Asthma institutions for asthmatic kids

So I've been studying the history of asthma, and recently I've been reading "Asthma: The Biography," by Mark Jackson. I found it interesting to note that back in the 1940s a "radical" method of removing asthmatic children from the home became a somewhat common treatment for asthma, especially those with difficult to manage asthma.

I find this interesting, because one of the Institutions where asthmatics were sent when separated from their homes was National Jewish Hospital in Denver.

On page 145 he writes the following:

"Others suggested the more radical measure of removing asthmatic children from supposedly emotionally disordered homes. Parentectomy (literally, cutting out the parent), as it became known, was pioneered during the 1940s by the American allergist M. Murray Peshkin, who established the Jewish National Home for Asthmatic Children in Denver (later the Children's Asthma Research Institute and Hospital). in order to treat children with intractable asthma. Separation from the home environment offered both reduced exposure to physical allergens and escape from the 'asthmatogenic emotional climate which existed in the child's own home'. According to Peshkin's reports, residence in the institution at Denver led to substantial or complete relief from asthma in 99% of children."

Of course back in the 1940s asthma experts were split between three basic theories:

1. Asthma was a disease of inflammation and bronchospasm
2. Asthma was a psychosomatic disorder
3. Both 1 and 2 above might be somehow involved in asthma

I have to agree that they were right, that absent the medicines we now have in 2010, removing many asthmatics from the home may have been very beneficial to them. I can completely understand that 99% of these asthmatic children may have benefited from being removed from home allergens and home stress.

When I was a patient at National Jewish in 1985 my asthma was much better controlled in the clean hospital environment as compared to at home, where mom and dad weren't interested in making many changes to my benefit. It's not that they didn't want me to breathe better, but changes come at a cost.

I found later in life that my asthma was much better controlled when I moved away to college. I found my asthma was even better controlled as soon as I stepped foot in an air conditioned building, or even an air conditioned hospital.

I know it must not have been fun to be plucked from your parents. I know personally, because in 1985 I spent six months at National Jewish. Yet that most kids noted improved asthma is in a way proof that controlling your environment, making needed changes to clean your home to get rid of asthma triggers, is an integral part of good asthma control.

And while asthma is no longer believed to be "caused" by emotions, emotions can act as an asthma trigger. And therefore, removal of children from stressful homes, where there is normal anxiety, can be of benefit to the child asthmatic.

In Britain open air schools were set up for asthmatic children "in rural or coastal settings or were temporarily relocated to settlements in mountainous areas of Europe..."

Then Jackson added:

"Although some American asthmatics later denounced parentectomy as 'one of the most shameful treatments foisted on the sufferers of any disease,' life in open-air schools was not universally detested by the children themselves: many of the children sent to schools in the countryside around Birmingham in England during the first half of the twentieth century remember their their time with some affection: '
As a child I suffered from bronchial asthma and was sent to Marsh Hill, which I enjoyed very much.' "

Interesting hey? Sick kids being plucked from their homes and liking it. Believe it or not I can understand it completely.

I remember being nervous about going to NJH, yet I knew it was going to help me get better. And I was nervous that I was going to 2-May when I thought I would get to go home, yet I later wrote in my journal, "2-May turned out to be a really nice place. I really like it here."

Thus, leaving Denver for me was almost as sad as leaving my family to go to Denver. Those I met in Denver had become my new family, and good friends.

Plus I was able to breathe well while there, and they provided me with the skills to breathe well when I was back at home.

My disadvantage is your advantage

You know what sucks most about having asthma. It's not being able to fix things around the house. It's not being able to build a wall and to put up drywall and finish it off myself. It's not being able to build things with wood.

I often joke with my friends that I can fix people who can't breath but I can't fix anything at home.

It's not like I don't know how to do carpentry work, it's my body won't let me. As soon as I get all the stuff and get set up, and as soon as I touch the wood my skin breaks out in hives and the asthma acts up. Actually, the allergies act up more so than the asthma. And that's even with all the high tech asthma and allergy stuff available today.

So I have to hire people to do jobs around the house most men should be able to do, and enjoy doing. When I have other people doing jobs I think I should be doing it feels, to me, like an attack on my manhood.

My dad owned a ton of apartments, and he'd give me a job to rip out carpet or something. I'd do it because it's a fun job. Yet even though I wore a mask, I still had to step outside every few minutes to wipe my dose and sdeeze.

The same happened as he was trying to teach me how to lay carpet, or do other projects. My bothers learned a lot from dad, and now they build things in their homes all the time, things I wish I could do.

So I was never able to finish a project working with my dad. If asthma sucks in any way shape or form in my opinion, that's where it sucks most for me. It's not even so much the asthma per se, but the allergies. I can handle the asthma. The allergies prevent me from doing carpentry work. The allergies suck the most.

I want to finish the basement. Yet I can't because if I did that I'd have to hire out the job. If I could do it I'd go to the store and do it right now because I have the week off. I can do it at 1/10th the cost too.

Well, that's just life.

However, my disadvantage is your advantage. Because I can't do that project, I spent much of my time here instead. Hence, I've become an asthma expert and writer of sorts -- a benefit of having asthma I suppose.

Is all asthma genetic? Somehow I think not

I've written in various posts that I believe you must have the asthma gene in order to have asthma. Yet based on recent articles and studies I've read, I'm now thinking it may be possible to get asthma (or something similar to it) even if you don't have the asthma gene.

Consider exercise induced asthma (EIA). Scientists now claim that EIA is no longer a proper diagnosis, as EIB is more like it, or exercise induced bronchospasm. They say this because some people who do not have asthma may have EIA, or more properly EIB.

As I note in this post, " The best definition I could find (about EIB) came from this post at AAAAI.org, which notes exercise doesn't necessarily "cause" asthma, but that "hyperventilation (fast breathing) associated with exercise cools and dries the upper and lower airway resulting in the release of histamine and other substances that produce the bronchospasm (spasming of the muscles in the air passages in your lungs)."

Later I wrote the following, "Actually, according to Dr. Christopher Randolph, a clinical professor at Yale University who was interviewed by The New York Time's, EIA is not quite the same as asthma. He notes the "'preferred term' in the scientific community for exercise-induced asthma is exercise-induced bronchoconstriction, or EIB."

The idea here is that even if you don't have the asthma gene, and you are constantly irritating your airway with fast, rapid breathing in cool, dry air, you may be damaging your lungs long term.

This is also evidence in an upcoming post I will release soon about Occupational Asthma. With occupational asthma, it is believed that if you are exposed to the same chemicals day in and day out, your body may develop a sensitivity to is even if you don't have the asthma gene. The end result in non-asthma gene occupational asthma.

Say you are born premature with an immature immune system. Many of these kids are predisposed to get asthma.

A virus called respiratory syncicial virus (RSV) is a bug that most children are exposed to. So, in the first three months of life many scientists believe your immune system is developing, and if you're exposed to the RSV bug, and this causes you to develop RSV pneumonia, this may cause lung damage that may make these kids at increased risk for developing asthma whether they have the asthma gene or not.

So, say you are born premature and you are exposed to RSV. Now you have an even greater risk of getting asthma, whether you have the gene or not.

Other studies have me leaning this way, such as studies that show you have an 80% chance of developing asthma if you are born by c-section as opposed to vaginal delivery. Or studies that show athletes have a 40% greater chance of getting asthma later in life as opposed to non athletes.

Or, as I noted in this post, "What I also found stunning was that this article from the New York Times noted half of all cross country skiers, and 17 percent of Olympic-level distance runners, have been diagnosed with EIA. Likewise, according to the American Academy of Allergy, Asthma and Immunology (AAAAI.org), 23 percent of all olympians have EIA."

So, since it's expected that only 10% of the population has the asthma gene, and 80% of those who are born by c-section get asthma, then you have to assume, or surmise, that many of that 80% do not have the asthma gene.

Or am I missing something. What do you think? Discuss.

Does Advair cause weight gain?

This is something that has been discussed a lot in asthma communities, as you can see here and here and here and here and here and here. Yet there has been very little documented evidence as to whether it is true or not.

Someone askes me this question here, and my answer was a quick, "Studies have shown that if you rinse your mouth out really well after using your Advair inhaler systemic side effects are very rare."

Yet considering the broad discussions on this topic, I'm now wondering if I was wrong. Is it possible that Advair does cause weight gain.

Asthma.emedtv.com notes that while weight gain was not listed among the side effects of Advair during initial testing, many asthmatics on Advair have noted weight gain. So perhaps further testing on this is merited.

I know I have seen some websites note that the higher dose (500/50) of Advair have been linked to increased side effects, even if you rinse your mouth after each use.

Yet most studies show that if you rinse your mouth well after using the lower dose of Advair (250/50) side effects are rare. So, this makes me wonder if I might be correct, and perhaps all those folks complaining of Advair weight gain were either on the higher dose, or not rinsing.

Still, for some reason that doesn't seem plausible.

Another consideration that might cause weight gain for some who take Advair, and this is listed as a possible side effect, is possible fluid retention. Now this may lead to weight gain. Of course fluid retention is also a complication of illnesses such as heart failure, so if you have this then you ought to be calling your doctor.

As far as my experience with weight gain and Advair, in the past when I did the Body For Life diet I lost up to 40 pounds in one 12 week period. Yet recently I only lost 20 in 20 weeks. Now this could be age catching up to me, or the fact I didn't stick to the diet as well as I did in the past.

Yet, and this idea crossed my mind, it could be that I am now on Advair. When I lost 40 pounds in 2002 to when I was trying to get in shape for my wedding, I was not on Advair. And, chances are, I was not the most compliant with my Flovent. So the level of steroids in my blood may be higher now than then.

However, I am only speculating. My weight loss has been slow as compared to in the past. Other folks on Advair who exercise have also noted a similar slow weight loss, or none at all. So I'm not alone in thinking this way.

Yet any of us who choose to blame the Advair may simply be trying to come up with an excuse for being overweight. I'm not blaming the Advair at all, just curious. Yet I have observed that I am constantly hungry. Is this genetics or Advair? Hard to know for sure. No studies have been done.

So what do you think? What is your experience with Advair and weight gain? Are there studies out there I'm not aware of? Discuss.

It appears mosquitos love asthma blood

My 1 YO baby had a large mosquito bite on her back, and so I humbly got out the bug spray and sprayed her little body to prevent any further damage. Moments later I noticed I was wheezing and a little tight.

This brought back a memory of many bug bites on my legs. I remember I used to get more than most other kids. I'd be up all night itching away, and by morning I'd have scarred up legs. Usually by the time school started in the fall I was glad there was a no shorts policy at our school.

I remember how there could be 20 people sitting around a camp fire, and all the mosquitos would be around me. Sometimes I could see a dark, swarming cloud of the little annoying pests over my head. They loved me, or at least my blood, and I hated them. I kept swatting and they kept biting. Yet I stayed outside because I was a kid, and loved the outside. I wanted to be like a normal person, and hang out where the fun was.

Yet I remember my mom and dad not allowing me to use bug spray because if I used it I usually had trouble breathing. I don't know if it was the smell or something in the spray itself. So there was actually a double edged sword per se, where if I used the spray the bugs didn't get me but I had trouble breathing. And if I didn't use it the bugs got me and I could breathe.

And it seemed that for some reason, even if no one used bug spray, the bugs just seemed to swarm around me. I don't know why this was. Perhaps they loved asthmatic blood better than normal blood.

As an adult this doesn't happen so much. Now I can use bug spray most of the time and it doesn't bother me. I suppose this could be because my air passages are larger, yet I bet it's also because modern wisdom has allowed me to obtain better asthma control.

The neat thing about my episode last night was I never had to use my rescue inhaler. I simply waited it out, and the long acting beta adrenergic I obtained from using Advair earlier in the day did the job. It's neat how that works. It never was like that in years past.

I never really thought of it when I was a kid, how much asthma effected my life. I never realized how tough of a kid I was, being willing to tough out another asthma attack just so I could be normal and hang with my relatives and friends.

The asthma never stopped me, and neither did the bugs -- bug spray or not.

Strabismus: Day 7-10

If you thought the redness, swelling and itchiness would be gone by day 10, you guessed wrong. However, over the past four days the irritation has progressively improved. I am now to the point I can actually keep both eyes open during the day, although vision is still blurred in the operated on eye.

I actually had to skip several of my children's baseball games, even though I figured by now I'd be able to go. I missed both due to windiness and blowing sand. This is also the main reason I find I'm unable to go to the beach.

When I had this surgery when I was 15 I remember being told to avoid getting your eye wet by swimming for at least a couple months, yet my doctor told me this time on more than one occasion he only wanted me to keep my eye dry for a week. However, I feel much more comfortable not swimming, and not getting my eye wet. Maybe there's been some research that shows it's okay, but until I see it first hand, I'm not swimming.

I still find myself with the urge to rub my eyes, something I'm prone to habitually do anyway due to chronic allergies. And I can't wait until I can rub my eyes at will again.

So everything's pretty much back to normal otherwise. The asthma is considerably good considering the high heat and humidity, the constant sound of lawnmowers, and the pollen of summer.

Tomorrow I get to go back to work, and I'm looking forward to it actually. I imagine I'll be getting a lot of looks and questions about my red eye.

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Update:

August 28, 2010: By about the three week mark the itching is pretty much gone. The eye feels relatively normal. I'm still tentative to touch or rub it though.

August 19, 2010: Saw the eye doctor today. He said everything looks good, including alignment, and he expects the eye to be good for another 30-40 years. He said there is still some redness and swelling, although minor. He also noted my healing process will take a little longer due to all the eye repair I've had in the past. No big deal. Feeling good. It's really neat as I navigate through life with my new vision. The surgery was definitely worth it.

Strabismus surgery day #6

Ah, if day #1 was the worse for having strabismus surgery, day #6 was the second worse. By now I'm feeling no pain, yet the itching in my eye is downright terrible. The worse part about the itching is it feels as though there are little bugs in there trying to get at my brain through my eyeball.

Although I saw my doctor today and he insisted the surgery was a success. My vision is still blurred in my right eye, but he insists as the inflammation goes down the itching will subside and my vision will be good as ever. His optimism was repeated by the eye muscle specialist.

So instead of having me use antibiotic eye drops, from now on it's prednisolone eye drops. Yes, good old steroids work to reduce inflammation just about anywhere in the body, and for me not only do I take inhaled steroids, it's eye steroids too. Only for the case of my eyes, it's only temporary.

After the 3 hour round trip to my opthamologist's office my eye was so itchy I had to start rubbing my left eye just so I could rub something. That's probably the worse part about having an itchy eye post strabismus surgery is you can't touch the eye. I also have allergies, so that probably doesn't help either.

So there really isn't much you can do for itchy eye. My doctor said the steroids should help, although it will probably take a day or two. We often say in the medical field things can seem to get worse before they get better, and day #6 post strabismus surgery might just be that "worse" they are talking about.

From here on out I'm expecting a downhill ride. The irritation was so bad that I couldn't think, so I popped a couple vicodin pills I had left over hoping it would at least allow me to get through the rest of the day. I'd say it worked.