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Back to School: Allergy and Asthma Preparation

Sending children back to school comes with a long checklist of items to remember. For example, you need to know what school supplies to buy. You will want to visit the school to find the classroom and meet the teacher. You will also plan after-school activities full of fun enrichment opportunities. If you have a child with asthma or allergies going back to school this fall, you need another item on that list. Specifically, your checklist should also include connecting with the teachers, school nurse and other school staff about your child’s symptoms, treatment and prevention strategies.

Here is a checklist for mothers, fathers and doctors to ensure your child is in good hands and prepared for the new school year.

Ensure your patients (and/or children) have an asthma check-up prior to school starting.  Even if the child is well controlled, meeting with the doctor is an opportunity to evaluate medications and physical activity restrictions.

Confirm medications are up-to-date, filled and not expired.  Double check that their current inhaler isn’t about to lose its’ juice on first day of school with no back-up.

Get an asthma or anaphylaxis action plan put together.  This should include informing staff at school, nurse, teachers, and your child!

Discuss medical emergency policies and procedures.  Ensure that your child’s school has procedures in place for identifying symptoms and for treatment of emergencies.  Be sure to check your state laws as they will govern what the school can and cannot do.  You can check out the 2014 State Honor Roll to see where your state stands regarding policies for children with asthma and allergies in school settings.

Talk to the school and teachers about triggers.  Insect stings.  Chalk dust.  Playground games.  Show and tell where animals are involved.  Food allergies.

There are so many things to think about during these back to school times!  But your patient’s health is KEY to a successful start to their school year.  Make sure you have scheduled appointments with your asthmatic “little ones” as they head on into their next year of school—healthy and prepared.

To help treat and diagnose them before the school year begins, be sure to implement Spirometry into your practice.  It is quick and easy to implement and train your staff on—even before school starts.

References:
http://mdspiro.com/for-your-practice 
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They Can’t Quit.  But What’s the Point?

We have been talking a lot about smoking over the past few weeks and its effect on COPD, asthma, and general health long-term.  And today, we have more.  Nearly 10 percent of cancer patients still smoke.  Nearly nine years after diagnosis, bad habits die hard and some are saying “What’s the point?”

Nine years after being diagnosed with cancer, nearly 10 percent of survivors still smoke cigarettes – and more than 80 percent of them light-up every day.  That’s according to a new study from American Cancer Society researchers who say the findings underscore the tenacity of tobacco cravings and the need for better long-term help.

Quitting smoking is really difficult,” said Dr. Lee Westmaas, Director of Tobacco Research at the American Cancer Society. “I think we tend to underestimate the power of addiction.”

Better screening of smoking habits and referral to smoking cessation programs are needed, not just right after a cancer diagnosis, but years later, the study published Wednesday in the journal Cancer Epidemiology, Biomarkers & Prevention, found.

Westmaas and his team analyzed data from patients in 11 state cancer registries, targeting those with the 10 most common kinds of cancer. They analyzed results from 2,938 survivors who answered a survey between January 2010 and December 2011, about nine years after they were diagnosed.

Overall, some 9.3 percent of cancer patients still smoked, the study found. But the rates jumped higher for different kinds of cancer: more than 17 percent for survivors of bladder cancer, nearly 15 percent for lung cancer, and more than 11 percent for ovarian cancer.

Other cancers included in the study were breast, prostate, uterine, skin melanoma, colorectal, kidney, and non-Hodgkin lymphoma.

Survivors were more likely to smoke if they were younger, had less education and income, and drank more alcohol, the study found.

15 Daily Cigarettes
Most of the current smokers – some 83 percent – lit up every day and smoked an average of nearly 15 cigarettes a day. Forty percent of the daily smokers puffed more than 15 cigarettes each day, the study found.

“That’s not surprising,” said Dr. Jonathan Bricker, a clinical psychologist and expert in smoking cessation with the Fred Hutchinson Cancer Research Center’s Public Health Sciences Division.

“You’d think it’s logical that a cancer diagnosis would be a wake-up call to people,” Bricker said. “But it’s not true.” Read more..

CDC Reports Annual Financial Cost of COPD to be $36 Billion in the United States

The American College of Chest Physicians (CHEST) announced the Online First publication of Total and State-Specific Medical and Absenteeism Costs of Chronic Obstructive Pulmonary Disease Among Adults Aged 18 Years in the United States for 2010 and Projections Through 2020 in the journal CHEST.

The report, presented by researchers at the Centers for Disease Control and Prevention (CDC), finds:

  • In 2010, the total national medical costs attributable to COPD were estimated at $32.1 billion dollars annually.
  • Absenteeism costs were $3.9 billion for a total burden of $36 billion in COPD-attributable costs.
  • An estimated 16.4 million days of work were lost due to COPD each year.
  • Of the medical cost, 18% was paid for by private insurance, 51% by Medicare, and 25% by Medicaid.
  • The study also projects a rise in medical costs from $32.1 billion in 2010 to $49 billion by 2020.

Chronic lower respiratory diseases, including COPD, are the third-leading cause of death in the United States. COPD claimed the lives of 134,676 people in 2010. In 2011, 12.7 million US adults were estimated to have COPD.
However, close to 24 million US adults have evidence of impaired lung function, indicating an under-diagnosis of COPD. Smoking is a primary risk factor of COPD, and approximately 80% of COPD deaths can be attributed to smoking.

"Evidence-based interventions that prevent and reduce tobacco use and reduce clinical complications of COPD may result in potential decreased COPD-attributable costs," said Earl Ford, MD, MPH, Division of Population Health, Centers for Disease Control and Prevention.

The report also offers state-by-state data. 

"For the first time, our analyses provide state-specific costs for COPD, which provide state public health practitioners with estimates of the economic burden of COPD within their borders and illustrates the potential medical and absenteeism costs savings to states through implementing state level programs that are designed to prevent the onset of COPD," says Earl Ford, MD, researcher with the Division of Population Health, CDC.

The full study can be found in the Online First section of CHEST.

80% of COPD deaths can be attributed to smoking?  It’s time to get your patients to stop smoking if they haven’t already.  As an aid to smoking cessation, a Breath CO monitor can be used as a motivational and educational tool. Self-reported smoking status has been shown to be unreliable and a CO monitor replaces...

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Yoga and COPD

In a recent publication of The Journal of Thoracic Disease, researchers performed a systematic review and meta-analysis to investigate the efficacy of yoga training in COPD patients.

Five randomized controlled trials involving 233 patients with COPD were studied.  The researchers found that yoga training lasting 3-9 months significantly improved the FEV1 and exercise capacity but had no effect on blood oxygenation or carbon dioxide levels.

Yoga originated in ancient India.  The idea is that the body’s organs and systems are cleansed through asanas (postures) and pranayama (controlling the breath).  Postures are taught to heal an illness, reduce stress or to look better.  Not only do yogic exercises have a positive effect on COPD patients but they also help those with asthma, cardiac diseases, diabetes, depressive disorders and more.

Yoga training can provide a complementary strategy for patients with COPD.  Apart from relaxing tense muscles, yoga can also alleviate mental pressure.

The conclusion of the study was that yoga seemed to improve lung function and exercise capacity and therefore might be used as part of a pulmonary rehabilitation program for COPD patients.

Help guide your patients to live a healthier lifestyle and to incorporate healing exercise like yoga into their daily lives.  This guidance will only support your treatment plan for your patients with COPD and asthma. The incorporation of spirometry into your practice continues to be the gold standard in diagnosing and properly treating your patients easily in your office.  Join us in creating a better diagnosed and treated patient today.

For more information about our Gold Standard Pulmonary Function Test—Spirometry, visit us at www.mdspiro.com.

References:
http://mdspiro.com/spirometry
http://mdspiro.com/for-your-practice
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4073384/
J Thorac Dis. Jun 2014; 6(6): 795–802. doi:  10.3978/j.issn.2072-1439.2014.06.05
Manocha R, Marks GB, Kenchington P, et al. Sahaja yoga in the management of moderate to severe asthma: a randomised controlled trial. Thorax 2002;57:110-5 [PMC free article] [PubMed]
Sabina AB, Williams AL, Wall HK, et al. Yoga intervention for adults with mild-to-moderate asthma: a pilot study. Ann Allergy Asthma Immunol 2005;94:543-8 [PubMed]
 Jayasinghe SR. Yoga in cardiac health (a review). Eur J Cardiovasc Prev Rehabil 2004;11:369-75 [PubMed]
Malhotra V, Singh S, Tandon OP, et al. The beneficial effect of yoga in...

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6 Surprising Asthma Triggers

Chances are, you know someone with asthma -- after all, about one in 12 people in the U.S. has the condition. Having asthma means to have airways that are inflamed, which makes them particularly sensitive to substances ranging from pollution to dust. Exposure to an asthma trigger can cause the narrowing and swelling of the airways, as well as increased production of mucus, making it very difficult to breathe. When these asthma symptoms are particularly intense, that’s called an asthma attack — and knowing what exactly triggers these attacks is vital for people with the respiratory condition.

Some asthma triggers are more commonly known than others. Secondhand smoke is an obvious one, as is mold. 

Mice
While it is common knowledge in the asthma world that pets can trigger an asthma attack, other animals can be culprits, too -- such as mice. It is a rather common allergen, especially in the cities.

Stinkbugs
It's hard to say many people find stinkbugs to be generally appealing to begin with. They really penetrate homes when the weather cools down.  Stinkbugs can be found in most states, including New York, Pennsylvania, New Jersey, the Carolinas, Virginia, West Virginia and Ohio. Plus, dead stinkbugs in the home could even attract mice, a distressing double-whammy for people with asthma.

Ladybugs
Ladybugs are certainly cuter than stinkbugs, but they can be just as harmful to people with asthma. Asian lady beetles in particular, penetrate homes in the fall and their body parts decompose. That allergen, the dust from their body parts, is pretty strong. 

The Highway
Sure, cars and highways are pretty hard to avoid in this day and age. But unfortunately for people with asthma, close proximity to a highway can spell trouble. The emissions of cars can not only increase the risk of asthma, but also increase the severity of asthma. Running along a highway is a bad idea too.  It is probably not a good idea for anybody, but that’s especially true for people with asthma.

Rhinovirus
Getting a cold is an annoyance for anyone, but for people with asthma, it can be life-threatening. That's because rhinoviruses -- the main cause of the common cold -- can also induce asthma attacks.  Allergens can trigger asthma attacks, but usually it is not as severe as that associated with the rhinovirus.

The flu can also pose a danger to people with asthma, which is why people with asthma should make sure they get their flu vaccine because the flu can...

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Obesity Increases the Risk of COPD Even for Non-Smokers

Obesity increases the risk and progression of chronic obstructive pulmonary disease (COPD), even for people who’ve never smoked before. A team of American and German researchers measured the waists, hips, body mass index (BMI), and physical activity of newly diagnosed COPD cases in the U.S., and published the clear link they found in the Canadian Medical Association Journal.

"We observed a stronger positive relation with abdominal body fat than with total body fat and COPD," Dr. Gundula Behrens, of the Department of Epidemiology and Preventive Medicine at the University of Regensburg in Germany, wrote. "In particular, overweight as measured by BMI emerged as a significant predictor of increased risk of COPD only among those with a large waist circumference."

Study:

The 113,279 men and women they looked at, all of whom were between the ages of 50 and 70, did not have COPD, heart disease, or cancer at the beginning of the study. The 10-year follow-up revealed that COPD had developed in 3,648 people. Women who had a waist circumference of 110 centimeters (43.3 inches) and men with a circumference of 118 centimeters (46.4 inches) had a 72 percent increased risk of COPD.

COPD is a lung disease caused by either chronic bronchitis or emphysema, making it very difficult for people to breathe over time. It is the third leading cause of death in America, according to the American Lung Association. There are 6.8 million women diagnosed with chronic bronchitis, which makes them twice as likely to be diagnosed as men, who make up 3.3 million of the affected population.

"Increased local, abdominal, and overall fat depots increase local and systemic inflammation, thus potentially stimulating COPD-related processes in the lung," the authors wrote, according to a press release earlier this month.

Obesity is a common and serious condition that's present in more than one-third of U.S. citizens — their BMIs are 30 or higher, according to the Centers for Disease Control and Prevention as they define obesity. BMI is not a direct measure of body fat, and knowing this, the researchers also looked at other factors including their amount of physical activity. In addition to waist circumference, other causes of COPD are pollution, smoking, and toxic particles or dust in the work place, which trigger chronic inflammation and difficult-to-heal injury in the lungs.

Those with large hip circumferences, who were also physically active at least five times a...

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Kids and Exercise-induced Asthma

Kids who have exercise-induced asthma (EIA) develop asthma symptoms after vigorous activity, such as running, swimming, or biking. Some develop symptoms only after physical exertion, while others have additional asthma triggers. With the proper medications, most kids with EIA can play sports like any other child. In fact, asthma affects more than 20% of elite athletes, and one in every six Olympic athletes, according to the American Academy of Allergy, Asthma, and Immunology.

As a doctor you can properly and accurately diagnose EIA after performing an exercise challenge with a pulmonary function test in your practice. You might want to target a child's tolerance for a particular exercise, as not every type or intensity of exercise affects kids with EIA the same way.

If exercise is the only asthma trigger, you may prescribe a medication for the child to take before exercising to prevent airways from tightening up. Of course, even after taking a preventive medication, asthma flare-ups can still occur and it is extremely important to monitor the child on an ongoing basis through spirometry tests and the utilization of peak flow meters during the course of treatment.

Parents or older kids should carry the proper rescue medication to all games and activities. Rescue medications work immediately to relieve asthma symptoms when they occur. The school nurse, coaches, club leaders (Boy Scouts, Girl Scouts, etc.), and teachers must be informed of a child's asthma plan of care so that kids take their medication as needed when away from home.

Additionally, asthma can be triggered by allergies.  An estimated 75% to 85% of people with asthma have some type of allergy. Even if the primary triggers are colds or exercise, allergies can sometimes play a role in aggravating the condition.

Work with your patient’s parents to create an asthma action plan today.  Take that next step in further caring for your patients and bring spirometry into your practice.  Your patients will be correctly diagnosed so you can treat them more accurately and conveniently.  Help children with asthma breathe easier and play a part in keeping them active and healthy.

For more information about our Gold Standard Pulmonary Function Test—Spirometry, visit us at www.mdspiro.com.

References:
http://mdspiro.com/spirometry 
http://www.aaaai.org/home.aspx
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The Third Leading Cause of Death in the US

The Centers for Disease Control and Prevention state that COPD is the THIRD leading cause of death in America. The third.  With heart disease and cancer taking the lead.  Approximately 15 million U.S. adults are estimated to have COPD.  When combining COPD with other health issues, this can be a serious problem in the lives of your patients and loved ones.

COPD is diagnosed in four stages, each of which are characterized by a measure of lung function and measured by the breathing test spirometry.  This important test shows how much air your patients’ lungs can hold and how fast they can release the air from the lungs.

Stage one is mild COPD.  A spirometry test will show some restriction.  A mild cough may be in play.

Stage two is moderate COPD.  Air flow begins to worsen at this stage.  Your patient may begin to notice a shortness of breath in activities like climbing stairs.  A cough may begin increasing and mucus production begins. They often will have prolonged symptoms of the flu or cough.  Typically this is the stage patients start to seek treatment.

Stage three is severe COPD.  Your patient will become short of breath after very little activity and will quickly become fatigued.  Their cough will become more frequent and airflow is severely limited, with times requiring hospitalization.

Stage four is very severe COPD.  At this point, quality of life for your patient is greatly impaired and symptoms have become life-threatening.  Lung function can be dropped to 30% or less and your patient usually requires oxygen therapy on a daily basis.  Complications can arise such as weight loss, fluid build-up in the legs and feet, chronic respiratory failure and heart disease (the number ONE killer of Americans).

Catching COPD early can make all of the difference in your patients’ lives so they can live a longer, happier, and healthy life.  

Take the step in caring for your patients and bring spirometry into your practice today.  Your patients will be correctly diagnosed so you can treat them more accurately and conveniently in your practice.

For more information about our Gold Standard Pulmonary Function Test—Spirometry, visit us at www.mdspiro.com.

References:
http://mdspiro.com/spirometry 
http://www.lung.org/lung-disease/copd/resources/facts-figures/COPD-Fact-Sheet.html
http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf

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