Monday, August 24, 2015

Links between baseball cards and asthma

One of the ways I entertained myself when I was an asthmatic kid was to collect baseball cards. I would walk along Manistee roads collecting cans and bottles and use the refund money to purchase cards.  Of course it was nice that a pack of cards when I started collecting was only 20 cents.  By the time I graduated I had amassed a very large collection. 

I continued to collect cards until I met my wife in the year 2000, at which time I put aside my collection with the idea I would pick it up again in a few years.  Of course, a few years turned into 15.  

My dad called me a couple weekends ago and said he was at a yard sale where a lady was trying to sell quite a large baseball card collection.  He said he offered $20 and was rejected.  He said she would probably take $50, and was wondering if I was interested.  I told dad to go for it.  

So here I am now with a baseball card collection of some guy I did not know.  I have over 20 boxes of cards, plus many books of cards.  I had no idea what I was getting into.  I was rather excited to surf through these cards to see what kind of treasures it contained.  

Now, this is where we link this story with asthma.  You see, baseball card boxes that are not sifted through regularly sit in closets and basements.  Little critters called dust mites find their way into such cozy little places and they lay eggs.  See what I'm getting at here.  

So the asthmatic purchases the cards and seeks to learn what treasures it contains.  He opens the box and sifts through the cards.  Even though he can smell the dust, in the excitement of the moment he does not think that something other than just cards came out of the boxes.  He does not see the microscopic dust mites that creep into the air and into his respiratory system.  

His airways become inflamed.  His nose starts to run and drip.  He sneezes.  He sniffs.  His chest becomes tight.  His shoulders become hunched.  All of a sudden he is in a full blown allergy attack that has evolved quickly into a full blown asthma attack.  

Claritin was taken, along with a Zyrtec, although those weren't expected to remedy the problem.  He knew that the only solution here was benadryl, which would make him tired.  His throat is scratchy, his scalp itches like crazy, his chin itches, he feels like he's breathing air molecules that are bloated from years of steroid use, and he is extremely tired.  

That pretty much describes my day yesterday.  That pretty much describes my night last night.  It was 2 a.m. when the benadryl wore off.  I had to make a decision to take sudafed, which might work, or benadryl, which I knew would work.  I decide if I was going to get any sleep then benedryl was the medicine of choice.  

About a half hour later the medicine kicked in.  I still felt symptoms, but the sedating effect of the medicine worked like Xanax and helped me to sleep well the rest of the night.  Yet here I am in the morning feeling like I want to go back to bed.  My dose feels duffy.  Breathing is somewhat hard, although manageable. I'm ready for a day at work.  

Did I mention that I had to take three breathing treatments yesterday for the first time in months, and, of course, one at 2 a.m. and one just now.  So, couple that with the 4 cups of coffee I just drank to stay awake today at work, I'm going to be somewhat jittery.  This will be fine so long as I don't have to do draw blood gases.  

So, what do we do with all these baseball cards?  This is yet another reminder that you cannot live normal with asthma, despite what the so called experts say.  Collecting antiques, living in a dusty museum, simply are, excuse the pun, not in the cards. 

Saturday, August 22, 2015

The goal of asthma bloggers

The goal of any asthma blogger is not to blog about asthma.  Allow me to repeat: The goal of any asthma writer is not to write about asthma.  The goal is asthma control, an asthma cure, and no need to write about breathing trouble at all.  

This is the truth I am telling you.  If there was no need to write about asthma all asthma bloggers would go away.  The reason we started writing in the first place about this disease is not enough attention was paid to it for the past 2,500 years, and it's for that reason it still exists while other diseases have disappeared from existence.  

The ancient Greeks knew about asthma, even defined it for the medical community.  Only a few random physicians took up the subject between then and 1900, from which time knowledge of the subject has gradually increased.  Today the disease gets the respect it has always deserved.

Yet because it nary gained the respect of the medical community until only recently, we still don't understand it very well.  We know a lot, but still not enough so that all asthmatics can achieve complete control or, better yet, a cure. 

So here we are, continuing to write about this disease called asthma.  We are learning more and more with each passing day, and yet we still know so little.  The goal, though, is to write about something else.

Being that my asthma is controlled right now, I would much rather write about my exercise routine.  I say this knowing that if the asthma acts up again such fun writing will once again turn to asthma. 

Thursday, August 06, 2015

Week 7 John for Life Report: A bad diet week

Tip: If you ever go to Michigan's Adventure, avoid this place.
There is an all you can eat place by the water park,
that charges the same price as this place,
only you get to eat all you want. 
The politically correct term for a diet and exercise program is "Body Transformation Program."  Most such programs suggest, that along with resistance training and aerobics, that you eat 5-6 smaller meals rather than three large meals.  The reason for this is so that you keep your blood sugar stable so that you can burn fat and gain muscle simultaneously.  

Each meal (what we call fuelings) should contain a portion of carbohydrate and a portion of protein.  As I described in my week 5 update, my calculated intake should be about 30 grams of carbohydrates and about 30 grams of protein with each meal.  That leaves me with about 6 grams of fat per meal.  

Now, sticking to my meal plan to a tee, and doing all my workouts to a tee, between July 19 and 31, I lost almost six pounds.  In fact, I did so well I got down to 211 pounds, one pound off my next significant goal. You bet I was ecstatic.  I decided to reward myself to a couple free meals when my family went to Michigan's Adventure the next day.  

The next day after that my wife wanted to go for dinner. I agreed. Then next day after that (we're into Sunday now) my wife wanted to go to dinner again. I agreed. Of course then Monday came and I decided I better get back to my regular fueling plan. Realizing I might have to make up ground, I skipped breakfast Monday and Tuesday and cut myself short on my meals.

On Tuesday night I bonked, and allowed myself a free meal.  I even had a few whisky and cokes.  It was awesome to have a free night in the middle of the week.  It was not so good the next day when all I wanted to do was eat.  I was good, but famished. 

So on Thursday I should not have been surprised to learn I gained three pounds.  So here we turn to John Hussman, who wrote: 
It's helpful to have both protein and carbohydrates in your portions. If you severely restrict carbohydrates, you'll "bonk" and slow down your metabolism. You'll also lose muscle. See, when you run too low on carbohydrate, the body first tries to burn fat, but if fat burning is too slow to provide enough energy, your body starts using protein for energy (gluconeogenesis). If you overly restrict protein, you won't build muscle, and you increase the risk that your body will feed on muscle mass.
Past experience (learning the hard way) has taught me not to allow such setbacks to disturb me.  Chances are, if I kick butt the next week, I will meet my next goal of 210 by next Friday.  So I just need to just decide that I am not going to splurge at Myle's Birthday Party tomorrow night.  I'm not going to do it.  I'm just going to have a taco or two and call it good.  This kind of stinks, because tomorrow was supposed to be my free day.  So, considering tonight I'm working the night shift, being tired tomorrow is going to make it extra hard to resist.  Chances are pretty good I will fail.  How's that for confidence?

That said, what lesson can we learn here.  Well, how about this: plan your free days around events in your life.  Do not give in to the temptation to eat free meals when you didn't plan for it.

There is one exception here, and it does help me to feel a little better about the week.  My wife was off work last weekend, and having those meals with her was our time together.  The thing is this: is it possible to spend quality time without going someplace that serves food?

That is a valid point, if I don't say so myself.  Maybe future date ideas should be a walk on the Pier, or a walk on the beach, or a trip to the State Park.  Maybe sitting by the lighthouse watching the sunset would be a good idea.

It's truly hard to eat healthy and to live a normal life.  For instance, nearly every night shift I work I have someone offer me some tempting foods or candies.  What will it be tonight? Cake? Coffee Cake? Ice Cream? Recess Peanut Butter Cups?

Usually what I do is I do not say no, because then I have to explain myself.  To avoid that, I take and say I will eat later.  My locker is chock full of candy, waiting for that inevitable day when I need to take a free day at work.

Saturday, August 01, 2015

Eat junk food and still lose weight

Several years ago I was doing the body for life, and had already lost 20 pounds.  One of my friends and I were talking about our respective diets, and it somehow came up that I took my kids to McDonald's.  My friend said, "So, when you go McDonald's, what do you eat?"

I said, "When I go to McDonald's, I eat Big Macs and fries."

"Really?" he said.  "How can you eat that junk and still lose weight?
I said, "Because most of what we learn about losing weight is a myth, and that's why most people probably fail at most diets."  

Anyway, this evolved into a nice discussion.  

As I sit here writing this, I can honestly tell you that I have just reached my goal of losing 15 pounds.  That said, I am now on my third Popsicle (the unhealthy kind) and I just got done eating macaroni and cheese and a handful of Doritos.  And tonight I'm going on a date with my wife tonight, and I plan on eating a bacon Swiss burger with onion rings, fried and a side order of deep fried mushrooms.  

And I still plan on losing 2 pounds this week.  

Look at it this way.  My wife and I discussed what kind of a diet we want to do when we get down to our ideal body weights, and we both decided we want to eat normal.  But what is a normal diet.  To learn, we decided we'd watch skinny people to see what they eat.  

What we learned is that skinny people eat normal foods.  They drink coca cola, they eat hamburgers and french fries, and they eat desserts.  The catch is that they limit what they put in their bodies.  For instance, one of my friends nurtured her Coke for hours.  But when she was done that was it.  She did not use having one bad food as an excuse to continue eating bad all day.  

So you have people go on diets that force them to give up the foods they crave, and they fail.  So why go on such a frivolous diet? A better approach is to find a diet that allows you to enjoy what you like, albeit in moderation.  

That said, I think diets like Weight Watchers are fine, where you are given a certain amount of points per day, and if you save enough points you can have a piece of chocolate each day, or a drink.  Actually, my wife likes to have a glass of wine at the end of her day, and Weight Watchers counts this as too many points, so she made up her own diet that allows her to have a drink of wine every day without her feeling guilty.  

My wife once lost over 40 pounds once by eating a piece of chocolate every day.  

A diet I like to do is the body for life.  I like this because you are good 6 days a week and you get one day where you can eat anything you want.  Sometimes I have taken this to extremes as I described above, and have eaten anything and everything with no limitations, while still losing weight.  

You see, the idea is there's a variety of ways you can diet and still enjoy the foods and drinks you love.  I usually plan my free days around events in my life. For instance, I took the 4th of July off, and took the day we went to Michigan's Adventure off, and so forth.  

The trick is that you don't want to overdue it.  While you can go to McDonald's and have a Big Mac and fries once a week, ideally on your already planned free day, if you go to McDonald's later in the week, say with your co-workers or friends, I'd recommend you have their chicken sandwich without the mayo.

Ideally, most experts recommend your free day calories, or all the extra calories you ingest throughout the course of the week if you so choose to have one free food a day, does not exceed 1.8% of your BMR, per John Hussman.  Granted, your selected diet may have other restrictions. 

Wednesday, July 29, 2015

The unintended side-effects of inhaled steroids

When I was a kid their were fears among physicians that inhaled corticosteroids would have the same side effects as systemic corticosteroids. Based on this fear, I actually have discharge instructions by Dr. Gunderson at West Shore Hospital from 1981 that says to use Vanceril prn (as needed).

Since then, studies have proven that the inhaled route greatly reduces the side effects of any medicine, especially if the mouth is rinsed out after each puff. Studies also show that daily use (not prn use) greatly reduced inflammation in asthmatic airways allowing them to both prevent and control their asthma. So today, if you are prescribed an inhaled corticosteroid, it is pertinent that you inhale it every day exactly as prescribed.  The good news is that most of the newer inhalers only require one puff a day, making compliance easy.

Still, especially when higher doses are used, diffusion of the medicine may occur in the mouth, throat, and intestinal tract after swallowing, resulting in systemic side effects.  

Here are some of the potential systemic side effects: 
  1. Impaired growth in children
  2. Decreased bone mineral density
  3. Skin thinning and bruising
  4. Cataracts
  5. Decreased immune system response resulting in high risk for pneumonia
  6. Slow healing
It must be noted here that these potential risks are far less than the risk of suffering from and possibly even dying from uncontrolled asthma.  All of these side effects can be dealt with, and while they may cause some disability, none cause an early demise.

Now allow me to address the side effects of ICS on me.

1.  I am the shortest in my family, so it is possible that ICS did have an effect on my height. However, this has been an acceptable trade off, as I do not care how tall I am.  I further discuss this in another post if you want to read on.  

2.  I do not know how yet if ICS have had an impact on my bones.  By all data that I have access to, this has not been an issue up to this point.  We'll see how it goes as I become an old(er) man. 

3.  Skin thinning is not a problem.  Bruising is.  Man, when I get bumped I bruise very easy. I sometimes have bruises that last for months.  

4.  Cataracts I do not have.  Again, we'll see how this goes as I get older.

5.  I have at present not had pneumonia.  I also do not think that I have colds longer than anyone else, yet. 

6.  Slow healing.  This never really posed a problem until I separated my shoulder in the spring of 2013. That injury still hurts me to this day.  Likewise, I (while sober) fell out of bed during the winter of 2015, and that injury still plagues me.  My doctor said that these injuries usually heal fast, although age and a lifelong history of inhaled steroid use may inhibit or slow the healing process.  Thankfully these slow to heal injuries only plague me when I'm working out or playing sports.  Still, it is a "potential" systemic side effect.

Now, that said, if I could go back and revisit the inhaled steroid question would I do it all over again?  Well, considering that I have severe asthma that is controlled by these medicines, I would definitely do it again. Inhaled steroids have allowed me to live a normal life with asthma for over 30 years now.  So, in my case, the potential risks were well worth the potential side effects.

My advice: If you have moderate to severe asthma, inhaled corticosteroids is considered a top-line treatment for you.  If you're doctor prescribes them, please give them a try and take them as prescribed every day. You will soon find that you can live normal with this disease as I did.

Further reading:

Sunday, July 26, 2015

The Benefits of Exercising with Asthma

This week I'm going to focus on exercise. There is simply no way I can emphasize enough the benefits of exercising, especially if you have a lung disease like asthma.  The benefits are so abounding that it absolutely essential that every asthmatic do it.  In fact, nearly every single asthma blogger that I know exercises.  It's no coincidence that we all do it, because we all learn that it is essential to living a good life with it.

There are actually two different types of exercise, and it's essential that you do both.  One is the aerobic kind, and the other is resistance training.  Still, regardless of which kind you do, here are the benefits that may result. 

1.  It helps you lose weight.  Now, keep in mind here that exercise alone will not cause you to lose weight. I have many friends who exercise and they get upset that they either stay pat or gain weight.  This is because it is a myth postulated by all those people trying to sell exercise equipment that exercise alone will cause you to lose weight. Still, exercising helps you to burn calories, and it helps you to develop muscle, which burns a ton more calories per day than adipose (fat) tissue. If you add in a healthy diet, you should easily be able to either maintain or lose weight if you exercise regularly.

2.  It makes you healthier.  So losing weight makes you healthier right from the get go.  Still, exercise by itself also increases your production of high-density lipoprotein (HDL), which is the good cholesterol.  This keeps your blood flowing smoothly and protects against high blood pressure, heart disease, stroke, depression, some cancers, arthritis, and falls.

3.  It makes you feel happy.  It is a proven fact that asthma is often linked with anxiety and depression even when your asthma is well controlled.  Exercise stimulates the brain to release a chemical called endorphins. They act like analgesics such as morphine to diminish the perception of pain, cause a sedative effect, reduce stress, ward off anxiety, ward off depression, boost self esteem, and improve sleep.  This is why people sense a feeling of euphoria after the run.  This is why all the participants in "The Biggest Loser" become so happy as the show progresses; they are in effect feeling the benefits of morphine without ever having to take the drug.

4.  It boosts your energy.  Increased muscle tone increases your endurance and improves your tolerance to exertion.  Physical activity increases oxygen and nutrients to the various tissues of your body to help your cardiovascular system work more efficiently.  A bonus is that it makes your heart and lungs work more efficiently, making it more easy for you to function during the course of the day.

5.  It increases your memory.  It stimulates the brain to release a chemical  brain-derived neurotrophic factor (BDNF) that rewrites memory circuits so your memory becomes better. So if you are a student, this is a HUGE incentive to exercise.

Further reading and references.

Thursday, July 23, 2015

John-for-Life: Five week update: Part 2

Okay, so I am now well into the 5th week of the body for life program, or what I refer to the John for Life program because I tweak it slightly for me.  The first four weeks were not the best, mainly because I had some really bad habits I had to defeat.  

So now that those first "adjustment" weeks are over, now I'm all in.  This meant reading and studying John Hussman's advice.  While up to this point I've been good but not great, now I'm going to shoot for the following.   

1.  Calculated Base Metabolic Rate (BMR):  This is the amount of calories you will typically burn lying in bed all day.  Mine is 1700 (170 goal weight*10).  If I stick around this range of caloric intake on a daily basis, I should burn about 1.5 pounds of fat in a week.  So a goal of losing 1-2 pounds a week is good. 

2.  Don't count calories.  Ironically, despite trying to keep your caloric intake in the required BMR range, the BFL program insists that you do not count calories.  Why? Because who does? It's too much work. Instead, a portion is fits comfortably on your palm or inside your cupped hands.  One low glycemic carbohydrate and one lean protein with each meal, and all the vegetables you want. 

3.  Fuelings.  Six per day 2.5-6 hours apart.  This should come to about 30 5 grams of fat per meal
  • Carbs = 40% of caloric intake (1700*.4/4 = 170 g a day/ 6 = 30 g per meal
  • Protein = 40% of caloric intake (1700*.4/4 = 170 g a day/ 6 = 30 g per meal)
  • Fat = 20% of caloric intake (1700*.2/9 = 37.7 g a day/6 = 6.3 g per meal
Okay, that's that.  Even though the first month wasn't perfect, it did allow me to lose seven pounds.  Since I started doing the above, I've already lost two pounds in two days. Although, over all, the above goals should allow me to reach a goal of about 1-2 pounds per week.  So the end of the year goal of 170 is in reach.