehydrate.

Tips for Parents

Communicating with teens about drinking is a challenge for all parents. As with most difficult topics, open, and honest communication goes a long way. Talk about your concerns in advance – before any party invitations. Educate yourself and your teen about the effects of drinking in general and the special considerations for those with type 1 diabetes.

Even if there will be consequences if your underage teen drinks, consider creating an agreement so that they know they can contact you for help if they run into trouble. This will keep them safe and keep their diabetes in control. Seek support from your teen’s healthcare providers and/or diabetes educators if needed.

Once your son or daughter knows all the potential and possibly life-threatening side effects to their health from drinking, we can hope they will seek out other activities that aren’t focused solely on drinking.

Additional Resources

JDF – Teen Tool Kit
The 411 on CGM
American Diabetes Association – Teens & Parties


E-Cigarettes: Continued Health Threat for Youth

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

Juul e-cigarette

Kids are now facing a new threat that is taking over high schools and middle schools across the United States – a new type of E-cigarette called Juul. Many parents may lack information on how E-cigarettes are spreading throughout their children’s schools and in their own neighborhoods.

Some teens and young adults find the E-cigarette Juul attractive because of its sleek design. The device can be easily charged on a laptop and go unnoticed by parents and teachers. Teens are drawn to Juul for a number of reasons, like its trendy decal skins, and the multiple flavors.

Studies have shown that most teens and young adults do not know that they are smoking nicotine, they think they are smoking water vapor when they are using Juul. Since nicotine is the prime ingredient in these devices, parents and school administrators are concerned.

Not only can nicotine be extremely addictive but it can be very harmful to teens and young adults in many ways such as:

  • Memory loss and attention loss for a developing teenage brain
  • Also increased risk for future addiction to other drug

Schools Educate about the Dangers of Juul E-Cigarettes

Parents and school administrators should worry about the long term effects of students using Juul or any other E-cigarettes.

Schools are trying their best to prevent usage of E-cigarettes on school grounds. Some schools have even installed detectors that scan the air for chemical changes and alert an administrator. Schools are also holding classes to review the dangers of using Juul with their students. They are also holding workshops to educate teachers and support staff on what a Juul is and how it works.

For more information about E-Cigarettes, the Juul device and the effects of using it check out the website www.tobaccofreekids.org

Additional Resources:

The Double Threat of Vaping

More information on E-Cigarette usage among youth from the Surgeon General

Image of Juul e-cigarette: By Mylesclark96 [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons


Added Sugar Amounts Now on Nutrition Facts Panel

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

Nutrition News: Added Sugar Now on the Nutrition Facts Panel

FDA_Nutrition_Facts_Label

By U.S. Food and Drug Administration [Public domain], via Wikimedia Commons

You may have already seen an updated Nutrition Facts label on products you’ve recently bought. Effective July 2018 the FDA will require that the Nutrition Facts label include a new category – added sugar. This category will be shown in the Total Carbohydrates section – on a separate line.

The FDA says that added sugars, “include sugars that are either added during the processing of foods, or are packaged as such (e.g., a bag of table sugar), and also includes sugars from syrups, honey, and concentrated fruit or vegetable juices.”

This is another step in a series of efforts to help all of us make better food choices and minimize our risk of obesity and chronic conditions such as cardiovascular disease and diabetes. Many medical studies have shown that those chronic diseases of adulthood often begin in childhood. The American Heart Association (AHA) also believes there is strong evidence that atherosclerosis starts in childhood – and a poor diet, especially one with a high sugar intake may be the culprit.

How Much is Too Much?

American Heart Association Recommendations on Sugar Intake for Children

AHA guidelines suggest a limit of 25 grams or less of added sugars per day for children – only 6 teaspoons. These new recommendations also advise limiting the intake of sugar sweetened beverages to one or fewer 8 oz. servings per week.

Furthermore, for kids under age 2 the recommendations are even more stringent – the AHA recommends avoiding all added sugar. For perspective, one 12 ounce sweetened beverage could contain 40 grams of sugar (9 teaspoons.)

How does that compare with the typical intake of added sugar by children? Studies show that most kids are consuming an average of 80 grams of added sugar per day – more than 3 times the recommended amount.

Focus on Natural Sugars: Reducing Sugar Consumption for Children with Diabetes

fruitChildren with diabetes already need to monitor their food intake to manage their condition. By moving focus away from processed foods with lots of added sugar to whole foods like fruits, vegetables and dairy items, children will get better nutrition. Whole foods with naturally occurring sugars also provide vitamins, minerals, fiber and antioxidants instead of empty calories.

Remember to read nutrition labels as you shop and try out new fruits and vegetables. Watch portion sizes and limit sugar sweetened beverages. Why not get your entire family on the healthy eating bandwagon for a healthier future?

Additional Resources

The New and Improved Nutrition Facts Label – Key Changes

AHA Statement on Added Sugar Consumption by Children

Diabetes Rates Rise Among Children and Teens


Fun Kids Asthma Awareness Activities

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

What’s better than sharing a fun website with your kids? Here is one to help them learn more about asthma for Asthma Awareness month. The name of the website is NoAttacks.org which is sponsored by the EPA.

When you visit the website you will be drawn in by all of the bright colors and fun activities. You will see different sections that you and your child can click on to learn more about asthma attack prevention and also tips on how to come up with an asthma action plan.

asthma triggers

Kids’ Stuff

In this section you’ll find downloadable books to read and coloring books.
There are also other fun activities from crossword puzzles to seek and find that will help you and your child learn more about asthma and asthma awareness.

air quality

Media Center

In the media center, watch and sing along with The Breathe Easies. The group sings about how to stop your asthma triggers in your home.

The Breathe Easies songs are available in five different languages, English, Spanish, Lakota, Navajo, and Anishinaabe.

breathe easies


Diabetes Rates Rise Among Children and Teens

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

The New England Journal of Medicine recently reported that new cases of both type 1 and type 2 diabetes are on the rise in youth. Estimates indicate that in the United States, 29.1 million people live with diabetes. About 208,000 of those are younger than 20. While Type 2 diabetes has a strong correlation with excess weight, type 1 diabetes is an auto immune condition.

The study’s goal was to reveal trends in newly diagnosed cases of diabetes within various ethnic groups. Research revealed that from 2002 to 2012 the rate of new cases of type 1 diabetes in youth went up approximately 1.8 percent each year. During the same time period, the rate of new cases of type 2 diabetes went up quicker, at 4.8 percent.

Diabetes Rates Rise: Other Findings in the Report:

  • Higher Type 1 Rates in Male Participants. Across all groups, the rate of new cases of type 1 diabetes increased more annually from 2003-2012 in males (2.2 percent) than in females (1.4 percent) ages 0-19.
  • Hispanic Youth Showed Largest Increase of Type 1. Among ages 0-19, the rate of new cases of type 1 diabetes increased most in Hispanic youth, a 4.2 percent annual increase.
  • Type 2 Rates Highest Amongst Native Americans. Among ages 10-19, the rate of new cases of type 2 diabetes rose most sharply in Native Americans (8.9 percent), Asian Americans/Pacific Islanders (8.5 percent) and non-Hispanic blacks (6.3 percent).
  • White Youth Showed Smallest Type 2 Increase. The smallest upturn was seen in whites (0.6 percent).
  • Higher Type 2 Rates in Female Participants. The rate of new cases of type 2 diabetes rose more sharply in females (6.2 percent) than in males (3.7 percent) ages 10-19.

Increased Health Care Burdens and Reduced Quality of Life

Living with diabetes from a young age sets up a longer lifetime of increased health care costs. It also creates potential for diabetes related complications. Efforts are underway by organizations like the Centers for Disease Control (CDC) to find ways to prevent or delay youth from developing Type 2 diabetes, which has become more common in recent years.

Since the cause of Type 1 diabetes is still unknown, more work is needed to find out possible disease triggers that leave the body unable to produce adequate insulin. This study’s insights into the varying rates of diabetes by ethnic group may lead to new research directions.

Additional Resources:

New England Journal of Medicine Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002-2012

CDC National Diabetes Prevention Program

Exercise and Blood Sugar Control for Kids with Diabetes


CDC Reports Drop in US Asthma Rates

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

The Centers for Disease Control (CDC) recently released data on the state of childhood asthma in their CDC Vital Signs: Asthma in Children – United States report. The news is good – there has been a drop in asthma rates. The number of children that experienced an asthma attack in the past year has declined with the overall rate dropping 8 % since 2001. Asthma is a prevalent chronic lung disease effecting 6 million children in the United States.

While this is good news in terms of quantity of attacks, the data did reveal that despite fewer attacks one in 6 with asthma still end up in the emergency room and one in 20 are hospitalized for their condition each year.

Other Findings in the Report on Asthma Rates:

  • The rate of hospitalizations for children with asthma fell from 10 percent in 2003 to about 5 percent in 2013.
  • Children with asthma are missing less school – on average 2.6 days per child in 2013.
  • More kids with asthma are learning the signs and symptoms of an asthma attack and how using an asthma action plan can improve their control.

Green, Yellow or Red: What is Asthma Control?

Traffic LightWell controlled asthma means that your child is in the GREEN zone of the asthma action plan. Good control implies that your child’s symptoms such as coughing, wheezing or shortness of breath occur only two or fewer days per week.

Other indications of well controlled asthma include restful sleep where symptoms don’t wake your child at night. Asthma should also not affect any of your child’s daily activities. Lastly, your child shouldn’t need to use their quick-relief inhaler very often, no more than two days per week.

Knowing your child’s best rate of air flow, as measured by a peak flow meter, is another tool to monitor their asthma control. Air flow measurements that drop below 80 % of their personal best levels may indicate it is time for medication.

Is your Asthma Action Plan Up to Date?

Every child with asthma needs their own customized asthma action plan. Your healthcare provider or asthma educator can help you create one – or help you update an existing plan.

Key Asthma Action Plan Details

  • What medicines to take and under what circumstances
  • List of asthma triggers
  • What early symptoms to watch out for
  • Instructions on how to manage a serious attack and when to seek emergency care
  • ‘Personal Best’ air flow as measured by a peak flow meter for comparison

Additional Resources

CDC Vital Signs: Asthma in Children – United States

Community Care of North Carolina: How to Create an Asthma Action Plan

FAQ: Are You Asthma Aware?


Exercise and Blood Sugar Control for Kids with Diabetes

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

There are many good reasons for anyone with diabetes to participate in a regular exercise program. But what are the important considerations about exercise and blood sugar control for kids with diabetes?

children-exercising-diabetes

Exercise can stabilize blood sugar levels and help maintain a healthy weight. Excess body fat prevents insulin from working to its full potential to control blood sugar. Another benefit of regular exercise is stress reduction and relaxation. Exercise is fun, especially when you are playing your favorite sport with your friends!

Preventing Low Blood Sugar – Hypoglycemia

Every diabetic knows the importance of planning in the successful management blood sugar. Regular blood sugar testing, or the use of a continuous glucose monitor, along with meal planning are all parts of comprehensive diabetes management plan. One consideration for active children, especially those participating in organized sports is the prevention of hypoglycemia.

Activities done for a long period of time, even at a moderate pace can cause the blood sugar levels to drop precipitously, even hours after the activity has ceased.

Keep coaches in the loop. They can assist with extra testing and have quick sugar snacks available, like fruit juices, hard candy, or honey. Coaches should know the signs of both low and high blood sugar, and keep handy instructions about what to do if either situation occurs.

Symptoms of Low Blood Sugar (hypoglycemia):Sweating, lightheadedness, shakiness, weakness, anxiety, hunger, headache, problems concentrating, and confusion

Symptoms of High Blood Sugar (hyperglycemia):Frequent urination, fatigue, increased thirst, blurred vision, and headache

Hyperglycemia and Dehydration

When your muscles work hard they signal for the body to release extra glycogen from storage in the liver. If this excess glucose is not needed, and the amount of insulin doesn’t match the blood glucose, hyperglycemia (too much blood sugar) can result.

Shorter intense activities – like sprinting or weight lifting may actually cause a rise in blood sugar. The body sees the energy expenditure uptick and releases stored glycogen from the liver. If the activity level is not maintained, the body can’t use the excess sugar and blood sugar levels go up.

Unfortunately the body tries to remove the excess glucose through increase urination – which can contribute to dehydration. As with all athletes, children with diabetes need to stay well hydrated during any physical activity. The excitement of competition can produce extra adrenaline, which can also raise blood sugar.

Planning is the Key

Your healthcare provider may recommend a change to insulin dosing on the days when your child has practice or a game where there will be a higher level of physical activity. Tracking blood sugar levels before, during and after activity can give valuable information to your child’s healthcare provider to adjust dosing schedules.

Get to know how your child’s body reacts to different kinds of activity. To prevent the worry of blood sugar swings consider adding a continuous glucose monitor (CGM) to your child’s diabetes management program. (link to 411 on CGM blog) A CGM will provide 24/7 updates on blood sugar levels and trending information.

A Lifetime of Fitness

Family Taking a WalkEveryone can appreciate the long-term benefits of fitness – improved functioning of your heart, lungs, and other vital body systems. Exercise enhances flexibility and increases muscle strength.

Even if your child does not play on a sports team you can still plan activities as a family to keep everyone moving. Ask your child to suggest activities for your family as they are much more likely to happily participate in activities that they already enjoy.

Additional Resources:

WebMD’s Safe Exercise Tip List for Children with Type 1 Diabetes

How to Exercise Safely with Type 1 Diabetes

The 411 on CGM


5 Keys to a Fun and Safe Summer Camp Experience for Kids with Asthma and Allergies

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

Summer may seem years away when you are wearing a scarf and lots of layers on a cold winter’s day. It will be here before you know it. What is your favorite memory of summer camp? Do you have happy memories of canoeing, campfires or maybe even sleeping under the stars? Summer camp is a time for all children to spend time on their own, make new friends and try out new activities.

As a parent of a child with asthma you already have many ongoing concerns about their daily environment and its impact on their lung health. Your apprehension is normal. As we have discussed in other asthma related posts, advance preparation is always the best strategy when choosing any activity for your child with asthma.

Summer Camp Fun

  • Consider both Traditional and Asthma-focused Camps

    An asthma-focused camp may include educational components and have specially trained staff. Traditional camps can be okay too, especially if they are willing to make accommodations for your child’s asthma.

  • Not All Camps are Created Equal

    Remember that some camps may be more asthma friendly than others. Consider your child’s specific triggers and allergens. Those who are very allergic to animals might be better off at a nature camp vs one centered on horseback riding. Those with high mold sensitivities might be better off at a camp with air conditioned cabins.

  • Review Camp Medication Administration Guidelines

    Check in with camp staff in advance to find out how medication is administered. Research how they manage daily, rescue and emergency medications. Ask your questions before camp begins. Find out which medications your child can keep with them and self-administer. Ask if they can keep rescue inhalers and epi pens with them at all times.

  • Food Concerns – From Campfire Treats to Dining Hall Delicacies

    Don’t forget about food allergies. Check out the meal and snack offerings. If your child can’t enjoy typical camp treats due to allergies see if you can send along some substitutes in advance so your child won’t feel left out.

  • Before, During and After

    Work with your child’s healthcare provider or asthma specialist to create a before, during and after plan for camp.

    Before: Are all of their medications up to date, including dosage changes related to your child’s growth since last summer.

    During: Update or create an asthma action plan to include situations that might arise at camp if your child is exposed to a trigger or allergen – whether known or new.

    After: At the conclusion of camp check in with the staff to ask how things went. This will help you plan for future camps. Don’t just ask about your child’s asthma. Ask your child about their favorite (and not so favorite) parts of their time at camp.


Camp Victory Junction

Children with chronic medical conditions, such as asthma, and others with serious illnesses that would preclude them from attending a traditional summer camp program should look into the options at Camp Victory Junction.

This summer, children ages 6 to 16, with asthma can register for Camp Victory Junction in Randleman, NC. The week of July 15-19 is designated especially for kids with heart, lung, kidney, and immunological diseases. Camp Victory Junction provides a typical camp experience within a medically-safe environment.

Additional Resources

Traveling with Asthma

The Sunshine Vitamin

Children’s Asthma Camps – Find a Camp (Nationwide search)

Participating organizations include: American Lung Association, American Academy of Allergy, Asthma and Immunology, American Academy of Pediatrics, Asthma and Allergy Foundation of America, and the American Thoracic Society.

About Camp Victory Junction

Victory Junction enriches the lives of children with chronic medical conditions or serious illnesses by providing life-changing camp experiences that are exciting, fun and empowering; all in a medically-safe environment at no cost to the camper or their family.

Located in the hills of Randleman, North Carolina, Victory Junction is spread across 84 acres, allowing children to do what they do best— be kids, play, imagine, make friends and enjoy the adventures and experiences of camp life.


Summer Camp for Everyone: Even Kids with Diabetes!

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

CampfireMany of us have fond memories of summer camp like singing around campfires, roasting marshmallows, creating arts and crafts treasures and swimming in cool refreshing lakes. Perhaps we’ll try to suppress the memories of itchy mosquito bites, rain soaked clothing, and ‘interesting’ food offerings. Good or bad, summer camp is definitely a rite of passage.

Even though the New Year has just begun summer will be here before you know it. It might be time to plan how your children will be spending their summer. If you are a parent of a child with diabetes, you have more to consider than the typical parent as you choose a summer camp program for your child.

Advance Preparation Will Reduce Anxiety and Worry

It is completely normal for parents to feel anxious about dropping their child off at an overnight summer camp. As we have discussed in other posts about diabetes , the key to managing diabetes centers on planning and preparation.

  • Research Options: Take time to investigate camp choices based on your child’s interests. Don’t focus solely on managing their disease.
  • Ask for help: Determine what services or accommodations your child may need during camp.
  • Document Needs: Gather documentation and create a written plan of care with your child’s healthcare provider.
  • Communicate: Connect with camp staff and open lines of communication as soon as possible.
  • Network: Check in with other parents that have sent children to programs in consideration. Ask your healthcare provider for additional ideas.

 

The American Diabetes Association notes that any camp should be prepared to make reasonable modifications so that any child with a chronic disease, like diabetes, can take full advantage of camp programs and activities like any other child.

Camp Victory Junction

Children with chronic medical conditions, such as diabetes, and others with serious illnesses that would preclude them from attending a traditional summer camp program should look into the options at Camp Victory Junction.

This summer, children ages 6 to 16, with diabetes can register for Camp Victory Junction in Randleman, NC. The week of June 17-12 is designated especially for kids with diabetes. Camp Victory Junction provides a typical camp experience within a medically-safe environment.

Additional Resources:

Traveling With Diabetes

Diabetes Tips: Making Sure Its In The Bag

American Diabetes Association: Rights of Children with Diabetes in Camp

Find a Camp – Nationwide Search

About Camp Victory Junction

Victory Junction enriches the lives of children with chronic medical conditions or serious illnesses by providing life-changing camp experiences that are exciting, fun and empowering; all in a medically-safe environment at no cost to the camper or their family.

Located in the hills of Randleman, North Carolina, Victory Junction is spread across 84 acres, allowing children to do what they do best— be kids, play, imagine, make friends and enjoy the adventures and experiences of camp life.


Diabetic Resolutions to Start 2018 off Right

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

ShutterstockThe New Year is right around the corner. This is a time for reflection and planning. Have you thought about what you would like to change in the coming year? Many people resolve to get more exercise, eat healthy, lose weight, spend more time with family and friends, etc. at the beginning of a new year. Diabetics usually are a little more specific with their resolutions. Here are some ways to start the year in optimal health.

Check in With Your Doctor

  • If you aren’t already, make sure to see your doctor two to four times this year
  • Review and continue to follow your testing schedule, tweaking if necessary
  • Make note of your most recent A1C, blood pressure, and cholesterol numbers
  • Start or review your meal plan with your diabetes educator, tweaking if necessary
  • Don’t forget to get a renal function and microalbumin test

 

Get Moving!

  •  Ramp up physical activity.  Remember something is better than nothing at all.
  • Take your medications exactly as they are prescribed

 

Care for Your Whole Body

  • Get an annual eye exam
  • Go to the dentist twice per year
  • Examine your feet for cuts and/or sores daily
  • Brush and floss daily
  • Get your flu shot

 

Don’t Bottle Up Stress! Deal With It Right Away Using One of These Techniques

  • Deep breathing
  • Learning to say no
  • Asking for help when you need it
  • Making time for you
  • Getting enough sleep (7-8 hours is ideal)
  • Exercising (with other people if that motivates you)
  • Seeing a counselor or social worker if none of the above approaches are effective

 

Although this is a long and possibly daunting list, it is realistic and doable.  With the help of your doctor, you can get 2018 started off on the right foot.  Share your resolutions with someone to hold yourself accountable.


Exercising with Asthma: Your Lungs Will Thank You

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

exercising with asthmaWe hear all the time from multiple sources to get more exercise.  Everyone has their reasons for not getting enough.  We all know we should do it more, but feel like we don’t have enough time or energy to do so.  If you suffer from asthma, you may fear that working out would make your symptoms worse.  Here are some of the best options for exercising with asthma

Exercising with Asthma: Best Exercises

  1. Walking – can actually improve one’s asthma symptoms if done long term and on a regular basis. It is recommended that asthma patients walk three times per week.  Remember to warm up and cool down just like with any other exercise.
  2. Yoga – allows us to control our breathing, which is beneficial for asthmatics because it can activate more areas of the lung.
  3. Biking – with the right pace, this is a great way to get your activity in and your stress level down.
  4. Golfing – the staggered activity of alternating swings with walking is great for keeping symptoms at bay, but be sure to check the pollen levels before heading out to the course.
  5. Running – keep your distance short and your pace moderate.
  6. Downhill Skiing — as long as you don’t try to tackle one of those black diamond slopes, this outdoor activity doesn’t require a lot of physical exertion, as the mountain does most of the work.
  7. Swimming – provided the pool doesn’t contain too much chlorine, the highly humidified, warm air breathed in while swimming can loosen mucus.

Exercising with Asthma: Best Sports

  1. Baseball – allows for breaks in activity to keep symptoms in check. Take a hit on your inhaler as needed while sitting in the dugout waiting to bat.
  2. Racquet sports – the players control the pace of the game, allowing for plenty of rest and water breaks.
  3. Softball – similar to baseball, players have adequate rest to hydrate, use their inhaler, and regroup.
  4. Volleyball – A little more intense, but the court is small, so players can move quickly in short bursts.
  5. Football – while sometimes annoying to spectators, this sport allows for many breaks between downs.

Activities such as cross-country skiing, basketball, and soccer are a bit too strenuous for asthmatics.  Cross-country skiing can dry out the airways with the cold air being a contributing factor.  Basketball requires too much running up and down the court while not providing enough rest time between plays.  Soccer players are in constant motion chasing the ball unless they are a goaltender.

Exercising in a way that works for you is great way to destress, which, in turn, can help keep your asthma symptoms from flaring up.  Always remember to consult your doctor before starting a new exercise program.  Keep your water bottle and inhaler with you at all times.  And remember, exercise should also be something you enjoy.

Additional Resources for Exercising with Asthma

Check out our previous exercise-related blogs for more information:

Regular, Moderate Exercise Improves Asthma Symptoms
Don’t Wheeze Your Way Through Exercise-Induced Asthma

 


Budget Your Calories for a Bountiful Thanksgiving

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

budget your caloriesThe year has flown by and Thanksgiving is only a few weeks away. For many, this holiday means overindulgence. For diabetics, it can be a very difficult time for many reasons. The hardest is resisting temptations. Who doesn’t love seconds or even thirds of their favorite dishes; i.e., mashed potatoes? An important thing to remember is “everything in moderation.” Here are a few tips to budget your calories and manage your blood sugar while still enjoying this wonderful time with family.

Stay on Schedule – Never Miss a Meal or Dose of Insulin

Set reminders on your smartphone for:

  • Meals and snacks to avoid a blood sugar dip
  • Blood sugar testing
  • Insulin doses

 

Budget Your Calories: Indulge in Sweets and Treats in Moderation

You can indulge in a few treats, but make sure to budget for those calories. Work treats into your existing carbohydrate budget instead of adding to it. Stick with proteins, vegetables and salad at dinner. Pick your favorite carb or treat and enjoy it with your calorie budget for the day.

Enjoy Alcohol in Moderation

Never drink on an empty stomach, as this lowers your blood sugar. Research nutrition information in advance for your favorite libations to make good choices. It is recommended that women with diabetes have no more than one drink per day and no more than two per day for men. The serving sizes vary depending on the type of drink.

One serving is:

  • 4 ounces of wine
  • 12 ounces of beer
  • 1 ounce of distilled spirits

 

Download Mobile Apps

Look for apps that help you count carbs for your favorite dishes, as well as how much insulin you need to take before meals.

Look for Lighter Menu Options When Eating Out

Choose dishes with less saturated fat, limit fried foods and sugars. Ask about substitutions. Most restaurants can accommodate your requests. Swap out butter with olive oil. Enjoy a baked or boiled potato in lieu of mashed potatoes or French fries.

If Asked to Bring a Dish, Cook a Light and Healthy One

This can put you at ease knowing that you can enjoy what you’ve prepared and takes out the guesswork of whether or not it is within your calorie budget.

Tips for Holiday Parties

Scan the table and look for vegetable-based options first, followed by meat or cheese. Use a napkin instead of a plate to keep your portions in check. Don’t socialize in front of the food table. Stay hydrated. Keeping water or a club soda in hand will also keep you and your hands full so you are less likely to overindulge.

Stay Active

Make it a priority to stick with your regular fitness routine while you are away from home. The holidays are generally the busiest time of the year for many people. You can break up your activity into 10-15 minute segments if it is not possible to get 30 minutes all at once.

Remember that there is a lot more to Thanksgiving and the holiday season than food. Focus on spending quality time with family and friends. Enjoy what you do eat and relax.


Six Best and Worst Foods for Asthmatics

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

fruitAsthma is a challenging, but very treatable illness. There are many medications and tools available to help relieve symptoms. Did you know that asthma prevention can start in your kitchen? Not all foods are created equal. What foods might be best for asthmatics? There are even healthy foods that may worsen your asthma symptoms.

Foods That May Improve Asthma Symptoms and Support Your Respiratory System

1. Apples – these contain flavonoids such as khellin, which has been shown to open the airways.
2. Cantaloupe – these are rich in Vitamin C, which we already know is good for our immune system. This vitamin aids in clearing out congestion in the airways.
3. Carrots – these contain beta-carotene, which is an antioxidant that is converted to Vitamin A. This vitamin can reduce the possibility of exercise-induced asthma.
4. Coffee – Coffee is a natural source of caffeine, which has been proven to improve airflow. On the other hand, caffeine (especially in high doses like that found in coffee) is not recommended for children for various reasons.
5. Flax seeds – these are rich in Omega-3s, which research has found to be beneficial to asthma. They also contain magnesium which relaxes the muscles surrounding the bronchi and airways, keeping them open.
6. Garlic – Garlic is an anti-inflammatory. Anti-inflammatories are beneficial to asthma because they reduce swelling and mucus production in the airways.

Potential Allergens and Intolerances That May Worsen Asthma

1. Eggs – Because many people already suffer from an egg allergy, the reaction when consuming eggs can be in the form of exacerbated asthma.
2. Peanuts – Another common allergen. Severe reactions can be fatal. Those with a peanut allergy can actually develop asthma.
3. Salt – Salt contributes to inflammation by causing fluid retention.
4. Shellfish – Yet another common allergen, particularly in children.
5. Wine – Studies suggest that the sulfites in wine may trigger asthma attacks. On the other hand, red wine has been found to lessen symptoms if consumed in moderation.
6. Milk – If you are lactose intolerant or have any other dairy-related allergy, consuming milk products can cause wheezing, coughing, and other respiratory problems. On the other hand, milk contains Vitamin D, which can ease symptoms.

We hope that this information has given you some food for thought. Ask your doctor if dietary changes could be included as a part of your asthma management plan. He or she may also be able to test you for food-related allergies that might be exacerbating your symptoms.

Additional Resources

Read our blog on How to Manage Food Allergies During the Holidays

Check out the Asthma and Allergy Foundation of America’s great online resource for kids with food allergies.


Insulin Pump vs. Multiple Injection: The Choice is Yours

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

insulin pump versus multiple daily injectionsTreating diabetes can be a very time consuming, day-after-day process, but today’s diabetic has a plethora of different treatment options available — more than ever before.

Type 1 diabetics can choose between an insulin pump or administering multiple daily injections (MDI) for their insulin delivery. If you are not on a pump currently, you probably aren’t aware of just how helpful these devices can be.  Below are some advantages of both methods.

Advantages of an Insulin Pump

  • Insulin delivery is continuous, which helps prevent sudden highs and lows in blood sugar levels
  • Blood sugar control is more accurate
  • Patients need fewer needle sticks
  • Patients have more flexibility
  • Dosage can be adjusted easily according to the patient’s activity level: i.e. while exercising or sleeping

Advantages of Multiple Injections

  • Injections require less training and education
  • MDI is less expensive
  • Easier to use
  • Not always connected to the body

What Does Research Show? Insulin Pump Versus Multiple Daily Injections

Recent studies suggest that insulin pump therapy may be slightly more effective than MDI when the patients received similar, proper training.  However, both methods have been proven to reduce HbA1c levels.  An insulin pump can improve quality of life in diabetics and allow them to be a little more carefree than those that use the MDI method.  The bottom line is to find the method that fits best in your life while keeping your HbA1c levels in check.

Many of the patients of Active Healthcare are benefiting from pump therapy.  We work with manufacturers to get the right pump for our patients, as well as carry all of the necessary supplies.

Please visit our Diabetes Management page for more information on how we can help you, as well as talk to your doctor to see if they think a pump is the right method for you.


Music to Our Lungs: How Making Music Can Help Asthma

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

Music is a wonderful stress release for many people. For some, the release comes from listening to the music and relating to the lyrics. It strikes a chord inside of us all. For others, making music is the release. Whether you play an instrument or sing, you are successfully dissolving the stress of your day-to-day. Congratulations! You have found an outlet.

You might think that asthma would make this more difficult and less enjoyable. Good news! You can still make music and be symptom free. Playing a wind instrument can actually make the asthmatic more aware of his/her breathing, as well as improve their posture. They feel calmer and more in control, which will make it less likely that they will suffer from an asthma attack.

Many children make music their extracurricular activity and/or attend music class during their regular school day. If your child is interested in music as a hobby, but suffers from asthma, there is hope. Talk to his/her doctor for tips on how they can manage this while participating in music class, band, orchestra, or chorus.

If your child is interested in band or orchestra

Certain instruments are better than others at helping asthma sufferers both with their symptoms and stress levels. Some good ones are:

  • Drums — gives the musician a great cardio workout
  • Strings — increases finger dexterity and motor skills
  • Trumpet — requires copious amounts of fast, high-pressure air
  • Trombone — requires a lot of free-flowing air
  • Flute — requires the most air out of all wind instruments
  • Oboe — the reed creates high levels of pressure, causing the player to carefully control their breathing

 

For children who like to hear the sound of their own voice

Chorus may be the better option. Asthmatic vocalists benefit from the controlled, deep breathing that singing requires.  Trained singers know that breathing from their diaphragm is the only way to go, which keeps them from feeling breathless.

Music instructors will assist you with controlling your breathing in such a way that you are not even thinking about your asthma while making music.  If you are performing and feel your chest tighten (a familiar sensation for those suffering with asthma), pull out your inhaler in between songs to regroup.

Remember to share any concerns with your doctor.  They can work with you to adjust your treatment to incorporate any new hobbies or activities.  Music can help the asthmatic patient manage their stress better, which, in turn, can help them manage their asthma better.

 


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 Leave a comment   , , , , ,

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.


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