Friday Links – Smoking Protection, Stress, Bacteria Trigger. Plus, the Pumpple.

Boys with Asthma Smoke Less as Teens
So! Silver lining. But only a very thin one, since researchers couldn’t find the same link in teen girls.

Dammit.

Mom’s Stress Worsens Kids’ Flares?
I don’t even know what to say here because, hello? The single biggest source of my worry and tension as a mom of two little girls was AG’s lung health. (That’s saying something, when you consider Mr. Asthma Mom and I had all kinds of hurdles to clear as inexperienced, debt-laden, woefully unprepared young parents.) If moms can’t eliminate the bronchial issues, just how are they supposed to manage the stress? (My solution back then: I didn’t.)

Don’t Double Up on Your Maintenance Inhaler When You’re Sick
Extra inhaled steroids during illness won’t hurt you, but this research suggests they won’t help – neither will burning through a prescription extra fast with no clear evidence of actual benefits in return.

Bacterial Infections Possibly a Major Kids’ Trigger
Maybe even more than viral respiratory infections, pointing towards the possibility of antibiotic treatment for some flares.

British Teacher in Neglectful School Asthma Death Quits
Remember the horrifying story of Sam Linton? The head teacher in that case had been suspended since March, but she formally resigned from the school.

Here’s the Gross Turducken of Desserts
File this one under The Inexplicable Trend of Foods Inside Other Foods.

9 responses to “Friday Links – Smoking Protection, Stress, Bacteria Trigger. Plus, the Pumpple.”

  1. MC says:

    Quite interesting…
    regarding the doubling the steroid inhaler during flares, did they include symbicort in the study?

    My last nasty flare when I got bronchitis a few weeks ago, was very likely a bacterial infection. It took 2 rounds of zithromax and one course of prednisone to get over it. What kind of was interesting was the doctors (both in the ER and urgent care) had no doubt or hesitation on giving me antibiotics. It was their first thought (the pred came up a few minutes later). Now, after feeling much better after the antibiotics, my mom is wondering if I shouldn’t get antibiotics every time that I start up a nasty flare.

    Ok, that pie in a cake is just kind of odd, mostly because of the filling that holds it together. I think I’ll stick with my muffin-pie I invented this summer (thanks Kerri!) that actually I know for a fact tastes great and doesn’t look or sound weird like the above does.

    I’m still shocked to hear things that happen to asthma kids in schools who don’t care and don’t know what to do. Maybe there really should be (which obviously there needs to be) a rise in asthma education… I know it’s not just at one school, but is very common. 2 years ago, I had no idea what asthma was, or what signs to look for or what to do in an emergency. I was like most people, totally ignorant.

  2. Sarah says:

    Regarding the story on inhaled steroids: Curiously, this article reports on the same subject, but claims that there is evidence in favor of a quadruple-dose increase of inhaled corticosteroids (while the Reuters article claims there isn’t). I wish my school had a subscription to that journal so I could read the article myself.

    But on a purely anecdotal note, I find that adding in alvesco doesn’t tend to have much of an effect until I’m up to two puffs, twice a day (which works out to about four times my typical effective steroid load – but my initial step up is effectively a doubling, and it’s never quite enough). But if this study pans out, it would explain why my flares don’t seem to pay attention to the steroid increase all that much.

    Anyway, it’s definitely something I’ll have to talk to my doctors and RT about; they may decide to change my asthma action plan because of this. In all, I’d like to see more studies like this on the whole “how to prevent the need for oral steroids in an acute exacerbation” area.

  3. Samantha says:

    Stress in mom can increase asthma? Lovely. Asthma is what CAUSES my stress most of the time. I’m also a bit distressed to see that not only being being chronically angry or irritable a problem (which I dont tend to be) but suppressing the response is too? If we cant make the stress go away, and we shouldnt suppress emotional response…what exactly are we supposed to do I wonder?

  4. Danielle says:

    The mom’s stress article is interesting… but seriously how do you avoid that? Seems like the mother of all vicious circles if you ask me, not fair. My mom, like you, now appears to be a well-adjusted asthma mom and that has nothing but a positive effect on me, but I can’t imagine it was easy eh?

    About the bacterial infections… interesting. Bacterial infections certainly are bad for asthma, but who knew it happened so often? I’m really wary of using antibiotics as a “precaution” in asthma flares though, just because I know how serious antibiotic resistance is. I always refuse antibiotics unless I’ve clearly got a a bacterial thing going on (crazy how many walk-in docs want to put you on antibiotics for an asthma flare when you haven’t even got a fever of wet-sounding lungs). It’s exciting if they can get better at determining what’s bacterial and what’s not, cause targeted asthma treatment is better for everyone :)

    Quite enjoyed your links today! Pumpple = eeeww!

  5. Sara C. says:

    When *I* am flaring, the only thing in the world that kicks it is a course of pred and a course of antibiotics. The last bad flare I had, apparently, I had “no sign of infection” so my doctor didn’t write me the script for a Zpack…and a month later, my lungs were still a mess, and she finally gave me the AB’s with in a day or 2, I felt better, and 10 days later, my lungs were completely clear again.

    This past flare of M’s was the first time she’s been given an antibiotic over the phone…and granted, it didn’t DO anything…but it’s likely her staph that’s causing it, and that needs a different AB

    And really…my stress level is making my kid worse…great…ONE MORE thing to feel guilty about. Thanks researchers….Guilt probably makes it worse too…we’ll need a study on that too.

  6. Kelley says:

    Ok, what on Earth does “Over-interference stemming from excessive protectiveness was found to be associated with worsening asthma of older children (over 7 years). ” actually mean? How does a mother “over-interfere” with their 8 year old child? Follow around their pre-teen/teen to the mall with their meds?
    The doubling-up study here was almost all adults…we’ve been advised & I have seen it work with my AG to double up at the first sign of a cold…it has prevented pneumonia/bronchitis/need for oral steroids numerous times & when I thought (in August) she was stable long enough not to need to do that….she needed the steroid burst ’cause she developed severe bronchitis (with that deep in the lungs wheezing, fever, chills, etc.) so I certainly won’t change what we do based on this article here.
    The article re: bacterial infections I sort of see as obvious…it is hard to differentiate bacterial from viral infections oftimes, and with her frequent bouts of sinus and/or lung problems, she’s been on some antibiotic (averaged) literally over a quarter of the time since she developed asthma 2.5 years ago, backed up early on by CT’s and chest x-rays showing the infection and subsequent inflammation in both areas.

  7. kerri says:

    I’m also curious about how Symbicort works into the doubling-of-ICS-when-sick theorem.

    My current dose [Dear America, do not freak out on me, I am over FDA recs; also: I am Canadian] when I am NOT flaring is 3 puffs twice a day [200/6]. When I’m sick, I ramp it up to three puffs three times a day [increasing by 1/3]. However, I’m also getting a ton more of the LABA formoterol in with that coming in at a mid-day dose to help get things more open. I’m curious if the LABA has any effect on how the extra steroids being dumped into my lungs work as opposed to if I were just doing a non-combo inhaled steroid [either with or without Ventolin, since the article didn’t really mention that].

    And how terrible is it that I want to try the Pumpple? [Okay . . . of COURSE I want to try it ;-) ]

  8. Amy says:

    MC–Interesting that the antibiotics seem to help. When AG was little & pre-diagnosis, drs. put her on course after course of them, thinking she had everything from bronchiolitis to pneumonia since no one knew she was flaring. Didn’t help, but of course every asthma case is different. Totally agree on asthma education – for parents, patients and educators.

    Sarah–Now you’ve got me wanting a subscription, too! I don’t double up AG’s Flovent for colds, but I have for the flu & other major resp. infections for a few years. Now I’m not sure if I should keep doing it or what–that kid’s lungs are the last place I want to experiment.

    Samantha–”Blog” is the only answer I can come up with.

    Danielle–I was thinking the same thing re: some sort of diagnostic to figure out who flares b/c of bacterial stuff. At the same time it would be wonderful if antibiotics could help people get flares under control faster, I wouldn’t want them even more over-diagnosed than they already are.

    Sara–It’s ALWAYS our fault, dontcha know? :)

    Kelley–Well, AG’s 11 and I’m still a huge fan of “over-interfering!”

    Kerri–Get yourself to Philly and tell us all how disgusting it is!

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