Emergency and Disaster Planning for those with Chronic Respiratory Conditions

Disasters and emergencies can happen to anyone at any time and sometimes without warning. It helps to have a plan in place if you have a chronic condition that requires the use of medical devices. Your local officials may or may not have prepared for your needs, so planning for an emergency before it happens is very important.

  • Ask your local officials if there is a plan for oxygen delivery, providing a power source for your equipment and where emergency shelters are located.
  • Contact your local power/utility companies and let them know that you have special needs and get on their priority list for restoring power.
  • If you are using ventilatory support, suction, a medical air compressor, CPAP or need to use your oxygen continuously consider purchasing a generator or portable batteries.
  • Have appropriate supplies (1-2 weeks) of medications, food and water.
  • Make sure you have a way to contact someone for help if your telephone or power is out of service. Purchase a battery that will charge your cell phone.
  • If using an oxygen concentrator make sure you have an oxygen cylinder as back up.
  • Know how to contact your medical supplier in an emergency.
  • Keep a list of all your medical equipment and the type, model and make and settings used.
  • For ventilator patients always have a bag/mask device available.
  • ALWAYS take the power cord for your machines, short trips or not.
  • Find out if there is an inhaler version of any medications you are taking with a nebulizer in case of a power outage.
  • If any medications require refrigeration have a plan for keeping them cold.
  • If you know a storm is coming and you may be forced to evacuate, be sure to have a full tank of gas in your car.

This list should help you devise a plan that will keep you and your loved ones safe during an emergency or disaster. Don’t wait for an emergency to happen, plan ahead.

Back to School with a “circle of care” for your Child with Asthma

Can it really be time to head back to school?

Preparing for another successful school year by supporting the management of your child’s asthma and anyone who interacts with him or her is at the top of your ‘must do’ list.

Who should be on that list? Maybe a few people you hadn’t considered or maybe you have but aren’t sure where to begin?

Start with the school nurse, teachers, the school bus driver and anyone who’s on the “need to know” list set by the school nurse and you. Establishing a good network of care will help to insure your child’s safety as well as encourage him or her to participate in all aspects of the new school year.

The whole process is much easier if roles and responsibilities can be defined for everyone.

You and your child should complete an Asthma Action Profile together to verify what you do and don’t know about your child’s asthma. It is important your child be included in establishing a current asthma record because you won’t always be there when they need help. Visit www.breathepa.org  or call 800-220-1990 and request an Asthma Action Profile. Make a copy of the one-page Asthma Record for the school nurse.

Next, meet with your physician, so your child and you can discuss and create an Asthma Action Plan. This plan should cover medications used both at home and at school. It should also include the purpose, and dosage of the medication, and what to do if your child has an asthma attack at school. Remember to provide current contact information and provide the needed medication for the school nurse office.

Meet with your school nurse and discuss what information should be shared with teachers and school bus driver. Your school nurse can determine the best way to share this information.

Making sure that everyone is on the same page will help support your efforts in keeping your child healthy, in school and ready to learn. For additional information or to find out how you can bring an asthma program to your school, contact Jeannie Simms at 800-220-1990.

 

 

Indoor Air Quality and Carpets

Did you know that you could control your allergies in the home if you control your Indoor Air Quality? You might be surprised to know that the biggest culprit is your carpet.

Switching to solid flooring and using washable area rugs is the best way to control severe allergy symptoms. Assuming those symptoms are directly related to carpet issues. Most people are not able to make this expensive modification to their home. It is also a personal preference that can change the overall look of a home.

According to the Asthma and Allergy Foundation of America, the rules listed below may help homeowners with carpet control allergens:

Rule #1: Select carpets with short tight weaves. They limit dirt and allergens from becoming imbedded, and consistent vacuuming will help keep such materials off of the top.

Rule #2: Look for newer vacuums with HEPA filtration.The Carpet and Rug Institute gives a seal of approval to vacuums that meet their standards, for more information visit www.carpet-rug.org. Keep in mind that the filters that will clog up over time. Periodic cleaning or replacement of the filters will keep them functional.

Rule #3: Try steam cleaning your home every six months. For DIY fans this can be a great project. Make sure any spills or stains are not only cleaned up quickly, but cleaned completely. A wet spot is an opportunity for mold growth.

Rule #4: This forth rule is my addition.Keep humidity levels low in a home. Please see previous blogs on basement wetness issues and mold.

Controlling Indoor Air Quality can be a chore, but easier breathing is a blessing for asthma sufferers.

E-Liquid Ingredients: You May Not Know What You’re Vaping

E-cigarettes do not contain actual tobacco or other harmful ingredients such as carbon monoxide and tar, which are found in traditional cigarettes. Instead, e-cigarettes use a liquid nicotine solution know as e-liquid or e-juice. What exactly is e-liquid? E-Liquid is made up of four basic ingredients; water, nicotine, flavorings, and a propylene glycol or vegetable glycerin base (or sometimes a mixture of PG and VG).

Nicotine – The addictive ingredient found in e-cigarettes and traditional cigarettes. Nicotine stimulates the central nervous system and raises blood pressure, respiration and heart rate. When nicotine enters the brain, it releases a feeling of pleasure as dopamine levels increase. Makers tend to offer their products in varying ranges of nicotine content, ranging from none to 36 milligrams per milliliter. Nicotine, while not considered a carcinogen, is still addictive and may “prime the brain to become addicted to other substances,” according to the National Institute on Drug Abuse.

Flavorings – Over seven thousand flavors exist including cherry, coconut, berry blast, fresh apple, sweet tarts, cinnamon and even tobacco. It would be impossible to list all of the chemicals that create the flavors here, but one chemical that stands out is diacetyl. Diacetyl is commonly used to create a buttery flavor to popcorn. While this chemical is believed to be perfectly safe to ingest, there is mounting evidence that inhaling diacetyl can trigger an incurable disease called Obliterative bronchiolitis (OB), also known as “Popcorn Lung.”

Propylene Glycol (PG) – This is a lab-made liquid that the FDA generally views as safe in food, drugs and cosmetics. It’s also used to make artificial smoke or fog for performances. It can irritate the lungs and eyes and may be more harmful for people with chronic lung diseases like asthma and emphysema.

Glycerin – Odorless and colorless, liquid glycerin has a slightly sweet taste. Like PG, the FDA generally views it as safe. It’s found in many products, including food and drugs, both prescription and over the counter medications.

While some of the ingredients listed above are known to be generally safe in food and drugs, what remains unclear are the health risks that come from inhaling large amounts of the chemicals over time. Long-term effects are almost guaranteed. What they are exactly cannot be defined just yet. One thing is for sure: they won’t be good.

 

A Look At How Flu Vaccines Are Made

Flu season is coming up soon, but have you ever thought about how the vaccines are made? Currently there are three influenza vaccine production technologies that are utilized in the United States.  All meet U.S. Food and Drug Administration (FDA) approval. They are:

  • Egg-based flu vaccine
  • Cell-based flu vaccine
  • Recombinant flu vaccine

Egg-based flu vaccine

The egg- based process has been used for some 70 years. When the current year’s flu virus strains have been identified by the World Health Organization (WHO) Influenza Surveillance System and approved for use in the United States by the FDA, these candidate vaccine viruses (CVVs) are injected into fertilized hen eggs and incubated for several days to allow the viruses to replicate. For flu shots, the influenza viruses are then inactivated (killed), and the virus antigen is purified. This method requires large numbers of chicken eggs and usually takes longer than other methods to produce a vaccine.

Cell-based flu vaccine

The cell-based production process for flu vaccines was approved by the FDA in 2012. However, until recently, this production process also began with egg-grown candidate vaccine viruses (CVVs). In August of 2016, the FDA issued an approval for Seqirus, the sole FDA approved cell-based flu vaccine manufacturer in the U.S. to use cell grown CVVs. Cell-based flu vaccine production does not require chicken eggs because the vaccine viruses used to make the vaccine are grown in animal cells. Cell culture technology has the potential for a faster start-up of the vaccine manufacturing process.

Recombinant flu vaccine

The recombinant method of producing flu vaccine was approved by the FDA for use in the U.S. market in 2013. This production method does not require an egg grown vaccine virus and does not use chicken eggs at all in the manufacturing process. It uses an influenza virus protein that is made by genetically modifying a virus that infects insect cells to produce the flu vaccine protein. The protein, as in other flu vaccines, then triggers the immune system of the person receiving the vaccine to make protective antibodies. Currently, recombinant flu vaccine is the only 100% egg free vaccine on the U.S. market.

As with all health related issues, it is best to have a discussion with your physician in making the determination as to which flu vaccine formulation is best for you.

For further information: www.cdc.gov/flu/protect/vaccine/how-fluvaccine-made.htm

CDC Presents A Patient Tuberculosis Education Series

The Centers for Disease Control and Prevention (CDC) has recently updated and made available a six booklet patient tuberculosis (TB) education series for healthcare providers to utilize with people who have TB disease, as well as those with latent tuberculosis infection (LTBI).

Education is a key element in CDC’s tuberculosis elimination strategy. To that end, this user-friendly series employs an easy-to-understand conversational style, colorful photos and actual patient examples. Topics covered in the six individual booklets are:

Booklet One: Get The Facts About TB Disease – How tuberculosis is transmitted, treatment of TB disease, and how to communicate with family and friends about the disease.

Booklet Two: What You Need To Know About TB Infection  – Definition of TB infection, the Mantoux Tuberculin Skin Test (TST), and why it is important to adhere to prescribed medication in LTBI.

Booklet Three: What You Need To Know About The TB Skin TestFacts about the TST.

Booklet Four: Protect Your Family And Friends From TB: The TB Contact InvestigationIssues relating to protecting others from TB and what to ask healthcare workers during a contact investigation.

Booklet Five: Take Steps To Control TB When You Have HIV – Vital importance of TB testing, and treatment of TB disease and TB infection when a person is HIV positive.

Booklet Six: Staying On Track With TB Medicine – Discussion of TB medications and hints for staying on target with medication regimens.

All of the above booklets are available in English, Spanish, Tagalog and Vietnamese. To access this material, visit  http://www.cdc.gov/tb/publications/culturalmaterials.htm

 

What Is H7N9 and Why is it of Worldwide Concern?

H7N9 is a subtype of influenza A viruses that is sometimes found in birds, but that does not usually affect humans. Many H7 viruses have circulated in poultry for centuries. However, beginning at the end of March 2013, China reported the first new cases of infections spread from birds to people with a new strain of H7N9, which was very different from previously known H7N9 viruses. Although the transmission of the virus to humans has remained sporadic, it has steadily increased to where in May 2017, China reported 688 human infections to the World Health Organization (WHO). This increasing number of human infections has raised serious concerns by WHO and also the federal Centers for Disease Control and Prevention (CDC).

Poultry infected with H7N9 virus do not experience any symptoms or signs of illness, yet they can transmit the virus to humans. To date, most of the reported human cases have experienced severe illness, beginning with high fever and cough, and frequently progressing to pneumonia. About 40% of these reported human cases have died. Although the H7N9 virus continues to have the greatest potential to cause a worldwide pandemic, presently there is no evidence of “sustained” spread of the virus from person to person. Ongoing spread of a virus among humans is necessary for a pandemic (global outbreak) to occur. Health officials are watching the situation closely for this.

Currently there is no publicly available vaccine to protect against H7N9 infection. Most of the H7N9 viruses which have been studied, however, appear to be susceptible to the three influenza antiviral drugs (oral oseltamivir, inhaled zanamivir and intravenous peramivir) that are recommended in the treatment of seasonal influenza.

No H7N9 virus infections of birds or humans have been detected in the United States so far, and at this time, the risk to people in the U.S. is considered to be very low. What about travel to China? Because H7N9 is not spreading easily from person to person, CDC and WHO are not recommending that people delay or cancel trips to China. CDC does advise travelers to China to take some common sense precautions such as not touching birds or other animals, avoiding live poultry markets, and washing hands often. All poultry and poultry products should be fully cooked.

It is always of significant public health concern whenever a new influenza A virus subtype (e.g. H7N9) that infects humans and causes severe illness emerges. For this reason, CDC, together with domestic and international partners such as WHO, continues to closely monitor the situation in China, with the goal of averting the possibility of a worldwide pandemic of H7N9 influenza.

For additional information visit: https://www.cdc.gov/flu/avianflu

Alternative and Complementary Treatments for Managing COPD

With the internet and Google at our fingertips, it’s easy to find all sorts of advice, options and less conventional means of controlling or managing the symptoms of chronic lung diseases. However, many of these solutions are untested or have minimal proof of benefit.

It’s important to get medical and clinical advice before beginning any sort of treatment or therapy to help control your lung disease.

In conjunction with medications typically prescribed, the following options are proven to work, though you should keep in mind that results vary due to severity of disease and lung damage already present:

  1. Pulmonary Rehabilitation is proven to help decrease symptoms, reduce number of exacerbations, improve lung function and, in some cases, help to decrease the amount of oxygen therapy needed.
  2. Breathing exercises/relaxation exercises
  3. Yoga and Tai Chi aim to calm the mind, which helps to calm the body and its responses to stress.
  4. Watch what you eat. Carbohydrates release carbon dioxide, which is already hard to expel with COPD. An excess will increase your breathing rate and make you feel more short of breath.

Here are some unproven therapies:

  1. Acupuncture, Ginseng and XCP paste—check with a doctor trained in Traditional Chinese Medicine before beginning any of these.
  2. Eucalyptus Oil can cause lung irritation and adversely interact with certain medications.
  3. Vitamin D has been proven in some small studies to prevent exacerbations, but requires taking extremely large doses. Instead try to add the foods high in Vitamin D to your diet, such as cheese and egg yolks. Foods fortified with Vitamin D, such as some dairy products, orange juice, cereals, and Omega-3 fatty fish (tuna, salmon and mackerel).

How Did You Sleep Last Night?

Most mornings, the question, “How did you sleep last night?” starts the conversation between my husband and me.  When my kids were teenagers, I was constantly bugging them about how they slept—if only to find a reason for their irritability.

I used to be a great sleeper, but one of the things I have really noticed about getting older is the way that my sleep quality is changing. Sure, there are still mornings when I wake up refreshed and energized, but my sleep has been changing enough that I am starting to experience more and more of those “not-so-great” mornings, too.

So, why is this even worth my time to share?  Because as my good night’s sleep becomes more elusive, I feel the impact more and more.  Of course, I already know that sleep is important.  Everyone knows sleep is important. Forty years ago, my grandma used to tell me that nothing was more important than a good night’s sleep.

Fast forward to 2017, and now there are hundreds of credible authorities who have used research and compiled data to back up the importance of sleep. The Center for Disease Control (CDC) has linked insufficient sleep to many chronic health issues such as diabetes, high blood pressure, obesity, depression and some cancers.   Beyond the health link, they also point out some important public health issues that are caused by people sleeping too little. They have linked lack of sleep to thousands of automobile crashes, industrial accidents and medical errors. On a daily basis, insufficient sleep has been shown to affect concentration, memory and overall performance on daily activities.  I definitely notice a decrease in my ability to focus after I have had a bad night of sleep.

In keeping with our mission at Breathe Pennsylvania to help our community live and breathe better, I will be sharing lots of information about sleep quality, effects of poor sleep, sleep apnea and what can be done about it.

If you have a personal story about sleep and breathing, stay tuned!  I’d love to hear from you as we explore this journey together.

Here’s to a good night’s sleep tonight!

What are the components that make up the flu vaccine?

Although summer is just beginning, the U.S. Food and Drug Administration has already announced the components of the influenza vaccine for the northern hemisphere in the 2017-2018 flu season.

For the trivalent vaccine the components are:

  • A/Michigan/45/2015 (H1N1)pdm09-like virus
  • A/Hong  Kong/4801/2014 (H3N2)-like virus
  • B/Brisbane/60/2008-like virus (B/Victoria lineage)

 In addition to the above, the quadrivalent vaccine will contain:

  • B/Phuket/3073/2013-like virus (B/Yamagata)

So how are flu vaccine components determined? There are more than 100 national influenza centers located throughout the world. These centers conduct year-round surveillance for influenza, involving testing thousands of influenza virus samples from patients. From these samples, the centers send representative viruses to five World Health Organization (WHO) Collaborating Centers for Reference and Research on Influenza, which are located in Atlanta, Georgia,United States; London, United Kingdom; Melbourne, Australia; Tokyo, Japan; and Beijing, China. As one of these Collaborating Centers, the Centers for Disease Control and Prevention (CDC) in Atlanta receives and tests thousands of influenza viruses from around the world.

Twice a year, the WHO consults with the directors of the WHO Collaborating Centers and with representatives of key national laboratories and academies. At these meetings, which take place in February for the selection of the upcoming northern hemisphere’s seasonal influenza vaccine and in September for the southern hemisphere’s vaccine, the WHO recommends specific vaccine viruses for inclusion in the vaccines.  Based on the WHO recommendations, each country then makes their own decision about which viruses should be included in influenza vaccines to be licensed in their country.

In the United States, the FDA makes the final decision about vaccine viruses to be included in flu vaccines to be sold. As soon as a decision has been made concerning which viruses should be incorporated into the vaccine, private sector manufacturers begin the process of producing the vaccine. The manufacturing process is time sensitive, as it takes at least six months to produce large quantities of influenza vaccine.  In order for vaccines to be delivered in time for vaccination to begin in the fall, manufacturers may actually begin to grow one or more of the vaccine viruses as early as January, based on their best guess as to what viruses are most likely to be included in the vaccine.

What Is The Best Time To Get A Flu Shot?

In western Pennsylvania, the flu season generally occurs in mid/late October through March. Since it takes approximately two weeks for protective vaccine antibodies to develop, September and early October are considered to be optimal times to receive a flu shot. However, a flu shot may be received at any time, even when the flu illness has actually occurred in the community.

What Is The Best Flu Vaccine Formulation To Receive—Trivalent or Quadrivalent?

In addition to the trivalent and quadrivalent formulations, in recent years a “high dose” flu vaccine has been developed specifically for people 65 years of age and older.

Keep in mind that, as with any health-related issue, it is best to discuss flu immunization with your doctor in making the decision as to which flu vaccine is most suitable for you. For additional information, visit https://www.cdc.gov/flu.