Blog - Active Healthcare

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


The Dangers of Hypoglycemia – New Educational Resources

Lisa Feierstein Diabetes Leave a comment   , , ,

One of the biggest fears of people living with Type 1 Diabetes (T1D) and their caregivers is a low blood sugar event, also known as hypoglycemia. While people with T1D may not recognize the signs of dropping blood sugar, most know how dangerous it can be if left unnoticed or untreated.

What is Hypoglycemia?

  • Low blood glucose levels – outside of your target range
  • Typically less than 70 mg/DL
  • Triggers your fight/flight response due to a release of adrenaline
  • If left untreated, may lead to seizure or coma.

What is Hypoglycemia Unawareness?

Diabetes Blood Glucose TestingHypoglycemia unawareness is a complication of T1D where the patient misses the typical symptoms of a blood sugar drop (palpitations, sweating, anxiety, etc.). When their body does not release adrenaline there are no warning symptoms and then they are at risk for life threatening complications.

Online Interactive Resource – Hypoglycemia Education

We recently came across a new educational resource about hypoglycemia from the ‘Diabetes Sisters.’ This online resource includes basic information about hypoglycemia as well as video-based and interactive learning, infographics and more. Topics include “What Does Hypoglycemia Feel Like?” and “How to Talk to Your Doctor About Hypoglycemia.”

Each topic includes videos, quick tips and a quiz to test what you’ve learned. Visit the website to test your knowledge and share with family and friends so that they can be familiar with the signs of low blood sugar and help you if needed. It is important that people with diabetes know the risks of hypoglycemia as part of your diabetes management plan.

Additional Resources

Diabetes Sisters – visit this online community to read stories of how others deal with the real life challenges of diabetes.

411 on the CGM

American Diabetes Association – Hypoglycemia (Low Blood Glucose)


Asthma and Allergy Awareness Month 2019

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

World Asthma Day - Stop for AsthmaEach May we celebrate Asthma and Allergy Awareness month. Additionally, the first Tuesday of May is also designated as World Asthma Day. This year it falls on Tuesday May 7.

The theme for this year’s World Asthma Day is ‘Stop for Asthma’. Each year the Global Initiative for Asthma (GINA) suggests activities to support asthma awareness in our communities.

Over 6 million children, and 26 million people total live with asthma in the United States.

We see the impact of asthma in missed days of school and increased emergency room visits due to out of control symptoms. Additionally sufferers often experience increased complications during respiratory illnesses like cold and flu.

Constant evaluation and adjustment of treatment protocols is the key to controlling asthma. Since there is no cure for asthma the goal is management of symptoms to improve quality of life.

Visit the CDC website for helpful resources for people with asthma, their friends and families, teachers, and coaches. Resources include tips for creating and updating your asthma action plan and how to use your inhaler. Check out the Meet the Challenge page for recommendations on asthma and physical activity.


Active Healthcare Donates Nebulizers

Active Healthcare Nebulizer Donation to WCPSSActive Healthcare recently donated a significant number of nebulizers to the Wake County Public School System. The nebulizers will be used in elementary schools by school nurses to help students manage their asthma.

Active Healthcare’s Back 2 Life Program works with local medical practices and community partners in the Triangle area of North Carolina to help facilitate various medical equipment supplies to needy patients.

We collect and refurbish the donated equipment. Visit our website donate nebulizer equipment you no longer need.

Additional Resources

World Asthma Day is an annual event organized by the Global Initiative for Asthma (GINA) to improve asthma awareness and care around the world. A staggering 300 million people worldwide live with asthma.

World Asthma Day - Stop for Asthma

Global Initiative for Asthma (GINA) – sponsor of World Asthma Day

The CDC website has tons of resources for people with asthma and their families.

Test your asthma knowledge for Asthma and Allergy Awareness month: 7 Asthma Myths


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 OTC Primatene Mist Approved By FDA

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

Should you consider using it as part of your Asthma Treatment Plan?

Primatene Mist ® was removed from the market back in 2011 due to the propellant used in the inhaler medication. Late last year the FDA approved a new over-the-counter version of the drug, which is now widely available. This new version uses the same active ingredient but does not contain CFCs (chlorofluorocarbons) which are known to deplete ozone in our atmosphere.

Asthma Experts Urge Caution

A number of asthma organizations have voiced strong concerns over the new Primatene Mist inhaler since it creates the impression that the management and treatment of asthma is a do-it-yourself proposition. Asthma is a chronic condition that requires ongoing management with your healthcare provider – whether it is mild, moderate or severe.

As a chilling reminder: 10 people die every day from asthma related complications

The active ingredient in Primatene mist is racemic epinephrine. This medication is not a recommended asthma treatment and can also give a false sense of control by masking asthma symptoms.

Lack of control and the often associated over use of quick-relief medications leads to respiratory complications and sometimes death in people with asthma. Experts worry that this new over-the-counter medication option will only escalate that scenario. Out of control symptoms followed by over use of a medication that masks symptoms can in turn lead to life-threatening complications.

FDA Approval and Recommendations

Asthma Rescue InhalerFDA officials approved the new medication in hopes of providing another cost effective treatment option, especially to patients with mild asthma. The active ingredient in the medication is the same, just a new propellant to allow it to be administered via a metered dose inhaler and with new administration instructions.

The FDA has only approved the medication in patients over 12 years of age. They caution that the medication should only be used by those already diagnosed with asthma, and not to treat symptoms such as wheezing, chest tightness or shortness of breath that may be related to other conditions.

The Manufacturer Weighs In

Amphastar, the manufacturer of Primatene Mist, indicates the over-the-counter medication is to be used for “temporary relief of mild symptoms of intermittent asthma” on their product website.

A Plan for Asthma Control

Remember to always check with your healthcare provider before making a change to your or your child’s asthma treatment regime and asthma action plan. Check out these additional resources for more information about this new medication, tools to navigate treatment options and a refresher on understanding asthma control.

Additional Resources

FDA – Safely Using the Newly Available OTC Asthma Inhaler Primatene Mist

Shared Decision Making Tool developed by the American College of Allergy, Asthma, and Immunology (ACAAI), American College of Chest Physicians (CHEST), and the Allergy and Asthma Network

Asthma Statistics and Understanding Asthma control


Upcoming Diabetes Educational Event – Taking Control of Your Diabetes

Lisa Feierstein Diabetes Leave a comment   , , , , ,

Patient Education is one of our favorite topics here at Active Healthcare. We wanted to share the exciting news about an upcoming diabetes educational event coming to the Triangle area of North Carolina in a few months.

Taking Control of Your Diabetes (TCOYD) is a non-profit charitable educational organization that sponsors educational events in cities across the United States for people with diabetes, their families, and caregivers.

Taking Control of Your Diabetes“TCOYD educates, motivates, empowers and inspires people with diabetes — and family and friends who care about them — to take a more active role managing their diabetes, and being self-advocates. We do this by providing the best diabetes conferences & educational programs!”

Save the Date: TCOYD in Raleigh on Saturday May 11

This educational conference is for patients with both Type 1 and Type 2 diabetes. The conference has sessions specifically designed for each group. Attendees can get the latest info on their disease and treatment options via keynote speakers and breakout sessions. Lunch is included in the $25 registration fee. Conference goers will also have the opportunity to ‘Ask a Specialist’ (Endocrinologists, Diabetes Educators, Dietitians, Nurses, and Pharmacists), visit the event’s health fair, meet with equipment vendors and also participate in a number of free health screenings.

The Triangle event will be held at the Raleigh Convention Center on Saturday, May 11th.

Full Raleigh Conference Schedule

For those of you outside of the Triangle Area, check out the TCOYD website for their full schedule of 2019 events. The conference will be in Charlotte NC area this fall on Saturday, November 2nd.

Additional Resources

Check out the TCOYD website for additional educational resources including videos and blog posts.

New Recommendations for Treatment of Type 1 Diabetes in Children and Adolescents

Diabetes Rates Among Children and Teens


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

Lisa Feierstein Allergies, Asthma, Breathe EZ 1 , , ,

The winter season is peak time for cold and flu. Getting vaccinated against the flu is always a good idea but remember that germs are sneaky and can lurk in the most unlikely places.

Bacteria and viruses are spread by both direct and in-direct contact. A sick person can sneeze or cough near you. You might touch something that has been contaminated by a sick person who has passed by before you.

Remember that people with asthma can often be more susceptible to any respiratory illness. Small children are still working to build their immune systems. When they catch a cold or virus from other kids or pick up germs in their environment, they get sick and share the illness with their family members.

Germs in Your Office

Pens - clipboardsYour desk is ground zero for germs in the office. Recent studies showed that your desk can have 400 times more bacteria than a toilet seat. These unfriendly office visitors can survive up to three days on these surfaces. Everyone should disinfect their desk work surfaces including the keyboard, mouse and phone on a regular basis, but during cold and flu season it is even more important.

Don’t forget about shared work spaces like the break room, copy machines and shared workstations. At our office, we encourage those who are sick to stay home. Fellow team members have been known to swoop in to wipe down the desks and work areas of their contagious colleagues to keep the sickness from spreading.

Germs in Your Home

germs, cleaningThe dirtiest parts of your home include the kitchen sink and drain, along with the sponges and dish rags you use to wipe the counter or wash dishes.

Any location where water is present is highly susceptible to bacterial accumulation. Again, if someone at home is sick, you’ll have to step up your disinfecting efforts.

Germs at the Doctor’s Office

Many pediatricians’ offices separate ‘well’ and ‘sick’ children in different waiting areas. This can be a great way to avoid others who are coughing and sneezing if you are well. Since the same doctors and staff are caring for both sets of patients, here are a few ways to avoid germ magnets at your MD office.

Bring your own pens and reading materials. Test swabs show that those waiting room clipboard pens are far dirtier than door handles and waiting rooms chairs.

Don’t be afraid to ask the staff to wash their hands, especially after touching hand held devices and stethoscopes, and before touching you.

Bottom line, wash your hands frequently, avoid contact with people that are obviously sick, and schedule frequent cleanings around your home and office. As a favor to everyone one else, if you’re sick, stay home and rest rather than spread the contagion.

Additional Resources:

CDC Flu Information

Cold weather Tips for Asthma Sufferers

Five Flu Myths Debunked


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


Time To Rake the Leaves – Fall Allergy Season

Lisa Feierstein Allergies, Asthma, Breathe EZ 1 , , , ,

Many of you may think that the springtime is the worst season for allergy sufferers. Everyone has different triggers, so the fall can also be troublesome for those with allergies and asthma. During the fall we enjoy beautiful scenery as the leaves change from green to brilliant shades of red, yellow and orange. As the season progresses, all those colorful leaves fall, becoming an allergy trigger of their own.

Fall Allergy Triggers: Pollen and Mold Spores

Although each allergy sufferer has different triggers, many people are allergic to plants that produce pollen in the fall season, such as ragweed. Another common fall allergen is mold spores. Remember all those beautiful fall leaves? Once they fall and linger on your lawn they get rained on – creating a perfect environment for the growth of mold spores.

Fall Leaves

When you rake all those leaves into a big pile – maybe for the neighborhood kids to jump into or to compost or bag up for pickup, all those mold spores are released back into the air.

Once exposed, your body reacts to the triggers and you’ll likely have a runny or stuffy nose, itchy or watery eyes and an irritated nose and throat. Doesn’t that sound like fun!

Outdoor Yardwork Tips: Protect Yourself Before and After

Since you can’t escape the yard work, if you suffer from allergies you can take these steps to minimize your symptoms this fall.

  • Wear a filter mask, especially when raking leaves
  • Rake often giving less time for mold spores to develop
  • Choose long sleeves and wear gloves to minimize exposure to your skin
  • Avoid touching your nose and eyes during yardwork
  • Choose early morning and evening times for yardwork when pollen counts are lowest

Once your yardwork is complete remember to leave your shoes at the door and change your clothing to limit tracking allergens into your home. Shower as soon as possible as allergens will linger on your skin and hair.

Even if you are not doing yardwork, just going outside can trigger an allergy attack. Remember it is best to stay inside when you hear one of your neighbors firing up their leaf blowers!

Allergy Medications Can Help

You can also work with your healthcare provider to choose the best over the counter and/or prescription medications to manage your seasonal symptoms. Some medications need to be taken in advance of the season for maximum effect. Consider adding nasal saline irrigation on a regular basis during the fall months to clear mucous and allergens from your system.

Additional Resources:

House Plants and Allergens

Holiday Planning For Those With Asthma and Allergies

Climate Changes and Outdoor Allergies


Asthma Sufferers – Plan for Fun at the NC State Fair

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

Are you excited about the North Carolina State Fair?

Here are some pointers to help you enjoy all the fair has to offer, even if you have asthma.

October is Not Too Early for Flu Shots

The flu causes inflammation and narrowing of your airways which can in turn trigger an asthma flare-up.

People with asthma should always get their yearly flu shot to both avoid catching the flu and suffering its complications that can trigger asthma attacks.

Sheep and Rabbits and Ponies Oh My!

State FairOne of the favorite kid friendly attractions at the fair is the petting zoo. Take the proper steps to protect yourself when visiting all of the adorable baby animals. Close contact with animals can trigger an asthma attack because you may come in contact with proteins that are found in animal saliva, skin flakes, urine and feces.

Animal fur collects pollen, mold and other outdoor allergens that can be another trigger of your asthma symptoms. Remind your family members to wash their hands after visiting the petting zoo. Do not touch your eyes or any part of your face until you wash your hands!

Navigating Fair Food: Be Aware of Food Allergies

Each year the food vendors at the North Carolina State Fair come up with new and existing food offerings. In 2017 a few of the special treats on the menu were Deep Fried Key Lime Bites, Flamin’ Hot Cheetos Corn on the Cob, and the Blue Hawaii Funnel Cake. If you are unsure about what you are ordering, ask for an ingredients list. Those with severe food allergies may want to skip the fair food altogether and pack their own snacks. Always remember to keep food allergy medication on hand.

Watch for Exposure to Second Hand Smoke

Big crowds at outdoor venues can mean increased exposure to second hand smoke. If you are exposed to second hand smoke it is best to try to remove yourself from the area. Smoke will irate your airways and can cause them to swell and narrow. Secondhand smoke is harmful to children and adults with asthma and is a common trigger.

Travel with an extra inhaler and asthma medications. Everyone can enjoy their day out at the fair when they are prepared to manage asthma flare-ups.

Now that you’re prepared, what are you looking forward to seeing at the fair this year? Share this post with family and friends.

Additional Resources:

North Carolina State Fair Website
Best and Worst Foods for Asthmatics
Five Flu Myths Debunked


Teen Focus: Dangerous Duo – Type 1 Diabetes and Drinking

Lisa Feierstein Children's Health, Diabetes 3 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


Surviving Summer Asthma Flare-Ups

Lisa Feierstein Asthma, Breathe EZ Leave a comment   , ,

summer asthma flare upsSummer is here! People with asthma should always be prepared for asthma triggers as the weather continues to get hotter.

You may experience triggers like coughing and shortness of breath due to the hot weather. Here are some tips for surviving summer asthma flare ups.

Tip 1: Exercise smart.

People with asthma may be more sensitive to extreme temperatures and the pollution that comes with it. That is why it is important to avoid outdoor exercising if air pollution is high. If you are going to work out, try to plan outdoor activities for early morning and late evening.

Tip 2: Check air quality

Always check the air quality before going outside. You can reduce the impact of your asthma triggers by being prepared and knowing your limits.

Sign up for air quality alerts by visiting airnow.gov.

Tip 3: Traveling Smart.

It is always best to plan ahead when you have asthma, especially before you take a trip. Whether you are traveling by airplane, train, or car it is always best to keep your asthma medications on hand at all times. Consider purchasing a portable nebulizer, which allows you to do treatments while traveling.

Tip 4: Talk to your Doctor.

If you are experiencing asthma symptoms and you cannot get your symptoms under control, it may be time to see your healthcare provider. Make sure to keep your asthma action plan up to date.

Tip 5: Exposure to Bad Environments

Change clothes and shower after outside work to remove allergens that could trigger an asthma attack. It is always best to be aware of what can be harmful to you and your asthma and take the proper steps to prevent yourself from having an attack.

Additional Resources

Ozone and Air Quality

AirNow – Air Quality Basics


Asthma Protection During Hurricane Season

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

Are You Prepared for Hurricane Season?

With June 1st being the beginning of hurricane season, what’s a better time to discuss how to protect yourself and your family from asthma triggers after a hurricane or tropical storm? Hurricanes produce high winds which blow pollen and mold spores into the air that can make asthma symptoms worse. During these times people with asthma can experience wheezing, coughing, tightness in the chest, and other complications with breathing. Here are a few tips to help prevent asthma attacks during the upcoming hurricane season.

hurricane season

Avoid Homes or Buildings with Suspected Mold Damage

Once any flooding clears and the cleanup process begins people with asthma are at risk of exposure to mold and dust. In extreme cases it is best to not even enter a building or home that has mold growth that you can see or smell. But if you have to be exposed to these conditions, protect yourself by wearing a filtering mask, rubber gloves, and eye protection.

Coping with Stress and Emotion

During the aftermath of a hurricane, stress levels are high and they can trigger an attack. That’s why it is best to take care of your emotional state of mind during these stressful times. Communicate and connect with other people and seek help if needed.

Washing Hands

Keeping your hands clean can help prevent the spread of germs. In many cases catching a cold or the flu can also trigger an asthma attack. If safe water is unavailable on a temporary basis use hand sanitizer.

Stock Up on Asthma Medications

Most importantly always have your asthma medication on hand and use as prescribed or when needed to control your asthma attacks. Consider storing medication and important documents in a waterproof container.

What About Climate Change?

Climate change may play a major factor in increasing allergies and asthma triggers. Rising temperatures lead to longer allergy seasons which can make the air quality worse. A warming climate also increases ground level ozone levels. This pollutant is considered to be one of the biggest hazards to people with asthma. It causes shortness of breath, coughing, aggravates lung diseases, and increases the frequency of asthma attacks.

Additional Resources

Helpful Links – Post Hurricane – Indoor Air Quality
What Climate Change Means for Allergy Season


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


7 Asthma Myths for Asthma Awareness Month

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

Did you know that May is Asthma Awareness month? With spring in the air it is a perfect time to test your knowledge and learn more about asthma symptoms and triggers. Check out these seven asthma myths.

Myth: All Asthma is the same

There are several types of asthma but here are the most common ones. Allergic asthma is most commonly associated with grass, mold, and dust. In cough-variant asthma the number one symptom is coughing. This commonly flairs when there is dust, cold air or a strong smell. Exercise-induced asthma is when you have a hard time catching your breath during intensive physical activity. The effects can last five to twenty minutes after working out.

Myth: People with Asthma Should Not Exercise

Physical activity is beneficial to everyone, including those with asthma. Exercise can be easier for people with asthma when it is done in places of high humidity as this helps open the airways.

Read some tips about Exercising with Asthma

Myth: Pets cause Asthma

For some people, asthma is triggered by pet allergens. The protein found in pets’ saliva, skin flakes, urine, and feces can also cause allergic reactions. Surprisingly the fur of an animal is not always an asthma trigger. Animals with fur can also be a carrier of other triggers such as dust and other allergens.

Read more about how Puppies Can Reduce A Child’s Risk for Asthma

Myth: Don’t Worry about Exposure to Secondhand Smoke

Secondhand smoke and smoke in general is not good for anyone’s health. Exposure to smoke is one of the most common asthma triggers. Smoke irritates airways and causes them to swell and narrow. Irritated airways can more easily fill with mucus making breathing more difficult.

Myth: You can Outgrow Asthma

People who have asthma when they are very young may outgrow their symptoms as their lungs develop. However, in many cases, symptoms can reoccur in adulthood following exposure to smoke or respiratory viruses.

Myth: Asthma is Contagious

Asthma is not contagious but it can run in your family. The Centers for Disease Control report that three-fifths of all asthma cases are hereditary. If one of your parents have asthma you are three to six times more likely to develop it yourself.

Myth: Asthma has a Cure

There is no cure for asthma but with the right tools and knowledge, your asthma can be managed so you can live a healthy life.

So how did you do on the quiz? See the additional links below to expand your asthma knowledge. Why not share this post with friends and family who need to learn more about this chronic disease.

Additional resources:

Asthma and Allergy Foundation of America – Asthma Facts and Figures
Asthma Facts and Figures

Social Media – Asthma and Allergy Awareness Campaigns
Asthma and Allergy Awareness Campaigns


Insulin Delivery Methods – New Technology

Lisa Feierstein Diabetes Leave a comment   , , , ,

Diabetes patients get their insulin in a variety of ways. Options include multiple daily injections and insulin pumps. Each of these methods involves a needle stick. New insulin delivery methods promise needle-free insulin delivery.

Insulin Patches

There’s an appealing new way of delivering insulin that’s in the stages of early research – insulin patches. The patch promises to deliver insulin through the skin similar to nicotine patches or patches for pain relief. The insulin would be delivered needle-free.

If successful, they would offer opportunities for people on insulin therapy to take it without needing to put needles or infusion sets into the body.

How Would The Insulin Patch Work?

Each patch would contain a set dose of insulin that is absorbed slowly through the skin. The insulin travels into the blood stream over a number of hours. Some of the insulin patches were developed to release insulin quickly. This feature addresses spikes in blood sugar following food intake (bolus insulin patches). Other patches have been developed to counterbalance the progressive release of glucose over the course of the day by the liver (basal insulin patches).

Diabetes New Insulin Delivery Methods

Technology Challenges in Insulin Patch Development

In order for insulin to pass through the skin in a controlled and consistent way, insulin patches require additional agents be added. These agents help prevent blood glucose levels from going too high or too low. A number of manufacturers are developing insulin patch options and conducting clinical trials. Early results are promising as being a feasible form of future treatment.

Inhaled Insulin – Another Delivery Method

Another another alternative insulin delivery method is inhaled insulin. The FDA approved inhaled insulin in 2014. Use by patients under the age of 18 is still not approved. Inhaled insulin can be used to manage both type 1 and type 2 diabetes. The insulin is in a powder format that is quickly absorbed after you inhale.

Some patients use inhaled insulin along with traditional injections. This regimen offers convenience and helps blood sugar management after eating and throughout their day. Additional versions of inhaled insulin are in development from a number of manufacturers.

Additional resources:

Smart Insulin Patch Development

Insulin basics from the American Diabetes Association

The 411 on CGM


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