Conference turris::womannotes-v3

    I have asthma and passing me the inhaler quickly would be the most
    effective help for me, but I do have more than one inhaler and only 
    one of them is helpful during times of distress.  It is called
    Proventil, (I believe that is the brand name and the drug is Albuterol,
    but I am not 100% sure that is correct.)  In the case of a very severe
    attack, when the inhaler does not work, the best thing that can be done 
    for a person is to get them to the emergency room (usually a shot of 
    adrenelin will take care of the problem.)
    
    I don't know the severity of your friends asthma, but chances are she
    has medicine that will help control her asthma so that attacks don't
    occur very often and are not too severe.  For example, I have an
    inhaler that I use before playing tennis or raquetball, (Intal Spray) 
    I also use this inhaler before I go into a house where there are cats or 
    dogs.  This medicine helps me go into a situation with a bit of 
    protection.  
    
    I have had a few serious asthma attacks in my life, but the inhaler has
    worked in all cases.  I did have to go the hospital once for adrenelin
    but that was before I was diagnosed and before I had any medication for
    asthma.  During periods which are bad for me, (which means a time
    period where I have wheezing and tightness for days or weeks) I take
    inhalers a few times a day.  They are very effective and I seldom have
    any problems with serious attacks.  On the very rare occaision that I
    have had serious trouble, the Proventil has stopped that attack and
    I begin a Prednisone six day pill series.  This is not something I want
    to take very often, but it is extremely effective.
    
    
    Personally I am not at all embarassed or reluctant to talk about
    asthma.  I also don't bring it up myself very often, (I dislike going
    on about medical problems)  but if someone asks a question I am not
    uncomfortable answering or explaining what I know about asthma and how
    it effects me.  Your friend may feel the same way.  Maybe you could
    tell her your concerns and she/he could explain what would be most
    helpful to them during an attack.  There are also a lot of people who
    do not have severe asthma and seldom have asthma attacks, maybe your
    friend is one of them.  You can also ask her which inhaler she uses
    when she is having an attack.  
    
    If you want more info on asthma, I'll be happy to answer anything that
    I know about.

    
    
    STAY CALM!!!!!
    
    That really is the most help you can give to an asthmatic.  
    
    I have had asthma for the past 20 years.  It is in a way a
    lung disorder which one can psyche themselves into and out of.
    The best thing you can do is try to get the person to calm
    down and try to breathe deeply.  Have the person sit up as this
    will keep the airway open. 
    
    Some things that have helped me have been a cup of strong coffee,
    turning on the shower as hot as it can go and sitting in the
    bathroom with the door shut to breath in the steam, and trying
    to relax.
    
    I think that asthma is more scary to an observer than to the person
    who is having the attack.  But again the most help you can give is 
    to try to get the person to calm down and breathe.
    
    
    Michele

    Again, you stay calm, and try to help them stay calm.  If they have
    medication nearby, help them take an inhale of it, and if they need
    pills help them take them as soon as possible, even though it may not
    hit their bloodstream for a while.
    
    If they DO NOT have their inhaler with them (most often Proventil or
    Ventolin, blue and yellow L-shaped inhaleers, but sometimes Metaprel or
    Isuprel which are white and green), ask loudly if anyone around has an
    inhaler - there are more asthmatics around than you think!  
    
    If they are having a LOT of trouble breathing, get them to a hospital,
    where epinephrine will sometimes be combined with oxygen and inhaled,
    or they may get a shot of epinephrine or adrenaline and then be watched
    for several hours until they are approved to go home.  
    
    If they feel that the episode will pass, particularly with medication,
    try and keep them calm.  Elevating their upper body while their lying
    down by about 30 degree seems to help, as does a vaporizer.  In
    addition, during long-term asthmatic bouts (the kind that sometimes
    lead to *gasp* bronchitis or pneumonia), it sometimes helps to rub the
    persons back gently (not hard, and not tickly, but with a smooth
    stroke, as if you were putting a child to sleep).  The purpose is to
    help relax the back muscles which tend to tighten because the person is
    breathing in VERY hard since the pathways to the air sacs in the lungs
    are so constricted it is difficult for them to inhale lots of new air
    and exhale all the carbon dioxide in their lungs.  Breathing very hard
    sometimes strains the back.  
    
    In addition, if they do go to a hospital and they are on a variety of
    medications, make sure the doctors know what they're on (I used to have
    my SO carry a list in his wallet of the medications I was on and how
    much I took and how often).  Sometimes in the hospital the doctor will
    do a blood test for various drugs which should be at a certain level in
    the bloodstream of the asthmatic (Aminophylline levels, for instance) -
    and having frequent episodes of intense asthma could indicate a need
    for a change in medication or dosage.
    
    The worst thing an asthmatic can do during an attack is panic.  It only
    makes it worse.  Try to help them stay calm, take the necessary
    medications, and get to the hospital if necessary (please note that a
    lot of attacks don't require a trip to the hospital, many asthmatics
    know when it's bad enough - although of course if they're the "stiff
    upper lip" type and they're turning blue or something you should
    probably take them there despite their protestations).  
    
    Asthma can be controlled, and it can be lived with.  Unfortunately,
    deaths due to asthma are on the rise because some asthmatics (or people
    who love asthmatics) are taking too long to get REAL help and this
    doesn't bode well for their health.....
    
    If it's a lingering bout of asthma/bronchitis (asthmatics will
    sometimes get chronic bronchitis frequently, particularly in winter),
    make sure if they cough up stuff that they check the color.  If it's
    yellow, that sometimes means serious bronchitis or the beginning of
    pneumonia.  Get 'em to a doctor for some prescriptions, or if it's
    really bad, a chest x-ray.  There's a new vaccine called a PNEUMOVAX
    that vaccinates you against 80 or 90 different strains of pneumonia,
    and I believe it's a one-shot deal - so asthmatics might want to get
    that.  In addition, sometimes doctors suggest that if there's a new
    type of flu, asthmatics might want to get flu shots because flu
    sometimes hits the lungs of asthmatics particularly hard, and this way
    they have a few days of aches after the injection, rather than 2 weeks
    in bed later.
    
    -------End core dump--------
    
    -Jody
    

    see also:
    
    MEDICAL
    141 - asthma
    
    HOLISTIC
    289- asthma
    351- asthma help 
    528 - asthma: exercise induced
    
    PARENTING_V2
    204 - living with asthma
    
    -Jody
    

    Re .1

    	Man, you sound just like me - I could've written that reply,
    almost word for word.

    	There isn't much I can add to what's already been written  -
    you all have covered it pretty well (excellent "brain dump", 
    Jody!).

    	One thing to be aware of though is that different asthmatics
    will handle attacks in different ways.  For me, when I'm having a 
    real bad attack, I usually just like to be left alone until it 
    passes.  I find there's nothing worse than having someone hovering 
    over me, asking what they can do, and worrying.  I feel like I have 
    to reassure them, and at the time, I'm not really in a state to do 
    that.  One time I really snapped at someone who kept asking if there 
    was anything he could do.  I didn't mean to, but I got frustrated 
    and just wanted to deal with it myself.  I know he meant well, but I 
    have lived with it long enough to know how to deal with it, and just 
    didn't want/need anyone else involved.  (Then again, another time a 
    friend just came over and rubbed my back without asking and that was 
    really nice!)

    	amy

    G'day,
    
    
    A few more suggestions...
    
    If an appropriate inhaler is not available - and don't give one if the
    person does not use one normally...
    
    Sit the person down at a table with a pillow in front of them on the
    table. They should sit more or less upright with their arms around, but
    not clutching the pillow. This allows max chest expansion, and helps
    relax the breathing muscles. (Asthma is an inability to breathe out,
    rather than in). Reassure the patient and monitor them carefully. if
    this does not resolve the situation in a few minutes, seek medical help
    = call an ambulance (or maybe a doctor if nearer). If the patient stops
    breathing, then perform the ABC (Airway, Breathing Circulation) of
    first aid until medical help arrives..
    
    Rest and reassurance are of prime importance. They reduce anxiety and
    help the patient to relax. If it is an allergic reaction, such as to
    a smoke filled room, open the windows. Ensure an adequate supply of
    fresh air. 
    
    Hope this helps. And yes, don't hover... go about something else (make
    a cup of tea/coffee) sit quietly and read a book. Having someone at
    hand is reassuring, providing they are not in a flap themselves..
    
    derek
    
    

    
    Thanks people - just what I needed to know! :-)
    'gail

    two more things.
    
    One - if you're going to have them near a pillow - make sure it's
    generally not dusty or feather because those are general allergens
    (unless they're not allergic to those particular things).
    
    Two - if you're desperate for anything to help, no inhalers or
    medications are near, sometimes caffeine will help reduce the asthma
    (the theophylline family of drugs is similar in chemical structure to
    caffeine...)
    
    -Jody
    

    G'day,
    
    As a first aider, you are responsible for the actions you take. 
    
    Since I am not a doctor, I would not dare to suggest that one chemical
    is like another enough to perform a similar action. Some folk are
    allergic to caffeine too.... If in doubt seek medical aid.
    
    With the propensity of some folk to sue at  the drop of a hat, _I_
    certainly would not take that chance...
    
    
    derek
     

    I've had chronic asthma all my (known) life.  Bad enough that the Army
    didn't want me - even in '66, when they were taking anyone who wasn't
    missing any major body parts (strangely enough, the Air Farce didn't
    care).  Most of the counsel previous to this entry was appropriate, but
    let me add a few personal observations:
    Intal:  GREAT stuff, but it is strictly a PREVENTATIVE, it must be used
    fairly regularly ahead of time to get the best effect.  Especially nice
    part is lack of side effects.  Many M.D.'s still don't know about it -
    ASK!
    Prednisone: this is a steroid.  Long term use is bad for internal
    organs.  When appropriate, there are broncial steriods available which 
    are inhaled, and quite local in effect (e.g. Vanceril) - much safer.
    Bronchial dialators - inhaled (e.g. proventil, isoproternal, perbuterol):
    increase heart rate, blood pressure, but beat making a trip to the E.R.
    - oral (e.g. theophyllins, terbutaline) again, preventatives; they need
    at least 30 minutes to become effective.  Uniphyll is a long acting
    variety which seems to avoid the stomach upsetting qualities of older
    theophyllins.
    These are all PRESCRIPTION pharmaceuticals.
    
    First aid: sitting at table is good idea; alternative to pillow is
    folded towel(s) - in any event, object is to raise arm to shoulder
    level to help expand chest.  Loosen belt to help breathing from
    abdomen.  I've found over the years that yoga breathing techniques help
    me best - less inclination to cough, which could lead to coughing
    "fit", and it helps calm me down which is the main problem to start
    with.  If subject can't sit up, lying down half way between on-side and
    on-stomach, works well and helps with circulation to brain (it needs
    first dibs on the scarce oxygen.)
    Sometimes hot steamy shower will abort (can i use that word
    here?) an impending attack - again, a surprise, since my asthma is
    sensitive to ambient humidity - which is why i live in the desert.
    
    I don't go ANYWHERE without my inhaler (and a spare in the car).
    
    Hope there's something useful to you here.
    				Dale
    

Re: 583.10 Derek

> As a first aider, you are responsible for the actions you take. 

Umm, that depends. Many places have what are called "good samaritan" laws that
protect you if you come to the aid of a stranger and act in good faith. The
rules are different if you are a professional, like a police officer. I don't
know what the rules are if you are trained in First Aid.

(Perhaps this should be another topic? If it spawns much discussion I think we
should move it.)

	-- Charles

    In Holland, when not trained in First Aid but doing the best you can
    (which in some situations is necessary) there's no way you can be sued.
    People who are trained in First Aid are covered for liability by an
    insurance payed for by the First Aid group where you are registered as
    a member.
    This organisation also checks if you have attendend the number of
    training sessions necessary for renewal of your diploma.
    
    Charles

  This week's (December 17th) issue of Science News had an article about
  the drugs used in asthma inhalers.  Apparently, at least for some asthma
  sufferers, use of these drugs does more (long-term) harm than good.

  JP

    As a sometime sufferer of Bronchial Asthma, and the sibling of a
    life-long sufferer, I just want to restate what has been mentioned
    about some drugs doing more long-term harm than good.  
    
    Prednisone is a steroid.  Long-term use of Prednisone can cause LIFE
    THREATENING effects.  Heck, *short-term* usage has caused me to gain 25
    pounds in 4 days.  No, I am not exaggerating.  25 pounds.  4 days.  As
    I only weighed 105 pounds at the time, you can imagine my discomfort.
    
    However, back to long-term usage.  My brother now has a morphine pump
    implanted in his body.  It delivers morphine directly to his spinal
    column.  The reason he has this lovely device is that the osteoporosis
    he developed as THE result of prednisone usage is causing his vertebrae
    to compress, and he is in constant pain.  He has lost 3 inches in
    height.
    
    Over the last 10 years, he has had >40 rib fractures.  Of course, these
    things are exacerbated by the weight he carries, partially as a result
    of the prednisone.
    
    Do not assume that prednisone (or other steroids) are the only choice
    available just because they are the first thing prescribed.  They are
    the quickest way to break an attack.  They are not necessarily the best
    way.  I always refuse them when I am hospitalized now.  An extra day of 
    difficult breathing is not worth the effects of these drugs.
    
    BTW, this is not all written from the prospective of a user.  I was, in
    another life, a college educated, hospital trained, Respiratory
    Therapist.
    
    E Grace
    

    Hmm,
    
    About two months ago, I caught 'something.'  Some type of bacteria
    that went into the lungs.  So my dr. prescribed sulfa and also
    the inhaler Proventil.    I'm feeling better but the wheezing is
    still there; she has long suspected I may have asthma and I'm
    beginning to believe her.  (I always have trouble breathing but
    I thought that was normal.)
    
    My sister-in-law has had asthma all her adult life; and has been
    on steroids all along...most of her attacks end up with her heading
    for the emergency and ICU for a week.
    
    I read somewhere that there is a drastic increase in asthma lately.
    I suspect it's the air we breathe, or try to.
    Maia
    

    G'day,
    
     Yes as a first aider, I am covered by insurance from St John
    Australia - provided I stick to the book. There was a case in the UK
    where a couple of first aiders treated a scrambles motor cycle rider
    who had come of his bike at speed. He sued for aggravated injuries. The
    court ruled that as tha f/aiders had stuck to the book, all was well.
    However, had they done something different, even if it was better than
    the book, they could have been liable. The book in this case was shown
    to be imperfect in its recommendations.
    
    However, the onus of responsibility is not implied here as a legal one,
    as such. If I perform first aid on someone, I am assuming
    responsibility for the well being of the patient. Recognising that I am
    not medically trained, I know that there is a limit to what I can do.
    However, I still have the onus of care to the patient. I have also to
    to know for myself, that I did the best I could do. The final act of
    this treatment is referral to professional help. This could be to tell
    the parent of a child, "Johnny has bumped his head, I think he should
    see a doctor and be checked". I place the onus of responsibility now
    with the parent to do what is right. It is up to them whether they heed
    tha advice or not. I cannot force them to do it. At the other extreme,
    if I perform Cardio-pulmonary resuscitation, I am accepting
    responsibility for the total life support for the patient. Once taken,
    I must continue until either patient recovers (hurray), A
    professionally trained person (para medic etc) takes over, a doctor
    says give up or I cannot physically continue. I have done all that I
    can. If the patient recovers due to my efforts, I would still fetch
    professional medical aid, for there may be complications that I cannot
    deal with. I need to terminate my onus of care. I can then walk awy
    feeling that I did the best I could, go round the corner and throw up,
    or have a stiff drink or cry or whatever treatment _I_ need! I have a
    duty of care to me too!
    
    
    derek
    

    I usually don't participate in this notesfile, but this note on Asthma
    caught my attention.
    
    I have had asthma since I was 5 or 6 years old.  I'm 24 now.  When I
    was younger I was on Prednisone every day of my life.  Each person
    reacts differently to Prednisone.  I have very strong lungs (just had a
    breathing test done this morning).  I do not have any damage to my body
    as a result of taking Prednisone.  I take it alot less often now that
    my asthma has gotten better.  I am taking it right now.  I have not
    gained any weight (some do, some don't).
    
    If I have an attack I cannot calm myself down enough to breath
    normally.  I have to get to the emergency room.  I carry my inhaler
    (ventolin) with my all the time.  Ask your friend about her asthma, and
    ask her what she would like you to do if she has an attack.  I believe
    that the asthmatic knows what's best for themselves if they have had it
    long enough.
    
    There are different severities of asthma.  Everyone in my family
    wheezes once in a while from allergies, cold weather, exersion, etc. 
    My sister grew out of it, my mother's asthma got better as she got
    older.  I have been getting better slowly, but I still require
    medication every day.
    
    I guess the main thing I want to point out is, every person and every
    situation is different.  Talk to your friend and find out how bad her
    asthma is.
    
    Carol

As another asthmatic (gee, who was it that said there's more around than you'd
expect?  ;-)   ), I'd like to stress the "Don't hover" advise,  There's nothing
more annoying to me than to have a friend tell me "calm down,  calm down",  when
I'm perfectly calm, just can't breath, dammit!... I'd suggest asking your 
friend what kind of inhaler she uses, and if you see her often, suggest that
you keep one also.  I tend to have one or two at my office, one in my 
secratery's office, two or so in my purse/ briefcase,  and one in most of my
coat pockets.  Overkill?  sure.  but it beats a trip to the ER anyday.

Also,  DO NOT USE ANY INHALER THAT"S NOT HER NORMAL ONE!!!  On a recent camping
trip, I was having trouble, couldn't get to mine easily,  so borrowed a friends,
and within 5 mins was in a DEEP chemical depression, with rapid pulse, faintness
etc.  I *knew* there was a reason I had never liked her brand.  :-)   Each
person may react differently to different brands,  they are not all equal.
(did I stress that enough?)

If your friend does have to go to the ER,  go with her.  Even into the 
examining room. She's probably in a state where she can't talk (rather use the
air to breathe!), and may not be able to write clearly.  And in my experience,
hospitals are too quick to give those shots of whatever/ adrenalen, when the
breathing treatments (O2 & some drug) may be all she needs.  There's been times
I've wished I had someone there to look out for me... those doctors are trigger
happy with those needles.  I'd  suggest talking to her and finding out what her
experiences are,  and what she'd like you to do.  

But most important, understand that while asthma may slow us down,  it really
doesn't stop us from doing anything  (so long as we have our inhaler/ medicene
along!)

    
    A small, but interesting, rathole.....
    
    My basenote here was non-gender specific.
    Through the string my "friend" has aquired a gender!
    
    Not that it matters really, but it's an interesting thing to watch....
    
    'gail
    

    I agree with a reply a few back that everyone is different.  You might
    want to ask your friend what triggers their attacks.  Unlike Ian, cold
    will trigger an attack for me - or just cooling, like when the sun goes
    down on a spring or fall day.  I've also had Monty Python induced
    attacks!  Knowing what triggers your friend's attacks might help, too.
    
    						Jan

    
    My son (6) had attacks....usually only at night.....I ripped out
    his carpet this summer and the attacks stoped.....I never took him
    in for the shot test either...seams kind of harsh for a 6 year old.
    I still use his breathing machine around when he gets colds (just
    to help him open his lungs at night).  I would figure it was the
    dust traped in the carpet that caused his problems.  He sometimes
    goes into his coughing spells when he gets real upset at me though.
    Can't figure this one out either.....he gets himself so hiped up
    that he ends up pukeing.......fun...fun...
    
    HW

    
    In engineering terms, stress-related asthma is a failure of the feed
    back mechanism.
    
    In normal people when you start coughing the system stops naturally -
    feedback if you like.
    
    In stress related asthma this isn't true, indeed the coughing may
    increase. It needs something to break the loop: in my case I punch
    myself on the chest, in your son's case he throws up. In either case it
    seems that this action blocks the feedback signal and allows the brain
    to recover control and stop the coughing.
    
    /. Ian .\

re: .23:
    He sometimes
    goes into his coughing spells when he gets real upset at me though.
    Can't figure this one out either.....he gets himself so hiped up
    that he ends up pukeing.......fun...fun...

I get something like this when I sprint the last 200 yards of a road-race.
I cough, gag, and spit (haven't puked anything disgusting for a while,
though).  Someone once explained this as a reaction to hyperventilation.
If so, this *might* be something your kid can unlearn.

Martin.