no.3/may 2011 asthma and allergiesdoc.mediaplanet.com/all_projects/7331.pdf · tips on managing...
TRANSCRIPT
AN iNdepeNdeNt SUppLeMeNt FROM MediApLANet tO tHe NAtiONAL pOSt
no.3/May 2011
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BIG NEWSf o r a s t h m a a n d a l l e r g y s u f f e r e r s
asThMa anD allERgIEs
Brandon gormley, Moncton Wildcats’ defenceman and Phoenix Coyotes fi rst round draft pick, puts his asthma on ice
FROM THE EMERGENCY ROOM
TO THE NHL
PH
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Phoenix Coyotes fi rst round draft pick, puts his asthma on icePH
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:NH
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3TIpS
oN MaNagINg YourCHroNIC DISeaSe
breathing easyHow to ensure your home is an allergen-free zone
Staying proactivetake care to properly treat your asthma
AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt2 · MAy 2011
challEngEs
asthma and allergy su� erers face a similar lifelong challenge—as curing their symptoms may not be a possibility, real change comes from living proactively.
“Now, at the age of 18, talking about my allergies is routine. Unless the food is from home, i do not eat anything before asking if it’s safe for me.”
Food allergies in a nutshellAlex Chippin is always on alert for his dietary needs.
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pAGe 6
patient compliance p. 3the proper treatment of your asthma starts with you.
an allergen-free home p. 7ensure you —or your guests—can always breathe easy.
Did you know that only nine percent of patients use their puffers correctly?
Metered dose inhalers or “puff ers” are the most prescribed aerosol medica-tion for people with breathing prob-lems. Unfortunately, patients of all ages rarely use them properly, seldom getting the right amount of inhaled medicine that their doctor prescribed.
The most common issue is poor coordination which aff ects timing inhalation and activation of the puff er and “catching” the medication as it comes speeding out at up to 100 km/h. This is especially true for children and the elderly.
Determining detectionTasting the medication is one way to self assess correct puff er use. Experi-encing any taste when using a puff er can indicate that the medication is
being deposited in the mouth, throat and stomach and not reaching the lungs. While side eff ects such as oral fungal infections, increased heart rate and anxiousness are possible, the patient is also at risk for exacerbations of their lung disease.
eradicating errorFortunately, there is a simple device available from your phar-macist called a valved holding
chamber that eliminates most human error associated with using a puffer. A chamber is designed to hold the aerosol medication until the patient is ready to inhale. A one-way valve prevents medi-cation from escaping, allowing patients to take one deep breath or multiple regular breaths through the chamber to get all of their med-ication.
In addition to being bisphenol A
(BPA) free, key features to look for in a valved holding chamber are:
■ Flow indicator: Provides visual feedback for easy breath counting and confi rmation of mask seal, and helps reassure parents and caregivers that medication is delivered.
■ portability: Small chambers (150mL) are easily carried in purses or backpacks.
■ anti-static material: Prevents aerosol medicine from “sticking” to the chamber which decreases the amount available to breathe in.
■ age appropriate colours and designs: May empower children to be less shy about taking their medication while at school.
Ask your pharmacist for more information about improving inhaler technique and avoiding asthma attacks through the use of a chamber and how the cost can be covered by health insurance.
Do you know how to puff properly? DON’T MISS!
Common asthma and allergy triggers
■ Dust mites ■ Animals ■ Cockroaches ■ Moulds ■ Pollens ■ Viral infections ■ Certain air pollutants ■ Smoke ■ Exercise ■ Cold air ■ Chemical fumes and other
strong-smelling substances like perfumes
■ Intense emotions
living the lifestyle is about more than medication
O n Tuesday, May 3, World Asthma Day will take place to remind everyone of the need to improve awareness and
care on a global stage. Asthma and allergies are serious
conditions that aff ect a large num-ber of Canadians. Over three million people have asthma in Canada, and about 60 percent of those people, or 1.8 million, do not have their asthma under control. The key message is that you do not have to accept a lower qual-ity of life just because you have this chronic disease—complete control is possible and you can live an active and symptom-free life. This means no nighttime awakenings, no emergency room visits, no lost time from work or school, and no limitations on your exercise. With these restrictions, you are letting asthma control your life, rather than the other way around.
It’s time to change To regain your quality of life, or to adjust to a new asthma diagnosis in the family, there are changes that need to be made to both mindset and
lifestyle. A diagnosis of asthma is not a house arrest sentence for your child. Life doesn’t end—you just need to incorporate new elements to your routine. After consulting with your physician, administering your pre-scribed medication will go a long way to control the symptoms of asthma. Asthma is not something that can be cured, only managed. Most of the serious cases in which people have had complications with asthma could have been avoided with compliance as well as awareness of how the individ-ual reacts during diff erent situations. Asthma is something you live with—how you live is up to you.
Medication is not the only solutionChanges in your lifestyle can be expanded past medical treatments. Your home and the environment around you can play a major part in how good or bad your asthma/allergy symptoms can be. Ensuring your home is friendly to both asthma or allergy suff ers in your family, as well as visitors to your home, can be a big relief to those around you. Simple changes can go a long way to someone who suff ers from these chronic dis-
eases and are defi nitely appreciated. The average person will be dormant in sleep for 7.5 hours a night, and during this time will be exposed to/breath in the environment around them. Mak-ing just small changes to your home can be a big step towards helping relieve these symptoms and protect yourself or those around you during the night.
Taking it into your own handsMillions of Canadians live with asthma; how they live is up to the choices they make and the way they control their disease. Speak-ing with your doctor, complying with your medication, monitoring your symptoms and maintaining your home are all positive steps towards ensuring your life isn’t restricted or spent constantly in fear of emergency room visits. Every asthma/allergy sufferer is different and you need to make the educated choices for you or your loved ones.
We encourage you to read this section and learn how you can help manage your asthma and allergies, beginning with small steps that you can start today.
Christine Hampsonpresident and CeO,Asthma Society of Canada
Deadly at any age
1 Approximately 20 children and 270 adults die from asthma
each year. It is estimated that more than 80 percent of asthma deaths could be prevented with proper asthma education.
an ever-present issue
2 In Canada, asthma is the lead-ing cause of absenteeism from
school and the third leading cause of work loss.
ASTHMA FACTS
“the most common issue is poor coordination.”Mark a. anselmo, MDDirector, Division of Pediatric Respiratory MedicineAlberta Children’s Hospital
AStHMA ANd ALLeRGieS3Rd editiON, MAy 2011
Responsible for this issue:publisher: Pat [email protected]: Penelope [email protected]: Alexander Chippin, Christine Hampson, Damien Lynch, Indrani Nadarajah, Daniel St. Louis
Managing Director: Gustav [email protected] Manager: Jackie [email protected] Developer: Chris [email protected]
photo Credit: All images are from iStock.com unless otherwise accredited.
Distributed within:National Post, May 2011This section was created by Mediaplanet and did not involve the National Post or its Editorial Departments.
Mediaplanet’s business is to create new cus-tomers for our advertisers by providing read-ers with high-quality editorial contentthat motivates them to act.
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Inhaled corticosteroids (ICS) are the mainstay of asthma treatment and recommended first line by the Canadian Thoracic Society.
In 1948 doctors at the Mayo Clinic first treated a group of arthritis patients with daily injections of the anti-infl ammatory drug. The pain-relieving results were dubbed “mirac-ulous”, but over the years, greater understanding of systemic cortico-steroids’ potency and eff ects on the body has led to their being used more cautiously.
Systemic corticosteroids can cause serious side effects over the long term, including cataracts, glaucoma, bleeding in the gastro-intestinal tract and osteoporosis.
The gold standard for treatmentOn the other hand, inhaled corticoste-roids (ICS) are a mainstay in asthma management and are viewed as the
Courtesy of the Asthma Society of Canada
AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOStAN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt MAy 2011 · 3
challEngEs nEws
Inhaled corticosteroids (ICS) are the mainstay of asthma treatment and recommended first line by the Canadian Thoracic Society.
In 1948 doctors at the Mayo Clinic first treated a group of arthritis patients with daily injections of the anti-inflammatory drug. The pain-relieving results were dubbed “mirac-ulous”, but over the years, greater understanding of systemic cortico-steroids’ potency and effects on the body has led to their being used more cautiously.
Systemic corticosteroids can cause serious side effects over the long term, including cataracts, glaucoma, bleeding in the gastro-intestinal tract and osteoporosis.
The gold standard for treatmentOn the other hand, inhaled corticoste-roids (ICS) are a mainstay in asthma management and are viewed as the
gold standard of therapy by the Cana-dian Thoracic Society. The society advises, in its Asthma Management Continuum 2010, that ICS remain the first-line controller therapy for children and adults. ICS are a preven-tative medicine and work long term to reduce swelling and mucus in the lungs. They also act on the immune system by blocking the production of substances that trigger allergic and inflammatory actions.
Previously, ICS had to be taken three to four times a day. Now, patients can have inhaled cortico-
steroids that only need to be taken once or twice a day, says University of Toronto assistant professor and asthma specialist, Dr. Sasson Lavi.
Steroid “phobia”Corticosteroids are closely related to cortisol, a hormone produced in the adrenal gland. Despite their impor-tance in asthma management, Dr. Lavi acknowledges that there is some fear about the effect of prolonged use of corticosteroids, particularly in children.
“There has been steroid phobia
in the public and some of it is justi-fied,” says Dr. Lavi. “No one is dis-puting the need to limit systemic corticosteroids. However, when one uses the recommended dosage of ICS, side-effects are less com-mon.” Most asthma patients only need to inhale low doses, and the usual side effects, though uncom-mon, are localized. These include hoarseness of voice and some-times, a superficial fungal infec-tion in the throat or mouth.
Physicians tend to err on the side of caution with ICS, and use the lowest possible concentra-tion. Some ICS can suppress the adrenal gland in children but also adults particularly at higher doses. Other studies have shown that even when ICS have been used in the lowest concentration, children have shown a slight lag in height, even though these same children may catch up. It is important if patients or parents have concerns about side effects or steroid con-
cerns they should talk to their doc-tor to explore all options
The Canadian Thoracic Society also recommends a leukotriene receptor antagonist as a second-line medication to control asthma. Dr. Lavi’s experience is that this class of medication can be very effective in treating some asthma patients.
Long-acting bronchodilatorsWhen ICS alone cannot control asthma, physicians frequently recommend long-acting bronchodilators in con-junction with ICS. This is called combi-nation treatment, says Dr. Lavi. There are now two types of long acting bron-chodilators on the market. Combination treatment will enable physicians to use a lower dose of ICS and still achieve good asthma control. Studies have shown that combination therapy is very effec-tive in adults and older children.
IndranI nadarajah
Inhaled corticosteroids: what are the risks?
There are many effective asth-ma medications on the mar-ket, but these medicines are not fulfilling their potential be-cause of poor patient compli-ance, say doctors.
Dr. Lavi says patients tend to be more responsible with medication the fewer times a day they have to take it. “If they only have to take the medication once a day, com-pliance is about 90 percent. This drops sharply to under 50 percent, if they have to take the medication two or three times a day.”
Not all patients are the sameDr. Lavi, who is also a specialist at Toronto’s Hospital for Sick Chil-dren’s division of allergy and clini-cal immunology, cautions against tarring every patient with the same brush. “You have to distin-guish between children, particu-larly under 12 years old, and adults.
Compliance in paediatrics asthma is superior to that of adult asthma. Parents are usually very conscien-
tious about ensuring their chil-dren take the required dosage.”
The situation becomes problem-atic with teenagers and adults, he continues. Teenagers sometimes don’t want to take their medica-tion because of peer pressure or because they don’t see the need for it. The use of once daily medica-tions might aid with compliance and help with control.
In adults, the compliance rate is about 40 percent to 50 percent, at the best of times. “If you tell an adult they need to have two puffs twice a day, only about half of them will comply.” The reasons are varied—they might be very busy, may just forget, or worry about potential side-effects. This is espe-cially true when the symptoms are relieved and patients become con-vinced they do not need medica-tion, he explains.
No quick fix for asthma
Some patients underestimate the seriousness of their condition. For instance, they would not be so cavalier about heart medication, he says. It is also probable that patients do not understand there is no quick fix for asthma. “It is very difficult for a family doctor who sees about 60 patients a day to satisfactorily explain why patient compliance is crucial, and why preventing symptoms flaring up is important.”
Many doctors are now referring their patients whose asthma is dif-ficult to control, to specialists for more intensive treatment.
Twenty years ago, doctors did not believe it was possible to change asthma’s outcome, in terms of deteriorating lung func-tion, but research has shown that this need not be the case. The key is proper, early diagnosis. Then comes aggressive treatment to prevent progressive inflammation
and “remodelling of the lungs”, explains Dr Lavi.
Worldwide, asthma prevalence rates are rising by about 50 per-cent every decade, according to the Asthma Society of Canada. Health Canada calculates that 2.7 million Canadians over the age of four have asthma. This increase may be par-tially attributed to better diagno-sis of the disease, but we still have a long way to go to understand the disease and its increasing preva-lence, according to Dr. Lavi.
From the patient’s perspective however, it can be very simple—manage your asthma on a daily basis and have an action plan for when it gets worse. This will enable most asthmatics to live a normal life, he concludes.
IndranI nadarajah
good asthma control requires patient compliance
TakINg preCauTIoNSStudies have shown that children using ICS may experience a slight lag in height at the time of treatment.
“there has been steroid phobia in the public and some of it is justified.”
Dr. Sasson LaviAssistant Professor and Asthma SpecialistUniversity of Toronto
AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt4 · MAy 2011
A life-long battle with asthma hasn’t hindered hockey player Brandon gormley. The 19-year-old defenceman, who is newly drafted to the phoenix Coyotes, stares down the disease with the same determination he uses forfacing o� with forwards in the rink.
Putting asthma on icePROFILE
Brandon gormley
■ Date of birth: February 18, 1992
■ Hometown: Murray River, Prince Edward Island.
■ NHL Team: Phoenix Coyotes
■ Current Team: Moncton Wildcats
■ position: Defence
■ Shoots: Left
■ Motto: “Asthma is not a problem if you manage it well.”
“I just take my meds and live my life... It’s all in the head. You learn to manage the situation,” Brandon gormley, 19, says of his asthma.
He should know—he’s lived with the condition almost all his young life. At fi ve weeks, when babies are beginning to show little smiles, Brandon’s parents were taught how to administer a puff er to their infant son to help him breathe better.
To say that his parents, Sharon and Darren, embarked on a roller coaster ride just after Brandon was born might be an understatement. “Brandon was perfect for the fi rst month. A great baby,” Sha-ron recalls. Unfortunately, he picked up a respiratory infection at four weeks old, and after a couple of trips to the emergency room with him, he was hospitalized for 11 days and tested for various diseases like cystic fi brosis and whooping cough. “He was fi nally discharged with puff ers and
inhaled steroids.”The family’s tribulation continued. At
nine months, Brandon was barely able to sit up, was still very weak, and wheezed a lot. “I said to the doctor, ‘Even the worst asthmatics in the world stop wheezing at some point but he never does,’” Sha-ron says. The doctor agreed, and Brandon was referred to a paediatrician, Mitchell Zelman, who diagnosed asthma and pre-scribed a nebulizer mask so that the baby could inhale the medication more eff ec-tively. Within a week Brandon was pulling himself up and walking around the furni-ture like any other 10 month old.
“Talk about feeling like a terrible mother! How could I not know that my child wasn’t walking because he couldn’t breathe?” she asks.
“Don’t hold him back”Those dark early days are now a distant, though still real, memory. Brandon found his life’s passion early and has excelled. With the paediatrician’s sage advice ring-
ing in his parents’ ears—“Don’t hold him back, unless he has a fever.”—he started playing hockey when he was three. His father was his minor hockey coach, which helped with his asthma management. “I could usually tell when he was getting bad before he would realize or admit it. He’d be falling down more on the ice, coughing at night—things like that were red fl ags for me,” says Darren.
Brandon has never let asthma stand in his way of playing professionally. Ironi-cally, it is his love for hockey which has made him very methodical about con-trolling his asthma. During the season he manages the asthma by using his puff er twice a day—once in the morning and again before going to sleep—and tak-ing a controller before he plays.
“There is no off -season for hockey. I have to be at, or near, peak physical fi t-ness all year round,” he explains. He trains harder than other players in prep-aration for each new season to maintain his edge.
room to breatheHis hard work is reaping dividends. Described by “Hockey News” as playing “a mature game from behind the blue line” with a potential to be an “all round defen-seman”, Brandon was picked in the fi rst round, and 13th overall, by the Phoenix Coyotes in the 2010 NHL Entry Draft. He currently plays for Moncton Wildcats in the Quebec Major Junior Hockey League. Don Maloney, general manager of Phoenix Coyotes, says, “We are very pleased to sign Brandon. He is a talented young defense-man and we are confi dent that he will be a big part of our organization for years to come.”
Brandon has one piece of advice for parents of young boys and girls who have asthma but who are crazy about hockey: “Don’t hold them back. My parents never held me back. You aren’t doing your kids any favours if you hold them back.”
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AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOStAN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt MAy 2011 · 5
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an asthma action plan is an effective way to make sure you are prepared for the dif-ferent levels of your chronic disease.
The Asthma Society of Canada says that due to the variants of the dis-ease, what works for some people may not work for you. Asthma care must be personalized.
green Zone
1These are cases where no symptoms occur on most days. Controller medication
is taken and the plan will indicate medication, size of dose and time administered.
Yellow Zone
2These are cases where symp-toms are present. In this zone the plan will explain if
an increase in controller medication or a switch to a diff erent medication is needed. Set a recovery time frame and doctor information.
red Zone
3Entry into this zone could happen for a number of rea-sons. Dial 911, identify the
reliever medication needed and how often it should be used during the wait.
A template for an Asthma Action Plan can be found on at Asthma.ca. To create your own, talk to your physician.
DID YOU KNOW?
?Do you have an asthma action Plan?
Courtesy of Asthma Society of Canada
3
2
1. Hitting the ice for the Moncton Wild-cats.2. gormley’s passion for hockey started in childhood.3. a proud new draft pick!PHOTO: 1: DANIEL ST. LOUIS, 2: PRIVATE, 3: NHL IMAGES
AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt6 · MAy 2011
as part of their policy to ac-commodate travellers with food allergies, last Decem-ber WestJet announced that it would include one adult and one child epipen on all its aircraft first aid kits.
EpiPen is an auto-injector that admin-isters a premeasured dose of epineph-rine (adrenaline) to counteract a severe allergic reaction, or anaphylaxis, in an individual. Food is the most common cause of anaphylaxis, but insect stings, medicine, latex, or even exercise can also trigger a reaction.
WestJet plans to have these devices
It may surprise some people, but the stronger building codes and bet-ter building materials of the last few decades have laid the foundations for more allergy triggers to remain in the home.
Rob Lanteigne, coordinator of the National Asthma Patient Alliance, part of the Asthma Society of Canada, says the emphasis on energy effi -ciency has led to air being circulated in the home less often, resulting in asthma and allergy triggers staying in one place for longer.
The Healthy Indoor Partnership, an industry association, concurs. Because houses are so well sealed, trapping humidity and pollutants indoors, the best strategy is to eliminate pollution sources to control air quality.
Four in fi ve people with asthma have underlying allergies, but simple strategies can help achieve better air quality in the home.
Commonsense guidelines ■ Keep indoor humidity levels at
between 35 percent to 50 percent. This will prevent dryness in the air,
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For alex Chippin, a life-long su� erer of food allergies, constant communication about his dietary needs is necessary to ensure grabbing a snack won’t lead to a severe allergic reaction.
when it comes to daily rou-tines, mine isn’t that d i f f e r e n t from any-one else’s.
But when it comes to my safety—that’s a diff erent story. The diff erence between you and I is that when I go out to a baseball game, movie, restau-rant or anywhere else, I carry an epi-nephrine auto-injector to help protect me in case I have an allergic reaction. At the grocery store, I read the labels before anything goes in the shop-ping cart. On an airplane, I decline the snack, and am aware of potential cross-contamination on surfaces that may have been touched by peanuts or nuts.
always on alertWhenever I eat at a restaurant, I tell the staff member serving me that I am allergic to peanuts and nuts, and ask them to let me know if what I’m ordering is a safe choice for me. It is easy to make assumptions based on previous experiences, but the last time I was about to do that, I was reminded of why that is not a great idea.
It’s dangerous to assumeSome restaurants in the United States are a bit different from the same restaurants here in Canada. I did not know this as a 13-year-old, travelling on a bus to Florida with my baseball team. It was my first experience being on a trip without my parents, which meant nobody would be standing beside me to make sure I asked about my aller-gens when I was ordering.
I stood in line, debating if I should bother telling the woman behind the counter about my food allergies. The line was already long enough. I did not want to make people wait any longer when I was already pretty sure that what I was going to order was safe since I’d ordered it before at home. The closer I got to the front, the more I leaned towards keeping my allergies to myself.
As I stepped up to give my order, I changed my mind at the last min-ute, and I told her about my aller-gies. It turned out that they had peanut butter all over the kitchen and there was a very high risk of cross-contamination. As I learned that day, assumptions and food allergies are words that should never go together.
Healthy communicationNow, at the age of 18, talking about my allergies is routine. Unless the food is from my own home, I do not eat any-thing before asking if it’s safe for me. This strategy has helped me avoid an allergic reaction—something that hasn’t happened since I was a toddler.
My friends and family know that I have a severe allergy to peanuts and nuts. When I leave home, I make sure to take a snack with me unless I know that there will be something safe for me to eat wherever I am going. Living with food allergies can be challenging, but support from friends and family makes it easier.
To some, food allergies may seem like a hard thing to manage, but for me its part of my daily routine. Anytime I leave my house, I take my epineph-rine auto injectors with me. Anytime I order food from a restaurant, I inform the waiter or waitress of my allergies. Anytime I go grocery shopping, I read the labels. For me, these things are all quite simple and help me safely man-age my allergies on my own, while allowing me to have the same life experiences as anyone else.
Food allergies do not stop me, and should not stop anyone from doing what they want to in life.
Managing food allergies in a nutshell
alex ChippinMember, youth Advisory panel, Anaphylaxis Canada
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aLWaYS oN aLerTextra prevalence is required for alex’s allergies when travelling.Here, he and his dad spend quality time together at the pro Football Hall of Fame in Canton, ohio.PHOTO: PRIVATE
AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOStAN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt MAy 2011 · 7
creating an allergen-free home
asthma is all in your head
Asthma is not imagined or faked. It occurs because you
have airway infl ammation and con-striction of the bronchi and bronchi-oles in your lungs. Triggers such as stress, crying, yelling or laughing can all provoke an asthma attack.
asthma can be curedThere is no cure for asthma, but there are safe, eff ective
ways to control it so you can live a normal, active life, free of symptoms.
everyone who has asthma is the same
Asthma varies from one per-son to another both in its
severity and the degree of treat-ment it requires.
I only have asthma when I have trouble breathing
Asthma is a chronic disease with an underlying infl am-
mation of the airways that causes asthma symptoms. Your asthma has not gone away just because you don’t have symptoms. Daily control with anti-infl ammatory medica-tion is needed. Left untreated, asthma can be a serious and life-threatening disease.
I only need to take my medication when I’m having trouble breathing
The chronic infl ammation of the airways needs daily treat-
ment with your controller medica-tion. Take your controller medication regularly as prescribed. The benefi ts of regular use far outweigh any risks.
I can stop taking my con-troller medication as soon as I feel better
Your anti-infl ammatory medi-cation is doing its job, which is
why you are feeling better. If you stop taking it, the airway infl ammation that leads to attacks may return. Always consult with your doctor before you stop taking your medication.
My child will outgrow her asthma
Asthma is a lifelong condition that will always require atten-
tion. Your child’s asthma may get less severe as he or she gets older but it can return at any time.
Steroids are dangerous, so I don’t want my child taking them
Steroid controller medications are inhaled, not swallowed,
which means they act locally where they are needed and are not absorbed throughout the body. Furthermore, they are corticosteroids, not the ana-bolic steroids used by bodybuilders. Studies have shown that, when cor-rectly used, inhaled corticosteroids are safe to take over time.
Steroids will stunt my child’s growth
Studies have indicated the use of inhaled corticosteroids does
not alter normal growth in children. Untreated asthma, however, can result in permanent lung damage and have an adverse eff ect on normal growth patterns. You should work with your doctor or asthma educator to fi nd the right medications for your child’s asthma.
I have to avoid sportsHaving asthma does not mean that you or your child should
limit physical activity. Many profes-sional athletes have asthma but are able to compete because they have learned to control it. If you have any limitations in your physical activity, your asthma may not be well con-trolled. Consult with your doctor to assess your asthma control level and determine a proper exercise regimen for you.
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as part of their policy to ac-commodate travellers with food allergies, last Decem-ber WestJet announced that it would include one adult and one child epipen on all its aircraft first aid kits.
EpiPen is an auto-injector that admin-isters a premeasured dose of epineph-rine (adrenaline) to counteract a severe allergic reaction, or anaphylaxis, in an individual. Food is the most common cause of anaphylaxis, but insect stings, medicine, latex, or even exercise can also trigger a reaction.
WestJet plans to have these devices
on all its aircraft by the end of this spring, and staff are already being trained to use these injectors as part of their emergency protocols , says West-Jet Public Relations manager Robert Palmer.
“We should be done soon. We have no fi rm estimate at to when, as we have 94 aircraft to equip and 2,600 or so fl ight attendants to train,” he added.
Safer travelsThis will provide greater reassurance to the more than 1.3 million Cana-dians that have food allergies, said Beatrice Povolo, marketing and com-
munications director at Anaphylaxis Canada, which worked with WestJet on the development of its allergy policies.
use will be supervisedAs a precautionary measure, the auto-injector will only be used under the supervision of MedLink, WestJet’s inflight medical services provider. “Even if a doctor or nurse were on board—and one usually is, more often than not—MedLink would still have to give the go-ahead before the pen could be deployed. If no medical professional were on board, a fl ight attendant could use the pen. But, again, only under
the supervision of MedLink,” Palmer emphasized.
WestJet has always carried epi-nepherin in vials, but the pens should provide an important additional mea-sure of convenience and ease of use, in the event of a medical emergency.
“Overall, this is a very positive step. The key element is to ensure that staff are properly trained on how to treat an allergic reaction on board,” says Povolo. She hoped other carriers would also follow WestJet’s example.
safer travels with auto-injectors on board
daMIEn LYnCh
It may surprise some people, but the stronger building codes and bet-ter building materials of the last few decades have laid the foundations for more allergy triggers to remain in the home.
Rob Lanteigne, coordinator of the National Asthma Patient Alliance, part of the Asthma Society of Canada, says the emphasis on energy effi -ciency has led to air being circulated in the home less often, resulting in asthma and allergy triggers staying in one place for longer.
The Healthy Indoor Partnership, an industry association, concurs. Because houses are so well sealed, trapping humidity and pollutants indoors, the best strategy is to eliminate pollution sources to control air quality.
Four in fi ve people with asthma have underlying allergies, but simple strategies can help achieve better air quality in the home.
Commonsense guidelines ■ Keep indoor humidity levels at
between 35 percent to 50 percent. This will prevent dryness in the air,
or excessive humidity which could encourage mould growth.
■ Avoid smoking in the house. If someone in the family must smoke, insist they have their cigarettes out-side and away from doors, windows and air intakes.
■ If there are pets, keep the bedroom, particularly children’s bedrooms, a no-go zone with the door shut at all
times. ■ While hardwood and tile fl oors are
preferred, most homes have rugs and some carpet. Vacuum thoroughly and frequently with a vacuum cleaner that has a HEPA (high effi ciency particu-late air) fi lter. Such fi lters, composed of randomly arranged fi bres, trap the fi ne particles which trigger allergy and asthma symptoms.
■ Kitchens, bathrooms, basements and other damp areas require regular cleaning and quick mop-ups of spills, to prevent mould growth.
artificial scents and cleaning productsArtifi cial scents from candles and air fresheners can be a trigger factor for certain individuals. Everyday items like varnished wooden furniture, paints, even cleaning products, can emit gases.
While the small amounts of toxins used in cleaning products are safe when tested in laboratory conditions, this does not mean the same fi nding will apply if four or fi ve cleaning products are used together or stored together, says Lanteigne. Many give off powerful odours. Use unscented cleaning prod-ucts wherever possible and search for non-toxic alternatives.
Finally, while open windows is a sign that spring has arrived, beware pollen count. Opening the windows on a day when the pollen count is high may be courting trouble.
“The real challenge for any home environment is the removal of triggers. Asthma and allergies can be managed. There are eff ective medications, but if we are not addressing the triggers at home, we are fi ghting a losing battle,” Lanteigne says.
“the real challenge for any home environment is the removal of triggers.”rob LanteigneCoordinatorNational Asthma patient Alliance
IndranI nadarajah
■ Question: How can you ensure that your living space isn’t aggravating your allergies—or your guests’?
■ answer: Being prevalent about your home’s air quality can help everyone breathe easier.
TIPS FOR SAFELY MANAGING FOOD ALLERGIES
■ read ingredient lists and labels on all food and beverage products every time. If in doubt, contact the manufacturer to ask for more information about the ingredients or potential for cross-contamination.
■ Carry an epinephrine auto-injector (e.g. EpiPen or Twinject) at all times and know how to use it. Replace the auto-injector before the expiry date.
■ Wear medical identifi cation (e.g.
MedicAlert® ) which indicates your allergies.
■ Tell others about you or your child’s allergies, including friends, teachers and co-workers so they can help in case of an emergency.
■ ask about ingredients and food preparation whenever eating away from home.
COUrTESY OF anaPhYLaXIS Canada
TIpInsIghT
For alex Chippin, a life-long su� erer of food allergies, constant communication about his dietary needs is necessary to ensure grabbing a snack won’t lead to a severe allergic reaction.
Healthy communicationNow, at the age of 18, talking about my allergies is routine. Unless the food is from my own home, I do not eat any-thing before asking if it’s safe for me. This strategy has helped me avoid an allergic reaction—something that hasn’t happened since I was a toddler.
My friends and family know that I have a severe allergy to peanuts and nuts. When I leave home, I make sure to take a snack with me unless I know that there will be something safe for me to eat wherever I am going. Living with food allergies can be challenging, but support from friends and family makes it easier.
To some, food allergies may seem like a hard thing to manage, but for me its part of my daily routine. Anytime I leave my house, I take my epineph-rine auto injectors with me. Anytime I order food from a restaurant, I inform the waiter or waitress of my allergies. Anytime I go grocery shopping, I read the labels. For me, these things are all quite simple and help me safely man-age my allergies on my own, while allowing me to have the same life experiences as anyone else.
Food allergies do not stop me, and should not stop anyone from doing what they want to in life.
Managing food allergies in a nutshell
The top 10 asthma myths
Courtesy of the Asthma Society of Canada
AN iNdepeNdeNt SUppLeMeNt by MediApLANet tO tHe NAtiONAL pOSt8 · MAy 2011
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InsPIRaTIOn
Brandon Gormley, currently playing for the Moncton Wildcats, has pursued his
passion for hockey despite his lifelong battle with asthma. His hard work and determina-tion paid off last year when he was the fi rst-round draft pick for the Phoenix Coyotes. Get the full story on page 4!
PHOTO: DANIEL ST. LOUIS
INSpIraTIoN
“Don’t hold him back.”