I know I don’t need to update anyone here on the Blog of Inferior Breathing with swine flu developments (except I just did). Parenting a kid with respiratory problems has a way of ramping up your typical pandemic monitoring a notch or ten.
Today I want to talk prevention and avoidance.
In my original swine flu post, I mentioned preparing but not panicking, to no one’s great surprise, I’m sure. My daughter’s asthma entails extra prep all the time, anyway, from giving an asthma action plan to the school to filling prescriptions before traveling anywhere. I’m used to this sort of thing, and I’m sure you are, too. If there were ever an advantage to a kid’s chronic health issue, this familiarity with thinking and planning ahead would be it. Of course, that advantage is seriously outweighed by the respiratory dangers our kids face in a flu outbreak, but too much of that kind of thinking is an all-cloud/no lining situation.
So.
Yesterday on the phone, I told my sister some of the steps I’m taking to keep the girls healthy and (hopefully) flu-free. She said, “Hey, those are good ideas.” When she described a step I hadn’t thought of, I said, “Hey, that’s a good idea.” Which led to:
Hey, let’s move this discussion on over to the blog.
Especially, after reading this comment on the previous swine flu post:
I am in BC (Canada) and we have now had six cases of this flu – although none close geographically to us. I too, have an asthmatic child (four-years-old) and he is currently getting over a cold.
My question is I would like to ensure he is as physically prepared as possible to combat this flu if he happens to contract it. I have been thinking keeping him on a twice-daily does of flovent and have the Ventolin on hand for acute care.
Also, he is taking daily vitamins
I realize the asthma meds are a double-edged sword in that they suppress the immune system, but they also keep his lungs clearer. Does anyone have any ideas to keep his immunity up?
Not being a doctor, a nurse, a respiratory therapist, or the parent of any children but my own, I can’t give anyone advice. I can share what’s going on in the Asthma Mom household, though:
Handwashing
All of us – and this includes Mr. Asthma Mom and me – have started washing our hands as soon as we step inside the house, no matter where we’ve been. By that I mean, even if I take a walk down the trail at the end of my street and come in contact with no other human being, I’m heading for the soap and water first thing when I get back. I figure if we follow this sort of open door/wash hands Pavlovian training, it will become habit for the times when it really matters, like after school or a trip to the grocery store.
Hand Wipes
I’ve thrown a packet of these into the bag I carry and in both girls’ backpacks for when we’re out and don’t have access to soap and water. Not the antibacterial kind, though – because of the whole good germ/bad germ issue I won’t get into right now, and because influenza is a virus, not a bacteria.
Lysol
I’m not thrilled with the antibacterial action in Lysol (see above), but it’s a fast and easy way to kill the flu virus. If anyone in this house gets sick, I’ll spray every doorknob, light switch, and virus-spreading surface they’ve touched with the brand-new can I bought yesterday. Otherwise, it’s staying in the cabinet.
Tissues
Since coughing or sneezing into a tissue helps cut down on transmission, I’ve placed boxes of them in every bedroom and the main rooms of my house. You probably do this already, as part of your normal outbreak-less life, but us? We’re the family that walks around with a spare roll of toilet paper for our noses when we have colds because I never – never – remember to buy tissues.
Maintenance Meds
AG usually tapers down to half her inhaled corticosteroid dose now and stops using it altogether by the end of May and throughout the summer season. I’ve held off on that for the moment.
Other, Not-So-Obvious Steps
These all fall under the category, *Could have no effect whatsoever, but it’s not hurting us to try.*
Shoes
As former Floridians, we rarely wear shoes inside, anyway, but now I’ve made it part of the routine:
Shoes off in garage—>open door—>wash hands
My thinking on this? Say a contagious student at the girls’ school vomits or sneezes or expels a little flu-ridden bodily fluid in some other way. With my luck, it would be one of my kids that managed to walk through the mess or any residual traces after clean-up. Also knowing my luck, the virus would somehow manage to stick to their shoes without rubbing off as they walk and then somehow transmit itself from those shoes to this family.
Yeah, it’s not likely. Probably, this scenario in my head isn’t even possible. This “preventative” step just plain makes me feel better (read: saner) even if it’s just functioning as the illusion of more control.
Plus, a bonus: no shoes = cleaner house w/out actually having to clean.
Fish Oil Capsules
Omega-3 fatty acids, found in oily fish, may help asthma inflammation and lung function in adults and decrease asthma symptoms in children. The connection is not established conclusively, but the research results are positive enough for me that AG takes fish oil capsules equivalent to that teaspoon of cod liver oil my mom had to swallow every morning when she was young. I like Nordic Naturals because they’re easy to find and ranked Best Choice by the Environmental Defense Fund. (Please note: My daughter takes these all the time, not just right now. This not medical advice. This is a personal decision I made for my own kid and only after clearing it with her doctor first.)
Garlic
Garlic has natural anti-inflammatory, antimicrobial, and other health properties. Conclusive proof that garlic will cure/treat/prevent ANY illness does not exist. However, garlic is good, and I’ve always used a lot of it in meals. Fresh garlic is more potent than cooked, so I make things like guacamole, homemade salad dressing, and bean dips. Again, this is something I do all year-round, not just right now.
Do you notice the theme here? These are all fairly reasonable (with the possible exception of the no-shoes rule) steps we take when anything particularly virulent is going around or just as part of our everyday life. Any respiratory illness has the potential to be worse for kids like AG than for non-asthmatics like her sister, so in general – I try to be careful and keep her lungs healthy while sticking to our normal routine and activities.
And now, I open it up to you. How do you protect your asthma kids?
Not having a sick kid, I’ll answer for me and say that my hand washing is legion. In fact my current flare is due to handwashing in the kitchen at work when my co worker caught the microwave on fire. I worry that my current dose of pred will deplete my immune system even more, so I’ve been comtemplating vitamins even though I don’t know what to take. I’ve also bumped my maintenance meds to max due to this flare and figuring I won’t taper to my regular dose until further notice. I’m also speaking to my doc today about viral treatment meds I should have on hand…
Well, we are all avid hand washers and I carry hand sanitizer in my purse and in the van.
When I pick my son up from school I find myself saying at least twice a week, “don’t touch your face until you wash your hands!” (itchy eyes, nose, etc.)
Good food and lots of rest and hand washing is what we do.
Now, if we could only get all of the other parents to get their kids to cover their coughs and sneezes, wash hands and keep the kids home when they’re sick, the parents of asthma kids would have a lot less to do and worry about!
Asthmagirl—Sorry you’re in the middle of a flare. What bad, bad timing. Although I’m like you–waiting on a call back from AG’s dr. about what to do with her meds if she comes down with the flu, just in case.
Marcia–You sure said a mouthful. I couldn’t agree more about other kids’ parents. One thing I’m grateful for–the girls’ school is very, very vigilant about making the kids wash their hands before lunch and, for my younger one, before snacktime. We’ve got swine flu cases in Denver now (although not in my county yet), so sure hope it helps…..
Got here from AG’s blog, and lo and behold, I too am Denver-metro-area with a slice of asthma in the family! Hubby & daughter (10) are both mild, mostly triggered by pollen/allergens. Me, not so much asthma as wildly tree-allergic. It’s such a small (pollen-filled) world!!!
We are mad hand-washers & have tissue boxes in every room, but that’s all the time. I don’t know that we’re changing the routine for the latest flu du jour; after Hubs & I both being sick for a month each last fall, we’ve been (knock wood) healthy. Daughter has been healthy all year & it’s been a big relief for the pharmacy bill.
I’m so glad I found your blog!!!
I have a son with asthma and I am particularly concerned because the young adult age group now has the highest rate of infection and hospitalization. I question what to do about the steroid inhaler. There is some evidence that the young people who died in Mexico had the “cytokine storm” reaction – meaning the immune system massively over-responded. But suppressing the immune system with oral or inhaled steroids can make you more likely to develop pneumonia. So what do you do? Right now my son is very sick with “something that’s going around” – don’t you love it when doctors say that? We went to an urgent care center last night and his flu test was negative but it’s only 70% accurate so I am quietly freaking out, especially since 3 people at his college have confirmed swine flu. They tried to contain it at first but I think they just gave up. The kids at college just don’t take it seriously and probably won’t change their behavior at all. Adults aren’t much better. I’m so sick of people who say it’s only people with “pre-existing” health problems who are at risk so they aren’t worried. I’ve been reading medical journals and it appears anyone with asthma fits in that category so that includes a heck of a lot of people. Of course the people who laugh this off are the same people who send their kids to school sick and brag about how they never miss school – then my son gets sick because of them and misses school for a week or more because of the asthma. My solution is to lock him in his room for the next year but that may be a hard one! To make it worse I also have asthma and a heart issue and a disabled daughter with a weak immune system. It’s going to be a long year or more ahead.
Hi Marie, and thanks for stopping by.
I know just what you mean about worrying over the cytokine storm vs. pneumonia. For now, I’m keeping my daughter’s meds the same (she tapers the steroid inhaler down right now and stays off it all summer). I’ve decided that at the end of summer, I’m going to ask the pediatrician about meds before the cold and flu season starts up, because I have the same question you do.
Anyway, just today there is good news on the vaccine horizon:
http://www.reuters.com/article/rbssHealthcareNews/idUSN2250630720090522
No one’s being directed to develop a vaccine yet, as far as I understand it, but this should free the money up.
I have a 12 year old son with well controlled asthma. He takes singulair, and advair and during spring allergy season uses flonase and Claritin. In the past he has been hospitalized with viral infections and has struggled to make it through winter colds without serious flares.
GOOD NEWS: He is currently day 3 or 4 of what New York City is calling “ILI” or influenza like illness and he is doing well. New York City is now admitting that ILI is presumed to be H1N1 and they have stopped testing outpatients for H1N1. We consulted with his allergist and increased his advair to twice a day. He had high fevers for 2 days (102.6) but his breathing has remained relatively unaffected (5 or 10% decrease in his peak flow readings). Today his temp has dropped to 99.0.
We did not treat him with antiviral because at the time he got sick the guidelines suggested using antivirals in kids with asthma only when there was known exposure to H1N1. By the time the policy switched to using antivirals with kids who have asthma and presumed exposure, we were out of the 48 hour window of most effective use.
I know that each case will be different but thought it might reassure some to hear that for us it looks as if this has been a mild flu virus without a challenging respiratory profile.
Thanks for sharing, Kate! This is very reassuring, actually. I appreciate your comment and I’m grateful your son is recovering quickly.
Amy,
Your distinction between concern and panic is very important. I totally agree. Update on my son’s course of illness. He was without fever on day 5 and 6, peak flows were OK but not great. Day 7 his peak flows declined to 75% of typical and high fever returned. We saw pediatric allergist as way to avoid current craziness of general peds office and he was diagnosed with pneumonia. Tx: Zithromax, Augmentin and he was started on Tamiflu. Day 8 and he is now seeming to improve. We are disappointed, of course, about the pnemonia but this still feels familiar and is not an uncommon pattern for him.
I think calm, vigilance is really important. Information is essential, too, and I appreciate your great blog.
Germ control in our house:
1. When we’re out of the house (mall, drug store, even work) we don’t touch our face without using PURELL first. It’s a hard habit to get, but you can do it.
2. PURELL the kids constantly when we’re out with them.
3. I took my 4 year old out of kindergarten. 2.5 hours of painting is not worth swine flu or any other flu. I can do that with him at home
4. I have done a lot of reading on this and you DO NOT need to use any kind of special cleaner like LYSOL. Any household soap kills germs on surfaces. LYSOL makes me wheeze so I hate that stuff…plus the whole antibacterial thing is a big no no. Avoid antibacterial soaps. This makes matters worse.
5. If we go to a party with a buffet dinner, we eat before we go and then try not to let others notice we’re not eating. People are gross with coughing and touching buffet food with their hands. Not worth it. Last party we went to I gave the kids cones before we left so they were very full!
6. The pool is a great place for kids to play with other kids without getting sick. the chlorine kills everything (if it doesn’t make your kids wheeze). I keep my kids away from other kids right now so it can get a bit lonely. We are lucky enough to have a pool so we invite friends over for pool time. Once the kids are out of the water “uh oh, it’s nap time!”.
I have others too, but I’m sure you already think I’m nuts. It’s extreme, but you know what? If we catch this thing at least I know i did everything i could to avoid it. Stay healthy everybody!
I carry purrell in the car, my kids clean their hands automatically now, 9 year old twins, one with moderate asthma. Shoes off at the door, hands washed at the sink. Everytime we plan on getting together with someone, I ask if they are healthy and explain that a simple cold in our house can result in a trip to the ER and 2 weeks of missed school. I have explained to people that the panic they felt when Swine Flu was announced is the state of mind I am in all the time, now it’s just over the top! I feel like I spend my life trying to keep my kids germ free so as to avoid asthma flare ups. I have to say, we do 500 mg of vit. c and fish oil every day and I really think that helps. Son is on symbicort for controller.