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Tuesday, April 24, 2018

What's a Certified Asthma Educator (AE-C)?


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In every profession, you have titles, licenses and certifications. In the world of asthma, the goal is to be a Certified Asthma Educator (AE-C). 

If you want to learn more about asthma, you want to learn from the best, right?!
That's where an AE-C comes in. An AE-C is a voluntary certification in the U.S., so, those of us that have studied for and passed the exam do it because we want to be known as an expert in the field. (I didn't even get a raise after passing the exam and getting my certification!)

It's not a easy exam (only 65% of people who take the exam actually pass it), and it's not cheap (I paid $350 to take the exam) and it takes about 3 hours. Did I mention that it's not an easy test? There are only about 3,500 AE-C's in the US that have passed the exam (that's not many considering there are over 25 million people here that have asthma! )

 How do you qualify to take the exam? NAECB (The National Asthma Educator Certification Board) says you are eligible IF:



1. You are a licensed or credentialed health care professionals OR

2. You provide professional direct patient asthma education and counseling with a minimum of 1,000 hours experience in these activities. 


NAECB lists the following currently licensed or credentialed health care professionals that qualify for the exam under #1.
Physicians (MD, DO)
Physician Assistants (PA-C)
Nurse Practitioners (NP)
Nurses (RN, LPN)
Respiratory Therapists (RRT, CRT)
Pulmonary Function Technologists (CPFT, RPFT)
Pharmacists (RPh)
Social Workers (CSW)
Health Educators (CHES)
Physical Therapists (PT)
Occupational Therapists (OT)
I fit under category #1, and was able to take (and pass!) the AE-C exam because I am a Health Educator and had a rigorous course study for my 4 year Bachelor of Science in Public Health degree. My classes included: first aid, anatomy and physiology, biology, physical science, behavioral science, epidemiology, human diseases, medical terminology, ethics, health and diversity, environmental health, modifying health behavior, research methods, bio- statistics, etc.

Once I made it through all those classes and graduated in Public Health, I could sit for the CHES exam through NCHEC. (This is also a $300 exam that takes 3 hour and also has a low pass rate.) It also means you are top in the field of Public Health. To maintain my CHES, I must re-certify with 75 continuing education (CE) credit hours over a 5 year period. I have to keep my CHES credential current to keep my AE-C current. With the AE-C credential, you need 35 hours of CE credits over 5 years. So that's 110 hours of CE credits.....every 5 years.

What does all this mean?

It means that anyone who takes the test must have at least a bachelors degree and some pretty intense classes in hard science, health, and medical field. 

AND once you pass it, you must continue to learn more by attending webinars from Allergy & Asthma Network , the EPA, state health department asthma programs, etc. This helps us learn more about the latest research, medications, changes to the guidelines, and much more.

I also attend the National Association of Asthma Educators conference.

It means learning, and then learning some more.

And I'm suddenly feeling tired that I have done so much!

So, if you are lucky enough to work with a Certified Asthma Educator, know that they are highly educated and trained, and must continue to learn more and stay updated so they can share that information with their clients.

And with that, I am going to take a nap.  I am tired.

Wednesday, April 18, 2018

Tell you doctor if you hate your medicine!

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My friend was telling me that she just had to use her Albuterol inhaler, and now her hands are shaking. She said that she probably had to use her Albuterol inhaler because she stopped using her controller inhaler. When looked at her surprised, she said she stopped using her controller inhaler because she didn't like the way it made her feel.  

I wanted to give her one of those, "You know better than that!" lectures. Instead, I gently reminded her that her controller inhaler does just that - controls the swelling in her lungs. It's a preventative medicine (just like people who take medicine for high blood pressure or high cholesterol.) You have to take your preventative medicine every day, knowing that it works. 

I grabbed my asthma medication poster from Allergy & Asthma Network and showed her the rainbow of inhalers that are available. 

I told her that if she doesn't like her medicine, let her doctor know! The doctor is going to send a prescription to the pharmacy, and if they don't hear back from you, they are going to assume that you are taking it. 

I showed her the green stripe on the poster, which shows all of the combination inhalers. That's the row that she's on now. I showed her where her inhaler was on the row and showed her all of the other inhalers that she could take. A lot of that depends on her insurance and which medicines her insurance company decides it wants to pay for. 

It's helpful if she works with her doctor and pharmacy to see if she can switch her inhaler. I mean, what's the point of paying for an inhaler (we all know they aren't cheap.....) if she's not going to use it?  

If you get a new inhaler, and don't like it. Don't stop taking it! Call your doc and let him know you don't like it. They can change your prescription to one you will use. 

We all want good, healthy lungs. And part of keeping your lungs healthy is taking care of them. Which means staying on your controller inhaler if the doctor has prescribed one for you.

So, keep that conversation going with your doc! 


Thursday, April 5, 2018

Coupons for prescriptions

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I popped into the pharmacy yesterday to pick our daily controller inhalers for my daughter and I, and had quite the shock at the register. They range up at $155.

It's a new pharmacy tech, so I said "Wait a minute. What was so expensive?" He said my daughter's controller inhaler was $80, and mine was $75.

I know that my pharmacy will find a manufacturer's coupon and apply that to our co-pay, so instead of paying a $80 copay for my daughter's inhaler, it will be $30. My co-pay for my inhaler is usually $75 but with a coupon, I can get it for $25.

Some of you may be thinking, "I pay WAY more than that each month for my inhaler!" I get it. My work has a $6,000 deductible for our insurance, which is a complete joke. My coworkers have to pay $250 EVERY month for their inhaler. They also have to pay full price for every doctor visit and emergency room visit.

So, I use my husband's insurance instead. It has a lower deductible and covers medications and doctor's visits once we meet our deductible. 
 
I know I shouldn't complain about paying $80 and $75 for an inhaler. But that's not all we get at the pharmacy. There are 5 people in my family with allergies, and 4 have asthma. So, we end up buying LOTS of controller inhalers, rescue inhalers, Albuterol vials for the nebulizer, and allergy medicine.  Plus medicine for other chronic conditions. So we use the manufacturer's coupons anytime we can!

When my son was younger, he was on a biologic (injections) for asthma. His little vial of Xolair was $1,000 every month (he was on the injections for 7 years). Our insurance covered most of it, but we still had a $150 co-pay. And that's on top of all the other inhalers, allergy medicine, and allergy shots. So, we found co-pay help on Needymeds. If you are on Xolair, you can get financial help here. 
Needymeds is a clearinghouse for co-pay assistance. Based on how much you make, you can find help for all/part of your medicine. Any medicine, not just asthma medicine. 

Here is the link to the brand name medications. Just click on the alphabet letter for your medicine. Each medicine will have co-pay help, coupons or both!
 

I don't use coupons at the grocery store, but I do at the pharmacy! I can save $50 each time I get an inhaler by using a coupon. Sign me up!
 
I will list some websites below for coupons. Your savings will depend on your insurance. 
 
Check here  for Dulera and Asmanex (this is good for 12 inhalers.)
 
If you use Symbicort, check here.
 
For Advair, check here. 
 
Check here for QVAR.
 
There are many more medicines and websites, but I can't list them all. Just type in the name of the medicine and "coupon" in my search bar. See what you can find!  (Or check on the Needymeds website for coupons.)
 
Another option is to use the website GoodRx. You can type in the name of your medicine and your zip code, and it will tell you how much your medicine costs at each pharmacy near you. Sometimes you can find your medicine for less at another pharmacy.
 
Good luck!  
 
 

Friday, March 30, 2018

1st time in the hospital?


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Last night, a dear friend sent a text to tell me that her daughter was in the hospital. She said she needed my expert help. As a Certified Asthma Educator (AE-C), and mom of 3 grown kids with asthma, I knew I could help.

For those of you who are regular readers of my blog, you know that my kids were hospitalized 12 times when they were younger (mostly due to pneumonia but once from smoke from a forest fire.)

So, I have had a little experience with kids in the hospital.

Things I wished I would have know when my kids were first diagnosed:



  • I once heard a doctor say if you wonder if.....and your next thought is "take my child to the emergency room", then go! The hospital has experts that can treat your child. If they just need to be treated and released, they will do that. But if they need to be admitted, you will be soooo glad you took them in to the emergency room. 

  • Ask questions! What is that pill? How often should she take it? What are the side effects? What is the IV for? What are you adding to the IV? What are you giving her for a breathing treatment? (I once had a new respiratory therapist give my daughter the adult dose instead of the child dose for an Albuterol treatment.) How do I know if she's getting better or worse? What should I look for?

  • Do you have a tooth brush? (Yes, the nurse or CNA can bring you a toothbrush, toothpaste and even a pair of scrubs if you are staying the night!) One time, I came to the ER after work with my son, and I was still wearing a skirt and high heels from work. I was not about to spend all night in those! So, the nurse found a pair of scrubs, slippers, and a toothbrush and toothpaste for me.
Let people know your child is in the hospital. When friends and neighbors ask what they can do to help, tell them! Ask them to pick or drop off other kids at school. Ask it they can get some bread and milk while they are at the grocery store. 

Let your child's teacher know. During one of the 12 hospitalizations for my kids, my son's 1st grade teacher came to see him at the hospital and brought a toy for him. Let all of your kid's teachers know that they have a sibling in the hospital. Your other children will need a little extra love and attention during that time. 

Most of all, be kind to yourself. Do some deep breathing to relax, have a good cry if you need one, eat a little chocolate. 

It's hard, but you can get through it!  




Monday, March 19, 2018

Ahh, spring and people burning brush.....Hey, wait!

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It's finally spring out west! And neighbors are already trimming their trees and bushes - and burning the clippings. Argh!

On my way home from work, I drove past a home just long enough for my car to fill up with smoke from them burning brush. I was starting a cold, so my lungs were already cranky. By the time I got home a short 5 minutes later, I was in desperate need of my inhaler.

I love spring - but not when neighbors trim their yard and burn the brush.

When my kids were in elementary school, a big problem was a neighbor who had a small orchard right next to the school. He trimmed all of his trees and decided to burn the tree limbs - during lunch recess - when 500 kids were outside playing. The entire playground was full of smoke.

I was NOT happy.

Since my kids were hospitalized a LOT when they were little, I was always trying to protect their little lungs. So, I marched over to the school to talk to the principal. 

It wasn't just my kids I was worried about. Its ALL the kids in the school with asthma. 1 in 12 kids have asthma, which means 2-3 kids per class, depending on the size. Times that by Kindergarten through 6th grade, and that's a lot of kids in one elementary school with asthma. 

I wanted to protect all of the kids from the fire and smoke. School is out at 3:00, why can't the neighbor wait until then to burn the tree limbs? Smoke has been known to hospitalize kids with asthma (really - my son ended up in ICU from smoke) so fires and smoke me nervous. 

From what I remember, they had me call the Fire Marshall and work out details with him to keep the neighbor from starting a fire and filling the playing with smoke.

Is there another way to get rid of tree branches and bushes? 

We have a lot of trees in our yard - 8 full grown trees, plus lots of bushes and a wisteria vine that grows up our pergola. So when my husbands trims the yard, he ends up with a truck full of branches and clippings.
 
Do we burn them? No!
 
The Hubby loads up the branches and trimmings and drives to the landfill at the edge of town. Our town has a green waste at the landfill, and they use a chipper there to grind up the branches and make mulch. Our town also has green waste garbage cans that we can fill up each week with tree limbs, ivy clippings, grass clippings, etc.
 
All of that goes to the green waste at the landfill, where they combine it into mulch. Then the neighbors head to the landfill to get mulch for their gardens. Win win! Recycling at it's finest!
 
We aren't filling the neighborhood with smoke, we are getting rid of the green waste, and it's being recycled for other neighbors to use in their gardens.  

And most of all, we are protecting our lungs.

Anyone else have a tough time with neighbors burning tree limbs or leaves?

Monday, March 5, 2018

Thanking the hospital staff again


 
We had a nice, long weekend with a Family Member in the hospital. I always hate getting one of "those" phone calls, then jumping in the car and driving 4 hours to the hospital.
 
This family member was in the ICU, then moved to a room on "the floor". 
 
During the 3 days we were there, I noticed the usual - room after room of patients and family members. And staff literally running from one room to the next.
 
How do they do it? Work 12 hour shifts and take care of one patient, run to the next room and are pleasant and helpful in that room?
 
When the nurse, aide or respiratory therapist would come in to Family Member's room. They were friendly, answered questions, and asked if WE needed anything (not just the family member.)
I wouldn't ask them if I needed something,  they are way too busy! Since I was there with the Hubby, one of us could stay in the room and the other could walk down to the cafeteria.
 
After we left to pick up something for Family Member, we decided to stop by a popular sandwich and bakery shop. We bought all of the cookies in the display, had them boxed up and left them at the nurse's desk with a note thanking them for all of their hard work.
 
The nurse popped in the hospital room a few minutes later, and while wiping crumbs from her cheek, thanked us for the cookies. She said she was so surprised that we would do something like that. 
 
I was surprised that she was surprised. Don't they ever get families that thank them?
 
I told her that we see you. We see you run from room to room. We see you patiently answer questions for Family Member (even if you just explained it 5 minutes ago.) We see you being friendly when we know your feet hurt and your back is sore. 
 
We see you and appreciate you.
 
We were surprised to see how quickly the cookies were eaten (and how excited the staff was), so we did the same thing the next day, with a new shift of hospital staff (that's the cookie photo above.)
 
Hospitals can bring out the worst in some people, and I'm sure they are not treated kindly in each room. But, I would like to spread a little joy and love.
 
And if I can do that with a big box of cookies, sign me up!
 
   
 
  
 
 
 
 



Tuesday, February 27, 2018

When to keep kids home from school

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I was listening to the radio on my commute to work and heard the 2 male hosts discussing when it was okay to let their kids stay home from school,  and how they would treat them.

They had opposite views! 

Host A said that he would send his kids to school if they were sick (I wanted to reach through the radio and strangle him....) but if they had to stay home, they had to stay in bed and not have any electronics, Netflix, etc. He said he felt like his kids were "faking it."

Host B said he would keep his kids home if they were sick (thank you!) and to help them feel better, he  would stop and get ice cream, and shoot off confetti cannons. I like his view MUCH better!

As mom to 3 grown kids with asthma, my kids missed a LOT of school when they were little.

How do you know if you should send them? I found a blog from Dr. Chad Hayes called "Too Sick for School? Here's Your Guide"

He covers 25 different illnesses, including asthma, vomiting, rashes, pink eye, etc. Here's what he says about asthma:

"Children with asthma have a lot of different triggers—from allergen exposures to viral infections, exercise, and a lot more. There’s no concern about spreading this to other children (except maybe the cold that kicked it off), so it really depends on the child’s symptoms. If they are having difficulty breathing, or if they need treatments so frequently that the school or daycare can’t provide them, keep them at home. But remember, missing school frequently due to asthma is a sign that it’s not well-controlled."

For me, if my kids were in the Yellow Zone of their Asthma Action Plan, they would stay home. If I knew they were going to need breathing treatments on the nebulizer every 4-6 hours, I would want to keep my eye on them at home. My kids would usually go from bad to worse VERY quickly (and that's why we had 12 hospitalizations.)

It used to drive me crazy when parents would send their kids to school when they were sick. I don't want my kids around someone else who has a fever or is throwing up. Don't share the misery! There were many parents who KNEW their kids were sick and throwing up, but sent them to school anyway. Then it just spreads through the whole classroom, and then to our families.

It's also very easy for a simple cold to turn to pneumonia or bronchitis when you have asthma. And that would mean another hospitalization for my kids.

And when my kids were discharged from the hospital, Asthma Doc would tell me to keep the kids home from school for a week. It takes a while for their lungs to bounce back and he would stress that their bodies need to heal.

Talk to your doc to see what he or she recommends, so you're not infecting the rest of the classroom. 

As for me, when someone is at home sick, they get soup, ice cream, Netflix - and anything else they want. Our lungs work hard with asthma and we deserve a rest!