Breathe Easy

 

A

 

 

ACT- Asthma control test (same thing as HRA-Health Risk Assessment) a series of specific questions to measure how well controlled patients asthma has been in the last month

 

Acute asthma- characterized by severity, sudden onset, short course

 

Adver- long acting beta 2 agonist, it is a combination drug of long acting Albuterol and Corticosteroid

 

Aerochambers- the brand name of our spacers

 

Airway- where air passes through in your trachea, nasal passages anywhere that air passes through to your lugs; an asthmatic’s airways become inflamed & more narrow

 

Albuterol- a quick relief/fast acting medication used for an asthma episode to relieve symptoms (every time you use your Albuterol you would use you spacer). This is the standard, most common inhaled asthma medication that is used by virtually all asthmatics. It comes as an inhaler and as a solution to put into a nebulizer machine.

Allergen- any substance that is eaten or inhaled, that is recognized by the immune system and causes an allergic reaction. An allergen naturally occurs. For example, diesel is not an allergen because it does not naturally occur in the environment, it is however an irritant. Allergens and irritants are both triggers.

Allergic solute- the crease on a child’s nose which results from the constant rubbing of nose, a classic sign found at physical examination of asthma

 

Alveoli- the smallest air sacs in the lungs where oxygen exchange occurs. If a child is exposed to smoke, the alveoli can become smaller or have less surface area

 

Anatomy- The bodily structure of a plant or an animal or of any of its parts. It is important to understand lung and airway anatomy to have a better grasp on the effects of asthma.

 

Animals- common triggers or allergens are cats and dogs and dander (skin/hair combination)chickens feathers, rodents, mice, cockroaches dust mites (allergens).

 

Antihistamine- we give these out on the NCA Breathmobile, this is medication to combat allergies. A drug that counteracts the effects of histamine by acting on histamine receptors without activating them but preventing their accessibility to histamine.

we give this after allergy testing too, some of those are Zyrtec Xyzal (we prescribe and give these) Benadryl Claritin

Asthma – a chronic (long-term) lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning.

Asthma action plan- a combined medication management and emergency plan written for healthcare providers, schools, and patients to have on hand for reference; an asthma action plan if followed correctly helps manage asthma and in the case of an emergency helps facilitate proper treatment; The reference for schools, the collaboration with health care provider, school, and Breathmobile. Everyone gets copy so everyone is on the same page.

 

Atopy- genetic predisposition for certain allergic hypersensitivity reactions. Atopy may have a hereditary component, although contact with the allergen must occur before the hypersensitivity reaction can develop

 

B

 

 

 

Behavioral- behavioral patterns amongst certain groups of people often contribute to the lack of control of asthma,  (medication compliance, smoking around children, not washing blankets, toys, and house properly, certain cultures do not recognized asthma as a disease, but a “winter” problem) This is the part of what Dr. Burns calls the three E’s that contribute to the prevalence of childhood asthma: Economics, Environment, and Education

 

Bleach- a common cleaning supply that is an irritant of asthma

Breathe- asthma makes it hard to breathe; Shortness of breathe or labored breathing is a symptom of asthma. The child feels like he is not getting enough air. This prompts him to breathe faster and heavier, using the shoulders to take deeper breaths.

Bronchodilators- these are medications that open up the airways, for example Albuterol

Bronchus (plural Bronchi)- is a passage of airway in the respiratory tract that conducts air into the lungs. The bronchus branches into smaller tubes, which in turn become bronchioles. When bronchi are irritated they become constricted and inflamed and produce mucus, which are the effects of asthma

Buccal- this is the scientific name for the inside of your mouth. This is important because of the hygiene involved with asthma. An infection in you mouth or thrush in you throat can occur if you don’t wash your mouth out or if you don’t use a spacer with corticoid steroids.

 

 

C

 

 

Children- our focus patient group on the NCA Breathmobile

 

Chronic asthma- long duration asthma, frequent recurrent asthma

 

Co morbidities- two or more coexisting medical conditions or diseases that are additional to an initial diagnosis. obesity, gerd (Gastroesophageal reflux disease (GERD) allergies, diabetes, asthma

 

Congestion- when fluid is in your sinuses, response to allergens

 

Control- it’s important to have your asthma controlled. Uncontrolled asthma is very dangerous.

 

Corticosteroids- those are the controller medicines; long term therapy medicines

 

Coughing- this is a common sign of an asthma attack or a reaction to allergens; it is often a tight cough. An asthmatic cough is often much different than the cough from a regular cold. It is a tight, short, non-phlegmy cough, as if your child can’t get in enough air to make the big, deep, junky cough typical of colds or bronchitis.

 

 

D

 

 

Damp- slightly wet; damp places are where mold can grow, damp places are NOT where you should store medication (such as the bathroom)

 

Dander- flakes of skin shed by dogs, cats, and rodents; this is an allergen

 

Decongestant- medication that relieves congestion

 

Depression/stress- a comorbid condition of asthma

 

Diaphragm- this muscle contracts and expands in order to breathe, when we have children do the Pulmonary Function Test, we ask them to blow hard using their diaphragm

 

Diesel- common irritant of asthma

 

Dilate- to open, in our case our medicines open the bronchials, this is what Albuterol does

 

Discus- a mechanism used to deliver some controller medications, for example Advert and Flovent can come in the form of a discus

 

Disease- asthma is an incurable, but manageable disease

 

Dust- common allergen

 

 

E

 

 

Education- one of Dr. Burn’s Three E’s. Asthma education is what the NCA Breathmobile provides. Being educated on asthma and asthma treatment is very important for parents of asthmatics and children with asthma.

 

Eliminate- The NCA Breathmobile encourages the elimination of household triggers, missed school days, missed work days, and  emergency room visits

 

Emergency room- a room in a hospital or clinic staffed and equipped to provide emergency care to persons requiring immediate medical treatment. When people do not have the knowledge, medication, or asthma specialists available to them, they take their children to the emergency room. The emergency room is considered episodic rescue, and does not help in the prevention of asthma attacks. Emergency rooms are very expensive and their constant use is a huge financial drain.

 

Environment- The circumstances or conditions that surround someone. This is one of Dr. Burn’s Three E’s. The environment in which people live, inside and outside of the home, can contribute to the existence of asthma. Studies have shown that people who live in heavily polluted areas or in areas where there are a lot of allergens (the Bay Area for example has a lot of dust mites and pollen) or in buildings that have indoor triggers, such as mold and pests, have a higher chance of developing asthma

 

Episode- asthma episode is another word for asthma attack

 

Exacerbation- when we say there is an exacerbation of asthma symptoms we are saying that the asthma symptoms are worsening; otherwise known as an asthma attack

 

Exercise- can be a trigger for those diagnosed with exercise induced asthma; however it’s a goal for all asthmatics and non asthmatics alike, to maintain a healthy lifestyle; those with controlled asthma can and should exercise

 

Exposure- exposure to certain triggers, such as pollen and pests, can cause asthma exacerbation or episodes

 

Extrinsic asthma -People whose asthma symptoms are brought on external factors such as pollen or dust, are said to have allergic or extrinsic asthma. This is particularly common in children who develop asthma. Most asthma cases are extrinsic asthma.

 

 

F

 

 

Family- asthma is not just a community disease, and one that can be felt by the whole family. The whole family should be aware of asthma symptoms and work together to understand how to use asthma medication and asthma triggers; all family members should be aware of the asthma action plan  

 

Feathers- a common allergen. Types of feathers include goose down, chicken feathers. Feathers are a favorite food of dust mites.  Dust mite excrement is the inhaled allergen that triggers asthma attacks.

 

Follow ups- a follow up appointment is always scheduled at the end of each Breathmobile appointment. By seeing patients every month, we can ensure that asthma is controlled.

 

 

FEV 1

 

FVC

 

FEV1/FVC

 

FEV6

 

PEF

 

 

G

 

 

Genetic (family history, gender, ethnicity)- Studies show that more than half of childhood asthma cases are related to genetics (meaning that often a parent or family member had or has asthma, too). Genetics explains some, but not all cases of asthma. Developing asthma is based on a combination of risk factors related to Genetics, Environment, such as air pollution exposure, and Immunology (your own unique immune system).

Gerd- GERD is the backward flow of stomach acids into the esophagus. When this acid enters the lower part of the esophagus, it can produce a burning sensation, otherwise known as heartburn. If it is untreated, GERD can lead to lung damage, esophageal ulcers, and other things. It is estimated that more than 75 percent of patients with asthma also experience gastroesophageal reflux disease (GERD). People with asthma are twice as likely to have GERD as those people who do not have asthma.

Growth- by controlling asthma and exercising we hope to promote the growth of the lungs; we also keep track of the growth of the patient for spiromtery(PFT); we keeping track of BMI which is the recommended weight based on age and height

 

 

H

 

 

Healthcare- the NCA Breathmobile is a healthcare intervention

 

Histamine- Histamine is the chemical (neuro-transmitter) your body produces when you’re having an allergic reaction. There is always some histamine in your body, a mosquito bite (for example), causes your body to release more histamine where the bite is, making your skin red and itchy.

 

Hospitalization- in the case of an asthma emergency a child is taken is hospitalized. When parents come onboard the Breathmobile one of the questions they are asked is if, when and how often their child was hospitalized because of asthma. Asthma hospitalization rates serve as indications of changes in the incidence of asthma, of its severity in the population, and of how well individual cases are being managed by families and the health care system. Asthma is always in the top 3 reasons why children are brought to the hospital.

 

Hyper responsiveness- immediate bronchial constriction, a very fast asthma attack

 

 

I

 

 

Immunologist- We have two immunologists on the NCA Breathmobile. An allergist/immunologist is a doctor trained to prevent, diagnose, manage, and treat allergic disease. Allergists/immunologists manage immune system disorders such as allergies, asthma, inherited immunodeficiency diseases, and autoimmune diseases.

Inflammation- Asthma is inflammatory disease of the airways. In those susceptible to asthma, the inflammation of the airways causes the airways to narrow periodically. This produces wheezing and breathlessness, sometimes to the point where the patient gasps for air.

 

Inhale- to draw air into the lungs. Children are often asked to do this on the Breathmobile while the Breathmobile staff does tests.

Inhaler- An inhaler a medical device used for delivering medication into the body via the lungs.  To reduce deposition in the mouth and throat, and to reduce the need for precise synchronization of the start of inhalation with actuation of the device, MDIs (metered-dose-inhaler) are sometimes used with a complementary spacer or holding chamber device. The most common type of inhaler is the pressurized MDI. In MDIs, medication is most commonly stored in solution in a pressurized canister.

Intermittent asthma- Mild intermittent asthma is the least severe type of asthma of the various types. People with this type of asthma typically have asthma symptoms that come and go.

Intrinsic asthma- asthma that is not caused by allergies and therefore there are no antibodies produced. Intrinsic asthma attacks are normally associated with inhalation of chemicals such as cigarette smoke or cleaning agents, taking aspirin, chest infection, stress, laughter, exercise, cold air, food preservatives or a myriad of other factors. This type of asthma is further categorized into categories such as exercise-induced, chemical induced, etc.

 

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K

 

 

L

 

 

Lung- asthma is a disease that affects the lungs. Asthma is a lung condition. Asthma affects the bronchial tubes, or airways in the lungs. People with asthma have inflamed airways that produce lots of thick mucus. They’re also overly sensitive, or hyperreactive, to certain things, like exercise, dust, or cigarette smoke. This hyperreactivity causes the smooth muscle that surrounds the airways in the lungs to tighten up. The combination of airway inflammation and muscle tightening narrows the airways and makes it difficult for air to move through.

 

 

M

 

Management- key to managing childhood asthma, is the ability to keep it under control. How do you control asthma? Here are some ways: 1.Keep your child hydrated: Being dehydrated can cause the lungs to become less elastic and make the asthma worse. Make sure your child drinks 6-8 glasses of water daily.2.Keep track of asthma attacks: With childhood asthma it is important for the parent to keep a record of how often asthma symptoms interferes with a child’s activity and how often he wakes up at night, wheezing or coughing.3.Become informed about asthma: Another key to managing asthma in your child, is to become educated. Have a list of questions you want your doctor to answer. Make sure your child takes their asthma medicine as prescribed (see education).4.Learn what triggers your child’s asthma: When dealing with childhood asthma, it is important to know what their triggers are. Also share this information with teachers, family member and care givers (see Trigger). 5.Rid your home of asthma triggers: Allergens and other triggers can send your child to the, emergency room. Keep your home mold and mildew free, change bed linens often and vacuum the home several times a week.

Medication- The NCA Breathmobile provides its patients with medication or with prescriptions for medication.  Medication in addition to education is important in the controlling and managing of asthma. Without proper medication, an asthmatic child can suffer greatly or even die.

 

Metered dose inhaler- all inhaled asthma medications are metered dose inhalers (MDI’s for short), with each inhaled puff there is a specific amount of drug in each dose.

Mucosal – lining of the esophagus, lines inside of your bronchioles, mucosal membranes throughout your airways and mucus in general, excessive mucus is an asthma symptom

 

 

N

 

Nasacort- Triamcinolone nasal spray is used to treat symptoms of seasonal (occurs only at certain times of year), and perennial (occurs all year round) allergic rhinitis and perennial nonallergic rhinitis. These symptoms include sneezing and stuffy, runny, or itchy nose. Triamcinolone is in a group of medications called corticosteroids. It works by decreasing inflammation (swelling that can cause other symptoms) in the nose.

Nasanex- Mometasone nasal inhalation is used for the treatment and prevention of nasal symptoms of seasonal and year-round allergies, including runny nose, sneezing, and itchy nose. Mometasone nasal inhalation is in a class of medications called topical steroids. It works by reducing inflammation (swelling) in the nasal passages.

Nose/Nasal- Nasal allergy symptoms are something people with allergic asthma often have in addition to asthma symptoms. This is a combination we often see on the NCA Breathmobile. Not only that, but when allergy symptoms go uncontrolled, asthma may actually get worse as well. The symptoms of allergic rhinitis (which is another name for nasal allergies) are close to those of the common cold. They may last for days or weeks at a time, or may even persist year-round, depending on what your allergy triggers are. Common nasal allergy symptoms include: Stuffy, congested nose; Runny nose; Sneezing, Itching in the nose, roof of the mouth, ears and / or throat, Itchy and / or watery eyes, Coughing, caused by mucus running down the back of your throat (post-nasal drip). A hallmark sign of nasal allergies in children is what is known as the “allergic salute.” (see allergic salute). This occurs when children push up on their noses with the palm of their hand in order to stop the itching or sniffles. Kids with allergies also often have what are called “shiners,” or dark circles under their eyes.

 

 

O

 

Obesity-Obesity is a term used to describe body weight that is much greater than what is healthy. If you are obese, you also have a much higher amount of body fat than is healthy or desirable. A number of studies have shown an association between obesity and asthma, both of which have become much more common over the past three decades

 

Obstruction – There are three major features of asthma: The first is Airway obstruction. During normal breathing, the bands of muscle that surround the airways are relaxed, and air moves freely. But in people with asthma, allergy-causing substances and environmental triggers make the bands of muscle surrounding the airways tighten, and air cannot move freely. Less air causes a person to feel short of breath, and the air moving through the tightened airways causes a whistling sound known as wheezing. The second is Inflammation of the bronchial tubes. People with asthma have red and swollen bronchial tubes. This inflammation is thought to contribute greatly to the long-term damage that asthma can cause to the lungs. And, therefore, treating this inflammation is key to managing asthma in the long run. The third is airway irritability. The airways of people with asthma are extremely sensitive. The airways tend to overreact and narrow due to even the slightest triggers such as pollen, animal dander, dust, or fumes.

 

P

 

 

Perennial asthma – asthma attacks that occur year round

PFT- Pulmonary Function Test a test to measure the functionality of the lungs. Spirometry, using a spirometer, is the most common of the pulmonary function tests, measuring lung function, specifically the measurement of the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled.

Physical examination- is the process by which a doctor on the Breathmobile investigates the body of a patient. It generally follows the taking of the medical history — an account of the symptoms as experienced by the patient. Together with the medical history, the physical examination aids in determining the correct diagnosis and devising the treatment plan. This data then becomes part of the medical record.

Prevention- There are many things you and your child can do to prevent asthma attacks. Some keys ones are Follow your asthma action plan. Identify and avoid asthma triggers. Monitor breathing. Identify and treat attacks early. Take your medication as prescribed. Just because your child’s asthma seems to be improving, don’t change anything without first talking to your doctor. Pay attention to increasing quick-relief inhaler use. If you find yourself relying on your quick-relief inhaler such as albuterol, your asthma isn’t under control.

Pulmicort – this is an inhaled corticose steroid, a controller medicine. Pulmicort contains budesonide which is a corticosteroid. Budesonide prevents the release of substances in the body that cause inflammation. Pulmicort is used to prevent asthma attacks. It will not treat an asthma attack that has already begun. It works by decreasing irritation and swelling in the airways, which helps to control or prevent asthma symptoms.

Pulse oximetry- is a non-invasive method allowing the monitoring of the oxygenation of a patient’s hemoglobin. A sensor is placed on a thin part of the patient’s body, usually a fingertip. Light with red wavelengths and light with infrared wavelengths is sequentially passed from one side to a photodetector on the other side.

 

Q

 

 

R

 

Respiratory Therapist- The Breathmobile usually has a Respiratory Therapist on-board. Respiratory Therapy is involved in the assessment and treatment of breathing disorders including chronic lung problems, such as asthma, bronchitis, emphysema, and chronic obstructive pulmonary disease (COPD), and the respiratory components of acute multisystemic conditions such as heart attacks and stroke. Respiratory Therapists (RT), also known as Respiratory Care Practitioners (RCP) are specialists in airway management, mechanical ventilation, and acid base balance.

Retractions- this is a symptom of asthma. This occurs during a severe asthma attack. You can see the chest sucking in below the ribs or below the neck when your child inhales.

Rhinitis- The swelling and inflammation of the mucous membranes inside the nose, eyes and throat. The swelling occurs in response to exposure to irritants or allergens that trigger histamine release within the body. This histamine also leads to secretion from the mucous membranes, resulting in fluid release in the nose, eyes and sinuses. This fluid results in fluid drainage down the throat, drainage out the nose or tearing in the eyes. When the Breathmobile doctor looks inside your child’s nose, Rhinitis is one of the first things she sees.

 

 

S

 

SABA- Short-acting bronchodilating agents (SABA) are one of the most common treatments on the Breathomobile (and childhood asthma in general). The use of these drugs generally provides rapid relief of coughing, wheezing, chest tightness, and shortness of breath. For example, albuterol.

 

Seasonal asthma -In this type of asthma, your child is generally well all year round; except for a particular season that has the pollens and plants your child is allergic too.

Singulir –a prescription medicine often prescribed on the Breathmobile used to prevent asthma attacks and for long-term treatment of asthma in adults and children 12 months and older. It also helps relieve symptoms of indoor and outdoor allergies

Sinusitis- is inflammation of the paranasal sinuses, which may be due to infection, allergy or autoimmune issues. Sinusitis is very common for children with asthma and allergies.

Skin testing- Skin testing for allergies is done by the Breathmobile’s allergists and immunologists to identify the substances that are causing your allergy symptoms. It is often performed by applying an extract of an allergen to your skin, scratching or pricking the skin to allow exposure, and then evaluating the skin’s reaction. It is very important to know what your child is allergic to, as this may be triggering your child’s asthma.

Snoring- We often ask parents if their children snore. Snoring and asthma are related. One of the symptoms of asthma is snoring. Snoring is caused by a narrow airway, and when asthma flares up it automatically narrows down part of the breathing passages making asthmatics more likely to suffer from snoring.

 

Spacer- An asthma spacer is an add-on device used to increase the ease of administering aerosolized medication from a “metered-dose inhaler” (MDI). The spacer adds space in the form of a tube called a “chamber” between the canister of medication and the patient’s mouth. The Breathmobile highly encourages the use of spacers. Spacers allow the medication to get deep into the child’s lungs. We usually give one spacer for home and one for school.

 

Spirometry- (meaning the measuring of breath) is the most common of the Pulmonary Function Tests (PFTs), measuring lung function, specifically the measurement of the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled. Spirometry is an important tool used for generating pneumotachographs which are helpful in assessing conditions such as asthma. Almost every child during each appointment on the Breathmobile does this.

 

 

T

 

 

Tobacco smoke- a common trigger of asthma attacks. It is an irritant.

 

 

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V

 

 

W

 

 

Wheezing- a common asthma symptom. This is a high-pitched, whistling sound that can occur either while breathing in or breathing out. It is much different from the rattling sound of simple chest congestion from a cold. The doctors on the Breathmobile always check for this when listening to a child.

 

 

X

 

Xyzal- a medication prescribed on the Breathmobile. an antihistamine that reduces the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose. It works by blocking the actions of histamine. Xyzal is used to treat symptoms of year-round (perennial) allergies in adults and children and also used to treat symptoms of seasonal allergies in adults and children.

 

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Z

 

Zyrtec- A drug we give on the Breathmobile. Zyrtec is an antihistamine that reduces the natural chemical histamine in the body. Zyrtec is used to prevent or treat symptoms of hay fever and to treat cold or allergy symptoms such as sneezing, itching, watery eyes, or runny nose. It can also be bought in stores.