Wednesday, January 20, 2010

American Idol Turns A Paige Onto Hollywood

I love watching American Idol. Last week it was Larry Platt’s “Pants on the Ground” that became an overnight sensation, but tonight, I think all of us with asthma or kids with asthma are cheering for Paige Dechausse.

What an inspiration! However, did anyone else notice that she used her inhaler incorrectly on the show? She did a “press and breathe” maneuver, rather than the correct “breathe/press” technique.

What’s the difference? Pressing the inhaler first leaves most of the medication in your mouth--where it's swallowed and winds up in your stomach. Instead, begin a slow, deep breath while pressing the inhaler. This carries the medication deep into the airways.

Better yet, use a valved holding chamber and the timing of the inhalation becomes less important. Why a valved holding chamber? The valve allows medication to flow only one way--into your airway--when you're ready to take a full, deep breath.

Valved holding chambers come in a variety of sizes for people of all ages, with and without masks. The PARI Vortex comes with a duck mask for young children, but having used one recently with my 4-month-old grandson, I discovered it wasn't possible to tell if he was actually inhaling the medication. Twenty-four hours later we were back at the pediatrician’s office giving Trey a breathing treatment. This time when he went home, it was with a prescription for a nebulizer machine and medication.

The new AeroChamber MAX with Flow-Vu has a distinct advantage, particularly for giving inhaler medications to children. There's a small flap or valve that's so sensitive that it shows you when the baby is inhaling the medication.

I don’t know about you, but I hope Paige makes it in Hollywood. It’s going to be fun to watch. A key to her success will be to keep her lungs healthy, exercise and inhale that medication deep into her airways. Remember: “breathe/press”!

Wednesday, January 13, 2010

Good to the Last Drop

The prescription label says: "Take one teaspoon of medicine every 12 hours." Not the teaspoon used to stir tea, but one you use to measure salt or baking soda in a recipe. At tea spoon is not a teaspoon by any measure!

But getting the teaspoon of medicine out of the spoon into your tum (or trickier yet, your baby’s mouth) is not always easy. Sure, you can use one of those tiny plastic cups packaged with the medicine, but the residual medicine slides back down into the cup and you wind up not giving or getting the full dose. You could try adding a few drops of water, giving it a swirl and downing the rest, but that really makes a mess. (Trust me; I tried it.)

My son uses a syringe shooter (that’s what I call it) to squirt medicine into baby Trey’s mouth. Most of it goes down his throat before he has a chance to think about spitting it back out. The benefit of this tactic is that there's no medicine left in the syringe. I think that’s the best way to make sure the full dose is given every time no matter how old you are.

Monday, January 11, 2010

Mr. Whiskers Meets His Match

After reading the Holiday issue of Allergy and Asthma Today in which Mr. Whiskers lamented getting dunked and bathed regularly by his allergy-prone family, my daughter-in-law, Kristin said she’d been bathing her cat every two weeks for years, ever since he was eight weeks old. Her reasons had nothing to do with allergies or asthma and everything to do with completing microbiology courses in medical school. Just because cats spend a lot of their leisure time preening doesn't mean that they're clean, she told me.

After Kristin and my son married, their combined menagerie consisted of a cat and two dogs, and before long, they added two precious boys to the family. So during the Christmas holidays when she offered to show me how to bathe a cat, I grabbed my camera and headed up the stairs behind her. Also pictured in the photos are JD, my 2-year-old grandson, and the family cat, Cat.

First you have to catch the cat!

Important: Clip the cat's claws!

Firmly and calmly hold the cat in place while drenching his fur. Be careful to keep water out of his eyes and ears.

Apply cat shampoo from head to tail.

Gently massage the face and tear ducts.

Rinse cat thoroughly.

These are the faces of a clean cat and a happy Kristin!

Tuesday, January 5, 2010

Post-Holiday Bug, and the Magic Italian Garlic Cure

All the traipsing through airports, day-after-Christmas shopping, shoveling snow without a muffler around my face, hugging my sick little grandsons and visiting pediaticians has landed me in bed honking and hacking. I'm cuddled up with a nebulizer, box of tissues, Ricola cough drops, Vicks VapoRub and both a nasal and inhaled corticosteroid. Oh, and my laptop and iPod Touch (a Christmas present from my husband).

Nothing like a dose of reality. It’s been eons since I’ve had a respiratory infection or asthma symptoms that I couldn’t nip at the first sign. As I retrieved my Aeroneb from the top shelf of the linen closet, I wondered if I had all the parts needed, if it would start and if I’d saved the instruction booklet. I unzipped the small case to find everything intact; the palm-sized, battery-operated base powered up on the first try. I plugged the power connector into the back of the nebulizer cup, poured the medicine in and instantly a fine mist silently streamed into my burning airways. I must remember to store it that way when this episode is over.

My husband has already been exposed to whatever I have, but I insisted that he sleep in the other room last night. Even so, while I was coughing up a lung, he was at the door asking if I was OK (no)--and in the rare moments of silence when I had stopped coughing, he was checking to make sure I was still alive.

It’s always worse at night, although the daytime version is no picnic either. John is taking me to the internist at 3:00 to find out if this really is bronchitis or if it's pneumonia or a sinus infection. I don’t feel like crawling out of my blankets, brushing my hair or changing out of my sweatshirt hoodie, flannel jammies and knee socks and climbing into uncontaminated clothing to go to the doctor’s office or anywhere at all. Maybe I could just roll the blankets around me and go in dressed as is. Somehow I don’t think that’s going to happen.

What I really want is Sandra Fusco-Walker’s (AANMA’s Director of Patient Advocacy) magic Italian garlic cure. Rather, I want someone to make it for me, since John’s specialty is pouring cereal. Here's her recipe: Boil two heads of garlic until fork-tender. Slice in half, separating the top from the bottom. Heat olive oil in cast-iron skillet, season the garlic halves and cook until golden on both sides. Smear onto French bread, and watch out! Talk about pulling the plug on mucus!

It seems this crud is everywhere but it has no name--no epidemic or pandemic status in the news. Despite pumps of hand sanitizers at every cash register and in my purse, this bug needs no handshake to multiply. Just the holidays.

Commiserate at

(By way of disclosure, Aeroneb, Ricola, Vicks and Sandra’s Magic Italian Garlic Cure did not pay for mentions in this blog.)

Monday, January 4, 2010

Happy New Year -- and Reality Check

How many of you spent the holidays hacking, honking, sniffling, sneezing, wheezing, feverish, nauseated or dashing to the bathroom? Or taking care of kids doing any of the above?

I spent part of the holidays in Atlanta with my oldest sons, Mike and Dan, Dan’s wife Kristin and my two littlest grandsons. Mike and Dan met me at the airport shortly after midnight. On the ride home, Dan said that J.D., his 2-year-old, had been diagnosed with croup earlier in the day. He was hoping that the baby, who's four months old, wouldn’t get it. The baby was cutting two bottom teeth but otherwise happy.

Then, the next day, the baby started wheezing. Kristin, a physician’s assistant said, “It’s just a little wheeze.”

“But it doesn’t belong there,” I said.

“He’s teething; babies get congested when they're teething,” she replied. I had to agree, but something about the wheeze seemed eerily familiar to me--it reminded me of when my daughter, Brooke, was a baby, before she was diagnosed with asthma. But Trey was happy, alert and cooing. All seemed fine.

By nightfall, however, Trey took a turn for the worst. The next morning, Dan took the baby to the pediatrician. Diagnosis: Broncholitis or RSV. Either way, Trey was producing more mucus than his little body could get rid of. He had his first breathing treatment and was sent home with a Xopenex metered-dose inhaler and a valved holding chamber with a little duck mask on it.

For the next two days, we gave Trey his medication on schedule but he grew worse. We were never quite sure if the baby was inhaling the medication. Three puffs every four hours should have done the trick, but we could see no improvement.

The next morning, Kristin had to drop J.D. off at day care and go to work, so Dan and I took Trey back to the pediatrician. This time we saw Dr. Furr. She listened to his chest and explained that while people love to debate the merits of holding chambers vs. nebulizers, there were times when a nebulizer was the best route because the medicine is wet and you know the baby is getting the medication. She gave the baby a breathing treatment at the office--and sure enough, he fired out a huge mucus plug splat onto the floor. His cheeks regained color and he smiled.

Dr. Furr explained that RSV is viral bronchiolitis, but that not all bronchiolitis is caused by RSV. Whatever the cause, she expected Trey to be really sick for a few weeks. She asked about the family history of asthma – Dan and I both have it, as do his sister and youngest brother, Joe. Dan and I don’t have allergies but Brooke and Joe do. She said to wait and see what develops, but that it would be no surprise to her if the baby develops asthma. If that's the case, it would be time to talk about pets, dust mites and other known allergens and how to avoid them.

It was a little odd standing in this room watching this conversation take place between my son and the pediatrician about my grandson, in contrast to when Brooke, the daughter who taught me everything about asthma and allergies I didn’t want to know, was a baby. This physician works in a busy office seeing patients with all kinds of ailments--the largest pediatric practice in the area--and yet she efficiently and effectively explained the diagnosis, answered all of Dan’s questions, told him what to expect after giving Trey his medication and how to know when to bring him back for additional treatment.

Wow. All in 15 minutes. With a smile on her face and a caring touch of her hands

Despite the coughing and hacking (in addition to sick animals and a few sleepless nights), the seven days spent with the family were precious and humbling. They were a reminder that just because you raised children once, doesn’t mean it would be any easier to do it again! A reminder that the never-ending work is offset by the unexpected leaps of joy over the smallest of things. A reminder that being a parent teaches you more about yourself than you could imagine, no matter how young or old your children are.

And how were your holidays?