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Currents Summer 2011

Currents Summer 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 Jul 01, 2011
Copyright:Attribution Non-commercial


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You’re struggling for breath.
It’shard to speak. You’re pale and sweat-ing. All this, and your blue rescueinhaler isn’t helping. You’re experi-encing an asthma attack.You can avoid this frightening sit-uation by acting on the No. 1warning sign that you’re heading intoan attack and the red zone of yourasthma action plan.“The precursor to an attack is a
How to Stop AnAsthma Attack 
Exercising Control
continued on page 35 
With the warmer weather
finally here,Canadians are outside and active.They’re cycling, jogging, playing socceror softball. But for up to 80 percent of people with asthma, physical exertion isa key trigger for breathing symptoms.Yet exercise-induced asthma does nothave to limit summertime activities.What exactly causes exercise-inducedasthma? When your body needs moreoxygen, the air you breathe in doesn’tget sufficiently warmed and humidifiedby the nose and upper breathing pas-sages – even on hot, humid days. Thenot-quite-warm-enough air reaches your lungs and can cause a reflex spasmin your breathing passages. The symp-toms – shortness of breath, wheezing,coughing – most commonly occurwithin five to 10 minutes of the start of exercise. (They can also occur immedi-ately, and in other cases not for a half hour or more.)Compounding the problem, a changein environment can exacerbate exercise-induced asthma. Exposure to allergenic,airborne pollens in summer, for exam-ple, can contribute to a flare-up, just asthe cold, dry air of a hockey rink willbother a person’s airways once winterreturns. As far as exertion goes, “all therules of asthma apply,” says JolantaPiszczek, a pharmacist and CertifiedRespiratory Educator in Toronto. “If 
SUMMER 2011 33
 If your asthma isunder control, you should be able toundertake just about any activity.
Warning Signs
on page 35 
 you’re inhaling a large volume of air atgreater speed, you’re exposed to theallergen that much more.”These factors may sound discourag-ing, but with good asthma control, youshould be able to undertake just aboutany activity. “Those with asthma shouldbe encouraged to get daily exercise,” says
PlayingHard WithAsthma
Jan Regier, a nurse and Certified AsthmaEducator in Calgary. And exercise keepsthe lungs in shape, too.If your asthma is under excellentcontrol, you should not experiencesymptoms after exercising. If you do, use youra rescue inhaler 15 minutes beforeflare-up, and that’s when you have totake steps,” says Pat Steele, aCertified Respiratory Educator andnurse technologist at the CapeBreton Chest Clinic in Nova Scotia.The symptoms of a flare-up put you into the “yellow zone” of yourasthma action plan. Here, there’s stilltime to head off an attack, says AnnBartlett, a CRE and respiratory nurseclinician at the Firestone Institute forRespiratory Health in Hamilton.
   P   h  o   t  o  :   J   O   N    F   E   I   N   G   E   R   S   H   /   M  a  s   t  e  r   f   i   l  e
Q& A
Certified Educators take yourasthma and allergy questions.
Send questions to: editor@allergicliving.com
Kathleen Frame
Q. I’ll be visiting relatives for a week later this summer andthey have a cat. I’m allergic to cats and they trigger myasthma. How should I best manage this?
Douglas Stewart:
To reduce the sniffles and sneezes, take anon-sedating antihistamine, beginning a day before your visitand continuing through it. For your asthma, review with yourdoctor whether your preventive therapy needs to be adjusted.For example, you might take a higher dose of your preventiveinhaler or temporarily use a combination preventive inhaler. Of course, bring your rescue inhaler with you and use it when nec-essary, without exceeding the dose suggested by your physician.Finally, make sure your written action plan is available toallow for early self-treatment in case your asthma flares despitethese precautions.
Q. Recently after I took an Aspirin, my asthma seemed toflare up. Does that seem possible?
Shawna McGhan:
Yes, it is possible that Aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) can make yourasthma worse. Up to 29 percent of adults with asthma will havebad – possibly life-threatening – reactions to NSAIDs. Aspirin-induced asthma was thought to be less common in children, butrecent studies show that up to 14 percent will react.As a general rule, people with asthma may want to avoidAspirin and other NSAIDs drugs such as ibuprofen, naproxenand diclofenac. Speak to your doctor about using alternativepain reliever medications, such as acetaminophen.
Douglas StewartShawna McGhan
Q. I’m 22 and have just been diagnosed with asthma. Will Ihave this for the rest of my life?
Kathleen Frame:
Asthma is often part of one’s genetic make-up. But it is a disease that can be treated and well-controlled.Most days and nights, you should be symptom-free – but youmay have periods throughout your life when it worsens. The key is to know your triggers, avoid them when possible, and quickly bring any flare-ups under control.Asthma will likely always be a part of you, but with a self-management plan and education about the disease – often froman asthma or respiratory educator or health-care provider – youcan live almost as though you don’t have it at all.
Q. With controlled asthma, do I really need to worry aboutbeing outside on smoggy summer days?
Douglas Stewart:
Airborne pollutants can worsen symptoms.If your asthma is worse on smoggy days, the simplest solution isavoidance. It’s wise to check the weather forecast and spend lesstime outside when the Air Quality Health Index is high. Stayinginside on those days, using air conditioning and even exercisingindoors instead of outdoors are all great ideas. Of course, if youmust be outside, be sure to carry your rescue inhaler.
Q. My 10-year-old complains that taking his corticosteroidinhaler “hurts his throat.” I wonder if he’s just trying to getout of using it. Any thoughts?
Shawna McGhan:
A sore throat is a common side effect of inhaled corticosteroids. To reduce or eliminate the discomfort,have your son gargle and rinse his mouth after using the inhaler.Next, confirm that he is using his inhaler properly; poor inhalertechnique can result in medicine particles getting stuck in hismouth. Finally, the addition of a spacer may reduce the amountof drug left in the throat. The spacer makes it easy to use theinhaler properly, avoids side effects in the mouth and maximizesthe amount of medicine going into the lungs.You may need to work with your doctor to address this sorethroat issue. But your son shouldn’t stop using the corticos-teroid; it’s essential for the treatment of his asthma.
Q. My son is 8 and always gets a cold that triggers hisasthma shortly after returning to school in the fall. Why?
Kathleen Frame:
Every year in Canada, a phenomenon occurscalled the September Spike. In the weeks after school begins,many school-age children experience a severe asthma flare-up.Viral infections are the leading cause of the spike. Other factorsinclude decreased asthma control in the summer and seasonalmold spores. To stave off the September Spike, tell your son towash his hands frequently to avoid getting a cold, and make surehe takes his preventer inhaler as prescribed.
Douglas Stewart is a pharmacist and Certified Respiratory Educator in Sudbury, Ontario. Shawna McGhan is a CRE and a nurse at the Alberta Asthma Centre in Edmonton. Kathleen Frame is a registered respiratory therapist and CRE at the South Riverdale Community Health Centre in Toronto.
SUMMER 2011 35
With Dr. Harold Kim
The Canadian Network for Respiratory Care
is a non-profit organizationand registered charity that works to improve the lives of those living withrespiratory disease. We conduct exams and certify health-care professionalsas Certified 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, pleasesee
or phone:
hen you think aboutsummer allergies, treesand weeds might springto mind. But don’t forget aboutgrass, a major cause of allergy. Itstarted in May, and will be polli-nating in June and July right acrossthe country.People with grass allergy typi-cally experience allergic rhinitis,the most common symptom of which is nasal congestion. It can bequite severe. Another symptom isallergic conjunctivitis, which strikes80 percent of grass allergic people,and is typically mild to moderate.Still, some people’s itchy, red andwatery eyes become so trouble-some that they require a referral toan ophthalmologist for potenttopical therapy and monitoring.Another potential complicationfor those with grass allergy is food-triggered oral allergy syndrome (orOAS). This occurs because the pro-teins present in grass are structuredsimilarly to proteins in certain fruitsand vegetables, and that may triggera reaction. Tomatoes and kiwis, forexample, can cause oral symptomsin grass-allergic patients.To manage your allergy, avoidgrass pollen by keeping windowsclosed and using air conditioningon hot days. Of course, when you’reexercise. If that is ineffective, there may beother factors, such as improper inhaler use.Speak to your certified educator or doctor toget a grip on control.Long-time runner Nancy Perron, 54, beganusing inhalers about 15 years ago after consis-tently experiencing asthma symptoms whileexercising. She now takes fluticasone twicedaily for control and terbutaline before runs.Over the years, “I’ve learned to really listento my body,” says the Ottawa resident, who’straining for her fourth half-marathon. She getstraining plans online and from running clubs,and modifies them to her abilities. Whenbreathing becomes difficult, she walks; aftertraining, she allows adequate time for recovery.“It’s not [about] expecting to win the race,but expecting to do the race. It’s adjusting yourmindset,” says Perron. “Focus on the positive,expect some bumps along the way, workthrough them and carry on.
   P   h  o   t  o  :   R   I   C   K   C   H   A   R   D
Continued from page 33
1.Shortness of breath and coughing(especially at night).2.Wheezing and/or chest tightness.3.Needing your reliever inhaler morethan usual.4.Difficulty with routine activities like running up the stairs.5. Fatigue and irritability are otherpossible precursors.
Warning Signsto Watch For
Continued from page 33
outside, grass can be hard to escape.From your backyard lawn to thefield where your child plays soccer,it’s everywhere. That’s where med-ication comes in. A non-sedatingantihistamine works well for mildsymptoms, or speak to your doctorabout intranasal corticosteroidsprays,which are highly effectivefor nasal and eye symptoms. Anti-allergy eye drops can be used if eyesymptoms persist.Finally, allergen immunothera-py,commonly known as allergy shots, is something to consider if treatment isn’t working. If you suf-fer from grass allergy, ask yourdoctor about these options.What sends someone into that yellowzone depends on personal triggers – any-thing from a cold to fragrances. “It’s whatI call your specific bell ringer,” saysBartlett. “It’s an individualized thing.”If you end up in your yellow zone,there’s no need to panic. Just get out yourreliever and follow your action plan.

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