Greetings to all of you who care for and love our precious children, our treasures from God! I want to lead off with this blog's Parenting Tip - please look into and work your hardest to send your children to a great faith and value-filled summer camp. Their experiences at camp can instill in them such faith and love and values that they will remember and grow from it the rest of their lives (many of our friends in our Life Group with church recall their camp experiences as the closest they have ever felt God). The above picture is from my daughter Annika's 2009 week long camp at Camp Allendale (http://www.camp-allendale.org/) in Trafalgar, IN, and my son Brendan went to the 2010 High School Wilderness Camp with Rainbow Christian Camp (http://www.rainbowcamp.org/) in Converse, IN.
Annika heard about the camp at church, had not stayed away from family before, and did not know anyone going to her camp last year. She had a terrific time, learned so many invaluable life lessons, and this year wants to go to 2 camps - she will attend a camp at Rainbow in July, and Camp Allendale again in August.
Brendan, age 15, did not at all want to go to a camp, but Bruce and I and my former husband Jim were a team together and told him he had to go to the Rainbow High School Wilderness Camp (our trainer Eric had gone to that camp when he was in high school and loved it). After a week in Arkansas with 12 other kids his age (and leader and 2 adult chaperons) canoeing, hiking, and climbing/repelling and with absolutely no electronics (no phones, watches, devices, or books except the Bible), he came home last week telling us of his great times and thanking us for the experience and making him go!...
Asthma
Asthma may develop at any age, although the majority of people are diagnosed in childhood. There is often a strong family history of asthma or allergies. Asthma can be very mild in some people, and vary to the extreme of severe and life-threatening (and even death) in some people.
Definition - a reversible inflammatory disorder of the airways, often triggered by allergen exposure, exercise, and cold air
Diagnosis - is based on 2 key elements
1. History or presence of respiratory symptoms consistent with asthma - wheeze, cough (typically worse at night), and/or shortness of breath (that are better with a bronchodilator like albuterol)
2. The demonstration of variable airflow obstruction (by formal pulmonary function testing or in office or at home peak expiratory flow measurement=peak flow).
Other conditions which may simulate asthma - post nasal drip syndrome (can cause upper airway wheeze-like sounds), gastroesophageal reflux disease (GERD), post-viral cough, habitual/psychological cough, vocal cord dysfunction, panic disorder, cough from ACE inhibitor blood pressure medicines, COPD (emphysema), and congestive heart failure
Treatment & Management
1. Monitoring of patients with asthma - symptom assessment and office/home monitoring with peak flow meters
2. Patient Education - learn how to monitor their symptoms and pulmonary function, and use their medicines
3. Controlling triggers - this can help decrease need for medications, and patients need to be aware and decrease trigger exposure - like allergens at home, workplace, daycare, or school, indoor allergens (dust mites, animal dander, molds, cockroaches) and respiratory irritants (tobacco smoke, wood smoke, cleaning products, perfumes, air pollutants) - consider formal allergy testing
--be aware of conditions that can worsen asthma - like sleep apnea, GERD, obesity, rhinitis/sinusitis, vocal cord dysfunction, and depression/chronic stress, and medicines that can worsen asthma (like blood pressure beta blockers and aspirin in some people)
4. Medicine Treatment - the goal is to minimize symptoms, reduce the chance of bad outcomes (hospitalizations or loss of lung function), and minimize adverse effects from medicines
-inhaled medicines can be taken in metered dose inhalers (some can be used with a spacer for younger children) and in aerosolized nebulizer breathing treatments
Treatment depends upon the asthma severity- from intermittent asthma (symptoms less than 2 days/week, and usually just needing a rescue inhaler=short acting bronchodilator as needed), mild persistent asthma (symptoms greater than 2 days/week-usually treated with a low dose inhaled cortisone or Singulair), moderate persistent asthma (symptoms daily-usually treated with a medium dose inhaled cortisone and long acting bronchodilator or Singulair), and severe persistent asthma (symptoms throughout the day - usually treated with a high dose inhaled cortisone with long acting bronchodilator and Singulair, and often additional medicines)
Rescue Inahlers - short acting bronchodilators
- all asthma patients need to have one available when/if needed for cough/wheeze/shortness of breath flares, and can be used a maximum of 4x/day for not longer than 1 week, and if needed 4x/day for more than 1 day you must see your physician
- only brand name metered dose inhalers are now available in the U.S. because of regulations that they need to be ozone friendly - Proventil HFA, Ventolin HFA, ProAir HFA, and Xopenex HFA, the least expensive available is a small size Ventolin HFA which you can get only at Walmart and Target pharmacies, and if needed due to cost, you can get generic ones at www.medisave.ca
- generic albuterol solution is available for nebulizers (and brand name Xopenex is also available for nebulizers)
Daily Controller Medicines
Inhaled Glucocorticoid (cortisone)-the most potent anti-inflammatory agents available for asthma treatment, and rinsing the mouth is required after using to avoid developing thrush/yeast infections
-Flovent
-Pulmicort
-Qvar
-Asmanex
-Azmacort and AeroBid
Inhaled Glucocorticoids with Long Acting Bronchodilators
-Advair (available in a powder round inhaler, or HFA inhaler)
-Symbicort
Long Acting Bronchodilators-must be used only along with a cortisone inhaler
-Serevent
-Foradil
Leukotriene Receptor Antagonists-these decrease infammation and bronchoconstriction
-Singulair
-Accolate
Chromones-decrease the early stages of asthmatic response/infammation
-Cromolyn (availabe in inhaler and nebulizer)
Theophylline-has both bronchodilatory and antiinflammatory properties, but can have irritating and serious side effects, and requires blood tests to keep the blood level adequate (want 5-15mcg/ml)
Oral Glucocorticoids(cortisone) - a short 7-10 day course can be required for asthma flares, or rarely for long term asthma control
Eric's Fitness - Dumbbell Complex Routine
by Eric Walden
Family & Faith
Marriage Tips - from "Red Hot Monogamy" - Couples need T.I.M.E. together. Below if what the authors feel you need as a minimum time commitment you should have with your spouse just to maintain your relationship:
Ten to Twenty minutes to talk together ALONE every day.
Invest in a weekly date night (or date lunch or breakfast) together for at least 4 hours (takes a couple hours to emotionally connect and leave some time for love making).
Make a Monthly "day away" policy. At least once a month spend 8-12 uninterrupted hours together to reconnect. You can spend time doing things you BOTH enjoy (exercising, relaxing, errands, etc.) and be sure to have the house or your bedroom alone for some red-hot monogamy during this special time together.
Escape quarterly (or at least biannually) for a 48 hour weekend, and you can keep a special marriage treasure box to save up money for your special times together.
Faith
Lessons so far from my woman's Bible study - we are doing Beth Moore's "Esther - It's Tough Being a Woman"
+It's tough being a woman in another woman's shadow... Esther trusted in God's providence and followed Him and worked to fulfill her God-given destiny.
+It's tough being a woman in a world where beauty is a treatment... We must understand and believe in God's teaching that true beauty is incorruptible - it is the beauty of our heart dedicated to God. Beth keeps an index card on her nightstand with 3 verses that she reads almost daily to remember and claim this beauty from God - Col. 2:10, Song of Solomon 7:10, and Psalm 90:17.
+It's tough being a woman in a mean world... Beth discusses that meanness always has a history, always perceives a threat, catches like a virus, but is curable through our Lord -Romans 12:17-21 - do not repay evil with evil, but do what is right and live in peace, do not take revenge but leave this to God's wrath, and "Do not be overcome by evil, but overcome evil with good."
Prodigal God - understanding our reckless extravagant God of grace and the core of the gospel, based on the teaching in Luke 15. My church, Trader's Point Christian Church, just finished a 3 week sermon series on this, and I will review in my next blog.
My prayer - God please give me zero tolerance for meanness, and quit competition. Thank you that we never have to measure up, since Christ took this for us all on the cross. Thank you that I am already accepted by God with all my brokenness, and am inspired to follow Jesus!
Hugs, Dr. Lisa
