Chris Harancher, MS, RRT, Named As Director of Sleep Apnea Education

Chris Harancher, MS, RRT, joined the Breathe Pennsylvania staff as the Director of Sleep Apnea Education. Harancher has been involved in respiratory care for 25 years. She started as a Registered Respiratory Therapist with Butler Health System in 1992 after earning her BS degree from Indiana University of PA.

After obtaining her Master’s Degree in Professional Leadership from Carlow University in 2007, she accepted a position in higher education to assist in the development of what is now the Venango College of Clarion University Respiratory Care program.  As the Program Director and former Director of Clinical Education, she has spent the past ten 10 years educating respiratory care and other allied health care students.

Harancher is an active member of the Pennsylvania Society for Respiratory Care (PSRC) and the American Association for Respiratory Care (AARC).

“As a respiratory therapist, I have cared for many patients whose health has been directly or indirectly affected by sleep apnea.  Many patients were either unaware that they had sleep apnea or were not compliant with their treatments,” Harancher said. “In my new role, I am excited to bring together my knowledge and passion for education to make a difference.”

Avoiding Pneumonia—Even in the Summer

Pneumonia can rear its ugly head at any time of the year and for those suffering from chronic lung diseases, it’s best to be cautious all year round. Pneumonia is an infection in one or both lungs, sometimes only a specific section of a lung. It occurs when organisms settle in the air sacs and then grow rapidly, causing the sacs to fill with pus and fluid while the body tries to fight the infection.

People who have COPD are at greater risk of getting pneumonia because excess mucus is being produced and can trap the bacteria or fungus, allowing it to grow. Some symptoms of pneumonia are similar to those of a COPD exacerbation and include:

  • Fever higher than 100.5 degrees or shaking chills
  • Shortness of breath or more rapid breathing
  • Cough with increase in mucus
  • Cough with change in mucus color
  • Increased heartrate
  • Pain in one area of the chest with deep breaths

Call your doctor is you are experiencing one or more of these symptoms. The best ways to avoid pneumonia are:

  • See your doctor regularly, even if you are feeling well
  • Get a flu shot
  • Get a pneumonia vaccine if you’re due to get one
  • Wash your hands
  • Don’t smoke
  • Rest—a tired body is more susceptible to getting sick

It’s possible to stay healthy if you watch for early warning signs of a flare-up and report them right away to your doctor.

Mold: How it Can Affect Your Breathing

How does mold affect us?  Most people have a natural resistance to mold.  However, high levels of certain kinds of molds can cause people to have reactions.  This is especially true for toxic molds.

Different people have different susceptibilities, but most reactions are similar to hay fever:  sneezing, watery eyes, coughing and difficulty with breathing.

Mold is a very small “plant” that grows through the transmission of spores.  These spores are let go and then attach themselves to nearby surfaces and continue to grow as new plants.

Many molds are black, so when people see or talk about “black mold” they may not be seeing the toxic mold known as “stackybotrous.”

Unlike the plants that we are familiar with, molds do not get their energy from the sun.  They give off mycotoxins which help break down the organic material they attach themselves to.  They receive their energy through consumption of these organic materials.  Mold needs two things to live: an organic sub-straight to feed off of and water.  It gets its water from the air through high humidity.  This is why basements – especially those in Western Pennsylvania– tend to have mold, as the humidity there is higher than the rest of the home.

If you suspect that there is mold in your house and you have an asthma condition, the best option – as always – is to test.

The Importance of Getting The Flu Shot

Each flu season, many people debate whether or not they should get a flu shot. However, when we are deciding what is the best thing to do for our children/adolescents with asthma, we need to have a better understanding of the facts and fears we have towards the flu vaccine. Immunization each year is the best way to protect yourself and your children/adolescents with asthma from the flu.

Flu is an infection of the nose, throat, and lungs caused by the influenza virus. Symptoms can be mild to severe, especially in children younger than 5 who have asthma. These children are at a greater risk for complications from the flu such as pneumonia, bronchitis, and ear infections. These complications can lead to a stay in the hospital and even death. In 2017, there were 72 pediatric deaths from flu complications–74% occurred in unvaccinated children ages 6 months to 17 years old.

In 2016-2017, the live attenuated influenza vaccine (LAIV) or the nasal spray was not recommended due to concerns of it effectiveness. Centers for Disease Control and Prevention noted that in 2015-2016, the nasal spray had no protective benefit for children ages 2 to 17 whereas the children who got the flu shot were 63% less likely to get the flu compared to those who weren’t vaccinated. CDC will review this recommendation for 2017-2018.

CDC also recommends that everyone 6 months and older should be vaccinated every year by the end of October. However, you can still get your shot through January or later.

In this past year, the recommendations for people with egg allergies were updated. If you only get hives after exposure to eggs, you can get the flu shot. However, if you have additional symptoms, you can still get the flu shot as long as it is administered and supervised by your doctor who can manage severe allergic conditions. People with egg allergies no longer need to wait 30 minutes after the vaccine has been administered. People who are high risk can also be treated with antiviral drugs. It is most effective if started within 48 hours.

So this October, don’t be the one who “should have, could have, would have” gotten the flu shot. Remember children and adolescents with asthma experience more asthma attacks if they get the flu. To learn more about asthma management, as well as Breathe Pennsylvania’s programs and services, visit us at www.breathepa.org.

Whooping Cough Remains a Public Health Concern

It’s National Infant Immunization Week, which serves as a good reminder for parents and all adults to check with their doctors to make sure that their pertussis vaccination, as well as all recommended immunizations, are up to date.

Pertussis, a highly contagious respiratory disease known as whooping cough, is caused by the bacterium Bordetella pertussis. The disease is usually spread by coughing or sneezing, or when sharing breathing space with someone who has it. The cough can last up to 10 weeks or longer. The disease may cause serious illness, and can even be life-threatening, especially in babies.

Approximately half of the babies who are younger than 1 and have whooping cough need to be hospitalized.

In 2015, 20,762 cases of whooping cough (and 6 deaths) in the United States were reported to the Center for Disease Control and Prevention (CDC). Of this number, 2,709 cases occurred in children younger than 1 year. Worldwide, there are an estimated 16 million cases of pertussis and some 195,000 deaths annually.

There are currently two vaccines for whooping cough, and they are effective against Diphtheria, Tetanus, and Pertussis. DTaP is licensed for children up to 6 years of age. One dose is to be administered at 2, 4, 6, 15-18 months and again at 4-6 years.  Additionally, a single dose of the Tdap vaccine is recommended for people ages 11 through 64.

So why are we still seeing whooping cough in the population when effective vaccines exist? There are several reasons. First, it is thought that there may be a waning vaccine immunity which takes place over time in adults who had been immunized as children. Babies, especially those younger than 6 months of age who have not yet built up vaccine immunity, can be infected by older siblings, parents, or caregivers who might not even know that they have the disease. For this reason, it is very important that pregnant women, healthcare providers and caregivers of children younger than 1 year of age be vaccinated with Tdap.  It is possible that vaccinated children and adults may still contract pertussis, however, the disease is typically much less severe in vaccinated people.

Make sure to get vaccinated, and protect yourselves, your families, and the community from vaccine preventable diseases.

Reference: https://www.cdc/pertussis

Rest and Relax on Vacation, Even with Asthma and Allergies

Summer is a few short months away, and if you’re a planner, you’ve probably already stated making arrangements for vacation. In all the fun of booking, preparing and going on vacation, I always forget one thing—I have asthma and allergies.  This might not seem like a big deal to some, but I am leaving the comfort zone of my allergy controlled home to go to a place that could be filled with triggers. I clean my home to help my asthma and allergies but will my hotel room offer the same amount of relief and comfort so I can enjoy vacation?

While preparing for a recent trip to Disney World, I set forth to see what I could find to make my stay a little better for my own asthma and allergies.

The night before we left for Florida, we stayed at the local airport Hyatt in a Certified Pure® room.  It was a few dollars more than a standard room, but well worth it. I could tell as soon as I entered the room it was different than other hotel rooms I stayed in. It felt very clean. The carpets were specially cleaned, there was an air purification system in the room, and the mattress and pillows were encased in dust mite free covers. The bathroom soaps were all Hypo-allergenic and the room had a very light scent of Tea Tree Essential Oil, which is known to destroy airborne pathogens that cause allergies. This room was very well taken care of and really helped me feel the comfort that I was looking for.

The main hotel chains that offer Certified Pure® rooms are:

  • Hilton
  • Hyatt
  • Residence Inn
  • Doubletree

To find a Certified Pure® room for your next trip, visit www.pureroom.com.

The good news didn’t stop there. Walt Disney World resorts offer an allergy friendly cleaning process, but it is important to make the request at time of booking or a few weeks prior to arrival to allow the cleaning staff enough time to prepare for your arrival. Here are a couple of allergy friendly services offered:

  • The resort can provide deep dry cleaning with additional shampooing of carpets, upholstery and drapes as long as the guest notifies the staff in advance.
  • Housekeeping can be asked to use only vinegar and baking soda to clean the hotel room during the guest’s stay, avoiding the harsh scents of regular heavy duty cleaners.
  • Steaming with hot water of any hard surfaces and bathroom and patio floors.
  • Guest room air conditioning filters can be changed.
  • Fragrance free soaps and hypoallergenic pillows are available.
  • Bed linens and towels can be sent out and laundered with special hypo-allergenic soaps.

Leaving the comforts of your own home for a vacation can be a great adventure or an exacerbation waiting to happen, but proper preparation before leaving can make your vacation one to remember.  Don’t be afraid to ask the resort, hotel, or realty company you’re working with if they offer special allergy friendly cleaning. Taking this extra step can make for a happy healthy vacation.

   

Do You Have Overlap Syndrome?

Overlap Syndrome refers to diseases that overlap each other where the combined effect is worse than either disease alone. Two conditions that often overlap are COPD and Obstructive Sleep Apnea (OSA).

COPD is not a new disease, as it existed but was ignored long before cigarette use was widespread. Though OSA is associated with obesity, it’s not limited to obesity and 22 million people are diagnosed in the U.S alone.

The most common factor of both conditions is low oxygen in the blood (hypoxemia), and with the overlap, a person can have 30 times more episodes of desaturations at night. This puts a strain on the right side of the heart, which can lead to pulmonary hypertension.

People with Idiopathic Pulmonary Fibrosis might also fall victim to Overlap Syndrome because studies show that more than 80% also have OSA.

Treatment of Overlap Syndrome is the same as if treating each disease individually, with the primary emphasis on maintaining normal oxygen saturation levels. The main treatments are inhaled bronchodilators and CPAP to treat sleep apnea.

If you have COPD or Pulmonary Fibrosis and find yourself having difficulty sleeping, you should ask your physician about being tested for OSA. Having the right treatments for all conditions can significantly help to avoid problems that can be a result of Overlap Syndrome.

Using Asthma Medications When You Have A Milk Allergy

Can inhaled asthma medications containing lactose cause an allergic reaction in someone with a cow’s milk protein allergy? First I think it is important to clarify we are talking about two different issues:

 A milk allergy is a true food allergy caused by an allergic reaction to the protein in milk. This allergy usually shows up early in life.

“Lactose intolerance,” is when there is not enough of the enzyme lactase needed to break down lactose. Lactose is the sugar in milk and other dairy products. This is more common and not as severe as a milk allergy. It may take longer to develop, and it can happen at any time.

As I researched this, I found different views. One side recommended those who have a “cow’s milk protein” allergy not use dry powder inhalers (DPIs) with lactose. The concern is that it may trigger a severe asthma attack for individuals who are “severely allergic” to cow’s milk, inhaling being far more dangerous than ingesting the same amount of milk protein. Pharmaceutical grade lactose contains small amounts of milk protein.

The other side of this issue is that lactose in DPIs is not likely to be a problem. For example, Advair diskus contains 12.5 mg lactose but 3,000 mg are needed to provide symptoms. You need to take into consideration how many times you ingested medications containing lactose along with anything else that may have been mistakenly ingested. Lactose intolerance symptoms are more likely if you have ingested multiple medications ingested.

The good news is that all pressurized, spray inhalers (MDIs) are lactose free.

Dry powder inhalers (DPIs) that do contain lactose include: Advair diskus, Flovent diskus, Foradil aerolozer capsules, Oxeze (long-acting bronchodilator) turbuhaler, Spiriva capsules, Symbicort turbuhaler, and Ventolin diskhaler, diskus, and rotacaps.

Two DPIs that are lactose-free include: Bricanyl (bronchodilator) and Pulicort (inhaled corticosteroid).

It’s important to take note: Advair diskus monograph now states “contraindicated in patients with IgE-mediated allergic reactions to lactose or milk.”

This is a good topic to bring up with your allergist! If there are comparable lactose-free alternatives, it does not hurt to choose the safer route.

2017 National Kick Butts Day

Did you know that tobacco use is the number one cause of preventable death? The costs of tobacco use are measured in lives and dollars and reach our families, communities, businesses and the government. Today, March 15, is National Kick Butts Day, a day when the youth and youth leaders and educators are encouraged to speak out and bring attention to the dangers of tobacco use in their communities.

In honor of National Kick Butts day, here are a few facts about tobacco use in the United States:

  • Every day, 3,200 people younger than 18 years start smoking.
  • 5.6 million are expected to die early because of tobacco and nicotine use.
  • Currently, one person dies every six seconds from a tobacco-related disease.

It is hard to quit smoking, but you can do it. To have the best chance of quitting, you need the facts, what your options are and where to go for help.

Breathe Pennsylvania has become Western Pennsylvania’s premier provider of tobacco education, cessation, and prevention programs. For more information on Tobacco Cessation, Education and Prevention programs, contact us at 724-772-1750 or rkishlock@breathepa.org.

Asbestos, Radon and Mold: Testing is the Only Way to Know

The real estate season is upon us, and having a home inspection can be an effective way to deal with lung related issues.  Information on home inspection reports mainly relates to the structures systems, but there are three common dangers to lung health that a report might comment on.

  1. Asbestos —Most uses of asbestos were outlawed in 1978. Many products with asbestos are not recognized during an inspection, and inspectors are not required to comment on any of them.  But, most Home Inspectors will call out some of these common asbestos products:  asbestos roofing and siding, flooring tiles, asbestos wrapped pipes or electrical items.  Be sure to ask about asbestos if the home was built before 1978.  As a side note, 1978 is also when lead in paint was outlawed.  It is a good date to know when buying an older home.
  1. Radon —A radon test is not required, but it’s worth the extra cost to get one considering Pennsylvania measures high in radon levels when compared to other states. According to the state Environmental Protection Agency, once a house tests high, it will always test high.  Ask your agent if the home has been tested before.  If they know, they have to tell you, and they have to give you the results.
  1. Mold—People have different sensitivities to mold. Some have no reaction, while others have severe reactions.  If a buyer knows they have an asthmatic condition, or they knowingly react to mold, then having additional testing done is strongly advised.  In such a case, one should ask for an inspector who is a certified indoor air professional that can do comprehensive testing with recommendations.  Relying on a single swab sample might not give the whole picture.

A final thing to watch out for is a sale where the deal fell through.  There are many reasons, unrelated to the three previous issues, for a deal to fall through.  However, all three of these issues are common reasons for a buyer to walk away.  You can always ask.  Check the disclosures before you make an offer.  Such issues, if known, are required to be listed there.  However, these are also common areas for people to turn the other cheek. Proper testing is the only sure way to know.