Live well with asthma: Peak flow meters – National Consumers League

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Even when you feel like you are breathing well, a peak flow meter can alert you to changes in your lung function. You may see a drop in peak flow numbers even before you have asthma symptoms (like coughing or wheezing). This device can help you manage your asthma and may reduce the number and severity of asthma flare-ups.

Keeping a peak flow chart can be very helpful to you, and to your health care provider. You can use it to track your lung function and provide important information on how you are responding to treatment at home so your doctor or nurse can help you with the best treatment plan.

Use and Care of Your Peak Flow Meter

  • Understand how to properly use your peak flow meter.
  • Follow the cleaning instructions. This will help keep the readings accurate.
  • Follow your health care provider’s recommendation on how often you should use your peak flow meter and at what time of day.

How to Graph Your Score

Ask your health care provider to help you determine your personal best peak flow score.

Your personal best peak flow score may change over time. It changes for children as they grow. Discuss this with your care provider at least once a year.

When you know this personal best score, you can graph your peak flow scores into zones:

  • green (best)
  • yellow (caution)
  • red (medical alert)

Using these colors helps you visually track scores that are in your own personalized zones. One easy way to do this is to use highlighters to color in the green, yellow, and red zones on your chart.

Green Zone: This is a score that is 80 percent to 100 percent of the personal best score. This is your goal for optimum management of your asthma.

Yellow Zone: This is a score that is 50 percent to 80 percent of the personal best score. This is your caution zone. Review your daily treatment plan for proper treatment in this zone, which may include a call to your health care provider or increased medication use or dose. If your prescribed treatment is not working, or you find yourself often falling within this zone, you may need to revise your daily treatment plan with your health care provider.

Red Zone: This is a score that is below 50 percent of your personal best score. Consider this your “danger” zone. Contact your health care provider for instruction when you get a reading in this zone.

Work with your health care provider to find your personal best peak flow score and set the color zones. Be sure to get written instructions on what to do when you record readings in each of these zones.

Let’s say your personal best peak flow score, as determined by your health care provider, was 625. Here is how the color zones could look:

Green Zone: Between 80 and 100% of personal best score. Determine 80% of your score to get the “floor” for the green zone. (625 x .80 = 500; green zone ranges from 500 to 625)

Yellow Zone: Between 50 and 80% of personal best score. Determine 50% of your score to get the “floor” for the yellow zone. (625 x .50 = 312; yellow zone from 312 to 500)

Red Zone: Below 50% of Personal Best (chart red zone below 312)

No matter what your peak flow meter number is, get help if you experience asthma symptoms that you and your health care provider have identified in your plan as being serious (such as severe wheezing or chest tightness).

Parenting a child with asthma is no picnic – National Consumers League

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Watching your child have an asthma attack, or even just symptoms, can be frightening. Keep your kids safe by planning ahead.

For parents of young babies with asthma 

Talk to your doctor to make a daily treatment plan. At the first sign of symptoms (wheezing, coughing, or rapid breathing) respond right away. See a doctor regularly to check on your baby’s asthma, even if the baby is not having symptoms.

Babies can go from having just a few asthma symptoms to a severe attack very quickly! Listen to your baby when he or she is breathing normally so you will be able to spot signs that something is wrong. Your baby needs emergency help if: 

  • Breathing rate increases to more than 40 breaths per minute while sleeping. To find breaths per minute, use a watch or timer to count the number of breaths your
    child takes in 15 seconds, and multiply that number by 4.
  • Suckling or feeding stops altogether.
  • Ribs or stomach move in and out deeply and rapidly
    when breathing.
  • Chest expands but does not deflate when exhaling.
    This is not normal breathing.
  • Face changes color from normal to pale or red in the face, or his or her fingernails turn blue.
  • Cry becomes softer and shorter.
  • Nostrils open wider.

DO NOT do these things if your baby is experiencing asthma symptoms:

  • Do not have your baby breathe warm, moist air (like the mist from a hot shower or vaporizer). These things may contain mold that you may not be able to see, and this could make your baby’s breathing worse.
  • Do not have your baby breathe into a brown paper
    bag     held tightly over the nose and mouth, as people often do for hyperventilation.
  • Do not give your baby over-the-counter medicines.
    Use the asthma medicines that your doctor has prescribed.
  • Do not give your baby a lot of liquid to drink. Normal amounts are okay. 

For parents of school-aged children with asthma

Asthma is the biggest reason children miss school days in the United States, causing more than 14 million missed school days a year! Because children spend so much time at school, teachers and other staff need to understand asthma, how to manage symptoms, and how to do their part to create a healthy breathing environment.

You can help your child stay healthy (and in school!) by welcoming teachers and staff into your child’s asthma management team. Talking regularly with people in your child’s school can help you manage your child’s asthma and enable the school provide a healthy environment. Be sure that the people charged with caring for your children during the day know what they can do to manage your child’s asthma.

By working together, you can keep your child’s asthma under control.

What You Can Do:

Here are some things you can do:

  1. Develop an asthma action plan for school – Work with your child’s health care provider to develop a plan with step-by-step instructions for how to avoid – and if necessary treat – an asthma flare up at school. The plan should include a list of your child’s asthma triggers, medications and emergency contacts. Make multiple copies of the plan and give them to all adults who interact with your child at school, such as teachers, principals, classroom aides, playground monitors and the school nurse.
  2. Make sure your child can take asthma medications at school. Talk with the school about how and when your child can take medications. A school nurse can hold medications (including a fast-acting inhaler or bronchodilator) for your child. Or, if your health care provider agrees, and your child is comfortable, ask that he or she be able to carry and use a fast-acting inhaler at school without asking permission. If your child is embarrassed about taking medications, try to arrange for a private area or time that will not attract attention. Confirm that asthma medications can be and are taken on field trips.
  3. Help your child fully and safely participate in physical activity at school. If exercise is an asthma trigger for your child, confirm that your child can use medications before, during and after physical activity. If necessary, ask the school for permission to modify the physical activity (such as walking quickly instead of running). Kid’s need exercise, so be sure to encourage your child’s participation; but be realistic about what he or she can handle, and keep needed medication available just in case.
  4. Monitor the school environment. Look at your child’s school for asthma triggers, such as strong smelling cleaning supplies. If triggers cannot be reduced, ask about switching your child to another classroom where there is less exposure to the triggers. Look for:
    • Air quality and ventilation

Are the school grounds free of tobacco smoke at all times? Are art and chemistry classrooms well ventilated so chemical vapors don’t spread?

    • Cleanliness

Are the classes dusted and cleaned regularly? Is dust-free chalk used? Are unscented cleaning chemicals used when possible?

    • Classroom pets

Pets with fur or feathers can trigger asthma. Even if the pet is not kept in your child’s classroom, air circulation systems can spread animal dander to other parts of the school.

    • Moisture

Moisture can lead to mold which can trigger asthma. Are windows free of condensation? Are classroom sinks and bathrooms free of leaks?

What Your Child’s School Can Do:

If you have questions about how the school supports children with asthma, talk to school personnel about your concerns.

For more information on what schools can do to manage asthma, visit the National Asthma Education and Prevention Program, National Heart Lung and Blood Institute.

Adapted from the Guidelines for the Diagnosis and Management of Asthma, National Asthma Education and Prevention Program of the National Heart, Lung and Blood Institute, 1997 and from guidelines from the School Asthma Education Subcommittee, National Asthma Education and Prevention Program, National Heart Lung and Blood Institute.

Live well with asthma: Know your triggers – National Consumers League

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May is Asthma Awareness Month! Did you know that many asthma patients have found that making just one lifestyle change helps improve their symptoms. Know your triggers and avoid them.

Things that bring on asthma or make it worse are called your triggers. It is important for you to know your own asthma triggers. They are different for everyone.

Here’s a list of some of the most common allergens (which cause an allergic reaction), irritants (which irritate your body), and other things that can bring on asthma symptoms. Your personal list may include some of these or even additional ones that you and your health care provider have identified.

Allergens

  • Dander (from the skin, hair, or feathers of animals)
  • Dust mites (insects too small to see found in house dust)
  • Cockroaches
  • Pollen from trees, grass, and flowers
  • Mold, both indoor and outdoor

Irritants

  • Tobacco smoke
  • Air pollution
  • Cold or dry air
  • Sudden changes in the weather
  • Strong odors (paint, chemicals, solvents)
  • Scented products (perfume, lotions, candles)
  • Strong emotional expression (including crying or laughing hard) and stress

Others

  • Common colds and other viral infections of the ear, nose and throat
  • Other infections, such as upper respiratory infections
  • Medicines, such as aspirin or beta-blockers
  • Sulfites in food or beverages (dried fruit, wine)
  • Diseases that cause heartburn can worsen asthma symptoms, especially at night.

Control and avoid your triggers

Using your asthma medicine regularly and the right way is a must for managing your asthma. It’s just as important to know what your triggers are and avoid them. Many people with asthma find that even making just one lifestyle change, like not hanging out with people who smoke or getting rid of family pets, has improved their asthma.

The following steps may help you reduce or get rid of the most common allergens and irritants that trigger asthma flare-ups.

Keep your home dust-free.

  • In at least the bedroom, get rid of heavy drapes, upholstered furniture, wool rugs, rug pads, stuffed animals and anything with feathers.
  • Use an airtight, allergy-proof plastic cover on all mattresses and pillows.
  • Use cotton or synthetic blankets, not quilts or comforters.
  • Use foam or Dacron (polyester fiber) pillows, not pillows filled with feathers.
  • Wash all bedding in hot water (150 degrees) every week.
  • Avoid using ceiling fans, and if you do use them, make sure you clean off dust from the hard-to-reach top side.
  • Cover air vents with glass fiber or cheesecloth filters.
  • Consider using a HEPA filter to control airborne allergens.

Keep your home bug-free.

  • Control cockroaches with insect sprays and roach traps, as cockroach allergens are a very common asthma and allergy trigger. Remember to wear a mask while spraying chemicals to avoid breathing in irritating fumes.

Keep your home pet-free (if you can).

  • Sometimes emotional attachments make it difficult to get rid of a family pet. If they have to live inside your house, keep them out of the bedroom where asthmatic family members sleep.
  • Choose a pet without fur or feathers (such as fish).

Keep your home mold-free.

  • Get rid of molds that are often found in basements, bathrooms, attics, closets, and water-damaged areas of the house.  If you find any, after removing it, make it less likely that it will return by taking out carpeting, wallpaper, or paneling in these areas.  Don’t use vaporizers or humidifiers in places that contain (or used to contain) mold.

Keep your home breathe-friendly.

  • Keep indoor humidity low(less than 50 percent), since dust mites and mold increase in high humidity.
  • Don’t smoke! And don’t let others smoke in your house.
  • Avoid using strong scentsand sprays, such as deodorizers, strong smelling cleaning products, and scented candles.
  • Don’t use the self-cleaning feature on your oven.
  • During pollen season, keep windows closed in the car and home to avoid exposure (especially on windy days).
  • Stay indoors when pollen counts are highest – during the middle of the day and afternoon.
  • Watch the weather report and listen for air quality news. Avoid being outside on days when pollution or ozone counts are high.

Outside Your Home

  • Remove wet leaves, cut grass or garden debris.
  • Use non-organic material for mulching and other landscaping.
  • Remove mold from roof shingles or siding.
  • Take your plants outside.
  • Wear a scarf over your mouth and nose in the winter.

 

Women’s health: Understanding hormone risk – National Consumers League

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Hormone health – whether related to health promotion, disease prevention, or optimal nutrition – is a critical issue for women and the health care providers who treat them. Issues such as hormone therapy, breast cancer prevention and treatment, and soy consumption are challenging health topics made more complicated by the ever-growing, and sometimes conflicting, information available to the public.  In this confusing environment, how do women and their health care providers access reliable information to make wise choices?

This question and others were explored at the National Consumers League’s Women’s Health Forum: Navigating Health Information, held on January 18, 2007 in Washington D.C., at the National Press Club. 

The forum provided attendees with background on these topics and explored how women and their health care providers must sift through vast amounts of often conflicting resources in order to find credible and reliable information. The American Nurses Association co-provided the forum and offered up to six hours of continuing education credit for nurses who attended. In addition to nurses, audience participants included other health care providers, consumer advocates, researchers, policy makers, and representatives from government and industry.

Tips for Identifying Reliable Resources

At the Women’s Health Forum, speakers and participants discussed the challenge of finding dependable information about the confusing and often controversial issues within women’s health. How’s a consumer to know whether what he or she is reading is trustworthy? The forum produced the following tips for judging the quality of health information:

1) When the resource includes information focusing on research for a specific medical treatment, consider the following:

  • What is the observed relative risk/benefit of the treatment, as well as the absolute risk/benefit? (See box below on the difference between absolute and relative risk) Are the findings statistically significant? Is this true for all populations or sub-groups evaluated?
  • Do the treatment studies have disease outcome results, or just surrogate markers?
  • If there is no evidence of harm or benefit available for the treatment, consider whether this is because the research findings are contradictory or not performed/available to the public; and
  • Is there a placebo effect – meaning that the patient’s symptoms are altered in some way (i.e., alleviated or exacerbated) by an otherwise inert treatment, due to the individual expecting or believing that it will work.

2) Always consider the source of information (does it appear in a peer-reviewed journal, or is it a sponsored white paper that has not undergone external scientific review?), the completeness of the research, and the financial ties of the source. Keep in mind that results from industry-sponsored studies are sometimes more favorable to that industry’s products than those conducted by independent third parties.

3) When reviewing health information, consider it in the context of your immediate concern (e.g., any symptoms you are trying to relieve or health conditions you want to treat now) AND your longer-term concerns (e.g., conditions or future health problems you are trying to avoid). Looking at the information in terms of both current and future health implications should help you make more informed and complete decisions.

Understanding risk

There are two main ways to talk about risk – relative risk and absolute risk.

Absolute risk refers to a person’s risk (or chance) of developing a disease over a certain time period.

Relative risk compares the risk of getting a disease in two different groups of people – such as a group taking medicine A compared to a group taking medicine B.

Although reports on new treatments often highlight the relative risk reduction of a treatment, the absolute risk gives a better sense of your individual risk. Both absolute and relative risk are important to consider, but relative risk can be misleading.

For Example:

Say 2 in 10,000 women risk developing cataracts by the time they are 70 years old. Research shows that a new treatment reduces the relative risk by 50%, meaning that a woman’s risk is reduced by half. In this example, the absolute risk of developing a cataract now falls from 2 in 10,000 women (.02%), to 1 in 10,000 women (.01%). A woman’s relative risk may be reduced by 50% with treatment, but a .02% absolute risk without treatment is still a pretty small risk.

This difference is particularly important for patients to consider when they look at the risks of particular treatments as well as benefits. If you have a very low absolute risk for a disease even before treatment, then the side effects associated with that treatment may not be worth the relative benefit you might get from taking it.