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Struggling to breathe Valley kids try to control their asthma By Jennifer Radcliffe Staff Writer Sunday, May 15, 2005 – PACOIMA — Wendy Valenzuela raises six children in a federally subsidized apartment in the East San Fernando Valley, working two part-time jobs to supplement her husband’s income as a house painter. But even on their shoestring budget, the couple scrimped to buy a $1,300 vacuum cleaner and $595 breathing machine to stave off their 5-year-old son’s asthma attacks — fits of coughing and wheezing that have landed Johnny in the emergency room several times. Johnny’s asthma has turned the family’s life upside down. It costs them extra money, keeps them awake at night and forces them to rethink even simple trips. "It affects everything. I don’t sleep at night. I get up every day wondering whether my son will have an asthma attack," Valenzuela said. The family is not alone. Asthma is the most common chronic childhood disease, affecting roughly 6 million U.S. youngsters and costing taxpayers $12.7 billion a year. An estimated 63,000 Los Angeles Unified School District students have asthma — prompting the nation’s second-largest district to create a $400,000-a-year program to try to keep youngsters healthy. Grass-roots efforts paint an even bleaker picture in the East San Fernando Valley. In a pocket of Pacoima, for example, 28 percent of residents report having asthma, and, in a nearby Sun Valley school, about 14 percent of children have been diagnosed. Surrounded by landfills, highways and other pollutants, many of Valenzuela’s East Valley neighbors are plagued by a condition that steals their babies’ breath and can turn their children shades of blue. "We’re the trash can for L.A. County," said Maria Sesma Sooy, outreach consultant for Fernangeles Elementary School in Sun Valley. "This is landfill heaven." While the actual causes of asthma are unknown, studies show that genetics, lung development and the environment can lead to its development. Triggers found in sub-par, overcrowded housing exacerbate the symptoms. "Asthma is an epidemic. We know the (triggers) and we have to eradicate them," said Jim Mangia, CEO of St. John’s Well Child and Family Center in Los Angeles. Even though asthma is a manageable condition, children of the area’s mostly poor and immigrant population usually are not properly diagnosed or treated. They’re also often uninsured or lack access to quality health care, experts said. "Although it is a chronic illness, you can manage it and can have a completely normal life," said Roberta Villanueva, an LAUSD nurse practitioner. "There’s just tons of kids out there that are completely mismanaged." Mismanaged asthma After a few frightening visits to the emergency room, 13-year-old Demi Williams was diagnosed with asthma. Her mother, North Hollywood resident Shari Holiday, left the hospital unsure of what the condition meant and how to help her daughter. "It’s so sad. She was uncomfortable and it seemed like there was nothing we could do," said Holiday, who was staying in a homeless shelter with three of her children. Children in the United States miss more than 10 million days of school a year because of asthma. Disrupted sleep leaves them with poor memory recall, problems concentrating and mood swings. After Demi was flagged for missing too many classes at Sun Valley Middle School, LAUSD’s Villanueva came to Holiday’s dormitory-style room to explain the condition. Holiday also learned that her daughter’s moderate asthma requires two medications — a daily treatment, such as a steroid, to keep the airways from becoming inflamed, and a quick-relief medicine to relax the muscles in an emergency. Only 55 percent of children in California with moderate or severe asthma regularly take the much-needed medicine for maintenance, according to a 2004 study, Children and Asthma in America. It’s among the mounting evidence that many asthma cases are mishandled. Some families — many of whom are poor, uneducated and speak a language other than English — also confuse the medicines or overuse the emergency formula. "These families require a lot more than just ‘here’s a prescription’ and send them out the door," Villanueva said. But because the East Valley is considered "medically underserved," hospitals and clinics are often overcrowded. Caregivers have little time to properly advise patients on how to use the medicines or how to asthma-proof their homes. Others lack current information on the condition or aren’t familiar with modern treatment goals. Some doctors are still reluctant to call it asthma, relying instead on more generic labels like "bronchitis" or "restrictive airway disease," which don’t require the same level of treatment. "There’s some people, because of fear of asthma and what it meant in the past, they don’t want to call it asthma," said Ana Saravia, a pediatrician at the Northeast Valley Health Corp. "People used to die from asthma." Finding triggers When Kevin Ayelan, 10, was diagnosed with asthma, he had to throw out his stuffed animals — sparing only a favorite bunny. The confident, athletic boy, who dreams of being president — or maybe just a lawyer — blames garbage for his asthma. "It’s the dump over there," he said, pointing from his house in Sun Valley. "A lot of people in my school have asthma too because of the dump." On top of throwing out dust-attracting toys, the Ayelans spent $10,000 tearing out their carpet, repainting their house and cutting back flowers in their yard to help calm Kevin’s condition. "The minute we changed everything, he got better," Kevin’s mom, Alma Ayelan said, adding that he’s down to one or two attacks a year. Many families like the Ayelans are at the mercy of social workers who are trying to spread the word about controlling asthma one East Valley house at a time. The workers explain how families can clean their house and change their lifestyles to reduce triggers. Doctors may diagnose the problem, but "they never go to the source and find out what’s causing it," said Liseth Romero-Martinez, director of programs for Pacoima Beautiful. Still, many renters have a tough time convincing their landlords to make even basic repairs, such as fixing leaky plumbing that can cause mold or attract cockroaches. Property owners need to be held responsible for meeting city and state codes. In addition, penalties need to be stiffer for companies that violate air quality laws, especially near schools, advocates said. "Kids need to be protected," said Martha Dina Arguello, director of health and environmental programs for Physicians for Social Responsibility in Los Angeles. The Asthma Collaborative, a collection of 40 groups from across the county, is supporting legislation that would tighten laws and drafting an asthma action plan that will address the area’s growing health problem. But even when asthma is seemingly under control, it still weighs heavily on parents’ minds. Ayelan was initially so concerned about Kevin’s well-being that she decided to study to become a certified nursing assistant and now works at the pediatric unit of All Saint’s Health Care. With her newfound education, she’s confident that Kevin’s asthma will not keep him from being an active little boy who plays sports, swims and studies hard enough in school to become an attorney. "He’s going to get better," she said. "He’s going to have a normal life. We don’t have to be scared all the time." —

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The Cassandra Complex – the ability to know the future but unable to be believed by others and impotent to do anything about it. – Hide quoted text — Show quoted text -> "12 Monkeys"  (1995)

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"Cymbal Man Freq." <Don’t Bot…@ForgedPostsAnonymous.unorg> wrote in message news:Szfie.25427$3b4.10417@twister.nyroc.rr.com… > "12 Monkeys"  (1995)

And they never resolve how and why he hears that voice.  Beautiful.  A troubling, unsettling movie, but well worth the price of admission. Miki

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"12 Monkeys"  (1995)

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Question:

I recall this subject from some years ago. Are there still schools with a zero tolerance rule about drugs that will not let children carry their own asthma meds? I am in a speech class, and need to give a persuasive speech.  As an asthmatic, I thought the topic of asthmatic children not being able to carry their own meds a fitting one. After all, it may fall on the right ears of someone who can help make a difference.  I’m 41yrs old, and a lot of people in this night  class are around my age. As a child, though I had asthma mildly & EIA pretty bad, I was not diagnosed then, nor were there the drugs and aids out there at that time that are out there now.  So, the question didn’t arise then. What I am asking for is information, and if possible, actually communicate with some parent that has this very problem with schools and their own children. What has happened? What have/ can you do about it? Has there been any efforts for legislation? Do you think it is true that embarassment and self conciousness will sometimes keep a child from asking for meds when they should? Is it hard to convence a teacher that they need help…. NOW….? Thanks for any help with this topic, Lou Ann

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- Hide quoted text — Show quoted text – I recall this subject from some years ago. Are there still schools with a zero tolerance rule about drugs that will not let children carry their own asthma meds? I am in a speech class, and need to give a persuasive speech.  As an asthmatic, I thought the topic of asthmatic children not being able to carry their own meds a fitting one. After all, it may fall on the right ears of someone who can help make a difference.  I’m 41yrs old, and a lot of people in this night  class are around my age. As a child, though I had asthma mildly & EIA pretty bad, I was not diagnosed then, nor were there the drugs and aids out there at that time that are out there now.  So, the question didn’t arise then. What I am asking for is information, and if possible, actually communicate with some parent that has this very problem with schools and their own children. What has happened? What have/ can you do about it? Has there been any efforts for legislation? Do you think it is true that embarassment and self conciousness will sometimes keep a child from asking for meds when they should? Is it hard to convence a teacher that they need help…. NOW….? Thanks for any help with this topic, Lou Ann

There have been several threads on this subject; you can research the archives of this NG at deja.com using your topic. There are new Federal laws protecting the rights of asthmatics; some school districts have old regulations that seem to conflict. Usually the best approach is to start off with a note from the parents to the school district, signed by the doctor, that the student needs to carry his rescue inhaler for medical reasons. Links: http://www.ama-assn.org/special/asthma/newsline/special/how.htm   How Asthma-Friendly Is Your School? http://www.schoolhealth.org/asthma.htm   How Asthma-Friendly Is Your School? Ellis

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Well,all my 4 kids are allowed to use their meds when they feel they need it. My kids are 10,6,5,5. The only thing is that the oldest one feels ashame  to use his meds infront of other kids. But his teacher solved the problem by letting him take his meds in the hall and not in front of others. My 6 year old did have a problem once though. During the lunchbreak he needed his meds and when he wanted to get them another boy took his ventolin and almost emptied the whole inhaler. Luckily the teacher saw it and Calvin was able to use his meds. But both me and the teacher had a talk with the boy and the parents of the boy and also the teacher had a talk with the class where Calvin was able to show how he uses his meds and tell something about asthma. After that nothing ever happened again. But I must say that we are lucky to have a teacher of whom the brother is a lung-specialist:)) Jeunesse

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– Hide quoted text — Show quoted text – I recall this subject from some years ago. Are there still schools with a zero tolerance rule about drugs that will not let children carry their own asthma meds? I am in a speech class, and need to give a persuasive speech.  As an asthmatic, I thought the topic of asthmatic children not being able to carry their own meds a fitting one. After all, it may fall on the right ears of someone who can help make a difference.  I’m 41yrs old, and a lot of people in this night  class are around my age. As a child, though I had asthma mildly & EIA pretty bad, I was not diagnosed then, nor were there the drugs and aids out there at that time that are out there now.  So, the question didn’t arise then. What I am asking for is information, and if possible, actually communicate with some parent that has this very problem with schools and their own children. What has happened? What have/ can you do about it? Has there been any efforts for legislation? Do you think it is true that embarassment and self conciousness will sometimes keep a child from asking for meds when they should? Is it hard to convence a teacher that they need help…. NOW….? Thanks for any help with this topic, Lou Ann

I’m not a parent, but in answer to you last question: "Do you think it is true that embarassment and self conciousness will sometimes keep a child from asking for meds when they should?" Yes, I do. I know that for me when I was in high school and even now in college, I feel very self concious and embarassed if I have to use the inhaler in front of people. I think this does keep kids from asking for meds when they need them, especially in todays society, where kids are already very aware of how they look, this is just one more thing to make them "different" from their peers. -AB- — I took a long look at my life… perhaps you heard the scream that followed? Before you buy.

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I recall in high school having to hide my inhaler from the hall monitors because they were "technically" not allowed, but it wasn’t difficult to take a puff, if needed, behind the open locker door.  I’ve also had schools that had relaxed their meds policies and let me carry my inhaler with me at all times (I think this was in junior high, when I started needing an inhaler regularly). High school was 15 years ago, btw, so it is entirely possible things have changed dramatically since then. Lisa S. — Starlight Bridals                  TOLL FREE!  888-VEILS-33 Affordable headpieces, veils, and more! Since 1995… http://starlightbridals.com – Hide quoted text — Show quoted text – I recall this subject from some years ago. Are there still schools with a zero tolerance rule about drugs that will not let children carry their own asthma meds? I am in a speech class, and need to give a persuasive speech.  As an asthmatic, I thought the topic of asthmatic children not being able to carry their own meds a fitting one. After all, it may fall on the right ears of someone who can help make a difference.  I’m 41yrs old, and a lot of people in this night  class are around my age. As a child, though I had asthma mildly & EIA pretty bad, I was not diagnosed then, nor were there the drugs and aids out there at that time that are out there now.  So, the question didn’t arise then. What I am asking for is information, and if possible, actually communicate with some parent that has this very problem with schools and their own children. What has happened? What have/ can you do about it? Has there been any efforts for legislation? Do you think it is true that embarassment and self conciousness will sometimes keep a child from asking for meds when they should? Is it hard to convence a teacher that they need help…. NOW….? Thanks for any help with this topic, Lou Ann

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My eight-year old son is in a pariochial school and is not allowed to carry his inhaler on his person. I snuck one into an inside pocket of his backpack and told him never to tell anyone that it’s there but that if need be, he could get at it. Hated having to model this sort of sneaky behavior but I took the occasion to impress upon him that his asthma can be a life-or-death matter and all bets are off in that event. Historically, a variety of mishaps have happened when he has traipsed to the school office in search of his meds. The latest occurred a few weeks ago: he walked over to the bread box where all the meds for some 775 students are (allegedly) housed and could not find the Ziploc bag containing his albuterol and spacer. Not being a particularly assertive child, he left. Fortunately, the saunter to and from the office apparently calmed the the rare stress attack he was under at the moment and he recovered with no ill effects. When he told me about this I was immediately concerned for several reasons. 1) Where in the Sam Hill was his medicine? 2) Why was he allowed to rifle through this veritable pharamcopeia unassisted, unmonitored, completely free of supervision? 3) Why was he allowed to leave without being checked on? And that’s just for starters. I went in the next morning and found his meds but not where they were supposed to be–apparently since he’s not a frequent flier his stuff migrated to the back of the breadbox and eventually into a cabinet below. I began a very calm and rational discussion of this with the vice-principal and secretary. The sec’y laid all responsibility squarely with me: If I don’t think he’s assertive enough to demand his meds then I shouldn’t make them available to him at the school. I should instead require that they call me and have me bring them to him. Absurd but I swear every bit of this is true. The vice-principal laid the blame on archdiocesan policy, which is allegedly guided by liability insurance restrictions based on the fact there is not a licensed nurse on the premises, ever. The stringent restrictions of this policy require that, for example, no school personnel is ever to touch a student’s meds–they are not even allowed to read the label to make certain it belongs to the child. I was told the mere act of reading the label opens their liability in the case of mis-dosing. I suppose I can see that point of view, but where the heck does respect for a human life enter in here? Not to mention the plain common sense that a child in distress seeking relief medication of any sort is probably not in possession of all his/her faculties and is more likely to err. It just boggles my mind. Is it any wonder that a young girl died of an untreated asthma attack in a local school (not ours) in this archdiocese last year? I’ve begun building a case to change policies but it’s a long, slow row to hoe and in order for me to be effective I have to work within the system rather than against it. People just don’t get it; they want to hide behind their rules and regulations and lay the blame and responsibility on everyone else. Sorry for the rant; hope there’s some persuasive material in here useful for your speech. BTW, we are not in some backwards, out-of-touch community. This is the largest archdiocese in the US and in a Major metro area. Jeanne Ed’s Asthma Track http://asthmatrack.org/

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My eight-year old son is in a pariochial school and is not allowed to carry his inhaler on his person.

Your school may be in violation of Federal Law. The best bet is to send a note to school countersigned by his doctor that he needs to carry his inhaler with him at all times for medical reasons, and stating he is capable of administering his own medication. Links: http://www.vh.org/Providers/ClinGuide/AsthmaIM/comp4/4-7.html  Figure 4-7: School Self-Management Plan http://www.ama-assn.org/special/asthma/newsline/special/school.htm   Asthma Management in Schools: Call To Action http://www.ama-assn.org/special/asthma/newsline/special/school.htm#ri… "Students’ Rights Most students with asthma who require assistance or  modifications in school are assured of receiving these  services by the Individuals with Disabilities Education  Act and the Rehabilitation Act of 1973. Although such  laws may need to be cited to ensure that the needs of  children with asthma are met during the school day,  ideally this "illness approach" will not be necessary,  Shiner says. "In most cases, children with asthma  shouldn’t be viewed as disabled. They can participate  fully in activities and have minimal acute episodes"  when physicians, families, and schools work together  to provide effective asthma management at school. " http://www.ama-assn.org/special/asthma/newsline/special/how.htm   How Asthma-Friendly Is Your School? http://www.schoolhealth.org/asthma.htm  How Asthma-Friendly Is Your School? Ellis

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While applying a logical response to a church may be pointless… The stringent restrictions of this policy require that, for example, no school personnel is ever to touch a student’s meds

1a) If "no school personnel is ever to touch a student’s meds", your child should have no problem carrying medication; no one there is allowed to confiscate/lay hands on the medication.      Q "Child are you carrying medicine?"      A "I’m carrying what my mom and doctor (and lawyer) said to carry." 1aa) The fact the ziplocked medication migrated to another location says the school has ALREADY violated their own policy. 1b) Check with the insurance company about the policy.  They’ll probably note the insurance company/school assumes no liability anyway if something happens to your child due to said child carrying and using medication on the premises, unhindered/unassisted by school officials. –they are not even allowed to read the label to make certain it belongs to the child. I was told the mere act of reading the label opens their liability in the case of mis-dosing.

2a) If "reading the label opens their liability", then school officials cannot state your child is carrying medication; asthma medication is color coded/marked/labeled, seeing this is essentially reading the label.      Q "Child show it to me."      A "You told my mom you can’t read this." 2b) See 1aa.  How does someone in an organized fashion put something away without looking at it? 2c) If a child uses the wrong medication, negligent homicide, child endangerment, etc. comes to mind. Then there’s: A) Check with you local political representative; it’s election time. B) Check if local investigative news wants a human interest story. OR C) If a satisfactory solution is not forthcoming, let the school know you’ll be notifying the insurance company of the way medication for children is handled, and how many children are involved.  Any insurance agent will see the possibility of wrongful death and similar expensive claims and: a) notify the school; b) raise the rates; c) cancel the policy; d) two of the previous three.  The school should be able to figure this out too.  You can say the secretary suggested this (assertiveness). OR D) Go to a better school. but where the heck does respect for a human life enter in here?

Sorry, but those [expletive deleted] you have to deal are [Expletives deleted].  Any church/school officials that puts $$money$$ before the lives of children are morally bankrupt. U.S. Bill of Rights Amendment IV The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized.

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Excellent points, and I was actually laughing out loud at its beautifully twisted logic. Are you an attorney? As for another school, well, it’s a classic rock-and-a-hard-place scenario. We are stuck in this municipality by virtue of a residency requirement attached to my husband’s continued employment. The public schools stink and all things considered, this school is quite a good one academically, albeit overly anal in their attention to rules and regs. Fascist regimes have seen more flexibility.   Another pariochial school in the area will be under the aegis of this same archdiocesan policy, although there is always the possibility they won’t be quite so tunnelled in their vision. This would all be much easier if I didn’t work part-time for this organization in exchange for tuition credit.   Thanks for all the info, Jeanne Ed’s Asthma Track http://asthmatrack.org/

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– Hide quoted text — Show quoted text – While applying a logical response to a church may be pointless… The stringent restrictions of this policy require that, for example, no school personnel is ever to touch a student’s meds 1a) If "no school personnel is ever to touch a student’s meds", your child should have no problem carrying medication; no one there is allowed to confiscate/lay hands on the medication.      Q "Child are you carrying medicine?"      A "I’m carrying what my mom and doctor (and lawyer) said to carry." 1aa) The fact the ziplocked medication migrated to another location says the school has ALREADY violated their own policy. 1b) Check with the insurance company about the policy.  They’ll probably note the insurance company/school assumes no liability anyway if something happens to your child due to said child carrying and using medication on the premises, unhindered/unassisted by school officials. –they are not even allowed to read the label to make certain it belongs to the child. I was told the mere act of reading the label opens their liability in the case of mis-dosing. 2a) If "reading the label opens their liability", then school officials cannot state your child is carrying medication; asthma medication is color coded/marked/labeled, seeing this is essentially reading the label.      Q "Child show it to me."      A "You told my mom you can’t read this." 2b) See 1aa.  How does someone in an organized fashion put something away without looking at it? 2c) If a child uses the wrong medication, negligent homicide, child endangerment, etc. comes to mind. Then there’s: A) Check with you local political representative; it’s election time. B) Check if local investigative news wants a human interest story. OR C) If a satisfactory solution is not forthcoming, let the school know you’ll be notifying the insurance company of the way medication for children is handled, and how many children are involved.  Any insurance agent will see the possibility of wrongful death and similar expensive claims and: a) notify the school; b) raise the rates; c) cancel the policy; d) two of the previous three.  The school should be able to figure this out too.  You can say the secretary suggested this (assertiveness). OR D) Go to a better school. but where the heck does respect for a human life enter in here? Sorry, but those [expletive deleted] you have to deal are [Expletives deleted].  Any church/school officials that puts $$money$$ before the lives of children are morally bankrupt. U.S. Bill of Rights Amendment IV The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized.

Nice work! reble Before you buy.

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Question:

Find her a doctor that specializes in pediatric asthma treatment.  They exist but are difficult to find.  Most pediatricians just don’t do an adequate job.   Loki – Hide quoted text — Show quoted text – My 3 year old daughter has asthma,,,I have found that these past few winter months have been rough on here,,,At night it seems to get worse,,she is coughing so much that she throws up,,I don’t know what to do,,,does anyone have any suggetions? Tara

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My 3 year old daughter has asthma,,,I have found that these past few winter months have been rough on here,,,At night it seems to get worse,,she is coughing so much that she throws up,,I don’t know what to do,,,does anyone have any suggetions? Tara

Tara, My son had something that sounds like that. He would cough and cough and then throw up. It lasted two years and stopped dead. It was diagnosed as asthma just before it stopped ( at age 4 ). He developed asthma again at age 11, but it was rather different…the cough now is nonproductive . Our doctor thinks, looking back, that he may have had a type of croup. Just a thought. Good luck. Cathy

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Aloha all and almost Happy New Year. I plan to move into a house in a dryer part of the island in a week or so. Problem is that the previous tenants smoked some?? Inside the house.   They will be there about four months when they move.  Unfortunately, smoking in Hawaii is still more prevalent than in California or other areas of the mainland. The house will!!  Be cleaned before I move in!.  I have used Amway cleaning products for some 20 years with good success for my

environment/allergies, etc. Question:  Aside form LOC and Germicidal cleaner and disinfectant has anyone any experience of cleaning cigarette smoke residue form walls, ceiling, drapes, upholstery and carpet? Results from experience would be appreciated.  Thanks all for sharing. Edmund Freeman, Kauai

sorry I haven’t had any luck with trying to remove the smoke residue from homes afer the smokers have left.  If the house has AC or Heat my suggestion would be to find another home Unless you have big bucks to tear out and either clean or replace the duct work.  Aslo n matter how well you clean the carpet the residue stays behind so if carpetted your out of luck.  I use to live there and when I moved i chose  house with no heat or AC, and tile floors through out.  It was Ok for awhile until i discovered a mold problem. So sorry no suggestions.

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(Antoinette Lavern) writes: sorry I haven’t had any luck with trying to remove the smoke residue from homes afer the smokers have left.  If the house has AC or Heat my suggestion would be to find another home Unless you have big bucks to tear out and either clean or replace the duct work.  Aslo n matter how well you clean the carpet the residue stays behind so if carpetted your out of luck. I use to live there and when I moved i chose  house with no heat or AC, and tile floors through out.  It was Ok for awhile until i discovered a mold problem.  So sorry no suggestions.

Sounds like what you are suggesting is called ‘interment’, in a crypt. There are professional ductwork cleaning sevices available, ask your AC/Heating specialist for a recommendation.  They may even do this themselves, the same as they do chimney/boiler cleanings.  This is not very expensive, and should be done periodically to also rid your home of mold, animal leavings, and other airborne contaminants that would normally have settled and accumulated there. Walls can be painted, carpets can be steam cleaned, and a little soap, water, and elbow grease will rid your home of as much smoker’s residue enabling it to at least if not to better conform to the rest of this imperfect world. Good luck in your new home! Sheldon

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I have found that if my son is coughing at night a humidifer in his room really helps.

Yes, warm humid air can help loosen the phlegm. See Mayo Clinic info: http://www.mayohealth.org/mayo/9711/htm/coughs.htm Treating coughs                Excerpt: "To ease the cough cycle, try these simple approaches: Drink extra liquids

Question:

In a book I recently read on children and asthma, it suggested a technique for "tracking" the number of doses left in an inhaler (using a standard Ventolin-200 dose inhaler).  The book said to put the inhaler tube (without the plastic "dispenser") in a basin of water.  A full inhaler will lay horizontal on the bottom, an inhaler with 150 doses left will float _under_ water in an upright (vertical) position, an inhaler with 100 doses left will float in an upright position near the surface, an inhaler with 50 doses left will float at a 45degree angle on the surface (the top corner just barely sticking out above the surface), and an empty inhaler will float horizontally on the surface. I’ve tried this out, and it seems to work for us.  Since we use Beclovent every day, I can easily count out the usage.  But since we only use the Ventolin only sporatically, I was never sure what the count was (and was always afraid that the inhaler was "empty" and we were administering any medicine).  This at least gives me another guesstimate – which I figure is better than "gee, it feels empty". %-) Bonnie Nelson MCNC Library PO Box 12889 RTP, NC 27709-2889 **working AT MCNC, not speaking FOR MCNC**

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 Were you the poster?  If so, what i was trying to suggest was that the  manufacturers are not supplying what they promise, specifically, the  200 doses aren’t there.  My experience indicates that the later doses  have less of the Ventolin.

That’s what the research is trying to figure out. Did you see my posting about the MA Report and its discussion of this topic? The claim by the pharmaceutical companies is that they put enough medication and propellant in the MDI to deliver a full 200 metered doses (or whatever the container is labeled for) before "tail-off" begins and the doses get unreliable. (I doubt that there’s a conspiracy out there to defraud us of our potentially expensive promised doses). There are other factors that are just now being understood, such as the effect of evaporation of the dose or propellant from the metering chamber, the effects of temperature and the effects of upright versus non-upright storage on the MDI’s ability to deliver consistent doses throughout the labeled number of doses (I still haven’t seen the research on this latter topic). And some MDIs are coming with warnings not to twist the canister upon (re)insertion into its sleeve, inferring that some damage can occur to the valve mechanism if the canister is twisted. I suspect that some or all of these factors may affect the amount of medication released or at least affect the pressure with which it’s released, giving rise to a (possibly flawed) suspicion that the proper medication is not being delivered. You’re not alone in your suspicion that doses beyond a certain point do not seem uniform. But my question remains: how do you judge this – by the pressure of the spray? by the amount of relief you achieve? Whatever the case, each individual has to be the judge of whether s/he is getting the proper dose of medication, and, if s/he doesn’t believe that the proper dose is being delivered, to proceed responsibly, i.e., switch to a new canister earlier, as opposed to taking more puffs and possibly overmedicating. If you’re part of an HMO or insurance company that reimburses for part or all of the medication that you receive, you may want to approach them with your concern; they have a financial motivation to get the drug companies to prove that you’re getting their money’s worth out of the medication. Of course, it’s also to their benefit to have you properly protected, although they may not always see it that way! — Mark Feblowitz,   GTE Laboratories Inc., 40 Sylvan Rd.  Waltham, MA 02254

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Huh? OK – I think I’ll open up a can of worms, here.   I think you’re confusing "useful doses" with "metered doses". The same amount of medication is released whether you use a spacer or not. A 90 microgram release is a 90 microgram release. How much of that metered dose that you actually deliver to your airways is another subject. I’m also a bit concerned as to how you judge whether you’ve gotten a "useful dose". It’s really not a good idea to freely adjust the number of sprays based simply on how tight you feel or on how much medication you believe you’ve inhaled. This clearly isn’t appropriate for inhaled steroids, for which you feel no immediate relief; for bronchodilators you may be getting more medication than is needed or safe, based on a subjective judgement of how much you believe you’ve inhaled. So how are we to count and judge "the number of doses" we get out of an MDI without proper study? Most of us are not equipped to measure how much of the promised 90 mcg is actually being released. We can’t judge based on how much relief that we get – that can vary greatly between individuals and also for a given individual based on the particular circumstances (how many ml’s of nebulized albuterol did you have during your most recent bout of status asthmaticus before you got any relief?). And we can’t even judge the amount of medication released based solely on the forcefulness of the spray (except for the *real* weak first spray from a dormant MDI). In the absense of any scientific data, the best we can do is count how many we’ve used, and if we believe that we get limited relief after 180 or 190 or 200 sprays, switch to a new MDI (not use more). And if the MDI has sat dormant for several days or longer and we believe that the first spray will be weak, to "waste one" by priming the MDI and only taking a dose after that. As I said in a prior post, hopefully the new attention being given to researching MDIs will give us better information. Perhaps we can even get Consumer Reports to give it a look(?!). – Hide quoted text — Show quoted text –  I’m surprised that you get 180 doses.  I know that i don’t get 150  single doses even though i use a spacer.  When i don’t use the spacer  i don’t get more than 50 useful single doses.  This stuff is very  expensive, especially if one doesn’t have health insurance.  I think  we should all count the number of doses, post it to the net and then  contact the FTC with the results.    … jeff   As I mentioned in previous postings, I read about a new device that   counts MDI sprays (I should have patented the idea when I had   it!). It’s called "The Doser(tm)", and it’s from the NEWMED   Corporation (800) 863-9633. (I have no business association with these   people – I’m just reporting what I’ve learned). I called them   yesterday and they told me a bit about their product. I expect to   receive sales literature from them in a couple of days.             *snipped here*   The price quoted to me was $29.95 each, plus $4.95 S&H for up to   10. They’re offering a special intro price of $24.95. I didn’t ask   about quantity discounts.   It sounds like a great idea. But if I were to get one for each active   MDI in our household, it would cost approx $280! I’m gonna hafta think   about that…   Happy Puffing!   Mark   —  I think my solution is a lot cheaper. (from an earler posting replying to  I made myself some small printed forms that I tape onto the box. I keep  the inhaler in the box and each time I use the inhaler, I "X" out one of  the "O"s on the printed forms. Since the company claims 200 inhalations,  and since we all know that the last inhalations aren’t worth much, I have  180 "o"s on the form. When all are crossed off, I start another cannister  and the exhausted cannister becomes a purse cannister, or emergency  cannister in the kitchen, bathroom, etc. You might want to develop a  similar method of keeping track. Just don’t fall for the company’s claims  as to the content. I really don’t find that I get 200 effective doses per  cannister.

– Mark Feblowitz,   GTE Laboratories Inc., 40 Sylvan Rd.  Waltham, MA 02254

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I’m surprised that you get 180 doses.  I know that i don’t get 150 single doses even though i use a spacer.  When i don’t use the spacer i don’t get more than 50 useful single doses.  This stuff is very expensive, especially if one doesn’t have health insurance.  I think we should all count the number of doses, post it to the net and then contact the FTC with the results.   … jeff – Hide quoted text — Show quoted text – As I mentioned in previous postings, I read about a new device that counts MDI sprays (I should have patented the idea when I had it!). It’s called "The Doser(tm)", and it’s from the NEWMED Corporation (800) 863-9633. (I have no business association with these people – I’m just reporting what I’ve learned). I called them yesterday and they told me a bit about their product. I expect to receive sales literature from them in a couple of days.           *snipped here* The price quoted to me was $29.95 each, plus $4.95 S&H for up to 10. They’re offering a special intro price of $24.95. I didn’t ask about quantity discounts. It sounds like a great idea. But if I were to get one for each active MDI in our household, it would cost approx $280! I’m gonna hafta think about that… Happy Puffing! Mark — I think my solution is a lot cheaper. (from an earler posting replying to I made myself some small printed forms that I tape onto the box. I keep the inhaler in the box and each time I use the inhaler, I "X" out one of the "O"s on the printed forms. Since the company claims 200 inhalations, and since we all know that the last inhalations aren’t worth much, I have 180 "o"s on the form. When all are crossed off, I start another cannister and the exhausted cannister becomes a purse cannister, or emergency cannister in the kitchen, bathroom, etc. You might want to develop a similar method of keeping track. Just don’t fall for the company’s claims as to the content. I really don’t find that I get 200 effective doses per cannister.

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As I mentioned in previous postings, I read about a new device that counts MDI sprays (I should have patented the idea when I had it!). It’s called "The Doser(tm)", and it’s from the NEWMED Corporation (800) 863-9633. (I have no business association with these people – I’m just reporting what I’ve learned). I called them yesterday and they told me a bit about their product. I expect to receive sales literature from them in a couple of days.

           *snipped here* The price quoted to me was $29.95 each, plus $4.95 S&H for up to 10. They’re offering a special intro price of $24.95. I didn’t ask about quantity discounts. It sounds like a great idea. But if I were to get one for each active MDI in our household, it would cost approx $280! I’m gonna hafta think about that… Happy Puffing! Mark —

I think my solution is a lot cheaper. (from an earler posting replying to I made myself some small printed forms that I tape onto the box. I keep the inhaler in the box and each time I use the inhaler, I "X" out one of the "O"s on the printed forms. Since the company claims 200 inhalations, and since we all know that the last inhalations aren’t worth much, I have 180 "o"s on the form. When all are crossed off, I start another cannister and the exhausted cannister becomes a purse cannister, or emergency cannister in the kitchen, bathroom, etc. You might want to develop a similar method of keeping track. Just don’t fall for the company’s claims as to the content. I really don’t find that I get 200 effective doses per cannister.

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As to this doser thing — did you ask them if it works with a spacer?   Agree that it would be kind of expensive to get it for all of them — but it sounds interesting – thanks for info –                                         Anne Peticolas

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I still just check by the "float" method. It works fine, and doesn’t cost anything! Renee Roberts

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As I mentioned in previous postings, I read about a new device that counts MDI sprays (I should have patented the idea when I had it!). It’s called "The Doser(tm)", and it’s from the NEWMED Corporation (800) 863-9633. (I have no business association with these people – I’m just reporting what I’ve learned). I called them yesterday and they told me a bit about their product. I expect to receive sales literature from them in a couple of days. The Doser attaches to the metal canister portion of an MDI – the part that you push to activate the spray. As you push on the Doser to release the medication, it records the fact that you’ve released one spray; it adds this to your daily total and subtracts it from the lifetime total of the canister (preset by you when you attach it to the canister). So after 4 puffs from a new, 200-puff MDI, your daily total will read "4" and the remaining puffs will be "196". It warns you when the medication is getting low. When you’re done with a canister, you move the Doser to the new canister and reset it. It comes with adapters to fit different sizes of MDIs. It’s said to last for approx 1 year; the battery is inaccessible , and is supposed to hold up to typical daily abuse (e.g., being banged around in a belt pack). The price quoted to me was $29.95 each, plus $4.95 S&H for up to 10. They’re offering a special intro price of $24.95. I didn’t ask about quantity discounts. It sounds like a great idea. But if I were to get one for each active MDI in our household, it would cost approx $280! I’m gonna hafta think about that… Happy Puffing! Mark — Mark Feblowitz,   GTE Laboratories Inc., 40 Sylvan Rd.  Waltham, MA 02254

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