Author Archives: Jackie Aim

If your child is not improving with early treatment

Inhaler

All the evidence now supports early use of the blue reliever at this stage can stop a mild asthma flare up from becoming an asthma attack.

The advice on this website is not to be used instead of seeing your family doctor or going to the hospital.

The tricky bit is knowing when to ask for help. If you have any concerns get a medical opinion.

Important

If the 5 puffs of the blue reliever inhaler does not last for the full 4 hours, then this is what we class as an “Asthma Attack” – No matter how well you think your child looks. Get medical help urgently.

Treating asthma early

Inhaler

By acting quickly at home you might stop the asthma getting worse. You may even stop a hospital admission.

Important

As soon as you see your child’s warning signs start using their blue inhaler straight away.
You will do your child no harm in giving this reliever inhaler and will do a lot of good.

Self management

If symptoms are early or mild give up to 5 puffs of the blue inhaler using a spacer every 4 hours for a few days while symptoms last.

Late warning signs -time to get help

Child in bed coughing

Not every child will have all of these symptoms. If you notice any of them you should seek help right away:

Disturbed sleep due to symptoms.
Troublesome cough.
Coughing spasms.
Cough until they gag or vomit.
A wheeze which can clearly be heard.
Tummy or ribs visibly sucking in when breathing.
Lethargic / sleepy / can’t be bothered.
Difficulty breathing.
Getting out of breath easily.
Wheezy / noisy breathing.
Breathing faster than normal.
Chest starts to get tight or hurts.
Struggling to speak in sentences due to breathlessness.

Spotting asthma warning signs

Asthma attacks do not usually happen without warning. Most children have early warning signs.

You might see these a day or two before the asthma flares up.
You should start treating your child’s asthma as soon as you see the following warning signs.
Most parents of children with asthma can spot their warning signs easily and can take action quickly to stop a flare up from becoming too bad.
If your child has a cough or cold, using Salbutamol can help to prevent this getting worse.

Spotting early warning signs
Pale. Dark circles at their eyes. Flushed face. Not eating as well as usual. Reluctant to leave you/ clingy. Crying / tearful. More irritable than usual. Restless and won’t sit still. Small annoying type cough. Quiet mild wheeze. Runny nose. Tired.	Mood changes. Change in face colour. Itchy, watery eyes. Itchy, scratchy or sore throat. Stroking chin or throat. Sneezing. Headache. Temperature. Chronic cough, especially at night.

First step

The most important thing to do for a worsening asthma is to give the blue reliever inhaler 4 puffs every 4 hours using a spacer.

By acting quickly at home, you might stop the asthma attack or symptoms from getting very bad. You might even stop a hospital admission.

If there is anything that you still do not understand, ask your child’s asthma team.

Important

The most important thing to do for a worsening asthma is to give the blue reliever inhaler every 4 hours using a spacer.

Look for symptoms

Child/ girl being shown how to use volumatic inhaler to treat asthma. Mother and nurse.

In asthma, the symptoms usually build up over hours or days and the plan is to:

Spot what is happening.
Give treatment.
Get an assessment early.
Get help at the right time.
Keep your child safe!

Pelvic floor exercises

Pelvic floor exercises can be quick and easily fitted into your daily activities.

Lie on your back with your knees bent.
Imagine you are at the toilet and you going to stop yourself passing urine midstream, or stop yourself from passing wind.
Do not hold your breath while doing this exercise.
You may feel your back passage moving – this is normal.
Try 5 quick holds – tightening the muscles and then straight away relaxing them.
Hold for 5 seconds, continuing to breathe normally, and then slowly relax. Repeat this 5 times.
Do not try and stop the flow while urinating as this may lead to problems passing water.
Remember to tighten your pelvic floor immediately before any activity (for example coughing, sneezing or lifting).

For more information please see: Bladder and bowel foundation: Pelvic floor exercises.

Stress Urinary Incontinence in COPD – what can you do?

Diagram showing pelvic floor muscles
If you have been taught ‘Pelvic Floor Exercises’ in the past then you should continue to do these again.

Try to contract your pelvic floor muscles during your Airway Clearance Technique or when coughing and sneezing.
Using an Airway Clearance Technique to clear sputum from your lungs reduces how much coughing is required to clear your chest. This can help reduce or avoid Stress Urinary Incontinence.
Avoid drinks high in caffeine as this makes you need to pass urine more often.
Try drinks such as herbal tea and diluting juice.
If you haven’t had any instruction on pelvic floor exercises in the past you can ask your GP for a referral for physiotherapy.
You should also discuss a referral to the continence service with a health care Professional, or you may be able to self refer.
Stress incontinence can be embarrassing but it can also be treated in a variety of ways. Don’t suffer in silence when you can get help.

Stress Urinary Incontinence and COPD

Lady coughing

If muscles in your pelvis became weak, there is a risk of you leaking urine during exertion, or straining yourself. For example when you sneeze or cough.
Women with COPD are more likely than men to have stress urinary incontinence because of the difference between male and female anatomy and after having children pelvic muscles can be weakened.

Your pelvic floor muscles are responsible for helping to maintain bladder and bowel control and support control of continence.

Often when you have COPD you will cough a lot.
The repeated downward pressure on your pelvic floor muscles during excessive coughing can make them weak.

Positive Expiratory Pressure and Oscillatory Positive Expiratory pressure

These techniques involve the use of devices. These are not commonly used by people with COPD. They can be used on their own, or at the same time as other breathing exercises such as Autogenic Drainage. For this reason you may also hear these devices being referred to as ‘adjuncts’.

Positive Expiratory Pressure mouthpiece.
Positive Expiratory Pressure mask.
Oscillatory Positive Expiratory Pressure, for example Flutter, Acapella, Aerobika.

Feel that Active Cycle of Breathing Technique or Autogenic Drainage is not effective.
Feel Active Cycle of Breathing Technique or Autogenic Drainage is making you wheezy or cough a lot.
Regularly produce a lot of sputum.
Your sputum is very sticky despite good hydration.

The following film shows one of these devices called Acapella.

Acapella from Cat Young on Vimeo.

View text transcript

We are now going to show you a short clip using a device called an Acapella. This is an oscillatory device which helps to clear secretions. What we are going to do first of all. I have set the dial to three, so that is your resistance and you will need to take a slightly bigger than normal breath in.

Put your lips around the mouthpiece and blow out through the machine. When you do that the machine will vibrate the air into your airways and loosen off the secretions.

We are going to do five breaths with the Acapella. Once you have done your five breaths we will go on to your huff. This is a medium sized breath in and you breathe out as if you are steaming up your mirror. You may hear the secretions moving. Keep huffing until you feel the urge to cough to clear the secretions.

Take five slightly bigger than normal breaths in. Blow into the Acapella machine.

Have a few normal relaxed breaths and repeat the five breaths and Acapella again. Some relaxed breaths followed by your huffing until you feel the urge to cough.