April 2010 Edition

Pulmonology


Perspectives

How Do You Do It?
by Janis C.
Why some people think it is okay to ask me this question I'll never know.  Sometimes they even make it into a statement (add long, serious face), "Oh, I don't know HOW you do it."  Which sounds even worse because it is laced with pity.

The HOW is not as easy to answer as the WHY.  Here is my stock answer:  "I'm his mother.  I just do it."

Focus:  Pulmonology

Breathing Easy:  A Trach at Home
by Lisa Jennings
Very few things in an individual's life are as fundamental as breathing.  In and out, over and over again.  Unfortunately, it is just not that simple for everyone. 

When my daughter Monica was born she was breathing just fine.  Pretty soon the problem became apparent:  she wasn't swallowing, not even her own secretions.  I knew nothing about aspiration, wheezing, crackles, stridor, oxygen saturation, and apnea before this new life came into mine. 


Asthma and the Child with Special Needs
by Terra Janice

For the millions of families affected by asthma, the first signs of wheezing, coughing, and shortness of breath in their children signal the need to begin treatment aimed to keep the airways open and everyone out of the ER.  An asthma attack can mean different things to different kids and their families, but it almost always means that immediate action needs to be taken, often involving medications, breathing treatments with a nebulizer, and an interruption of whatever daily activities had been taking place.  Asthma rarely affects just the child; rather, it typically affects parents and caregivers, siblings, and a whole team of people who know what to do when a patient has an asthma attack or flare-up.



According to statistics compiled by a panel of pediatric pulmonologists, asthma affects millions of children in the US, and accounts for almost half of the ER department visits by children.  Of those that seek emergency care, nearly 35% are hospitalized for further support and treatment.  Asthma is one of the leading reasons children are hospitalized, and the ramifications of needing this level of support for a disease like asthma extend to many days of missed school for the children, and days of missed work for the parents of children with asthma.  With as widespread of a disease as asthma is, it is no surprise that many people are either personally affected by asthma, or know someone who is.

(Read More)

Understanding Hypoventilation and Its Treatment
Most of us have a general understanding of what the term hyperventilation means, since hyperventilation, also called overbreathing or fast breathing, is more commonly experienced, at least jokingly.  The logical conclusion is that hypoventilation is simply the opposite of hyperventilation, a state in which someone is breathing too slowly.  This is not the case.

Hypoventilation is by definition inadequate breathing resulting in impaired gas exchange, meaning that the body is unable to remove carbon dioxide appropriately.  The result is an increase in carbon dioxide levels (hypercapnia) in the blood.   While either slow breathing or shallow breathing may occur with hypoventilation, the rate or depth of breathing is not diagnostic, since hypoventilation by definition only occurs if there is an increase in carbon dioxide levels.
(Read More)

Being a Kid:  Thriving with a Trach and Vent
by Deb Millard
When I was pregnant, I was nervous about a lot of things.  One of my recurring worries was whether or not my little guy would slip through my hands during bath time.  I think those kinds of worries and fears are pretty normal for new moms.  When Connor was born with a lot of challenges, I found my little worry was just that--a very little worry-- and most certainly not something I couldn't manage.  I was about to embark on the journey of my life, and the ups and downs of Connor's life would teach me some incredible things.

I could write volumes about all Connor's life has taught me, but right now I'd like to focus on how very typical a child's life can be, no matter what challenges he may face.  It really is a matter of perspective.
(Read More)


Specialty Article

GI and Nutrition
Learning about Parenteral Nutrition and Central Lines:  The Oley Foundation's Online Training Modules
As parents of children with complex medical issues, we are used to learning new skills, medical procedures, and techniques.  Most of us can typically master a new piece of medical equipment in an unbelievably short period of time.  But when your child needs a central line or is beginning parenteral nutrition (abbreviated TPN, PN, or HPN), there is a lot to learn, and the learning curve is steep.  Not only do you need to master site care, dressing changes, cap changes, accessing a port, preparing IV bags, adding vitamins and medications, running antibiotics, programming a pump, and other aspects of daily care, but you also have to become adept at taking vital signs and recognizing when there is a potentially serious health problem.

The Oley Foundation, a non-profit agency dedicated to providing information and enhancing the lives of people who use enteral and parenteral nutrition, has begun an online training program to help families learn to manage parenteral nutrition and central line care. While designed for adults, the majority of information in these modules is applicable to children as well.  Currently, two of eight planned online modules are available for free at http://www.oley.org/Education_Module1.html. 

Feature Article

While all children need to get away from the monotony of every day life occasionally, children with medical needs or disabilities often crave this experience even more.  Nothing can be better than time spent away from school, therapies, doctors' appointments, and hospital stays.  A great way to let your child get away from it all is to send him or her to overnight camp.

It may be very difficult to imagine that your child can go to camp, but there are camps out there designed for children with almost every type of special need of disability.  These camps include intensive medical or self-help support, allowing children to flourish away from home.