Asthma is clinically diagnosed by a triad of Cough, wheezing and shortness of breath in combination or each symptom individually. In addition to close follow up with a Physician, self management to a certain degree is very helpful.
Patients with Asthma should avoid environmental triggers such as, dust or animal dander. Heavy draperies can collect dust. Wash bed sheets and pillows in hot water once a week. Possibly no exposure to Pets like dogs and cats. They should avoid exposure to extremes of temperatures as well. Make sure basements are not damp and there is no sign of mold in the house. Consider getting heating ducts cleaned. During winter, Humidifier may be needed.
No smoking otherwise medicines will not be effective and smoke can be life threatening as well. Nobody should be allowed to smoke around Asthmatics.
Make sure reflux and nasal congestion are adequately treated as these are the most commonly overlooked causes of uncontrolled Asthma.
Know how to use your Peak flow meter. If Peak flow suggests decrease to between 20% and 50% and accompanied by symptoms, use your rescue inhaler more often. If it falls bellow 50%, you might need more therapy. Keep your Physician informed and seek advice, sooner the better.
If the colour of your sputum changes to yellow or green, you will need Antibiotics and if accompanied with shortness of breath and wheezing, Prednisone is usually prescribed.
Yearly Flu shots and every five years, Pneumonia shots are very important to prevent Asthma exacerbation.
Know how to use your inhalers. Make sure to only use rescue inhaler and not maintenance inhalers during exacerbation.
Ideal body weight might be helpful. Adequate sleep time at night might be beneficial.
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Sunday, April 5, 2009
Sleeplessness or Insomnia can be secondary to another disorder like Chronic pain or Anxiety or primarily on it's own. Sleep specialists now treat not only secondary disorders but Insomnia itself as a separate entity.
First and foremost is the importance of Sleep Hygiene as outlined by me in earlier blog posting. In Short, Sleeping at scheduled times with the goal of 7 hrs and no napping during the day. Using bed only to sleep and avoiding large meals and stimulants near bed times.
Following are different modalities that can be applied alone or in combination for treatment of Insomnia by anyone.
Stimulus Control Therapy.
Start preparing to go to bed about 15 minutes before its time to go to sleep. Do your routine, namely, brushing your teeth, turning off the TV, meditation, listening to soothing music etc.
Then go to bed and try in your mind to go to sleep for 10 minutes and if can not fall asleep, get up and do some mundane work. Once sleepy, try again for 10 minutes and if still can not fall asleep, get up again and repeat all these steps until asleep or it's time to wake up. Then no looking back and no napping till it's time to go to sleep, again.
Use the bed only to sleep and restrict your time in bed to time sleeping, not simply lying down. Do not watch TV or read in bed. Sleep Restriction can also come handy for people who sleep very few hours, they can apply Stimulus Control Therapy to their duration of sleep and gradually increase their sleep time to ideal of 7 hours.
This works in people whose mind start racing with thoughts as the head hits the pillow. They need to rethink their concerns as for example, that their job is not at stake and nobody at work has even noticed any change. Apart from Cognitive therapy these same people can benefit from progressive tension and relaxation of their muscles starting from toes and finishing with their head and neck muscles. Soft music can help divert attention. They should also beforehand use an organizer for the next day and future dates.
Some people benefit from warm shower before going to sleep.
Keeping sleep logs about duration of sleep and daytime naps to measure your progress helps.
If problem persists see a sleep specialist for further help with all of the above and possible sleeping pills. Remember all above ways to treat Insomnia have been found superior than medication in the long run.
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