Greetings (and Apologies) from Canada...from the slightly-less-Angry Asthma Mama

Hi, everyone --

Just wanted to offer sincere apologies to everyone - with Gmail's new tab format, I missed a lot of comments over the last few months!! So sorry!! I'll be better about looking out for these from now on.

Quick update - we're all fine up here in the Great White North, our new(ish) home. Everyone's asthma has been relatively calm, including mine. In fact, since starting CrossFit last year, I've hardly had a single flare. That's pretty amazing, considering how intense a CrossFit workout can be!

I've also had to start a low FODMAPs diet (whole other blog there...) which may have helped, since it eliminates dairy and gluten from my diet, among many, many other foods. I do, as time goes on, believe that diet has a lot to do with health. Yes, I realize that's obvious, but more specifically, I'm starting to believe that processed foods and factory farmed meats may have more to do with our health issues than we imagine. For me, removing the wheat and milk has made a huge difference. I've lost weight, and I *swear* I've gained about 50 IQ points! I don't feel like napping mid-afternoon either. And there's the thing where I don't have asthma flares, too.

Getting the kids to follow suit is next to impossible, but I've cut their processed food intake substantially. I bake snacks for them, rather than buy them. (It's relaxing, too - baking on Sundays. Love it.) I use good ingredients. I cook dinner more, and I buy organic when I can. (Admittedly, that's not NEARLY as often as I'd like, but you do what you can!) We eat less pasta, and more rice and quinoa. More fruit and veggies. Less milk, more water.

I don't know that this change has had  a huge impact on anyone's health - and it would be hard to quantify, even if it did. There's been so much change, it's hard to attribute anyone's good health to any one thing. Life in Canada has been less stressful over all. I see my kids more. They have less homework and, when it's not below freezing as it's been for the last six weeks, they spend more time outdoors. They have nice friends who enjoy simpler things - there's less pressure to wear "the right" sneakers or have an iPhone. But it has been a big change, and 18 months later, I think we're all getting used to the fact that this is our home now.

For me, life is much less complicated. I walk my kids to school often, and I take my dog for walks in the woods every (non-subzero) day. I have a nice job and I'm slowly making friends and making a life for myself. I still have a lot to figure out, but overall, it's good. It's more peaceful, less stressful. In Canada, I just feel like there's so much less noise and so much more calm. Can't ask for much more than that.

Bronchitis, Bronchitis, Bronchitis...Pneumonia?

What a week!

Last week, Ig was coughing for days. He started running a fever on the Tuesday, so I kept him home from school for a few days. Then Friday, Ozzy started coughing - always a concern. By Sunday, he was pretty sick, so I took him to the walk-in clinic. They told me his lungs were clear, but he was pretty sick and running a fever, so I kept him home Monday through Thursday.

Of course, B couldn't be left unscathed. He got sick Wednesday, so he was home Wednesday-Friday. He never seemed quite as sick as Oz, but his cough sounded appalling. I forced him to do a few nebulizer treatments.

[As a note, the symptoms of this illness have been a barking cough and fever. The two older guys complained that their chests hurt on the second day of the illness. Sounds like bronchitis, right? The school vice principal told me a lot of kids were out with bronchitis over the last week. Oz got nebs every 4-6 hours for the first two days, then switched to an albuterol MDI every 6-12 hours.]

Hanging this on our front door...

The school coordinated a trip to go snow-tubing last night. Ozzy seemed well enough and had gone to school, so he went with DH and Ig. B and I stayed home and ordered sushi, which cheered him up since he'd really wanted to go! The other guys got back after 3 hours of snow tubing, chattered incessantly for 15 minutes, then (as if on cue) passed out on the couch.

Today, B seemed better, but Oz was super-whiny. He protested going to dance class, which has been the trend lately. (Doesn't like the new school, hates jazz class, etc. I think he just wants to stay home and play video games.) He was much whinier and adamant about not going today, but he missed last week and there's no class next week, so I forced him to go. I have no tolerance for whining. (Really, does anyone?)  He did look a little pale after dance, though, and then he turned down a grilled cheese sandwich. Ozzy turning down fried carbs and dairy is just weird, so I should have KNOWN something was up...

DH decided to take us out to one of his old haunts for dinner, so we ended up driving 30 minutes to go to a dive that specializes in souvlaki and fries. (Men!)  I'm not feeling well, which shouldn't surprise anyone after taking care of the bronchio boys for a week. Ozzy was excited, but once we got there, complained incessantly about how cold he was. Of course, he'd worn a t-shirt and a hoodie only - in Ontario in early March - so I chalked this up to being under-dressed in a drafty restaurant. (What is it with grade school boys not wearing jackets? Are parkas in winter "uncool" or something?) He ate about half his dinner.

When we got home, I went up to put my PJs on, because a) I'm not feeling well and b) I love PJs. When I came down a few minutes later, Ozzy was passed out on the couch.

Uh-oh.

I let him sleep for an hour so, but when stirred an woke up for a minute, I took his temp. 101.3.

Again, uh-oh.

I'll be watching this kid VERY closely tomorrow. The last time (2 times?) he had pneumonia, I'm pretty sure this is how it went down. He got sick, he got better for a day or so, then he took a nosedive.

If he's running a fever tomorrow morning, we're going STRAIGHT to the clinic.

In fact, I'm gonna run upstairs right now and count his breaths...

Meet GeckoCap, The Newest, Coolest Tool for Asthma Compliance

Last month, the folks at GeckoCap contacted me in response to my post about how to get your kid to actually take their maintenance meds.  I went to their site to see what the heck a GeckoCap was,  and was actually pretty blown away. This product is SUPER-COOL, and I'm pretty sure it will work.

Rather than explain it, I interviewed GeckoCap's Founder and CTO, Mark Maalouf. Here's what he told me:

1.     What is the Gecko Cap and who will it help?

GeckoCap is a small, glowing device that fits on top of inhalers. First, it helps children with asthma develop proper habits. Children often forget to take their maintenance inhalers as prescribed [REALLY?], and with time this often leads to more usage of the rescue inhaler, missed activities with friends, and perhaps even missed school days. The GeckoCap glows as a reminder when the inhaler should be used based on the prescription, and every time it is used the information is sent to an online account. Children have their own dashboard where they can keep track of how well they’re doing - see the next question for more on this!

GeckoCap helps parents too. I’m sure you’ll agree that it’s very difficult to keep track of if and when your child is taking their medication. It’s even more difficult when they’re bouncing around between school, visiting friends, on field trips, or between two homes. Parents have their own dashboards where they can track how well their child is doing. They also get reminders/notifications for things like a prescription running low as well as alerts when the rescue inhaler is used. These alerts prompt the parents for the reason behind the rescue inhaler usage (sports, weather …) so you can finally get real data to look for trends. Parents can also easily see the history and create reports. How often do you go to your child’s physician and can’t comfortably answer the question about their inhaler compliance?

2.     Explain the whole gamification thing to me.

We are working with child psychologists to figure out how to really change behavior for the better. For the younger children, this includes their very own dashboard with a cute avatar that changes moods based on how well they’re doing. Children also get rewarded with points and badges for things like taking their maintenance inhaler properly several days in a row. Parents get points too for things like entering the trigger for the rescue inhaler usage, and they can assign these points to their child. Parents can choose what the points mean in the house (perhaps the child can redeem them for an extra piece of dessert!), but we are also working on some partnerships to redeem points for real things like gifts.

3.     Do I need to get my kid an iPad for this to be successful?

No! Without getting too technical, the cap sends and receives data to a smartphone or tablet which has Bluetooth 4.0 (this includes the iPhone 4S, iPhone 5, and newer iPad and Android devices). That device then sends the data to the internet.

What this means is that you need at least one device like that in the home for the GeckoCap to work, but it does not have to be with your child. If they are at school all day and use the cap, the data will automatically be sync’d when they get back home and are close enough to your iPad. The only benefit of having your child carry around their own smartphone or tablet is that the updates and notifications will occur more frequently, rather than when your child gets back home.

4.     Does it work with all MDIs?

That’s the plan! We are working with industrial designers right now to finalize the version that will be sold, and one of the most important design goals is for the GeckoCap to fit on all MDIs. We’re tinkering with a couple of ways to do this best.

5.     Where can I get one and how much will it cost?

Glad you asked, because we just launched a campaign to pre-sell GeckoCap. We’re aiming for it to be available in September, and for a limited time you can pre-purchase one for $39. That campaign site has a lot more information too, please check it out!

6.     One last question: Why did you decide to create this thing? What's the back story?

To make a long story short, the team and concept behind GeckoCap were formed at a healthcare-related competition at MIT in 2012. One of the founders has a young child with asthma and another is a physician, so GeckoCap grew naturally out of that partnership. Among several other features, the original concept tested peak flow, provided a GPS tracking system to alert users of high risk locations, and had a spacer. It ended up winning first prize at the competition, and since then the concept was refined and simplified from a jack-of-all-trades product to a simpler and more consumer-friendly one.

I'm very excited about the GeckoCap, and definitely plan to try it out. I'm so glad that someone's thinking creatively about the issues that affect our kids. These are technologies I use frequently in my marketing/PR career....I never thought I'd be using them to manage the kids' asthma! Based on the early buzz GeckoCap is getting and how well it was received at CES this year, I'm thinking this is going to be bigger than musical toothbrushes!

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!