Many people suffer from difficulty swallowing (dysphagia) acutely or chronically. Difficulty with swallowing may be a result of a problem anywhere from the lips to the stomach. It may be identified by weight loss, coughing or choking when eating, delayed cough or regurgitation, or outright obstruction. This is more likely to be an issue after a stroke or in elderly and frail individuals. In the inpatient population, symptoms suggesting some level of dysphagia may be as high as 34%. So what do you do if you feel like your swallow isn’t quite right?
“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!
This past week, Britain’s Queen Elizabeth II was hospitalized with a “stomach bug”. Gastroenteritis (also called the “stomach flu”) is the second most common illness in the United States. So, chances are good that your family has been affected by gastroenteritis already this year!
What are the symptoms of gastroenteritis?
Gastroenteritis is inflammation of the stomach and intestines causing symptoms of diarrhea, vomiting, cramping, and fever. If a person is not able to keep up with fluid losses from diarrhea and vomiting, then they can become dehydrated. Gastroenteritis occurs year-round and affects people of all ages. Those who are young, old, or have a suppressed immune system are more susceptible to severe gastroenteritis and to dehydration.
What causes gastroenteritis?
The majority of cases are caused by a viral infection (occasionally, a bacterial infection) transmitted through contact with another sick person or contaminated food/drink.
I have gastroenteritis, how can I feel better?
Rest and fluids! Staying hydrated is the most important step to controlling gastroenteritis. Some good options for staying hydrated include sports drinks or oral rehydration solutions (such as Pedialyte in drug and grocery stores).
I typically do not recommend any anti-diarrheal medications as this may even prolong the illness. In addition, antibiotic therapy is not helpful unless a specific bacterial cause is identified.
When should I call my doctor?
If you have questions or concerns you should always call your provider. However, things to watch for if you have gastroenteritis include:
Patients who are well educated about their medical conditions and who use self-management plans created in collaboration with their doctors have better outcomes in a number of chronic medical conditions. Chronic obstructive pulmonary disease (COPD), which includes both chronic bronchitis and emphysema, is no exception. Patients who understand the disease process that causes COPD and who understand their treatment and management plans have fewer emergency room visits, fewer hospitalizations and fewer days with COPD-related symptoms.
If you are one of the 12 million people who know they have COPD, what can you do to have more days without COPD-related symptoms?