Children's Health Archives - Active Healthcare

Telehealth Considerations for Asthma Patients

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

Telehealth has been around for a while, but during the COVID-19 pandemic its use grew dramatically. COVID-19 has made many of us consider telehealth visits vs in-person ones. For some practitioners that was the only way they saw patients during the pandemic. This healthcare delivery method has advantages for both the practitioner and patient.

Recent studies from the National Institutes of Health showed that 30% of outpatient visits during the pandemic utilized telehealth. While overall medical visits were down, the use of telehealth increased 23 times when comparing months prior and during the COVID-19 pandemic period that began in March 2020.

Telehealth visit advantages:

● Scheduling convenience – less time missed from school or work
● Patients may miss fewer appointments
● Lower costs – telehealth visits are cost effective for families
● Expanded options – visits to out of town specialists are possible without travel
● Increased efficiencies – telehealth visits can allow more time for patient education
● Reduced risk of infection – online visits limit exposure to others and potential contagions in the healthcare practitioners office

Telehealth visit challenges:

● Technology is required for both the patient and practitioner for a successful telehealth appointment including high speed internet connections and web cameras or smart phones.
● Some patients may not be comfortable meeting with healthcare provider over the internet.

What should families consider in choosing between in-person vs telehealth visits?

While telehealth visits can work for an acute infection like strep throat they won’t always be appropriate for asthma patients.

Here are a few scenarios to consider a telehealth appointment for your asthma management:

● Prescription refills for your asthma medications
● Routine follow-up appointments when your symptoms are under control
● New or increased asthma or allergy symptoms that are under control
● Review mild medication side effects
● Asthma education needs like how to use equipment (inhalers, nebulizers) or your medications

However, if you need a test or if your provider needs to check vital signs or breathing, you will likely need to schedule an in-person visit. Examples of a reason for on in-person visit would include new or worsening symptoms that require increased use of a rescue inhaler.

Bottom line – out of control asthma symptoms needs urgent in-person follow-up!

Just like with any regular medical appointment remember to get organized prior to your visit:

● Prepare a list of questions for your healthcare provider
● Confirm what your insurance plan covers in terms of telehealth and any associated costs
● Check out your internet connectivity and test any portal logins prior to the appointment

Telehealth healthcare visits give patients more options to keep their asthma in control and manage symptoms. Check out if your provider uses telehealth and save some time and money on your next visit.

Additional Resources:

National Institutes of Health article: Patient satisfaction with telemedicine encounters in an allergy and immunology practice during the coronavirus disease 2019 pandemic

Centers for Disease Control article: Using Telehealth to Expand Access to Essential Health Services during the COVID-19 Pandemic

Hidden Spots for Germs: Home, Office and Doctor’s Office

Surviving Summer Asthma Flare-Ups

Image by Tumisu from Pixabay


4 Immune Boosting Foods for Kids

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

The famous quote by the Greek physician Hippocrates says,

“Let food be thy medicine, and let medicine be thy food.”

We’ve all heard about the benefits of adding immunity boosting foods to our diets. Check out these four immune boosting foods to add to your family’s eating plan.

Probiotics

Probiotics are living microorganisms that naturally occur in fermented foods such as yogurt, kefir, sauerkraut and some pickled foods. These ‘live and active cultures’ aid your digestion and also can help you fight off sickness. Yogurt is also a great source of vitamin D which also support our immune system.

Yogurt can make a healthy, immunity boosting snack for kids of all ages. Remember to read product labels and choose brands with lower amounts of added sugar. Consider making your own low-sugar blends by adding chopped fruit, nuts or a spoonful of all-fruit spread to plain yogurt.

Vitamin C

Vitamin C is a well-known immunity boosting food. This vitamin is thought to increase the production of white blood cells, which are key to fighting infections in the body.

A glass of orange juice is not your only option to increase vitamin C in your family’s diet. Consider eating more fruits and veggies that are high in vitamin C such as bell peppers, broccoli, sweet potatoes, and spinach. All of these fruits and vegetables make easy and tasty snacks and side dishes – red bell pepper slices, broccoli and ranch dip, and roasted sweet potato fries.

Zinc

Another immunity booster is the mineral zinc. Deficiency of this essential mineral can keep your immune system from working efficiently.

Zinc can be found in beans, seeds, nuts, meat, poultry and seafood. Nuts are a convenient and nutritious snack, and there are so many to choose from. Try adding chia or flax seeds to your oatmeal or muffins for a nutritional boost.

Ginger

Ginger is a well-known natural remedy for nausea. The flavorful root contains gingerol – a relative of capsaicin found in spicy peppers which may help reduce inflammation in our bodies.

Ginger can provide a flavor boosting punch to many recipes. Consider adding fresh ginger to a stir fry, soup, or a smoothie. Fresh ginger root can even be steeped to make tea!

Remember that it is always better to get your nutrients from whole food sources versus supplements. Don’t forget to consider any food sensitivities or allergies, especially for children with allergies and asthma. Check in with your healthcare provider if you have specific questions relating to your child’s nutrition and diet.

Additional Resources:

Five Healthy New Year’s Resolution Ideas for Families

Exposure to Healthy Foods on TV can Influence Kids’ Food choices

Immunity Boosting Foods

Vegetable Image by Maciej Rudnicki from Pixabay
Ginger Image by Joseph Mucira from Pixabay


Five Healthy New Year’s Resolution Ideas for Families

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

Have you already abandoned your New Year’s resolutions? Given that face, one wonders if it is worth it to make resolutions for our families. Many resolutions center on improving our health – like eating less fast food, losing weight or starting an exercise program. Set your family up for success in the New Year with these resolution tips.

Making Resolutions is Family Goal-setting

• Remember to get input from everyone in the family
• Set small goals – they will be more achievable
• Adjust your plan to be age-appropriate for all your family members
• Prioritize and focus on a few key goals
• Track your progress – use family meetings to remind and reinforce your resolutions

Five Healthy Resolution Ideas for Your Family

Reduce Screen Time – Yes that means your phone too!

Virtual school and COVID restrictions mean more time at home – this makes it even harder to avoid excessive screen time. Consider spending time outdoors, puzzles, or board game tournaments. Adults, kids and the whole family can find new hobbies or spend more time with current ones.

Make Healthy Eating a Priority – Say Yes to Fruits and Veggies and No to Diets

Rather than a hard to stick to diet that leaves everyone craving treats and sweets – commit to meal planning and cooking together. Why not try a new fruit or vegetable each week? Remember to include everyone in meal preparation and planning.

Increase Movement – All physical activity counts, not just traditional exercise programs.

If exercise or working out is a hard sell, increasing movement of all types can be fun and heart pumping – think dancing, trips to playgrounds, or nature-themed scavenger hunts.

Share the Load of Household Tasks – Everyone should help with chores

No one likes doing chores, but the old time adage, ‘Many hands make light work,’ is also true. The process is even harder if you expend more energy reminding kids (or adults) to do their chose. Other options to consider include a ‘chore jar’ where everyone can pick their assignment for the day or coming week.

Champion a Cause – Teach the importance of Community Service

New Year’s resolutions don’t just need to be about improving oneself, but can also look outward to our communities and world. Research and study to come up with a list of causes that are important to your family. As an example your family can support protecting the environment by composting, recycling and purchasing products made from recycled materials.

Embrace small changes and celebrate your achievements as you work to make new healthy habits as a family in the coming year. Good luck with your New Year’s resolutions. Let us know how it goes!

Additional Resources

Exercising with Asthma
Six Best and Worst Foods for Asthmatics
7 Tips for Teaching Kids How to Set Goals


Disposable Flavored Vaping Products Overlooked by Recent Federal Ban

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

Public health professionals, healthcare providers, and parents around the country were overjoyed when the Federal government banned flavored vaping products in February of this year. One of the most popular brands, Juul, had already pulled its flavored pods off the market in October 2019.

With the recent rapid increase in teen vaping, the new ban provided another pathway to limit their access to nicotine and its negative health effects.

Loophole in Federal Ban of Flavored Vaping Liquids

As it turns out flavored vaping products are still for sale – in disposable versions which are not excluded by the recent ban. These disposable products are designed for one time use and are available in many kid-friendly flavors.

Brands such as Puff Bar, blu, and Posh all sell disposable products for teens craving a vaping fix – with flavors like pink lemonade, mighty mint and mango bomb.

These new disposable vaping products are inexpensive and widely available.

Teen Vaping Statistics

The 2019 Youth Tobacco Survey revealed that 25% of HS students have vaped in the last 30 days. This is up from 21% the previous year, and double the rate in 2016.

Sweet and fruity flavors in vaping liquids cut the harshness of the tobacco. Researchers conclude that this will lead to users inhaling more deeply and in the process absorbing even higher amounts of nicotine versus a normal cigarette.

Advice for Parents

Lead with information not accusations.  If you suspect your teen is vaping or might have friends who are, start with the facts and your concerns versus putting them on the spot with a direct question like, “Are you vaping?”

Do your research. Check out some of the links below and learn about what products are popular, what they look like, and how they can be purchased.

Ask for help and support efforts to quit. Help and support your teen if they want to quit. Seek out online resources like the North Carolina Quit Line or the Truth Initiative.

Additional Resources

The North Carolina Quit Line – E-Cigarette Users
The Truth Initiative – Inspiring Tobacco Free Lives
The Vape Talk – Resources for Parents on Vaping
Parents Against Vaping – Parent ToolKit
It’s Not Just Water Vapor – Risk of Secondhand Vapor Exposure
E-Cigarettes: Continued Health Thread for Youth


Dealing with the Flu in Children with Type 1 Diabetes

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

Even when you and your family are doing all the right things to avoid illness you can still be unlucky and catch whatever is ‘going around.’ This time of year that means the flu. The 2019 – 2020 flu season has been quite severe with an estimated 31 million people sickened by the virus. More than 14,000 people have died, including almost 100 children.

Monitor Blood Glucose (BG) Levels

The body’s natural reaction to infection will effect blood glucose levels and control. When your child is sick, their routines are disrupted including their eating schedule and appetite which can further impact BG levels. Flu symptoms such as high fevers and sore throats can lead to dehydration and difficulty eating and drinking. The bottom line is that it may be much harder to control BG levels.

  • Consider monitoring BG and ketones more frequently while your child is sick
  • Maintain normal medication schedules
  • Keep normal eating schedules if possible and offer alternatives
  • Stay hydrated – adequate fluid will flush excess ketones and prevent dehydration that can raise BG levels.
  • Focus on carb-free and caffeine free beverages to minimize impact on BG levels

child cold or flu

Beware of Over- the-counter Medications (OTC) for Cold and Flu Symptoms

  1. Check ingredients: Cough syrup may contain added sugar that can worsen BG control.  Look for medications in pill form or sugar free options.
  2. Educate yourself about medication side effects: Acetaminophen may cause false readings on a CGM, Ibuprofen and aspirin can lower BG levels by interfering with the insulin metabolism. Decongestants like pseudo epinephrine can raise BG levels.
  3. Ask for guidance: Check with your healthcare provider for recommendations on OTC cold and flu medications.
  4. Consider non-drug treatment options first: These include fluids, cold compresses, humidifiers, and saline sprays and rinses.

Diabetic Ketoacidosis (DKA)

DKA is an acute complication that can occur in T1 diabetics when their body shifts from using glucose for fuel to ketones – which are derived from fatty acids. Children with the flu may be at higher risk for this serious condition.

Know When to Call your Healthcare Provider

Just like anyone else, children with T1D may need to see their healthcare provider when flu or cold symptoms worsen.

  1. Fever over 103 degrees or a fever that lingers for days without other symptoms.
  2. High BG levels and/or ketones in your urine – based on recommendation from your healthcare provider.
  3. Inability to keep food or liquid down, severe vomiting or diarrhea, decreased urination or other signs of dehydration. Lack of interest in eating or drinking.
  4. Difficulty breathing or blue lips.

If you think your child may have the flu your healthcare provider can test for it and prescribe antiviral medication. These drugs won’t cure the flu but may reduce the severity of the illness.

Additional Resources:

Recommendations from the CDC – Flu and People with Diabetes
Type 1 Diabetes Recommendations from the American Diabetes Association (ADA)
Tips for Managing Type 1 Diabetes at School


Exposure to Healthy Foods on TV Can Influence Kid’s Food Choices

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

healthy foods

Have you or your family made any New Year’s resolutions this year? Often times resolutions focus on our health. If limiting snacks or just eating a healthier diet is among your family’s New Year’s resolutions you might wonder about the impact of media on our food choices – both good and bad. Cooking shows are very popular and can focus on a type of cuisine, baking, or even tips for streamlining your family’s meal preparation.

A recent study from the Journal of Nutritional Education and Behavior gives new insight into how television cooking shows influence the eating habits of children.

Study Details

  1. 125 children ages 10 to 12 from the Netherlands
  2. Study participants viewed a ten minute child-oriented cooking program
  3. The study was conducted in a school environment
  4. Study participants were offered a snack to thank them for participating
  5. Snack offerings included healthy options such as apples and cucumbers as well as less healthy options such as chips and pretzels.

Study Findings

It is not surprising that some of the children who watched the cooking segment featuring healthy food options chose to eat a healthy snack. What is compelling is the magnitude of the effect.

Children shown the program featuring food preparation with healthy options were 2.7 times more likely to pick a healthy snack as a reward versus those who watched a program featuring unhealthy foods.

Study authors also noted that the cooking programs provided exposure to new healthy food options to children and their families. The cooking shows modeled portion control and showcased healthier food options in a positive light.

Make Healthy Eating a Family Activity

Research has shown that children are more likely to eat (or at least try) fruits and vegetables if they help prepare them. Cooking healthy meals for your family will require more preparation. Remember to involve your children in grocery shopping and meal planning too!

Poor dietary choices in childhood and adolescence can negatively impact health for a lifetime. Selecting healthy food options help our families maintain healthy weights and minimize the risk of diseases related to obesity.

Just like good food choices, remember to make good media choices for your family, for better health in the New Year and beyond.

Additional Resources:

Journal of Nutrition Education and Behavior Study
Using a Low Carb Diet to Help Treat Type 1 Diabetes
Added Sugar Amounts Now on Nutrition Facts Panel


Upper Airway Microbiome Offers Clues For Future Asthma Treatments

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

There has been extensive research on the microbiome of the human digestive system, but not as much study of the typical bacterium present in our upper respiratory system.

Your Microbiome – Good and Bad Bacteria

Scientists classify bacteria as either beneficial or pathogenic.

You may be familiar with beneficial bacteria found in fermented foods like yogurt that help us digest our food, absorb nutrients and maintain a healthy digestive system. Most of us have been exposed to pathogenic bacteria like the ones that cause strep throat (Streptococcus), pneumonia (Streptococcus pneumoniae) and food poisoning (Escherichia coli and Salmonella).

Study Details

The Yellow Zone Inhaled Corticosteroids to Prevent Exacerbations (STICS) was conducted at the Washington University School of Medicine in St Louis and funded by the National Institutes of Health (NIH).

While the study was seeking to investigate the effectiveness of significantly higher doses of inhaled corticosteroids at the first sign of an asthma attack, the review of the nasal mucous samples revealed a distinct difference in the bacteria profile of the study participant’s upper respiratory biome between control and asthma flare up.

The study found no benefit to the larger doses of medication at the start of an asthma attack.

 

Study participants included 214 children with mild to moderate asthma that were currently treating their asthma symptoms and flare-ups with inhaled corticosteroids.

Curious Results

Nasal samples were collected from study participants twice. First when their asthma was under control, and when the participants had the signs of an emerging flare-up – known as the “yellow zone”.

 

The study data revealed that a rapid change occurred in the airway microbiome of study participants as they transitioned from respiratory health to disease.

 

Asthma in control: Microbiome dominated by beneficial bacteria

Yellow Zone: Microbiome contained bacteria associated with diseases like pneumonia and strep throat – Staphylococcus and Streptococcus.

Future Research Opportunities

This study showed a link between the bacteria and asthma symptoms but did not prove cause and effect.

Future study of the upper respiratory microbiome will help asthma researchers in their development of new asthma treatments. These new treatments might target the bacteria present in the upper respiratory microbiome in hopes of preventing asthma symptom flare ups.

Additional Resources

Study Information – Washington University School of Medicine
The Human Microbiome
Wearable Asthma Informatics: Future of Asthma Care in Children
Hidden Spots for Germs: Home, Office and Doctors Office


Resilience – The Key to Combatting Adverse Childhood Events (ACEs)

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

The CDC’s Adverse Childhood Events Study (ACE study) revealed a remarkable connection between traumatic events in childhood and chronic diseases and social and emotional problems in adulthood. High ACE scores may mean significantly higher rates of heart disease, lung cancer, diabetes, depression and risk of suicide.

As you would expect, the higher your ACE score, the higher your risk of health issues in adulthood. Studies show with an ACE score of 4 or more your risk of a host of chronic health conditions increases by over 200%. Specifically the risk of depression increases by 400%; the risk of suicide by 1000%. Nearly two-thirds of adults have at least one ACE.

Staggering Statistics

  • An ACE score of 4 increases your odds of getting asthma by 73%
  • A traumatic event during childhood (just one ACE) can triple the risk of developing Type 1 diabetes.

Does a high ACE score sentence you to a life filled with chronic disease? 

Pediatrician Nadine Burke Harris believes the answer to that question is a resounding NO. She has personally seen the positive impact of interventional programs where healthcare providers and community resources work together to support those at risk.


Dr. Harris’ approach suggests the following:

  • Screen all patients routinely to determine ACE scores.
  • Provide additional support to families with children with high ACE scores including home visits from professionals, mental health care, nutrition counseling, holistic interventions, and if needed, medications.
  • Educate parents on the negative impacts of chronic stress
  • Increase treatment for patients with asthma or diabetics with higher ACEs scores.

Resilience and Children with Chronic Diseases

Can we train our brains to be more resilient in the face of personal struggles and health problems?  Here are a few tips on how to help your child be more resilient.

Focus on the positive – Encourage your child to connect with friends and other adults.  Support activities and hobbies where your child can build relationships with those with similar interests and build confidence.

Banish Blame –Children may feel guilty that they have a chronic illness. Empower them to live their best life and work through their chronic disease’s challenges.

ACE hugFight Stress – Have your whole family learn a new technique to relieve stress such as yoga, mindfulness, or mediation. Parents need to practice what they preach!

Validate Emotions – Children may have difficulty verbalizing what they are feeling. Listen first and always acknowledge their feelings.

Remain Optimistic – Life is a journey and your child and family may experience setbacks. Help your child set and strive for realistic goals.

Hug Often – Don’t underestimate the value of a hug as a tangible reminder of your love and support. Research shows that giving and receiving hugs reduces stress, and has a host of health related benefits.

We’re All in This Together

ACEs affect all of us directly or indirectly regardless of income level, and impact lifelong health and social well-being. Together, we can lessen these effects by teaching and learning resilience skills, and adopting trauma-informed practices and policies.

Check out some of the resources below for more information about ACE and how to build resilience to combat the effects of chronic stress.

Additional Resources

CDC ACE Study Website
How Childhood Trauma Affects Health Across a Lifetime – Ted Talk by Nadine Burke Harris, MD.
ACE Connections Blog
ACEs Quiz link
Six Skills to Help Build Resilience (narrated)
Building Resilience in Children
Wake County NC Resilience Initiative
Benefits of the 20 Second Hug


Halloween Ideas for Kids with Diabetes

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

Halloween is a beloved holiday for most kids, especially those with a sweet tooth. However, if you have a diabetic child you may be worried about blood sugar spikes that Halloween candy can bring.

Despite your child’s diagnosis, there are ways for them to enjoy Halloween with their friends and family. All it takes is some preparation and some creativity.

Here are a few ideas for a fun, diabetes-friendly Halloween for you and your family.

enjoy halloween diabetes

Instead of Trick or Treating, try these ideas:

Start a new Halloween tradition: Try a family dinner or movie night for Halloween fun without candy. Even a family board game night can be a great Halloween tradition, especially if the whole family gets dressed up in costumes.

Have a Halloween party: By organizing your own Halloween party, you have control over the treats and activities. This will allow you you to substitute diabetes-friendly alternatives to candy and other sugary snacks. If you offer plenty of spooky games and crafts, even your child’s friends may forget the lack of candy on the buffet table.

Tips for Diabetes-friendly Trick or Treating

Every family and every child with diabetes is different. If you and your child want to make trick or treating part of your Halloween this year, here are some tips that may help avoid blood sugar spikes.

Give neighbors alternative treats for your child: Before Halloween, you can give your neighbors non-candy treats or small toys for them to give to your child. Then, your child can have the fun of collecting treasures around the neighborhood without the worries that over-indulging in candy could bring.

Have a protein-rich dinner beforehand: Protein can help mitigate the effects of excess sugar. So before heading out for trick or treating, serve a protein-rich dinner to get your child’s blood sugar in the ideal range.

Find another home for the candy haul: Even those of us without diabetes know that eating a lot of candy at once isn’t a good idea. Once your child has collected a bag full of candy, there are many opportunities to re-purpose that extra candy for a better cause.

Save for Low Sugar Days – Pack up excess candy and use to combat low blood sugar. This allows your child to enjoy some candy when they really need it.

Halloween Fairy/Sugar Goblin – Many families have invented an imaginary creature that will exchange candy for a toy at night when your child is asleep. This can be a great way to avoid tantrums from lost candy with the excitement of a new toy.

Donation – Help your community by donating your extra candy to a homeless shelter, assisted living center, or other organization in need.

Start Planning Early for a Memorable and Diabetes-Safe Halloween

Every kid deserves a fun and safe Halloween. With these tips, you can make your child’s Halloween one to remember.

Additional Resources

13 Halloween Ideas for T1D Families – T1 Everyday Magic
Added Sugar Amounts Now on Nutrition Facts Panel


Using a Low Carb Diet to Help Treat Type 1 Diabetes

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

For children with type 1 diabetes, snack time isn’t always simple. Diet is an important part of a diabetes management plan to help avoid blood sugar spikes. But new research by endocrinologists at Boston Children’s Hospital suggests that food can be used as a powerful tool to help keep blood sugar under control.

low carb veggies

About the Study

Endocrinologists Dr. David Ludwig and Dr. Belinda Lennerz from Boston Children’s Hospital conducted an observational study on diabetic children who follow a very low carb diet. The children’s very low carb diets included on average only 36 grams of carbs a day.

The parents of these children were members of a Facebook group for families with diabetic children. The observational data was confirmed by the child’s doctors and analyzed using the latest techniques.

Here are just 3 possible benefits of a very low carb diet for children with diabetes.

Greater Glycemic Control

Children in the study had what the researchers called “exceptional” glycemic control. The common target range for hemoglobin A1c values are below 7%. However, children in the study had average hemoglobin A1c values at 5.67%, within the normal range for children overall.

Researchers are very excited at the prospect of diabetic children achieving normal hemoglobin A1c values with the help of diet. More research is needed to confirm the connection, but the possibility is an amazing development in the treatment of type 1 diabetes.

Less Complications

The study found that children on the very low carb diet had lower hospitalization rates than usual. Only 1% of the children were hospitalized for hypoglycemia and only 2% were hospitalized for diabetic ketoacidosis.

Boost Mental Health

High or low blood sugar is known to negatively impact mood, mental resilience, and overall brain health. For children with diabetes prone to high or low blood sugar spikes, mental health is especially important. For more information and other ways to improve mental health in your diabetic child, see our blog on mental health for teens with type 1 diabetes.

Diet can be a powerful tool in the management of type 1 diabetes.

Ask your doctor about whether a low carb or other specialized diet could be a good addition to your child’s diabetes management plan.

Resources

Very Low Carb Diet can safely curb blood sugar in type 1 diabetes, study suggests – Boston Children’s Hospital
Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet (Original Research) – Pediatrics
New Recommendations from the ADA: Management of Type 1 Diabetes In Children and Adolescents
Added Sugar Amounts Now On Nutrition Facts Panel


Wearable Asthma Informatics – Future of Asthma Care in Children

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

wearable asthma informaticsAn incredible amount of research has gone into childhood asthma in the last few years, leading to deeper understanding of the condition and better care for children with asthma.
New technology hopes to help predict a child’s asthma attacks before they occur. A wearable asthma informatics system is under development as part of an initiative of the US National Institutes of Health.

What is PRISMS?

This new asthma monitoring system is part of the PRISMS Initiative, which stands for Pediatric Research Using Integrated Sensor Monitoring Systems. A team of researchers from University of California-Los Angeles and the University of Southern California are developing an integrated platform of wearable sensors that can gather data about the environment of children with asthma and help predict asthma attacks.

How does the Asthma Informatics Platform Work?

The platform connects a variety of sensors and equipment using bluetooth and wi-fi, compiling all the data for health professionals. The platform includes the following:

Smart Watch: acts as a hub connecting to all other devices during the day and collects bioinformatics like activity level and heart rate.
Air Quality Sensor: attached to backpack or placed nearby and measures very small particulates in the air that can make asthma worse.
Medication Sensor: receptor in inhaler that records when medicine is taken.
Spirometer: measures the volume of breath twice a day, data is automatically sent to the system.
Smartphone app: includes questionnaires to gather data from the child about their environment.

How will PRISMS help asthma care?

With the data that PRISMS collects, medical professionals can identify patterns and help families identify asthma triggers. In the future, a platform like PRISMS could send alerts when sensors detect that an asthma attack is likely.

Overall, using the data from all children in the study, researchers hope to find new trends in childhood asthma. Patterns realized from the data of the children in the study may lead to new treatments and new environmental policies to keep all children healthy.

New Technology will bring better care for children with Asthma

In the future, portable medical health devices may be commonplace, and the data collected from systems like PRISMS will help make asthma care better than ever.

Resources

Predicting Asthma Attacks in Kids – Chemical & Engineering News
PRISMS Initiative – National Institutes of Health
Got Asthma or Allergies? There’s an App for That!


Tips For Managing Type 1 Diabetes at School

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

Back to School 3

 

The first day of school will be here before you know it. If your child has type 1 diabetes, there should be a few extra items on your back to school checklist to make sure that your child and their school are ready for the year ahead.

Here are a few important tips for an easy adjustment back to school:

1. Make a Diabetes Management Plan

Your child’s Diabetes Management Plan is an essential tool. Work with your doctor to draft a plan containing all important information concerning your child’s diabetes care. Include all medication details, symptoms of low blood sugar, target blood sugar range, and other important details those caring for your child should know.

2. Connect with the school nurse and other staff

Provide a copy of your child’s Diabetes Management Plan to the school nurse, administration, and all of your child’s teachers, coaches, and other supervising adults. If your child’s school does not have a full time nurse, figure out which staff members are best equipped to help if the nurse is not present.

All your child’s teachers should be aware of symptoms of low blood sugar, what your child needs to do to manage their blood sugar, and what help your child will need with those steps, if any.

In addition, your child should wear a medical notification bracelet or necklace that indicates their diabetes diagnosis. This guarantees that even substitutes or other rotating staff will be aware of your child’s condition in case of an emergency.

If needed, consider creating a 504 plan. A 504 plan is an official document that details the exact responsibilities of the school and ensures that your child has the same opportunities as all other students.

3. Pack their backpack with the essentials

Make sure your child has the tools they need for diabetes management during the school day. Build a compact kit full of testing supplies, antiseptic wipes, and backup insulin, as well as glucose tablets or other fast-acting snacks for raising blood sugar.

4. Get your child involved (as age appropriate)

As your child gets older, they should take on more responsibility for their diabetes care. Depending on the age of your child, help them identify their symptoms of low blood sugar. When your child has a greater understanding and more responsibility in their own care, they will have more confidence in the face of adversity at school and beyond.

Give your child the foundation they need to succeed in the New Year

With careful preparation, you can ensure that your child gets the most out of their school days, minimizing the stress from managing their diabetes.

Additional Resources

Tips for Managing Diabetes at School from the CDC
Monitoring Diabetes at School
Diabetic Tips: Making Sure It’s in the Bag


Back to School Tips for Kids with Asthma

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

back to school 2It’s that time of year again. A fun summer has come and gone and it’s time to start thinking about back to school. While stocking up on school supplies, don’t forget to prepare your child’s asthma plan for the new school year.

The American Lung Association has published a “Back to School with Asthma Checklist” for a smooth adjustment back to school for children with asthma. With careful preparation, your child can focus on enjoying their school days without worrying about their asthma.

Here are some tips for making this school year a good one:

1. Schedule a checkup before school starts

Summer is the perfect time to fit in a doctor’s appointment, since your child’s schedule may be less busy. Be sure to bring any forms required by your child’s school so that you can be prepared for meeting with the school nurse (See Tip #2 below).

Discuss how your child’s asthma treatment plan has been working in the past year. In particular, make sure your child knows how to use their inhaler and spacer properly.

Review your child’s asthma triggers, and make a plan to help your child avoid exposure at school. A summer checkup is a great time to discuss any troubles with allergies, which are common in children with asthma.

2. Get the school nurse on board

If your child is starting a new school, or has a recent asthma diagnosis, make sure that the school nurse is part of your child’s asthma team. First, make sure all necessary forms documenting your children’s medication are submitted timely so they can be processed before school starts.

With the help of your child’s doctor, write an Asthma Action Plan and share it with the school nurse. If your child’s school does not have a full time nurse, include the receptionist or other staff members in the Asthma Action Plan as well.

3. Don’t forget after school activities

If your child participates in an after-school activity, make sure your child’s coach or activity leader has access to your child’s Asthma Action Plan. It’s very important that those supervising your child know what an asthma emergency looks like and how best to help your child.

Make back to school easy with these tips

After a fun summer, transitioning back to school can be hard for many kids. If your child has asthma, keeping these tips in mind can make it easier.

Additional Resources

Back to School with Asthma Checklist – American Lung Association
Does Back to School Mean Back to Allergies?


It’s Not Just Water Vapor: Risk of Secondhand Vapor Exposure

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

It is hard to imagine that many people still believe that the vapor produced by e-cigarettes is harmless. They believe that the sweet smelling cloud produced by someone vaping nearby is just water vapor. The secondhand vapor from e-cigarettes actually contains many of the same chemicals that are found in traditional ones. These contaminants include propylene glycol, vegetable glycerin, nicotine and many different flavoring agents.

E-Cigarettes: Continued Health Threat for YouthNo one should be inhaling any of these toxic substances because they will all cause inflammation in your lungs. Asthma sufferers and those with allergies are especially at risk of exposure to lung irritants. Studies by the National Academies of Science indicate that e-cigarette use increases asthma symptoms such as coughing and wheezing.

The good news is that e-cigarettes are different from traditional cigarettes in one way, they only emit vapor when they are being used. 

New Research Based on the Florida Youth Tobacco Survey

The Florida Youth Tobacco Survey data (link to data) was the basis for some recent research to determine the connection between electronic nicotine delivery systems (ENDS) and asthma symptoms. The survey data indicates that e-cigarette use was up almost 600% from 2012 to 2018 in youth ages 11-17. The rate of youth trying e-cigarettes is also up over 350% in the same date range.

Survey Data Demographics:

  • Study based on surveys from almost 50,000 youth and teens.
  • 33,500 respondents were in High School and another 36,000 were in Middle School.
  • Respondents were evenly split by gender.
  • One-third identified as Hispanic, one-third are white, and one-fifth as African American.
  • About 75% of survey participants lived in large or mid-sized metro areas.
  • The research focused on the 11,000 respondents diagnosed with asthma.

 

Study Definition of Exposure to secondhand vaping aerosol:  Exposure to someone vaping either in the same room or in a car within the last month.

Secondhand vaping exposure increased the likelihood of an asthma attack by 27%, regardless of whether the children themselves smoked or vaped.


Tips for Parents

Juul e-cigaretteThe statistics on the rates of vaping are staggering. In 2018 the CDC reported that 20% of high school students vaped in the past 30 days. Smoking rates in the same age group are actually lower at only 8 percent. The rate of teen smoking continues to fall; it is 50% lower than it was in 2011.

The national rate of smoking in adults is 14% (2017), down from 20% in 2005. In contrast only 2.8% of adults use e-cigarettes.

Nicotine is toxic to children, even at minimal exposure levels. Their developing bodies are even more susceptible to environmental pollutants like nicotine and the other dangerous components of e-cigarette vapor.

  • Encourage your children to avoid secondhand vaping aerosols just like secondhand smoke from traditional cigarettes.
  • Educate family members and friends who vape to do so away from children and especially not in enclosed spaces.
  • Communicate with your children about the dangers of smoking and vaping so they know the risks.

 

If your child has asthma, consider adding limiting exposure to vaping in your child’s asthma action plan – due to the possibility of it triggering an asthma attack.

Additional Resources


Mental Health for Teens with Type 1 Diabetes

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

Research shows that diabetics are at higher risk for mood disorders and other mental illness. During the often tumultuous teenage years, it’s important for parents and caregivers of teens with diabetes to understand how diabetes and mental health interact.

Why mental health is crucial for teens with diabetes

teen mental healthAccording to the American Diabetes Association, diabetic teens tend to show 2-3 times the rate of psychological distress than their peers without diabetes.

Living with diabetes is not easy and can add to the other stress that teens experience. Stress has a negative effect on diabetes, leading to a feedback loop if both a teen’s stress and diabetes are not managed correctly.

Here are some tips for supporting the mental health of teens with diabetes.

Encourage independence

Every teenager wants to be more independent, including those with diabetes. New technology can make it easier than ever for teens to take on a larger role in their diabetes care. Cell phone apps can sync to continuous glucose monitors (see our previous blog “The 411 on CGM” for more information), allowing teens to take initiative while their parents are kept in the loop with automatic updates.

Prioritize self-care

The busy lives of teens can leave no room for personal time to recharge. Especially during stressful times like finals, encourage your teen to take short breaks. Spending a few minutes to take a walk, listen to music, or do something else enjoyable can do wonders to lower stress.

Build a foundation of self-esteem and acceptance

Insecurity can cause teens with diabetes to try and hide their condition from peers. From a young age, educate your child about diabetes and how each part of their diabetes management plan is important. This will instill self-confidence and a greater sense of self-understanding in your child.

Be aware of warning signs

Early detection of psychological distress is important, especially for teens with diabetes. If you notice your teen has lost interest in their favorite activities or has unexpectedly lost or gained weight, check in with your teen and consider getting the help of a professional if needed.

Take care of your own mental health as a caregiver

Several studies have shown that caregivers of children with diabetes have a higher likelihood of depression. While caring for your child, don’t neglect your own mental health. Try joining a local support group for parents of children with type 1 diabetes. Talking with other parents in the same situation can do wonders to boost your outlook.

Wellness of body and mind for diabetic teens is possible

The teenage years are the best time to develop good habits for both physical and mental health. For teens with diabetes, these good habits allow a smooth transition into self-sufficient diabetes management in adulthood.

Additional Resources

ADA Position Statement

JDRF (Triangle/Eastern NC ) – Support Resources for Parents of Children with Type 1 Diabetes

CDC: Diabetes & Mental Health

Teen Focus: Dangerous Duo Type 1 Diabetes and Drinking

Can Diabetes Give You The Blues?

The Lowdown on Stress and Diabetes


Summer Camp for Everyone – Even Kids with Asthma!

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

Many families may already be planning for the upcoming summer. Attending camp is one of many rites of passage for children, and those with asthma shouldn’t have to miss out. We’ve previously shared tips for families of children with asthma on choosing and preparing for summer camp. This year we’d like to highlight a couple of summer camp options in North Carolina.

Camp Victory Junction: Heart/Lung/Kidney – July 14 – 18 2019

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 14-18 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.

Visit the camp website (https://victoryjunction.org/ ) for additional information about the schedule and registration.

Camp Coast: Helping Kids Control Their Asthma

The Vidant Medical center Pediatric Asthma program and Children’s Miracle Network in Greenville NC sponsor Camp Coast. This program includes day camps at a variety of locations like school and wellness centers. Weekend retreats are also offered throughout the year.

The fall weekend retreat is for children ages 7 to 17, along with their parents. This unique program includes all the activities you’d expect to experience at camp, along with educational sessions about asthma and tips to improve control of the disease.

Camp Coast is staffed by volunteer physicians, nurses and respiratory therapists.  These respiratory professionals are on hand to provide medical care and also observe campers’ medication administration to ensure proper usage for optimal treatment.

Transportation from Greenville to the camp location in Columbia, NC is available.

Visit their website for additional information and to contact camp staff about registration information. (https://www.vidanthealth.com/Programs-Support/Childrens/Camps)

Additional resources:

Children’s Asthma Camps – Find A Camp – Nationwide

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


New Recommendations from the ADA: Management of Type 1 Diabetes in Children and Adolescents

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

The American Diabetes Association recently shared an updated position statement on the management of type 1 diabetes in children and Adolescents. This statement is an update to their previous position statement issued in 2005. Their statement highlights the common sense idea that children are not just mini-adults. Treatment plans for children with Type 1 diabetes need to be tailored to both their current situation and their future growth and development.

The following areas were highlighted in the updated statement of recommendations for children and adolescents with Type 1 Diabetes (T1D):

  • Diagnosis of Diabetes
  • Blood Glucose Level Management
  • Lifestyle Considerations
  • Self-Management of Diabetes
  • Complications and Comorbidities
  • The Transition from Childhood to Adolescence and Adulthood

Diabetes Blood Glucose Testing

New Recommendations for Blood Glucose (BG) Management in Children and Adolescents

Most children’s T1D should be treated with insulin regimens with either multiple daily injections or via insulin pump therapy. Healthcare professionals should measure A1C levels of their non-adult patients at 3 month intervals. The target level of A1C should be 7.5 %. Patients or their caregivers should monitor BG levels multiple times a day, typically 6 to 10 times.

Medical devices such as insulin pumps and continuous glucose monitors (CGM) can be very helpful in the management of T1D. The ADA recommends that the CGM be considered in all children and adolescents, even though not using insulin pump therapy. Studies have found that compliant use such devices correlates with better BG control, lower A1C levels and reduction in hypoglycemic events.

Adjunctive Therapies for Children with T1D

One highlight in their recommendations between the management of type 1 diabetes in children versus adults is in regard to adjunctive therapies. They do not recommend the use of adjunctive therapies, such as the medication metformin in children. Clinical trials showed that despite the advantages of such therapies to help with weight loss or other diabetes comorbidities, there are more risks than benefits for children.

Check back next month for our follow-up blog talking about the unique behavioral aspects of managing diabetes in children and adolescents. We’ll focus on the challenges of self-management of their disease and other related health and wellness concerns.

Additional Resources

411 on CGM
Exercise for Children with Diabetes
ADA Position Statement


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


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