Asthma 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


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 Tips – The Effect of Sugar and Dairy on Asthma

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

Now that summer has come and gone, the grocery store is filled with Halloween candy displays. Those with asthma know to avoid pollen and pet dander to help prevent asthma attacks. However, do you know that eating excess sugar and dairy can also have an negative effect on asthma?

Here’s how sugar and dairy effect your lungs and some tips for an asthma-friendly Halloween.

Candy Corn

 

How Sugar and Dairy Consumption Effects Asthma

Sugar is often inflammatory, even to those without asthma. Higher consumption of sugar can cause airway inflammation, making asthma worse.

Other common Halloween candy ingredients are dairy products. Eating dairy causes the body to produce excess mucus, which can make breathing more difficult.

Avoiding candy in large quantities is important for everyone, but is particularly crucial for those with asthma. With Halloween around the corner, avoiding candy becomes more difficult, especially for children.

Tips for an Asthma-friendly Halloween

Emphasize candy-free activities: Instead of trick or treating, try a haunted house or movie night.

Limit candy consumption: If you and your child do go trick or treating, stick to snacking on a few pieces of candy that evening and save the rest of the haul for later.

Have a Halloween party: Holding your own Halloween party is a great way to guarantee healthy asthma-friendly snacks like popcorn, fruit, and veggies are available for you or your child. A night of spooky crafts, fun games, and a family friendly movie can make for a Halloween your child will remember for years to come.

Avoid other allergies/triggers: If you or your child will be attending a party at another home, avoid indoor allergies like pets as much as possible. For trick or treating, check the air quality and pollen levels before heading out

With these tips, Halloween can be fun for the whole family

Everyone has their favorite Halloween candy treat. However, for a healthy holiday for all, keep the candy to a minimum. Shifting the focus away from candy to more healthy spooky fun will guarantee a fun holiday for all.

Additional Resources

Asthma and Nutrition: How Food Effects your Lungs – American Lung Association
Sugar Intake Linked to Kids’ Asthma? – WebMD
Six Best and Worst Foods for Asthmatics


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!


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?


New Generics Available for 3 Asthma Medications: Advair Diskus, Ventolin, and Proair

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

Asthma Rescue InhalerNew Generics available for 3 Asthma Medications: Advair Diskus, Ventolin, and Proair

Having asthma or any other chronic health condition can be costly. According to a study from the Annals of the American Thoracic Society, people with asthma spend on average around $1,800 a year on prescription medications alone.

Until recently, the options for asthma medications were limited to brand names only. But new generic versions of common asthma medications Advair Diskus, Ventolin, and Proair have been approved by the FDA and are now available as low-cost alternatives.

What is a generic?

Once a patent expires, other companies are allowed to make their version of the medicine. These alternative versions are called generics. Though generics can take a while to get developed, once they are approved by the FDA, they can make a large impact on the market.

Most generic medications are just as effective as their name-brand counterparts, but come with lower price tags. Switching to a generic can allow you to save money while still enjoying the same medical benefits.

All about the new generic inhalers

Advair Diskus is a long-acting bronchodilator that is often prescribed for asthma. Featuring a combination of fluticasone and salmeterol, Advair works as a preventative treatment. This new generic is more similar to Advair’s formula, making the switch to its generic alternative more feasible.

Ventolin is a short-acting beta agonist that is commonly prescribed as a rescue inhaler for acute symptoms. Though one generic, Proair (also known as albuterol) has been available for several years, new generic versions produced by GlaxoSmithKline have been approved by the FDA. With more new options entering the market, prices for quick-relief inhalers may drop overall.

How can I switch to a generic inhaler?

If you or your child are currently taking Advair Diskus, Ventolin, or Proair ask your doctor about switching your prescription to a generic version. If your provider feels the medicines are similar enough, they may be willing to offer you the substitute. In general, asking about generic versions whenever you receive a prescription can help you save money.

Explore affordable medication options

Prescription medications for your chronic asthma are necessary to prevent exacerbating your condition. Switching to generic can be a great way to save money while still keeping your asthma treated and under control.

Additional Resources


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


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


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

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

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


Time To Rake the Leaves – Fall Allergy Season

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

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


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


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


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


CDC Reports Drop in US Asthma Rates

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

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

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

Other Findings in the Report on Asthma Rates:

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

Green, Yellow or Red: What is Asthma Control?

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

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

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

Is your Asthma Action Plan Up to Date?

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

Key Asthma Action Plan Details

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

Additional Resources

CDC Vital Signs: Asthma in Children – United States

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

FAQ: Are You Asthma Aware?


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

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

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

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

Summer Camp Fun

  • Consider both Traditional and Asthma-focused Camps

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

  • Not All Camps are Created Equal

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

  • Review Camp Medication Administration Guidelines

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

  • Food Concerns – From Campfire Treats to Dining Hall Delicacies

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

  • Before, During and After

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

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

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

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


Camp Victory Junction

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

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

Additional Resources

Traveling with Asthma

The Sunshine Vitamin

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

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

About Camp Victory Junction

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

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


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