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Currents Winter 2011

Currents Winter 2011

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This new asthma and allergy publication is produced by the Canadian Network for Respiratory Care in conjunction with Allergic Living magazine.
This new asthma and allergy publication is produced by the Canadian Network for Respiratory Care in conjunction with Allergic Living magazine.

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Published by: Allergic Living magazine on Dec 09, 2010
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winter 2011
allergic living
33
   P   h  o   t  o  :   B   R   A   D   W   R   O   B   L   E   S   K   I   /   M  a  s   t  e  r   f   i   l  e
CANADIAN NETWORK FOR RESPIRATORY CARE SPECIAL SUPPLEMENTWINTER 2011
I remember waking up
in the night as achild, terrified, struggling to breathe. My grandmother would sit me on her lapand, in addition to medication,give me
kahwa 
– dark coffee in alittle African cup. Lulled by her prayer recitals and thewarmth of the
kahwa 
, I
Can a CoffeeHelp Asthma?
BY SHIRIN JETHA
See 
Breathing Well 
on page 35 
Living in Whitehorse,
Tracee Vickerman knows cold air. As a cer-tified respiratory educator and pharmacist, she also knows asthma– and that cold air can make asthma worse, but it shouldn’t stop you in your tracks.So when Vickerman discovered that a combi-nation of cold air, exercise and out-of-control asthma wasstraining a local cross-country skier’s ability to compete last win-ter, she was determined to keep her from quitting the sport.Vickerman explains that breathing cold, dry air can irritatethe airways, causing passages to constrict and spasm, reducingairflow. For those with sensitive airways, even just walking out-side in the winter can be enough to trigger asthma.Cold air also contributes to exercise-induced asthma.Symptoms typically begin after several minutes of vigorousactivity when a person begins to breathe through the mouthrather than inhaling through the nose, which warms andhumidifies air. In a person with asthma, the contrast betweenthe warm air in the lungs and cold inhaled air can cause the air-ways to swell and secrete mucus, leading to wheeze, cough ortightness in the chest.But cold weather sports don’t have to be avoided, stresses Dr.Robert Cowie of the Health Research Innovation Centre inCalgary. “People with asthma can participate in any sport they like,” he says. The key is to have your asthma under control andwould drift to sleep, breathing easy untilthe morning. Years later, as an asthmaeducator, I’ve often thought back tothose moments – and the effects, if any,of caffeine on the lungs.This year a major review by TheCochrane Collaboration group lookedat several studies examining caffeine’seffect on lung function. The researchersfound that while caffeine canopen up the airways, it takesone to five cups of coffeeto make a difference, andthe effect will only last afew hours. They also cautioned thatdrinking coffee before a lung functionexam may skew test results, and you couldbe prescribed a lower dose of medicationthan you require for asthma control.So forget foregoing your meds; ittakes too much caffeine to make enoughof a difference. Plus you could end upbattling caffeine side effects like agita-tion, insomnia, or nervousness. But agrandmother’s loving care in the dead of night? That’s remains a timeless remedy.
Shirin Jetha is a pharmacist and CRE.
Cold, dry air can irritate airways.
BY KRISTINA BERGEN
Don’t Let WinterSteal Your Breath
 
 
Q. My daughter desperately wants a pet, but she has asth-ma. Would something small, like a hamster, be OK?
Jo-Anne St. Vincent:
Any pet with dander, saliva and urinecan be an asthma trigger. If allergies run in your family, there isa 50 per cent chance that your child will become allergic to a newpet, which could aggravate her asthma.Although it is not recommended, a smaller pet that stays inan enclosed container may cause fewer problems than cats ordogs that roam the house. If you do get a hamster, be sure not tokeep it in your daughter’s bedroom and don’t let her clean thecage. Monitor her asthma closely and be prepared to give the petaway if the asthma worsens. A fish would be a safer alternative.
Q. Why did my asthma educator ask me to demonstratehow I use my inhaler when I’ve been using one for years?
Maria Muirhead:
Although many inhalation devices are fairly straightforward, some people don’t use them correctly and arenot getting the maximum benefit from their medication. Somemay never have learned the correct technique; others may haveforgotten. By reviewing inhalation technique, your asthma edu-cator aims to help you get the most from your treatment plan.
Q. I find I often have to use my puffer after a few drinks. Isalcohol an asthma trigger?
Dora Chan:
For some people, alcohol – usually wine – can trig-ger asthma attacks. It’s thought that the non-alcoholic
Q& A
Certified Educators take yourasthma and allergy questions.
Send questions to: editor@allergicliving.com
Jo-Anne St. VincentMaria MuirheadDora Chan
34
allergic living
winter 2011
SUPPLEMENT
ingredients in these drinks are triggering the symptoms, includ-ing sulphites (used as preservatives) and histamine (createdduring fermentation).In other people, particularly those of Asian descent, an inabil-ity to metabolize alcohol can lead to facial flushing, an increasedheart rate and constricted or wheezy breathing. Like any othertrigger, be sure to avoid alcoholic drinks that cause asthmasymptoms. Having your asthma under control should help.
Q. My husband and I are hoping to put in a gas fireplace. Isit correct to assume this would be safer than wood-burn-ing since our son has moderate, controlled asthma?
Jo-Anne St. Vincent:
Wood-burning fireplaces can exposefamily members to a number of environmental triggers includ-ing smoke and mould. Exposure to these triggers on an ongoingbasis may affect your son’s asthma control.Unfortunately, a gas fireplace can also affect air quality. Gas-burning fireplaces emit nitrogen oxide, which can increaseairway inflammation. Ultimately, a gas fireplace would be thebetter choice. Proper maintenance of any fireplace, however, isof the utmost importance. If installing, have this done profes-sionally and get it inspected yearly. Ensure both the fireplace andthe room it is in are well-ventilated.
Q. I thought my childhood asthma had returned, but myphysician told me it’s not asthma, it’s COPD. Can youexplain how this differs from asthma?
Dora Chan:
Chronic obstructive pulmonary disease (COPD) isa progressive lung disease in which the airways are inflamed,swollen, and partly blocked by mucus. This causes coughing andmakes it more difficult to breathe. In COPD, the lung tissue ispermanently damaged. Smoking is the biggest cause of COPD,but there are other environmental and genetic causes.With asthma, triggers in the environment, such as dust, coldair, animals and plants, cause airway inflammation and mucusproduction. This airway obstruction can be reversed and pre-vented by using medications and by avoiding triggers.
Q. How can peak flow readings help me manage my asthma?
Maria Muirhead:
If you have moderate to severe asthma,charting the difference between your morning and evening peakflow readings is an effective way of determining asthma control.In general, evening readings are higher, meaning your airwaysare narrower in the morning and wider in the evening. A varia-tion of more than 15 per cent indicates that your asthma controlis deteriorating. (Your respiratory educator can show you how tocalculate the variation between your the readings.) At that point, you would have to refer to your asthma action plan for guidanceon medication dosing and when to seek medical attention.
 Jo-Anne St. Vincent is a nurse and CAE at the Children’s Asthma Education Centre in Winnipeg. Dora Chan is a pharmacist and CRE at Taddle Creek Family Health Team in Toronto. Maria Muirhead is a CRE and author of 
My Asthma Book
and 
Smoking= Problems (Big Problems!).
 
winter 2011
allergic living
35
THEASTHMAEXPERT
With Dr. Harold Kim
   P   h  o   t  o  :   R   I   C   K    C   H   A   R   D
The Canadian Network for Respiratory Care
is a non-profit organizationand registered charity that works to improve the lives of those living with res-piratory disease. We conduct exams and certify health-care professionals asCertified Asthma and Respiratory Educators (CAEs and CREs).Our CAEs and CREs work to help patients with their asthma, COPD,allergies and smoking cessation efforts.For more information about CNRC or to locate a CAE or CRE, please seewww.cnrchome.net or phone: 905-880-1092.
CNRC: ABOUT US
Wintertime is mostly indoor time
, andthat means perennial or year-roundallergies can really affect people. Since50 per cent of Canadians own pets,their dander is a key inside allergen.When it comes to pets, much of theallergy research, and the urban leg-ends, concern cats and their infamousFel d 1 allergen. For instance, allergistsget asked all the time: Is there is a non-allergenic cat? While there are a fewresearchers trying to breed litters with-out the major allergen, so far the answerremains a resounding, “No!”When an allergist identifies cat asthe cause of asthma or rhinitis symp-toms, we recommend that the cat beremoved from the home. But we knowonly a small minority of patients willfollow this advice. As a result, patientsand researchersboth have tried a myr-iad of methods to decrease cat allergen.I know patients who shave their cats,wash their cats or wrap their cats. Thereare studies that show using HEPA fil-ters and washing the cat at least once aweek may decrease allergen levels, butlikely will not lead to improved symp-toms over the long term.Some suggestions allergists make:remove carpet from the bedroom; keeppets out of the bedroom; use dust mitecovers; and clean the house frequently.These strategies, however, have notbeen proven to reduce symptoms.
For more information about CNRC,contact us at: www.cnrchome.netor 905-880-1092.
to take some simple measures before head-ingoutside. For Vickerman’s cross-country skier, improving performance involvedmanaging her asthma with medications,covering her face in the cold air and warm-ing up longer before training or racing.By taking steps to keep cold air out of their lungs, Vickerman says athletes withasthma go the distance, even when it’sfreezing outside.
Cold Exercise Tips
Tracee Vickerman, pharmacist and CRE  provides these pointers:
Exercise-induced asthma affects almost90 per cent of those with asthma, so beforeundertaking a sport, make sure yourbreathing is well-managed.Warm up indoors for at least 30 minutesand allow your body to recover from exer-tion with an adequate cool-down routine.Talk to your doctor or asthma educatorabout whether a dose of reliever medica-tion 10 to 15 minutes before being exposedto cold air or starting to exercise is the rightstrategy for you.Drink plenty of water. Dehydration caneven induce bronchospasm before exerciseeven begins and worsen exercise-inducedasthma symptoms.Wrap your face with a scarf or wear a heat-exchange mask when exercising outdoors.The mask warms and humidifies cold air.I do recommend that the pet beremoved, and symptoms often alsorequire medical therapy. For asthma,this usually includes corticosteroidinhalers and a rescue bronchodilatorinhaler. For rhinitis, nasal cortico-steroids and antihistamines are thenorm.In the end, patients must make a dif-ficult decision. While the source of theallergen is often treated like a memberof the family, it’s better to find anothergood home for your cat or dog. Thatway, the pet’s in good hands, and yourhealth won’t suffer.
1
True or False: All meter-dose inhalershave to be shaken before use.
2
True or False: Lungs can get used torescue inhalers, causing them to beless effective.
3
True or False: Emotional stress can bean asthma trigger.
Quiz Answers page 36 
QUIZBreathing WellIn Wintertime
continued from page 33

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