Asthma: Let Your Child Do the Talking

When you visit the doctor with your child, do you talk to the doctor or nurse, or does your child? How you communicate with the doctor may make a difference in your child's care, said researchers in an article published in the July 2013 issue of the journal Annals of Allergy, Asthma & Immunology.

As parents, we want to be sure that the healthcare professionals get all the information that we feel is important. But in this study - which looked at children who have asthma - researchers picked up on information that only the child can present and the difference that it could make in their care.

"Our research shows that physicians should ask parents and children about the effects asthma is having on the child's daily life," said lead study author Margaret Burks, MD, in a press release. "Parents can often think symptoms are better or worse than what the child is really experiencing, especially if they are not with their children all day."

Researchers enrolled 79 children who were between five and 17 years old into their study. Fifty-three of the children had acute asthma and 26 had refractory asthma. The researchers asked the children to fill out the Pediatric Asthma Quality of Life Questionnaire and their caregivers completed the Pediatric Asthma Caregiver’s Quality of Life Questionnaire.

When comparing the questionnaire responses, the researchers found that while the scores between the two – the children and the caregivers – were similar, the children reported a better activity-related quality of life than did their caregivers. There was also a greater difference between how boys responded compared with their caregivers.

Taking this information, the researchers concluded that while the caregivers are important and can provide useful information to the healthcare professionals, it’s important to ask the children directly too, to see how they view their illness and its impact on their quality of life.

The American College of Allergy, Asthma & Immunology has put together a list that it feels are the five most important topics that children with asthma should discuss with their allergist:

1. Asthma prevents me from playing sports and taking part in other activities -- If your child cannot play sports or participate in gym class and recess activities, it's important they tell their allergist. This can be an indication their asthma isn't properly controlled. If they can participate in activities, it is also important they tell their allergist, to show their condition is being well managed.

2. When I am outside or at home my asthma symptoms become worse -- An estimated 60 to 80 percent of children with asthma also have an allergy. If nearly inescapable allergens, such as pollen, mold, dust and pet dander are triggering your child's asthma symptoms, an allergist may include immunotherapy (allergy shots) as part of a treatment plan.

3. I often feel sad or different from other kids because I have asthma -- Nearly half of children with asthma report feeling depressed or left out of activities due to their condition. Anyone with asthma should be able to feel good and be active. No one should accept less.

4. There have been times I have missed school because of my condition -- Asthma is the most common chronic illness in childhood and is a leading caused in missed school days. Research shows children under the care of a board-certified allergist see a 77 percent reduction in lost time from school.

5. My asthma disappeared -- It is important your child carry and use their inhaler as prescribed, even if symptoms aren't bothersome. While asthma symptoms are controllable with the proper treatment, there isn't a cure for asthma and it likely won't disappear. An asthma attack can strike at any time.

Mental Health in a Disaster Situation - Quebec, California, Alberta...

Many of you may have heard about the disaster that just affected a small town in Quebec, Lac Megantic. A train with crude oil crashed in the center of this little lakeside town of 6,000 people and erupted into a fireball. The result was flattened buildings and several deaths - a war zone depiction, we're told. Many people still remain unaccounted for, which means the death toll will likely rise.

The day after this event, there was the Asiana plane crash in San Francisco. Before that, massive flooding in Calgary and High River, Alberta. And the list goes on. Major disasters affecting many people - those who are affected directly and those who go in to help the victims.

Mental health is a funny thing. We can be so strong in the face of such adversity as we work through such events, but then a seemingly small incident can be the last straw and send someone into a place they didn't know existed. For this reason, it is so important to address mental health issues from the start. We have to know that this is a vital part of the whole realm of care that people need.

The American Psychological Association offers a volunteer disaster relief service that responds to disasters across the continent. They have an informative tip sheet for the general public to learn about the psychological effect of disasters: Managing traumatic stress: Tips for recovering from disasters and other traumatic events. It discusses what can happen during and after the event, how different people may respond to the event, how to help yourself, and when you should seek professional help. There is also a post-traumatic growth inventory survey that may help people figure out how they are feeling.

If you are helping others, either in an official capacity or just doing what you can to help out, it's important to take care of yourself too. You know that airline instruction about if you're traveling with a young child or someone who needs help - if oxygen masks drop, place yours on first before the one on the person in your care? That's because that person needs you to be strong enough to help them, so you need the oxygen. It's the same thing with mental health. If you're not mentally healthy, if you're burned out, depressed, anxious about what you've seen and heard, you can't be as effective a helper. So you need to take care of yourself.

The Emergency Social Services site at the British Columbia government website says it well:

"As disaster workers we have the potential to become secondary victims, working long, hard hours under poor conditions. In some cases, physical dangers exist."

The page goes on to give tips on how you can help relieve the stress, even in the midst of chaos.

Remember, that just because the event is over, it doesn't mean that it no longer has an effect. Take care of yourself. Be aware that you may be vulnerable. And most importantly - ask for help. It's the only way people can know that you need them. 

Wise Words About Depression, From a Teen

Invisible diseases are the toughest to cope with, in my opinion. Invisible health issues, such as chronic pain, celiac disease, or fibromyalgia, are difficult for people to understand because they can't see them. They can't see the problems that they cause and the effects that they have. A cast on your arm is easy to understand. Scars on your skin are obvious to see. But something hidden, invisible - not so much.

Depression is one of those illnesses and not only is it invisible, it's also a mental illness. This makes it even more difficult. As Kevin Breel says in his fantastic talk about depression, we are so accepting and understanding of any body part breaking, except for the brain. How true. 

If our appendix becomes inflamed and needs to be removed, we have surgery. If we get cancer, we get treatment. If we break a limb, we get a cast. But if our brain doesn't act right, if chemicals are not the right level or messages are interrupted, we're stuck. 

What makes Kevin's talk so compelling, so important, is his age (19) and who he is (a writer and stand-up comic). As he says in his talk, no one would guess that he struggles with depression. He's a handsome, popular, high achieving young man. Smiling and working hard, he's one of the last people you would ever dream as having a serious problem like depression. But he did. And he still does.

The good news is that people are beginning to talk about it more. When young people like Kevin speak out and celebrities like Jon Hamm and Bruce Springsteen talk about their experience with depression, those who have been hiding may begin to see that they're not alone. Why is it so important that we talk about depression? Because people need to know they aren't the only ones living with it. They need to know that other people have similar problems and that there is hope.

This week, there was an article in the New York Times article that discussed a treatment for depression, called transcranial magnetic stimulation, or TMS. TMS isn't for everyone and it may not work for all who try it, but maybe someone who needs it will read about it and benefit from it. If we don't write articles and blog posts about depression and its treatment, people feel alone.

If I can help you take just one thing away from this blog post, it's that you understand that people with depression are everywhere and may be among those who you least expect it. If you have depression, it can be difficult to reach out. The reasons are so varied and so individual, but they can range from fear of being thought less of ("What does he have to be depressed about? Doesn't he know what real problems are, how lucky he is?") to fear ("If my boss finds out, I might get fired.") And even if people do want to ask for help, sometimes they don't know how.

Depression has many descriptions. I see it as a hole, a deep, deep hole. And once you're in it, unless someone lowers a ladder, you feel like you'll never get out. If you are depressed, ask someone for that ladder. If you know someone who is depressed, please offer it. Let that person know you're there and that you care. 

Relaxing Sunday and.... Last Day of Blogathon 2013

We did it! Made it through all 30 days without missing a beat. Yay! So it's fitting that today is relaxing Sunday too.

I'll take a break from posting for a few days, refuel, so to speak. Unless a really interesting topic catches my attention. Tomorrow is Canada Day, our celebration of the country that has given us so much. We have our problems, there's no doubt about that. I live in Montreal, which seems to be political corruption and scandal central these days. I had a good laugh the other day though. Another mayor resigned from office, from Laval, the city beside Montreal, and the CBC news anchor in TV said, "Another mayor in Quebec resigned today, but not for the usual reasons."

I wish we had a mayor like Naheed Nenshi. What a jewel he has turned out to be. Calgarians, many of us are very envious that you have such a personable, unflappable, cool mayor. I don't imagine he set out to be cool, but watching him speak to the media, he is truly cool. Funny and direct, he got his point across in a kind but firm manner.

That's Canada, eh? From coast to coast, we have our problems, but there are always some shining examples of how great we can be.

Happy Canada Day to my fellow Canadians.