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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:

It’s National Nutrition Month! Eat Right - Your Way, Every Day

March is the month to celebrate healthy eating habits and Registered Dietitians everywhere making an impact on our nation’s nutritional health. Each year the Academy of Nutrition and Dietetics promotes National Nutrition Month by selecting a theme to support Americans in making informed and sound decisions with their dietary intake. In 2013 the theme is Eat Right, Your Way, Every Day.

What does that this mean?

We are each unique individuals with different ethnicities, cultural practices and traditions, food preferences, and health concerns. These factors guide and influence our food choices on a daily basis. There is a common misconception that “eating healthy” means cutting out certain foods or feeling deprived. RD’s recognize that all foods can be healthfully incorporated into a well balanced, daily eating plan within a person’s energy needs.

National Nutrition Month at Swedish

In honor of National Nutrition Month, the Nutrition Services department at First Hill, Cherry Hill, Ballard, and Issaquah has been featuring a nutrition booth in the cafeteria celebrating the health benefits of different country’s cultural cuisines. Swedish Registered Dietitians and Diet Technicians have been present each Wednesday from 11:30 a.m. to 1:30 p.m., providing healthful eating tips, handouts, and food samples from the featured country of the week!

The first week of National Nutrition Month highlighted foods from the Philippines. The native dishes displayed were Pompano and pinakbet:

Mother Nature’s Role in Healing Our Children

I am a pediatric hospitalist. That is, I am a pediatrician who takes care of children sick enough to be hospitalized. So my writing about the importance of children spending time outdoors and enjoying nature might be surprising. Even though I may only take care of a child for the worst few days of their life, I am still quite passionate about the fundamental role of outdoor play in a child’s health and well-being.

Even during acute illness, I find that children often heal faster when they are given more opportunities to be playful and (illness-allowing) go outdoors to allow Mother Nature to heal them from within. So needless to say, I am often amazed at how little exposure many of these children have had, even prior to becoming ill, to spend time playing outdoors and getting to know their environment.

Now especially, as the days begin to get longer, and the refreshing spring air returns to our beautiful Pacific Northwest, I start thinking about all the wonderful outdoor fun I used to have as a child, and the importance such activities had on my own health and overall sense of well-being.

I worry that children of today encounter ....

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 ...

Hearing Aid Life Expectancy and Power

Our concept of age depends on the object of our attention. For example, the average ant lives to be about 45-60 days. The average fly lives about 15-30 days. The average albatross lives between 42-50 years.

Electronics must be viewed differently however. They cannot eat something and become more energetic. There is the total lifespan of the device coupled with the power required to maintain the function it was designed for. A television is expected to last about 10 years, but will not work if it is not plugged in. The average car battery will only be useful for 5-7 years. A watch battery can vary from 1 to 6 years.

With our daily electronics, we take advantage of all types of batteries. How long can you go before you need to recharge your cell phone? Now imagine you used the phone continuously. How about the electronic tablets? Technology is wonderful, but must be constantly powered. Batteries for these devices last only a matter of hours before we need to find an alternate power source. With the electronics we depend on, it is critical to know how long we can expect to use them. This is even more true when those electronics begin to age. Highly sensitive and detailed instruments are classic examples of those devices for which we need to know the total life of the device and its power consumption.

A hearing aid is an example of such a device.

Hearing aids can use both disposable and rechargeable batteries. The cost effectiveness and convenience will vary greatly. The predicted number of hours for each battery will be hearing aid, and person, specific.

Also: the ear is small. Therefore the hearing aid must be small. The battery must then be even smaller.

As with any battery driven electronic device, hearing aids last much longer than their power source. The average hearing aid lifespan will vary significantly due to the amount of care provided to it. Accidents can and do happen. When it comes to hearing aids, seven years may not appear to be a very long time, but the device is considered ANCIENT by that time. The average person is expected to replace a hearing aid every 3-5 years.

There are several reasons for this:

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