chronic medical conditions Archives - Active Healthcare

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


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


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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