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Currents Winter 2012

Currents Winter 2012

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Currents from the Winter 2012 issue.
Currents from the Winter 2012 issue.

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Published by: Allergic Living magazine on Nov 30, 2011
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CANADIAN NETWORK FOR RESPIRATORY CARE SPECIAL SUPPLEMENT • WINTER 2012
Annette MacLeod thought
her asthmawas under control. But then she beganto experience symptoms at night. Aboutonce a week, she found herself joltedout of sleep, wheezing, and it wouldquickly progress to coughing and short-ness of breath, requiring her inhaler.And she found she needed her inhalerupon waking most mornings, too.After a particularly frightening night,MacLeod, 42, of Whitby, Ontario, madea decision that enough was enough. Shebooked an appointment with her doc-
 ALLERGIC LIVING |
WINTER 2012 45
BY JACLYN LAW
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Night Symptoms
continued on page 47 
BY DEBRA MORRIS
Feline Foe
Don’t Let AsthmaSteal Your Sleep
There’s no doubt about it:
cats makelovely pets – provided you’re notallergic. Within minutes of exposure,people with cat allergy can experi-ence itchy eyes, runny nose, sneezing,congestion, even hives – not to men-tion asthma symptoms such aswheezing and difficulty breathing.The trigger is not the cat’s fur, butrather proteins from urine, sweat andsaliva that are carried on dander. Soregardless of length of hair, howmuch it sheds or even if the breed istouted as “hypoallergenic,” every cathas the potential to set off an allergy.Avoidance is the best means of control if cats are your trigger. But if Toronto. “With asthma, one single dis-turbance at night from respiratory symptoms that include coughing, you must be around one, don’t touchit! Take an antihistamine and, if youhave asthma, also your asthma med-ications before being around the cat.Ask the feline’s owner to move the petto another room while you’re there.You might consider immunother-apy. A series of injections given over athree- to five-year period could makeoccasional exposures to cats far moretolerable. Ask your allergist whetherthis treatment is for you.The hardest situation is when youor your kids develop an allergy to your cat. No one likes to have toremove a cherished pet from theirhome. But it’s important to do so if the allergy triggers asthma. Yourlungs will thank you.
Debra Morris is a nurse and CAE at Halifax Allergy & Asthma Associates.
Wheezing at night? Your  asthma isn’tunder control.
tor, who adjusted her medications andasthma action plan.A recent Canadian study shows thatabout 20 percent of people with asthmahave trouble falling or staying asleep(compared to 13 percent of the generalpopulation). A few fitful nights mightseem insignificant, but don’t ignore thewarning signs, says certified respiratory educator Kathleen Frame, who’s also aregistered respiratory therapist and anasthma program coordinator at SouthRiverdale Community Health Centre in
 
46
 ALLERGIC LIVING |
WINTER 2012
suPPlement 
Q& A
Certified Educators take yourasthma and allergy questions.
Send questions to: editor@allergicliving.com
Tracy Cushing
Q: Our son’s asthma is under control, except he still hasbreathing issues in frigid winter air. Would a scarf over hismouth help him?
Josie Luongo:
A scarf over his nose and mouth would help. Ittraps heat and moisture when exhaling and subsequently mois-turizes the inhaled air so as to the minimize drying of the airway and the narrowing that follows. Using his rescue inhaler beforegoing outdoors may also be helpful. It is important that he con-tinues to use his controller medication and refer to his asthmaaction plan to determine if increasing the dose is necessary.
Q: What is the effect of a woman’s menstrual cycle onasthma?
Julie Gaalaas:
Hormones are an asthma trigger for some.Many women experience worsening asthma symptoms through-out different phases of their menstrual cycle. If you are noticingthese changes in your asthma, I suggest tracking your symptomsthroughout your cycle using a symptom diary. This way, you willknow in advance when your asthma is likely to deteriorate.Ensuring you have an asthma action plan will allow you todeal with your symptoms in advance and prevent your asthmafrom worsening.
Q: I’m really allergic to dust mites, and worried about anupcoming visit to my mom’s place, where I sneeze andcough non-stop. (She has wall-to-wall carpets as well as
Josie LuongoJulie Gaalaas
antiques.) What should I do when I can’t avoid dust?
Tracy Cushing:
Ask your mother to vacuum (with a HEPA fil-ter vacuum, if possible) and dust before your visit, especially inthe rooms where you’re likely to spend the most time. Alsorequest that she washes all of the linens on your bed with hotwater and dries them on the hottest setting. Bring along a dustmite-proof pillow cover with you for the trip.Speak to your asthma educator about your asthma action planand whether it needs adjusting prior to your visit. Be sure tobring an ample supply of your breathing medications with you.
Q: My daughter was born when I was 34 weeks pregnant.She was only four pounds. Now she’s 7 and has asthma.Would her premature birth be a factor?
Josie Luongo:
That depends on her respiratory health history.There are many factors associated with the development of asth-ma, including exposure to allergens and tobacco smoke, genetics,infections and airway size.In premature babies, especially those with a low birth weight,the smaller airways put them at a higher risk for wheezing ininfancy and early childhood. Whether this wheezing will persistand be diagnosed as asthma at age 7 and beyond can depend ontheir lung function, family history and their personal history of atopy (a predisposition to develop allergic reactions) or allergies.
Q: Is it possible that eating a big meal can trigger asthma?I’ve noticed this in myself.
Julie Gaalaas:
There are many reasons why you experienceasthma symptoms after eating a large meal. Overeating can causepressure on the diaphragm, making it difficult to take a deepbreath. Eating a large meal may also cause acid reflux, which canincrease asthma symptoms if left untreated. Think about where you are dining; there may be triggers present, such as pets or cig-arette smoke. You may even have a food allergy.It’s important to ensure that your asthma is in control by using your controller medication daily and following your asthmaaction plan. This way you will have fewer symptoms and need your rescue inhaler less often.
Q: After being sick almost all the time, my 4-year-old was just diagnosed with asthma. I look forward to her beinghealthy; how long does that usually take?
Tracy Cushing:
It may take a number of months to achieveasthma control. Two main factors come into play. The first isenvironmental control: learning about what triggers cause hersymptoms and how to help avoid them. The second factor ismedication dosing. Your doctor may adjust medications anddosing a number of times to ensure your child is receiving theappropriate dose for proper symptom control.Keeping a diary to review with your doctor or asthma educa-tor is a great way to keep track of symptoms, medication time,exercise and other factors that may affect your child’s breathing.
Tracy Cushing is a respiratory therapist and CRE in Halifax. Julie Gaalaas is a respiratory therapist and CRE in Camrose, Alberta. Josie Luongo is a pharmacist and CRE in Toronto.
 
 ALLERGIC LIVING |
WINTER 2012 47
The Canadian Network for Respiratory Care
is a non-profit organizationandregistered charity that works to improve the lives of Canadians living withrespiratory disease.We certify health-care professionals as Certified Asthma and Respiratory Educators (CAEs and CREs). Our CAEs and CREs work to help patients withtheir asthma, COPD, allergies and smoking cessation efforts. For more infor-mation or to find a CAE or CRE near you, please
see www.cnrchome.net
orphone:
905-880-1092
.
ABOUT US
N
asal congestion, sneezingand drippy noses, andweepy or swollen eyes. Thesymptoms of allergic rhinitis aren’t just uncomfortable, they can have asignificant effect on quality of life.Fortunately, medications are avail-able that can bring you relief. Theseare recommended if avoiding yourallergens is impossible, or whenavoidance alone does not lead toadequate symptom improvement.The most common medicationfor allergic rhinitis is an oral antihis-tamine. Non-sedating pills shouldalways be tried first. Most peoplefind these over-the-counter prod-ucts effective for mild nasal and eyesymptoms. The sedating antihista-mines are also effective, but may leadto significant fatigue. The impair-ment from these medications caneven affect learning in children ordriving in adults.If you have more significantsymptoms or if you don’t find anti-histamines effective, your doctorwill likely prescribe a nasal corticos-teroid spray. These medicationswork best when they are used regu-larly. Although your symptoms may improve within hours, the maxi-mum benefit is usually seen in five toseven days. These sprays are effectivefor the most bothersome symptoms
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Night Symptoms
Continued from page 45 
shortness of breath, tightness in the chestand wheezing is enough to have cause forconcern.”Sleep loss affects thinking, concentra-tion and learning, but fatigue isn’t the only problem. If left unchecked, asthma-relatedinflammation can change the structure of lung tissue, making the condition harderto manage. Frame likens inflamed lungs toa forest fire that must be completely quelled – embers included – or the blazewill return. This may require weeks of anti-inflammatory therapy.She recommends keeping notes aboutsymptoms and looking for patterns.Triggers could include irritants in the bed-room (dust, mold, an old mattress);daytime exposure to triggers; fumes andchemicals; and seasonal changes (springpollen and autumn mold spores). In win-ter, closed windows may lead to higherindoor mold exposure, says Frame. Forsome people, moving from standing tolying down causes symptoms. Colds andthe flu can also worsen asthma; in chil-dren, it has been reported that up to 90percent of attacks are triggered this way.If an asthma attack wakes you, use yourreliever medication. If you need it againwithin two hours, your asthma is “danger-ously uncontrolled,” says Frame. Use thepuffer every 10 minutes, and call 911 or goto the emergency room, then follow upwith a visit to your health-care providerand a certified respiratory educator.
THEASTHMAEXPERT
With Dr. Harold Kim
of rhinitis, including nasal conges-tion and even eye symptoms.Allergen immunotherapy, alsoknown as “allergy shots,” should beconsidered when nasal corticos-teroid sprays are not effective or notwell-tolerated. Allergy shots requirea significant time commitment, andthere is a small risk of systemic aller-gic reactions. This type of treatmentshould be prescribed by an allergist.So my message is: don’t suffer withallergic rhinitis, take action. It’s wortha visit to the doctor to find out whichof these widely available treatmentswill have you breathing easily again.
Quiz answers, page 48 
True or False: Mouth breathinghelps minimize the effects ofcold, dry air on asthma.True or False: Pet dander is lessof a problem in winter months.True or False: People withexercise-induced asthmashould avoid too much exertion.
QUIZ
123

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