Puffing

The first Monday of the month and the last Monday of Respirology.

Actually, I quite like Respirology. The consult service is busy, but I have legitimately learned a lot and am now less afraid to mess (constructively) with people’s puffers when they are admitted to me in the future.

I also quite like Medical Mondays. Check out other medically affiliated blogs at the link on the image below.

Since it is the second to last day of resp, I thought I would share this lovely image.

Image from pinterest.com.

I remember seeing this episode and laughing hysterically.

It is so true.

People have no clue how to use their puffers. And they think they do. And they often can’t figure out why they aren’t getting better. But it is often because something isn’t being done right. And often this is because nobody asked and nobody taught.

I know this from both sides of the hypothetical office.

I have been on puffers off and on since I was about 9. I am one of those weirdos that did not have childhood asthma in the wheezy since toddlerhood kind of ways. I developed asthma in my late kid years.

I finally gained control of my asthma when I was in my 20s.

I have CONSISTENTLY PROPERLY used my puffers never.

Okay, never isn’t a fair term. I have used them consistently and properly, but not for more than a few months at a time.

I had a puffer for the odd “chest infection” as a tween. I never had an aerochamber. We figured out how it worked by reading the instructions.

One time, I was prescribed a turbuhaler. That is a puffer that has a powder you suck in. There is no puff of aerosol. We couldn’t figure out why we couldn’t taste or see it (this is before the days of Google, boys and girls), so I took a good 20 hits of puffer before we figured it out.

Google would have shown me this… Instead of just the words on the tube. And helpful tidbits like you shouldn’t taste or see anything. Image from theasthmacenter.org.

I was first given an aerochamber at 14. By this point, my breathing issues were beyond asthma and got into this weird laryngeal spasm thing, so that not only did I wheeze, but I had stridor because I didn’t keep my airway open right any more for some reason that is still beyond me (and probably at least partly psychosomatic).

What 14 year old who audibly wheezes and hacks wants to add to her awesomeness by carrying an aerochamber everywhere?

Not this one.

So, I used it at home and no where else.

It took years of titrations, allergy shots and finally growing up enough to see the greatness of not being sick all the time to finally establish good asthma control. If I had actually used the darn puffers properly all the time, it might have been quicker. Maybe not because there was other stuff at play, but maybe.

Instead, I would take them until I felt well, then I would forget them most of the time until got a cold, which would then linger forever because my airways hated me. That is when I would start taking them properly again.

Now, I have an action plan. I have that figured out with lots of medical education, doctors orders and real experience.

I don’t always follow it. I miss days of my steroid inhaler sometimes. That usually comes back to bite me. I forget to restart my seasonal asthma/allergy medication when Spring comes (seriously, I just realized this now). My aerochamber (that I have had for an indeterminate period of time) has a crack in it (I will get a new one next time I see the doctor), so I confess, I haven’t been using it. And I also confess I never carry it with me.

So, if I, the doctor suck at managing my respiratory illness, I know that  most patients are probably kind of like me too. That being said, I think it is doable.

I mean, it is where your priorities are at…. Breathing is good. The problem is that when you feel good and a problem doesn’t flare that instant, you don’t always think (for instance, I would never skip my migraine prophylaxis because 1 or 2 missed doses and I am out for the count for a day).

What I am pointing out is that puffers are inconvenient. Moreso than taking a pill. If you have an aerochamber, they are bulky, need to be washed and don’t fit in a nice purse (especially if you are me and like to carry a book).

The directions for puffers are variable. Often, I see people who don’t understand why their directions are different from the ones on the bottle and different from their friend. They get mixed up. People don’t understand that one is to keep you well long term and another is for emergencies only.

And don’t even get me started on proper use.

One of the docs I work with said that he suspects 75% of people prescribed puffers don’t use them properly. Mind you probably 20 or 25% of those people don’t use them properly because they don’t actually need them (that is a rant for another day). I’d believe it.

Today, I saw someone grab their puffer from their bedside table and try to use it without the aerochamber with me, the resident working for the lung specialists, standing right there!

I put it together and showed her how it worked. She had never seen it used that way before. Mind you, it had a mask because this person had such bad respiratory distress taking a single deep breath and holding for 10 seconds was out of the question. But, until then, that is what the person tried to do, but couldn’t do.

Image from asthma.ca

That is why I ask how you use your puffers.

Because I don’t always do it right, but I want you to do it right. I like it when people show me up and do everything to a tea and rattle off the proper timing and dosing. But, when you don’t know, I show you.

You can’t get better if you don’t get appropriate drug.

That message is as much for me as it is the other millions of people with respiratory disease.

But seriously, if you would up here looking for advice on how to take your puffer… GO SEE YOUR DOCTOR!

My Feelings about FYI (if you’re a teenage ___) as a non-parent and former teenager

FYI (if you’re a teenage girl) by Mrs. Hall at Given Breath has been getting a ton of social media attention.  Basically, it is a letter to teenage girls regarding posting what I would agree to be inappropriate photos of themselves on the internet and the consequences of this and saying that she doesn’t feel it appropriate for her teenage son to see.

I saw this response that was Freshly Pressed (yay!) the other day called FYI (if you’re a teenage boy) by Iron Daisy.  Again, this post is basically the same message, but to teenage boys who also post selfies all over the internet and regarding the fact that she doesn’t want her teenage daughter seeing all of that.

First of all, I agree wholeheartedly with the concept of these posts.  Not the content entirely, but the concept.

And yes, I love the irony.

Don’t hate.

To start off, you have to look at the perspective of the (first) mom.  If they are raising their children in the Christian faith, then if you don’t share their beliefs, you may or may not share their perspective on how bodies should be portrayed or concepts of sin (particularly lust) and such.

I share that faith, so that piece makes sense to me.

But, this is really not simply a faith issue.

People don’t think about the messages that they send when they post pictures of themselves on the internet.  I know, I have some gosh-awful pictures of me (in the “oh goodness, why that angle” or “why am I wearing that/doing that” spectrum of awful.  Nonetheless, everything has some sort of purpose or some sort of message.  There is a reason behind why you intentionally post self-photos. I mean sometimes it is to show where you are or what you are doing.

That is fine.

The issue is when you are posting them to flaunt yourself and particularly your body at other people.  Sure, some people out there are saying that you just like to see what you look like.  But really, are you looking for the attention of people who may be attracted to you?  Are you fishing for compliments?  Would you be embarrassed if your boss found the pictures when you are in your 20s or 30s?

These are things to think about.  And I think that is part of the issue the Moms were getting at.

But, then there is the whole concept of lust and that it really isn’t appropriate to flaunt your body like that.  I mean, your body is yours, but I would also like to think that if you show it off that much you are at risk of it not just being yours but that of a million people who see that photo.  Not just those that you want to, but the creepers that are, well, creepy.

The Moms in these posts are helping to protect their kids.  Really, no teenager (or human) should have to look at someone’s “sexy” selfies (unless they are your spouse).  The Bible equates lust with adultery and if you see it, and you want it, you probably lust after it.  And putting it out there is just as bad as looking at it.

This being said, I get that it is normal teenage behaviour.  Showing off oneself.

Kind of like mating rituals.

Sure.

There are other facets of normal teenage behaviour.  This is when you learn more about appropriate body image.  This is when you grow to respect oneself.

I feel like posting scandalous photos or looking at them is not necessarily fostering these things.

Teenagers do all kinds of stupid things.  I am sure most people can agree on that.  The goal is to teach them to minimize the stupidity.  Even if it is normal.

So yes, I confess that when I am a Mom I will hold this stance.

I know, a non-mom making mom claims.

But, for what it is worth, I really do think that.  I won’t want my kids to be exposed to that.  And I would have a zero tolerance policy if I caught one of my kids posting those kinds of pictures.

Yes, I get that my kids will probably do that and see that stuff.  I am not a head in the clouds oblivious person.

A bigger piece of all of this is this is teaching self-respect and appropriate body image and sexuality.  Boundaries are huge these days.  Social and otherwise.

I don’t really know how to do this.  But, I guess I will figure it out.  As much as I don’t want my kids to be ashamed of themselves, I also don’t want them to harm themselves with a lack of shame.  Middle ground is good.

Now, don’t go calling me a slut shamer.

Well, I guess you can if you want.  That is not what I am going for, though.

I agree that taking sexy selfies is normal teenage behaviour.  As is having sex, underage drinking and experimenting with drugs.  Varying degrees of risk.  And things that different parents try to prevent their kids from doing for their own safety.  I, in my head, already know that I will one day want to bubble my kids.  Just saying.

Anyway, slut shaming is degrading or mocking women (or men) for their sexual behaviour/tendencies.  It is wrong.  Point blank.

I get that the posts do mock these kids who are choosing to take these photos.  Because really, the overarching concept of posting such photos on Facebook is, at least to me, a little silly.  And I don’t quite support mocking these girls or boys to the point where they feel badly about themselves.  Offering good counsel is one thing, but there is a fine line for some people.

I think these girls and boys are potentially fine members of society (well, I don’t know, but odds are).  And I can’t say or know anything really to judge them except for reported bad taste in picture taking.

It is unfair to treat anyone poorly for their choices.  Degrading or bashing young men or women is not good at any point.

That being said, I think the spirit behind the posts is that these kids need to learn that their choices have consequences.  That other people may see the images and, yes, judge them because that is unfortunately how the world works.  And some of the people that judge them may just make a semi-humorous advice post, but others may be more predatory.    Slut shaming is real.  And so is sexual assault.

So, sure it is just an innocent picture.  But, sometimes a picture is a sign of bigger issues or can bring on bigger issues.

Kids (and adults alike) need to learn there are consequences to things that may seem harmless.   They need to learn that their bodies are not something to be sold or flaunted, but loved.  And teenagers aren’t quite at the point where they can always make those decisions for themselves. There is a learning curve.

So, in summary, I think sexy selfies are stupid, just like a ton of other teen rituals.  I don’t want my kids to do it, but I get that others will do it and that is fine because it is their perogative.  Nonetheless, I wish people would start to grasp that nothing is in isolation and there are consequences often beyond what is initially perceived.

Lastly, all teens and kids these days need prayers.  All of them.  There is a lot of bad stuff out there an a lot of tough decisions to make.