Vote for the Mama!

The Angry Asthma Mama has been nominated for Healthline's Best Health Blog of 2012! Please take 5 seconds and vote for me? I'm entry #263. Lots of competition...

Compliance with Asthma Meds, or How Do You Get an 8 Year Old to Take His Flovent?

OK....I know there are some moms and dads who read this blog who have kids older than mine. So here's my question for you:

How do you get your kids to take their asthma meds?

My Ozzy is 8 now, and getting him to take his Flovent (which he can now administer himself) requires something just shy of an act of Congress. I have to take his digital toys away every morning until all his to-dos are done, and even then, Flovent requires three reminders. And if I forget to remind, he forgets to take. 

And let's not even talk about the rinsing after!

I'd love to say I could be there every time to administer, but I have two other kids and myself to get ready in the AM - and one of those other kids requires my nearly constant supervision.

What works in your house? I'd love some suggestions!

Symbicort Question for YOU!

You probably don't know this, but I moved to Canada recently. That's a long story for another day. But the relevant part is, since I'm the only one in the family who isn't Canadian, I have no health coverage here. And, of course, asthma season is upon us.

The past few days, every I time I inhale after 6:00pm, I feel like I'm going to cough. For me, this means one of my lovely bronchitis-like flares is coming on. Since, un-medicated, these typically last for 3 months, I though I'd be proactive. But the only medication I have on hand is Symbicort.

The nice kind of thrush

So Symbicort works well to keep my asthma controlled, but OMG - the side effects!! I get thrush like no one gets thrush! So gross! I will have laryngitis within days (and I sing, did you know that?) and worse, worst of all, I will get thrush in, you know, that other place thrush can occur. And it's so awful and painful that I can't even think about it.

But, hey - my cough will be controlled!

I'm going to try like hell to have my parents send some Qvar up here, but until then...I'm begging you all... how can I take Symbicort and NOT get thrush? I gargle for days and rinse 1000 times, but nothing seems to work. Is there some trick I'm missing? Drinking raw cranberry juice? Eating Greek yogurt while standing on my head?

Please...your advice!

Sanofi Markets New Intradermal Flu Vaccine

I read this in one of my industry trades this morning. Sanofi Pasteur actually hired Chris O'Donnell to peddle their new intradermal flu vaccine. Why bother?

A little less ouch, a lot less flu risk.

Well, let's face it: Even if are children are asthmatic, most of us don't get flu shots. Sure, we have our kids get them (unless, like mine, your kid is allergic to eggs or fish. Or because we're scared about thimerosal, but that's another story altogether.), but most of the adults skip the stick. And we do that, most likely, because we hate getting shots.

So this new vaccine is cool. It's not really a shot. My dad is a pharmacist who has to administer flu vaccines, and he says these needles are literally 90% smaller than regular shots, and they just barely puncture the skin. They're fairly painless, and they don't ache for days after like the old needles.

Of course, you can still get the old-fashioned injection. If you're a masochistic and that's you're thing, then have at it, Ana Steele.

For me, if I can't get the intra-nasal vaccine, I'll go the intra-dermal route. I'm scared to death of needles. ;)

AngryAsthmaMama makes ... Best of the Web? Really?

Another comment worth sharing...

Although I'm late posting this one, possibly because I've moved to Canada over the last month, I'm very proud to have been named one of the best Asthma sites for 2012 by Healthline.com.

Here's the note I received:

Hi Aimee, Healthline editors recently published the final list of their favorite Asthma blogs and your blog made the list. You can find the complete list at: 

http://www.healthline.com/health-slideshow/best-asthma-blogs 

(in no particular order). We encourage you to share your status as one of the best blogs on the web with your friends, family, & followers. Please let me know if you have any questions. Congrats & continue the great work!

Warm Regards, 

Tracy

Thanks to everyone at Healthline, especially Tracy, for this honor. And apologies for the late acceptance!

Here's the uber-cool badge, which I may well have made into a t-shirt!

Pulmicort and Mood Swings

This came in through the comments today, and I thought I'd share it. While my kids never had issues with mood swings related to their corticosteroids, over the years I've had many comments about kids who have.

If you notice your child is have severe mood swings, talking about suicide or doing anything especially weird while on inhaled steroids, PLEASE CALL YOUR DOCTOR IMMEDIATELY.  Trust your gut: If you feel like something's wrong with your kid, something is probably wrong with your kid!

Anyway, to that point, here's the comment I wanted to share:

My son was recently put on Pulmicort twice daily to help control his asthma. A day or so after he started the Pulmicort, his mood started changing. He was suddenly obsessed with questions about dying, crying everyday, and kept talking about "thoughts" he could not get out of his head. He kept saying, "My brain keeps telling me to kill myself, but I would never do that." He insisted that the thoughts won't go away. The thoughts progressed into visions of other people dying and questioning beliefs in God. We realized all this began when he started taking Pulmicort so we decided to take him to the Dr. that prescribed it. He told us to take him off it immediately and that we should see a difference in 2-5 days. Well today is day 3 and I have my happy, loving, and kind son back. I normally don't write on blogs, but felt this is so important to let others know who may be experiencing the same thing with their child. It was helpful to me to see others going through the same thing and to know that it can get better once the Pulmicort is stopped. 

Thanks so much for sharing this. It's obviously very personal, but I think a lot of other parents benefit from this level of honesty. Let me know if your doctor puts your son on a different medication and how that goes.

Anyone use ProAir?

I'm out of Ventolin and had to start using ProAir over the last few weeks. I swear, I can never tell if I'm actually getting anything out of that inhaler. Is it just me?

My doctor said something this morning about it being a lighter mist or something... I thought it was just that the spray mechanism was crappy and didn't work half the time! Per the ProAir site:

ProAir® HFA delivers medicine in a warmer, lower-impact, longer-duration plume.4-6

...so I guess the feeling of getting little-to-no mist is intentional!

Interested in hearing how others like ProAir vs. Ventolin and other MDIs.  (For me, the counter is reason enough to prefer Ventolin, honestly.)

Video of Dr. April Wazeka, Our All-Time Favorite Doc Ever!

MorristownGreen, the news site for a nearby town, posted a video of our absolute favorite pediatric pulmonologist, Dr. April Wazeka!  I'm so happy to be able to "introduce" her to all of you!

Dr. Wazeka looked after my boys when they were younger, and really got them on the path to recovery. She's the best of the best, always taking time with us, listening to me, and respecting my choices. There's no doctor I recommend more highly....I can't imagine anyone not being impressed with her. (For the record, the ONLY reason we don't see her anymore is that she's now got two children of her own and works limited hours. Since my work hours aren't as flexible as they once were, it's just harder to see her. But I'm sure as her kids enter grade school, we'll manage to sync back up!)

Happy, Healthy New Year.

So...eight years into this blog, who is the most seriously asthmatic in the family?  The mama, natch! B and Ig aren't even on asthma meds anymore!

I'm now on Qvar 80, 2 puffs a day. Oz is down to Flovent 100 (diskus, not MDI now) but he hasn't been sick in AGES.  I just had a major flare in November, so I WIN. Whoopee!

The flare in November felt a lot like what I had previously thought was my twice-annual bronchitis. Stupidly, when the doc had started me on Qvar over the summer, I never filled the prescription. I honestly thought he was over-prescribing, since I only got bronchitis in the winter and spring, and had really mile exercise-induced asthma. (Nothing a puff of albuterol couldn't handle after a rough workout.)

But when the cough got really bad in late October, I realized I probably needed the steroids. I was coughing till I gagged, and could barely get through a sentence without coughing. I called the doctor and tried to schedule an appointment, but due to our freak snowstorm here in the east, I couldn't get in. After phone tag with the doctor over the course three days, I got my Qvar Rx filled.

Within 48 hours of starting the Qvar, I was 75% better. It took a light course of orals to get me the rest of the way through, but the experience taught me something critical: I've probably never had bronchitis.

All those times I was diagnosed with bronchitis, it's likely I was just flaring. Thank God, my GP always assumed it was viral and never put me on antibiotics, but it's amazing to think I'd been misdiagnosed for so long.

So, while I'm not thrilled about being on Qvar every day, it beats the Symbicort and Asmanex I've been on the past. I didn't like the way they made me feel, or the unfortunate yeast infections they seemed to cause. (Ick. Seriously. ICK.)

Meanwhile, while I've always eaten well and exercised daily, I'm taking my diet even more seriously now. No more processed foods. More sleep. Whatever I can do to improve my health overall, I'm doing it. I have three boys to take care of - which is a TON of work all on its own, a full time job, and a singing career that (while small) is still really important to me! I need my health!  And I don't want to be on inhaled corticosteroids forever.

The boys are going off processed foods, too, much to their chagrin. No more KD, candy or packaged cookies. It's whole wheat pasta and 100% fruit leather from here on in! They'll learn to love it. Maybe.

So...wish me luck as I start this new year with optimism and a healthy new direction for my family and me.

New Specialist; PFT Log

So... we started seeing an asthma and allergy specialist last week for Ozzy. We love our pulmonologist, but she has two kids now, and her hours are very limited. Combine that with the fact that she's based at a hospital 20 minutes away (pay for parking, wait forever, etc.) the new local specialist is a winner.

We saw him for the first time this past week, since we were running out of our Flovent 110, and he was very thorough. I was interviewed, Oz was examined, which I expected - but he also did scratch tests and spirometry on the first visit. He also gave us a peak flow meter, and on that first day, Oz blew a 280.

Ozzy's meds were changed slightly, due to the fact that (a) he's done really well this winter and (b) this doctor doesn't like using spacers and masks - he thinks the kids don't get enough medication this way. So Oz was switched to a Flovent 100 discus (half the dose, yea!!) and a MaxAir instant inhaler. He seems to do really well with the new "delivery systems." I'm happy to not have to shell out for or clean spacers, myself!

Of course he got sick over the weekend and started flaring. The cough isn't bad, but it's a cough, and his only other symptom is fever. (B also has a fever with no other symptoms.)

On Saturday, I decided to check peak flow. It was 200. I gave him the MaxAir, and it went up to 225.

Today, with 102 fever, I checked again. He's barely hitting 200.

I guess I'll check him again later, and we'll see how he is. This meter doesn't have "zones," but he's down by a good 25 percent - assuming 280 was a good number for him. He only had the one test when he was healthy.

Probably worth a call to check in.

Xopenex Comment - "It makes my daughter sad all the time!"

Just wanted to address the comment that came in from a mom who's daughter cries all the time since starting on Xopenex....

I'm sorry I didn't mention it sooner, but please call your doctor about this! Meds shouldn't change our kids' personalities!!  Ask your doctor for a suitable substitute for rescue meds. Sometimes a different brand of albuterol or levalbuterol can make a difference - but definitely ask your practitioner.

I hope this helps! I know it's a simple response, but it's really the only answer!

I hope you're able to resolve this soon, and that your little girl is back to her happy little self in no time!

Mom's Asthma: Question for you guys

Hi, all -

As I enter my first full season as a newly-diagnosed asthmatic, I have a few questions for you. As you know, I took myself off Symbicort this spring - I just felt ill from that stuff. I intend to find a new pulmonologist soon and look at some different meds.

Anyway, this past week, everyone in my office, on the bus, apparently in most of lower Manhattan, has had a violent, horrible-sounding cough. Seriously, I thought my boss was going to break a rib in the office, the way he was coughing.

Yesterday, when I woke up, I felt run down and a little "fluffy-headed." I had a very slight fever. I'd been feeling a little tightness in my chest the day before, but not enough to make me think this was asthma-related.

Today I have the same feelings...fatigue, a little tightness, but no fever. Is this the start of a flare? What should I be doing?

Thanks for your tips!

PS - the kids have been doing well. B's had some bad allergies, but no major flares. Oz has been doing really well...but I'm terrified that I've caught whatever horrible illness the folks around me at work have, and that one of the boys (Oz, particularly) will end up in the ER again.

They're all getting flu shots in the morning!

Off Symbicort - and Surviving

Quick update - Last month, I went off Symbicort.

While it may have been helping, I couldn't shake the feeling that, at least in warm weather, my asthma really isn't that bad. And with the improving weather, I felt crappier than ever AND I was getting yeast infections, a pleasure I haven't experienced in a good 10 years. (BLECCH.)

So I took myself off the Symbicort, making sure to always carry an albuterol MDI. And you know what? I've been fine. I'm also avoiding processed foods, exercising every day and trying to drink plenty of water. I still don't get enough sleep, but I don't expect I'll ever get that!!

Come fall, I'll find a new pulmonologist and make sure I'm set up for the cold weather. But for now, I feel OK. I barely need the MDI - even though I'm now in the city every day in 90+ degree weather.

Kids' Diagnosis and Note on ProAir

We saw my *least* fave pediatrician in the group. She diagnosed both boys with sinus infections, and said their lungs were clear. She said it might be viral, but she wanted to start antibiotics anyway.

I'm going to wait 24 hours before starting.

I'm also going to take Oz to the pulmonologist.

I don't believe in taking antibiotics for everything. If you're not SURE it's bacterial, why do antibiotics? Why risk developing resistance? Although I'd hate to put Oz at risk for another pneumonia...Would I be doing that? And Ig seems to be completely on the mend already.  Thoughts?

I did show her our barely functioning ProAir inhaler, too. She said they know it's an issue, and they've got calls into the manufacturer. She said to insist on either Ventolin or Proventil next time, although I'd be just as happy with the Warwick generic. But glad I said something.

I wonder if I can return the two ProAir MDIs I have for another brand...?

****
Update: Went to the pulmonologist, who sent us for a chest X-ray. It was clear! Looks like we're definitely sinus infection/ asthma flare. The PP wants us to start the Biaxin, so I guess we will.

A word on Albuterol MDIs

Have to make this quick note on MDIs, particular rescue inhalers....First, I actually preferred the old aerosol MDIs as a parent, although I'm green as can be and I hate CFCs. But those things worked well, particularly if your kids need spacers. Whatever that ozone-eating propellant was, it *worked.* Some of the new ones work well, too - but not as well as the old ones.

Since I've been diagnosed, I've had free samples of Ventolin and Proventil. I liked how well these worked, and I also liked that they had counters. But of course, my insurance doesn't cover name brands.

There are two generics I seem to be able to get from my pharmacy. One is Warwick. I like this one. Despite the fact that there's no counter! But it works well and reliably.

The other generic I get is ProAir. I do NOT like ProAir. It comes in a red case - maybe you've had it, too? What I find with this product is that you can not press the product down hard enough to get a decent amount of the medication out. Additionally, it clogs. All. The. Time.  To me, this is a big problem. If I actually need my rescue inhaler, I probably need for it to actually work.

What's worse is trying to use ProAir with a spacer. My kids' asthma is FAR worse than mind, and half the time I can't tell if they're actually getting medication.

So in the spirit of brevity: Makers of ProAir  - albuterol is albuterol, the meds are fine, but PLEASE - give us a better MDI!! (And maybe include a counter?)

Please don't let it be pneumonia. Please don't let it be pneumonia. Please...

Home with the two younger boys today. Ig started coughing over the weekend, started running low-grade on Sunday. He's 99.3 now, but his cough is awful. He has to draw in a huge, narrow breath, and then he lets out this long spell of deep, resonant, slightly muffled-sounding coughs. He only weighs about 40 pounds, so they seem to take over his entire little body.

Oz had his usual dry, asthma for a few days, and we were giving him albuterol, but yesterday he really needed a neb before school. At 1:30, he was sent home from school. His teacher said he hadn't been himself all day - too quiet, low on energy. When the nurse called for us to pick him up, she said he was running about 99.

He needed a neb the second he got home, and he was running 99.9.  Overnight, he was coughing his head off, of course, and I had to give him albuterol and ibuprofen overnight. He was over 102 at 5:30 this AM.

Ig was up a lot overnight, too. I gave him Dimetapp.

This morning, Oz's cough was soooo bad. I gave him a neb of Xopenex, but less than an hour later his was still coughing violently, so I gave him another neb - DuoNeb this time. The DuoNeb has alwasy worked well for us, but it really hasn't slowed the coughing today.

The sound of the cough is different since that neb - it sounds more resonant. Maybe it's loosened up a bit? I can't say for sure, but it sounds AWFUL. And he's still coughing til he gags, pretty much.

This is NOT going to be a fun day. This seems so similar to what we went through in January with the pneumonias - I'm just praying this isn't the same thing!

I'm calling the doctor as soon as they open at 8:30 ET. I'll let you know how it goes.

Students Face Health Risks from Air Contamination | Environmental Working Group

Classroom asthma, Children's Asthma created by cleaning supplies | Environmental Working Group

Posted using ShareThis

Found this while surfing ... thought my "Mom" readers, as well as any students, might find it helpful and interesting. I sure did.

We've been switching, slowly but surely, to green and safe cleaning product. Most of what we use is from Trader Joe's "Next to Godliness" line, and we've also tried and liked WowGreen and some other brands. (Call me wacky, but I just don't feel like I've really *cleaned* when I've used only vinegar. And it leaves my house smelling like a tossed salad.)

As always, I'd love to hear your thoughts and ideas on this one!

Asthma/Allergy Update - me, B and Oz

So, lately our house has been feeling a little...small. It's a great house - a ranch with a full walk-out basement. Not a stitch of carpet anywhere, and we've kept it fairly upholstery free. (If you're asthmatic, you know that the first thing you look for in a house is hardwood and/or tile!)

We have three bedrooms...and three kids. The two oldest boys love sharing a room with a bunk bed, and Ig has his own room. But the living space is very close to the bedrooms, and while we've made the basement into a bright and fun rec room, the kids don't spend a ton of time down there.

....which is why we've been hitting open houses on weekends. We're not sure we're serious about moving, but we're curious to see what's out there. Plus, we're having some "issues" with our town's special education programs, and they may well be insurmountable, so we may well have to move, once we find a town that's more willing to provide necessary  services for Ig. But that's another post for another day.

So, to my point. We went to an open house on Sunday, and in addition to having two cats, they also had loads of potpourri to hide the cat smell. And loads of broadloom. As soon as we walked in, I took two puffs of albuterol.

After checking out the house (beautiful curb appeal, bad corner, weird downstairs floor plan), we headed home. Within five minutes, I was coughing hard enough to gag. More albuterol.  Then I was OK for the rest of the day...but the next morning, I felt like I'd swallowed a Nerf ball, and it had lodged somewhere between my throat and chest. Not a nice sensation. And my chest hurt, too. I wasn't sure if it was asthma-related, indigestion, or just muscular.

I'm much better today, but realizing that I have a lot to learn about my triggers and the severity of each trigger.  A few sips of ice water got me going today! I need to start documenting what they are. Also, I need to see about getting a spare inhaler.  Right now I have one that I keep in the bathroom, and one I carry with me, but my purse MDI only has a few puffs left on it. Will they give you an RX for spare?

In other news, B tried eggs today for the first time since he was a baby. He had a moderate allergy, and they used to make him vomit. Last time he had them, just a few years ago, his face went bright red and he had a headache. He's always afraid to eat them - as well as mayo, French toast, and anything else "eggy."

But today, he had a little bit of my hard-boiled egg - just a few bites of white and yolk, and he's been perfectly fine.

But Ozzy's been coughing ever since. Go figure.

Mom's Asthma - Symbicort

Another quickie update -

While the Asmanex did stop the coughing, mostly, I had a heavy feeling in my chest and just didn't feel well overall. I almost felt like there was a wet sponge wedged under my sternum, and it sort of pulsated or spasmed before I started coughing. Ick.

I called the doctor's office when I ran out of the Asmanex, and told them I wasn't feeling that much better. They gave me a sample of Symbicort, which I've been on  before.

It's only been a few days, and while I'm coughing a bit more, I feel SO much better overall.The only downside is that I keep losing my voice.

For other people, this might not be a big deal but (surprise!) I sing professionally and am booked every Friday this month. I had to cancel last week, because I couldn't get through two songs, and I'm supposed to sing four. During rehearsal, I was so winded after my first number, I could barely get through the less challenging second song. Singing, after all, does rely heavily on breath support.

When I asked the doctor about the laryngitis - which seemed to occur after every presentation I gave, or any time I spoke for 10 minutes at a time or longer - he said it was probably from the Symbicort. So, in addition to rinsing my mouth after taking the stuff (which you should do after taking ANY inhaled steroid), I am now gargling. It's very feminine and appealing, I assure you.

So...hopefully we're on the right path now. I'm looking forward to feeling better soon!

Update on Mom's Asthma

Two quick things:

• First of all, I doubled my Asmanex dose, so now I'm doing two puffs in the AM and in the PM.Within 48 hours of dose-doubling, my cough pretty much stopped completely - despite the fact that I seem to have a head cold. Pretty impressive. Still need albuterol from time to time (like right now, in fact), but sooooo much better!
• Secondly, I found this article on cough-variant asthma, and it's seems 100% like what I've got. Cold air and strong smells are definitely among my biggest triggers, and I don't think I've ever wheezed.

The timing for the sudden improvement is pretty fortuitous. I have a singing gig every Friday night in March, and I was in no shape to perform. The big concern: My accompanist has about 5,000 cats, and his whole house does kinda reek of cat pee. Should make for a fun rehearsal. I'll definitely bring the MDI!