To Camp or Not to Camp?

Campfires, smores, ziplines, new friends. Summer camps bring many new fun experiences. However, for kids with allergies, asthma, and food allergies (as well as their parents), the thought of summer camp may also invoke anxiety and fear. With a little extra preparation, anxieties can be calmed and kids with allergies and asthma do not have to miss out on all the exciting adventures that camp brings. Here are a few tips to help make the planning easier:

1.) Choose the right camp.

There are several things to think about when choosing what camp to send your kids to:

• Do the counselors/staff have any specialty training in recognizing food allergy reactions/asthma attacks and in how to respond to these situations?

• Are medically trained professionals there at all times? What are their credentials?

• How far away is the camp from the nearest emergency room/hospital?

• Is the kitchen staff trained in how to prepare food-allergy friendly meals? Do they know how to avoid cross contamination?

Remember, there are specialty camps for kids with food allergies, FPIES, EoE, atopic dermatitis, and asthma. There is not always one in your area but there are several across the country. Food Allergy Research & Education has a list of Food Allergy safe camps https://www.foodallergy.org/resources/heading-camp.

Food Allergy and Anaphylaxis Connection Team also has Camp Tag which is open to kids with any allergy condition and their siblings!

https://www.foodallergyawareness.org/programs/camp-tag-the-allergy-gang/camp-tag-the-allergy-gang-2022/#:~:text=Camp%20TAG%20provides%20a%20safe,children%20who%20share%20similar%20experiences.

2.) Make sure to see the allergist before you go.

• Make sure that your child’s Food Allergy Action Plan or Asthma Action Plan is up to date.

• Make sure all dosages are correct for their current weight.

• Make sure all of their medications have current prescriptions.

3.) Communicate with the camp ahead of time.

• Make sure the camp has an up-to-date Food Allergy Action Plan or Asthma Action Plan.

• Make sure they are aware of your child’s food allergies and that the kitchen is prepared to make their meals.

• Make sure you have determined if the counselor will carry your child’s albuterol/epipen or if your child will self-carry.

• If there are any off-site field trips, make sure that the child’s emergency medicine goes with them.

• Determine if your child is allowed to bring their own food-allergy friendly snacks.

4.) Don’t forget about contact allergies.

• Some kids have contact allergies to certain sunscreens. If this is the case, make sure to bring your own. Blue Lizard is usually well tolerated.

• Teach your kids about what poison ivy, poison oak, and poison sumac look like. Calamine lotion may help, but if there is extensive exposure, an oral steroid may be needed. The camp doctor should be able to prescribe this.

To guarantee a great summer for your child, do some advance planning to make sure the camp you select can meet medical needs while allowing for a great camping experience.

Asthma

Asthma is a chronic lung condition in which the airways become inflamed, constricted (narrowed), and produce excess mucus. This can make it difficult to breath. The most common symptoms of asthma are cough, wheezing (a whistling noise when you exhale), chest tightness, and shortness of breath. If you have recurrent bronchitis or colds always tend to go to your chest, that could be asthma. Do you feel after you are sick, you have a cough that lingers longer than anyone else’s seems to? Does your child have trouble keeping up with kids their age when running and playing? All that could be asthma. Often people think you have to wheeze to have asthma, but that is not true. Some people only have cough. In fact, asthma is one of the most common causes of chronic cough. Some people with asthma have symptoms on an almost daily basis. Others only have symptoms when they are sick or when their allergies are flaring. Asthma symptoms commonly occur in the middle of the night or with exercise but can occur at any time. Symptoms may be minor, but at times, symptoms can be severe and even lead to a life-threatening attack.

Asthma can be allergic or non-allergic, meaning that it is caused by other factors such as exercise, illness, stress, extreme weather, or other irritants. Even those with allergic asthma may have symptoms triggered by non-allergic factors. Asthma often occurs in children but can start in adulthood as well. There is not one specific cause of asthma. Genetics are thought to play a major role. So, if one of your family members has allergies or asthma, you may be at increased risk for developing asthma. Environmental factors can also play a role, such as exposure to air pollution, exhaust fumes, chemicals, or secondhand smoke.

If you think you may have asthma or want to be screened for asthma, you can schedule an appointment with an allergist. They will first take a detailed history and perform a physical examination. Then you will have a pulmonary function test which will measure your lung function. Sometimes, they may also recommend allergy testing if they think allergies are a main trigger for your asthma.

Asthma is a chronic condition that has to be managed over time. There is no cure for asthma. That being said, there are many effective treatments available so that asthma does not affect how you live your life. Avoidance of triggers such as allergies and irritants is the first line of treatment. Next, medications are used to both treat and prevent asthma symptoms. The main medications used to control asthma symptoms are inhalers. There are many different inhalers, and your doctor will help determine the right fit for you. There are also newer therapies available as add on therapies referred to as biologic therapies for moderate to severe asthma. Your doctor should make you an asthma action plan that explains how and when to use each of your asthma medications and what to do if your asthma starts flaring. Lastly, for allergic asthma, allergy immunotherapy, commonly referred to allergy shots can help treat asthma.

You should see an allergist for your asthma if:

· Your asthma symptoms occur every day and often at night or limit your activity

· You have had a life-threatening asthma attack

· You take oral steroids or steroid injections twice a year or more

· You have been hospitalized for your asthma

· You are not responding to your current asthma treatment

· Your goals for asthma treatment have not been met

· Your symptoms are unusual or hard to diagnose

· You have allergies or sinus issues that complicate your asthma

· You think allergy shots may help

· You are interested in biologic therapies

· You want to identify your allergy seasons that may be contributing to your asthma

· You need more instructions or a more detailed treatment plan

Don’t let asthma hold you back! Take control of your asthma so you can live the life you want!

Vocal Cord Dysfunction

What is Vocal Cord Dysfunction?

Vocal cord dysfunction (VCD) occurs when the vocal cords close when they should be open. Your vocal cords open to allow you to breathe in air. If the vocal cords close during inspiration this creates airflow obstruction. VCD can also be referred to as Paradoxical Vocal Fold Movement (PVFM). The most common symptoms of VCD are shortness of breath, hoarseness, voice changes, throat tightness, coughing, wheezing, and even chest tightness. Many of these symptoms are common in asthma. In fact, nearly 80% of VCD episodes are wrongly diagnosed as asthma. While asthma and VCD are 2 completely distinct conditions with different treatment methods, one can have both asthma and VCD and even have attacks of both at the same time. Difficult to control asthma that is not responding to typical asthma therapies can often be from coexisting VCD that is untreated.

What are the triggers for Vocal Cord Dysfunction?

While some people can have VCD with no identifiable trigger, many people can identify certain factors which seem to make an attack more likely. Some of the most common triggers include:

· Exercise

· Irritants such as perfumes, strong smells, fumes, cigarette smoke, chemical, and pollutants

· Stress and Anxiety

· Gastroesophageal reflux disease

· Infections such as colds, viral infections, and sinusitis

· Certain medications (mainly neuroleptic drugs such as phenothiazines)

How do you diagnose Vocal Cord Dysfunction?

VCD can sometimes be hard to diagnose, especially because symptoms are so similar to asthma. Thus, often it can take time between the onset of symptoms and the diagnosis of VCD. History and physical exam are always important in diagnosis. Then usually pulmonary function testing or spirometry will be performed. This is a breathing test that shows airflow in your lungs. It can screen for asthma but also can have some abnormalities in VCD. In some cases, a laryngoscopy will be recommended. This is a test using a camera to visualize your vocal cords while breathing.

How is Vocal Cord Dysfunction treated?

The main treatment for VCD involved speech therapy. Speech language pathologists who specialize in VCD can teach one breathing techniques. While the vocal cords move involuntarily, there are breathing exercises that can stop the paradoxical motion and spasms seen in VCD. Approximately 90% of patients with VCD improve with speech therapy. Some patients with VCD have known triggers. Trying to decrease exposure to or control certain triggers can also aid in treatment of VCD.