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Tips for getting the most out of your inhalers

“Darn! My inhaler is out and I am going to have to call today, a Sunday, to get a refill…”

Spring is here! And that means asthma season is back, and with the nicer weather, pollen counts are high. Flowers are wonderful and the trees beautiful, but if you are like me, some of those plants have your number. The beautiful smells come with itchy eyes, sneezes, and for some, a serious amount of wheezing.

Patients are reaching for their inhalers more often, and sometimes getting into serious respiratory trouble, especially if their medication is running short. Inhalers are expensive, too, and so using them optimally is both financially and healthfully important.

Fortunately, a couple of tricks can really help maximize an asthma spray’s value.

The medication comes out fast and hard when you squeeze the canister, and it can be difficult to time your breath to inhale the dose well, plus with the energy of the release being so high, a lot of misted drug can zoom right out of your mouth. The trick is to use a ‘spacer’, and the simplest is a rolled up piece of paper, to about a one inch diameter. Tuck the sprayer in the far end, wrap your lips around the outside of the other end, and take your leisure squeezing and breathing! The tube holds the mist in place for a few seconds, letting you better coordinate your inhalation and improve substantially the amount of drug you get to where it is needed.

The second tip is to use a steroid inhaler daily if you need your rescue inhaler more than a few times a week. The rescue inhaler will become less effective the more you use it if you don’t directly treat the inflammation of the allergic response in your bronchial tubes with a low dose of cortisone type medication. The dose of the latter is small and will not cause harm to the rest of your system if used according to directions, but it will keep your rescue medication most beneficial!

Two years in the life of the Swedish blog

For those of you who don't know, today is the official two year anniversary of the Swedish blog - this means Swedish has been blogging several times a week for two full years!

What have we been blogging about this year?

Who's been blogging?

We've had people from across Swedish blogging (more than 100 the last time we checked), including:

  • Surgeons

  • Nurses

  • Family Medicine and Primary Care Physicians

  • Dietitians

  • Educators

  • (And many others!)

Why are we blogging?

We started the blog as a way to connect with you (our community), whether you're a current patient, a past patient, a future patient…or just someone who stumbled across our site looking for health information. We believe our role is to be a resource of information, both online and off. Blogging gives us an easy way to keep you up to date, informed, and engaged on a number of health topics

Chronic Snoring Solutions

Novelist Anthony Burgess once said, “Laugh and the world laughs with you, snore and you sleep alone”.

It’s a saying that hits home for many. Chronic snoring is an embarrassing problem for sufferers and a source of aggravation for their loved ones. From loving and maybe not so loving nudges to ear plugs, the weary-eyed partners of snorers often finally move on to seek shelter from the nightly onslaught in a far away quiet room in the house.

(Single folks are not immune as any overnight trips with friends, business partners, potential mates becomes a source of anxiety and embarrassment.)

Snoring occurs because during sleep, the muscles that helps to keep the airway open relaxes and the resulting narrowing and turbulence can cause vibrations that lead to snoring.

After a more serious condition called Obstructive Sleep Apnea has been sufficiently ruled out, try these steps to help with snoring:

New medication for MS, Tecfidera (BG-12), Approved by FDA

On March 27, the U.S. Food and Drug Administration approved the newest treatment in the increasing number of disease modifying therapies (DMTs) available to treat multiple sclerosis. Tecfidera (BG-12) is an oral capsule to treat adults with relapsing forms of MS. Research participants at the MS Center at Swedish participated in clinical trials for Tecfidera.

 

The trials reported that people taking Tecfidera had fewer relapses and less frequent worsening of disability compared to people taking a placebo. There were also fewer and less-severe side effects with Tecfidera than other treatments.

 

The studies found that ...

Non-invasive advances for treating early stage non small cell lung cancer

Stereotactic Ablative Radiotherapy is a new term that has been coined to describe the delivery of very high doses of radiation delivered over a handful of treatment sessions. This precise method targets small tumors located in the lung. This new treatment has been pioneered and studied extensively in patients who are not suitable candidates for an operation but have been diagnosed with early stage Non-Small Cell Lung Cancer.

The advantages of this approach are that the treatment can be completed in 1-2 weeks (including the planning time), and only requires 3-5 treatments. The treatment requires highly specialized planning and preparation and is delivered using state of the art linear accelerators like the CyberKnife®. Our team has been offering stereotactic ablative radiotherapy for over 4 years.

The results are outstanding for this population of patients. A number of studies have demonstrated that the local tumor control rates exceed ...

MS Research Update: Pulse therapy for breakthrough multiple sclerosis

A small pilot study from the University of Southern California suggests a pulse adrenocorticotropic hormone (ACTH) therapy could be effective in patients with breakthrough multiple sclerosis attacks while on beta-interferon. “Breakthrough” attacks that occur after starting a disease modifying therapy (DMT).

 

The study compared the safety and benefits of monthly pulse ACTH to monthly methylprednisone (MP) pulse in patients on beta-interferon. Over 15 months, researchers found that those treated with ACTH had fewer relapses and fewer psychiatric side effects. ACTH gel is currently used to treat MS relapses, but researchers note it may be able to alter the body’s immune responses beyond producing steroids.

 

As I discussed with the Medscape reporter, Megan Brooks, last week, the results of this study are ....

MS Research Update: Salt and Multiple Sclerosis

Increased dietary salt was reported to increase the immune attack on myelin in three studies this week. All three were published in the journal Nature.

  1. A study by Kleinewietfeld, et al, looked at TH17 cells, which is a type of lymphocyte that is highly inflammatory and that causes substantial tissue damage. These cells were grown in cultures in the lab. Some had normal and others high salt levels in their cultures. Those grown in a high salt environment had increased markers for inflammation. This seemed to be due to activation of one particular set of chemical signals in the cell, called the p38/MAPK pathway. They also looked at mice with an MS-like disease called experimental allergic encephalomyelitis (EAE). Mice fed a high salt diet had worse EAE than those fed a normal diet.
  2. A study by Wu, et al, also looked at TH17 cells. An analysis was done on genes associated with activation of TH17 cells, and SGK1 was identified as an important protein in this process. The SGK1 pathway was found to be more active if cells were cultured in a high salt environment. This was then studied in mice with EAE. Mice fed a high salt diet had more severe EAE. Blocking the SGK1 pathway seemed to reverse the effect of the high salt diet on the EAE.
  3. A study by Yosef, et al, also looked a the genes associated with activation of TH17 cells. They identified 22 sets of related genes that increased TH17 cell activity and 5 that decreased activity.

TH17 cells are highly inflammatory and likely contribute to the severe damage done to tissues in a number of diseases. Their precise role in MS is not fully understood, but it is believed that ...

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