That means knowing exactly how symptoms 8 dpo bfp buy diamox 250mg free shipping, when medicine bobblehead fallout 4 purchase diamox 250mg without a prescription, and why your addicted brain is most likely to get triggered and start competing with your rational treatment xanthoma generic diamox 250mg with visa, recovering brain for control treatment xerostomia discount diamox 250 mg fast delivery. The purpose of this chapter is to teach you three strategies that can help you to identify the situations and ways of thinking that fuel your addictive behavior: (1) identifying your unique triggers for alcohol or drug use, (2) recognizing distorted thinking, and (3) using self-monitoring skills. The more frequently you are able to recognize and anticipate when your addicted brain is taking hold and causing you to think and act in irrational, self-destructive ways, the better you will get at intentionally using your rational brain to make healthier choices for yourself. Each time your rational brain wins control over your behavior, your recovery gets a little bit stronger and your addicted brain loses a little bit of power over your behavior. In the long term, your rational brain can take over completely, so that making healthy choices is N the Addiction Recovery Skills Workbook no longer a fight; it is a way of life. In this chapter, and the next, you will learn how to use cognitive and behavioral therapy skills to become a "self expert" and reclaim that control. Becoming a "self expert" is a process of understanding how your addiction controls you, so that, with time and practice, you can turn the tables on it. That means getting a handle on the wide range of situations, places, people, and experiences that activate your addicted brain. Typically, when you encounter a trigger, this causes a sequence of experiences that leads to drug or alcohol use when your addicted brain is in control. As you progress through the exercises in this chapter, you will learn to notice when you are triggered, and what exactly that feels like for you. For instance, when you are triggered, you may or may not be aware of the thoughts that are going through your head. Maybe you are simply aware of an urge or craving to drink or use drugs, and if so, that is a great start. As you will learn, there are many components of cravings and people experience them differently. Once you are aware of what happened, you can begin an inner dialogue with yourself about it, and you can use this inner dialogue to cope with the thoughts, feelings, and cravings without drinking or using drugs. Another key component of becoming a "self expert" is developing an awareness of the kinds of things your addicted brain will tell you to get you to drink or use drugs. In this chapter, you will learn about some red flag thoughts that a lot of people with addictions experience when they are feeling triggered. This will prepare you for the next chapter, where you will learn how to "talk back" to the thoughts using your rational, recovering brain. In fact, cravings are one of the symptoms that define the disease of addiction (American Psychiatric Association 2013). Physically, when you are addicted to something, your body becomes dependent on having a steady, consistent dose of it in your system. When that steady dose is diminished, or taken away abruptly, your addicted brain will communicate urges to you to get you to replenish it. This is because, as your body is adjusting to receiving less of the substance, you can experience uncomfortable physical and mental withdrawal symptoms. The conditioned, addicted part of your brain will tell you that you need to drink or use to get back to feeling normal. The psychological urge or craving can feel just as potent-and sometimes even stronger. You may recall that in chapter 2, you learned about how your use of alcohol or drugs can become a conditioned, automatic response to certain cues, much like a habit. When drinking or using drugs becomes associated, or "linked," with certain situations, emotions, people, or things, then those become triggers. Because that psychological link between triggers and using substances can be very powerful, being in the presence of these triggers can become quite uncomfortable without alcohol or drugs. Studies have shown that triggers fall into several categories (Marlatt and Gordon 1985; Larimer, Palmer, and Marlatt 1999). As you become a self expert, think about which of these categories apply to you, so that you can learn to become more selfaware when you enter triggering situations: Negative emotional states: Some people drink or use drugs as a way of "self-medicating" uncomfortable emotions such as anxiety, sadness, boredom, loneliness, or anger. This is another category of triggers-some people drink or use when they have a fight with a partner or a family member. Often it is the combination of a conflict and your emotional reaction to it that places you at risk for a relapse. In fact, in one of the largest studies of the reasons people with addictions relapse (Marlatt 1996), more than 50 percent of the relapses were triggered by negative emotional states stemming from interpersonal conflict. If interpersonal problems are a trigger for you, then finding a healthier place to put the anger or other negative emotions that arise is going to be an important part of your recovery. For some people, these are the most challenging situations when trying to abstain from alcohol or drug use. To overcome this challenge, you first need to understand why this situation is difficult for you. For some people, it is hard to refuse an offer of alcohol or drugs simply because it is so tempting. For others, self-consciousness can take over, leading them to feel worried about how others will think about them or judge them if they make different choices. This is a very natural tendency but it is an important one to work through in your recovery. Social pressures to use substances can be direct (for example, someone offering you a drink or drugs), or indirect (as in being around people who you know have drugs or who are drinking or using in front of you). You will learn how to respond to these kinds of social pressures in the next chapter. Or maybe when something reminds you of the positive emotions or sensations that drinking or using can bring on for you, you experience a desire to feel those things (like relaxation, elation, confidence, or an energy boost). If this is you, then one of your goals will be to find other sources of positive emotions and rewarding experiences or activities that are compatible with your recovery. Another important goal will be to learn to think more carefully about the full range of effects that you can expect drinking or using drugs to have on you. Place a check mark beside the triggers that you have experienced, and place a star next to the ones that you feel come up repeatedly for you. Remember that internal triggers are just what they sound like; they are emotions inside of you. External triggers, on the other hand, are cues that are external to you-such as places, people, or situations that you have come to associate with drinking or using. Internal Triggers Depression Loneliness Happiness Excitement Feeling stressed Feeling irritable Feeling overwhelmed Feeling jealous Anxiety Boredom Anger Feeling rejected Frustration Guilt or shame Needing an energy boost Withdrawal symptoms 87 the Addiction Recovery Skills Workbook Other internal triggers: External Triggers In this exercise, we focus on four types of external triggers: people, places, situations or activities, and things. Under each category, place a check mark beside the triggers that apply to you, and place a star next to those that come up repeatedly for you. In the exercises that follow, you will start connecting your personal triggers with specific thoughts. In everyday life, our thoughts are directly connected to our emotions and our actions. As someone with an addiction, your irrational thoughts around drinking or using mostly come from your addicted brain. Thoughts are very important to notice and understand, because when we encounter a trigger- or any stressful or unexpected situation- the way we think about it dictates the way that we cope with it (Marlatt and Gordon 1985). He has been abstinent from alcohol for two months and is doing well in his recovery. Scott feels devalued by his boss, leading him to feel inadequate both personally and professionally. Ideally, Scott would respond to this with some positive coping skills, like finding a healthy outlet for the emotions that this feedback from his boss brought on. He might try to resolve things with the client who is upset, and find a way to communicate with his boss constructively to improve his standing at work. You might notice as you look at each of his thoughts that he is not stepping back from the situation to try and evaluate whether there is anything constructive about the feedback his boss gave him, or whether there is a way to get some resolution to the problem. Instead, his irrational thoughts take hold; he is quick to interpret many aspects of the situation as reflections of his own personal inadequacy. Looking at life from this irrational perspective, it is not surprising that he feels like a failure-an unlikable and unsuccessful person-and that he predicts that he will be fired.
Soft tissue wound healing at teeth treatment zollinger ellison syndrome generic 250 mg diamox with mastercard, dental implants and the edentulous ridge when using barrier membranes medicine online buy generic diamox 250 mg online, growth and differentiation factors and soft tissue substitutes treatment tinnitus buy diamox 250 mg otc. Keratinized gingiva height increases after alveolar corticotomy and augmentation bone grafting medicine lodge ks purchase 250mg diamox amex. Periodontal Accelerated Osteogenic Orthodontics: A Description of the Surgical Technique. An evidence-based analysis of periodontally accelerated orthodontic and osteogenic techniques: A synthesis of scientific perspectives. Miniscrew implant-supported maxillary canine retraction with and without corticotomyfacilitated orthodontics. Orthodontic treatment acceleration with corticotomy-assisted exposure of palatally impacted canines. Enhanced effect of combined treatment with corticotomy and skeletal anchorage in open bite correction. Does alveolar corticotomy accelerate orthodontic tooth movement when retracting upper canines? Dedicated legislative advocacy means that California dentists have more protection today and tomorrow. Patients present, provide their information, get checked in and proceed with treatment. The patient provided a name, date of birth, phone number, insurance information and Social Security number. The dentist completed the treatment without incident and the office submitted a claim to the insurance company to receive payment for services rendered. The office staff realized they had been given false information when they received a call from the individual whose Social Security number and insurance information were used to obtain treatment. The caller questioned why his insurance was billed when he was not even a patient at that practice. The office tried calling the individual who was treated, but the woman who answered stated that there was no one there by that name. Once the office realized that they did not know the true identity of the individual they treated, they contacted the Advice Line for guidance. The Risk Management analyst advised the dentist not to release any information about the mystery patient to the individual whose identity was stolen. The analyst also recommended that the dentist file a police report and report the incident to the dental benefits plan provider. This case illustrates the unfortunate reality that medical identity theft has made its way into the dental office. According to the Ponemon Institute, a private cybersecurity research firm, more than 2. Patients report a lack of trust in their medical providers for failing to protect their private data. According to the Federal Trade Commission, medical identity theft stems from several scenarios. The most common are data breaches within medical care providers, where thieves gain access to medical data systems, and "friendly fraud," where someone known to the victim assumes his or her identity. Another type of scenario is one wherein thieves target unsuspecting individuals by posing as an employee of an insurance company, pharmacy or medical or dental office and asking for personal information, including plan numbers or Social Security numbers. You are a dentist deserving of an insurance company relentless in its pursuit to keep you protected. Conducting comprehensive background screenings and random audits of charts and billing activity for any friends or family members who have been seen in the office can go a long way in catching and thwarting illegal activity. Therefore, it is imperative to instruct employees to ask for photo identification as patients present. Most dental patients are already familiar and comfortable with providing photo identification when visiting their medical care providers. Some offices take photos of their patients, making it easier to identify patients when they arrive. If patients are hesitant to have their pictures taken, reassure them that it is only for internal use and will not be posted on social media or used for any marketing purposes. Let them know of your commitment to protect their personal information and prevent fraud. When training your staff on spotting possible fraudulent patient activities, some red flags to look for are: Questionable or altered documents or signatures. Refusing to present identification or provide identifying information when requested. An accompanying individual addressing the presenting individual with a different name. It is not advisable to refuse treatment; instead, inform the patient that there are discrepancies that need to be looked into further and then make other arrangements for payment until the issue is resolved. In addition, ensure that your staff is trained to educate patients on best practices for keeping their private data private. For example, patients should be informed that your staff will never ask for Social Security numbers or dental benefit plan numbers over the phone, so if they receive unsolicited calls from people requesting this information, they should hang up immediately. Remind patients to carefully review statements from insurance companies to look for suspicious or unauthorized treatments or payments. Medical identity theft is a multifaceted, complex crime and it takes the diligence of all players - medical and dental professionals, patients, insurance providers and law enforcement - to halt its progress. To schedule a confidential consultation with an experienced risk management analyst, visit tdicinsurance. Bank Practice Finance is your provider for customized practice financing that may help your business grow. Bank Practice Finance Competitive fixed rates Term up to 10 years 100% financing options on acquisitions No prepayment penalty options Contact a practice finance specialist today. Bank National Association and are subject to normal credit approval and program guidelines. Beautiful and modern 1,465 square foot facility with 4 fully-equipped operatories. Approximately 1,600+ square feet with five (5) fully-equipped operatories set up for right hand delivery. There is a reception area, business office, consult room, staff lounge, lab, sterilization area, private office and separate storage area. Practice has approximately 1,200 active patients with new patients accepted on a selective basis. Great opportunity for a skilled dentist to take over a 35 year practice with seasoned staff and loyal patient base. Russell Okihara Jim Engel Kerri McCullough Gina Miller Jaci Hardison Steve Caudill Thinh Tran 1. These are found in the California Code of Regulations Title 8 Chapter 4 Subchapter 1 Unfired Pressure Vessel Safety Orders, Subchapter 3 Compressed Air Safety Orders, Subchapter 5 Electrical Safety Orders and Subchapter 7 General Industry Safety Orders and can be viewed on the Department of Industrial Relations website, dir. Employers should be aware of other occupational safety regulations applicable to dental facilities. Alternate protection must be provided when portable extinguisher is removed from service for maintenance and recharging. Empty and recharge every six years a stored pressure dry chemical extinguisher that requires a 12-year hydrostatic test except if it has a nonrefillable disposable container. Hydrostatic testing performed by a trained individual with suitable testing equipment and facilities. Mount extinguishers on the wall and identify and maintain them in a fully charged and operable condition. Selection and distribution of fire extinguishers within the dental facility must be based on type of fires anticipated in the work place. Fire Classification Extinguisher Type Class A fires include wood, paper and textiles - place extinguisher every 75 feet or less. Class B fires include flammable liquids - place extinguisher every 50 feet or less.
Disciplined licenses for dentists are public records and a quick check will show that the proportion of disciplinary actions in some states treatment quincke edema generic diamox 250mg otc, such as California medicine used for uti buy generic diamox 250 mg line, is two or three times the rate in other states treatment yersinia pestis buy cheap diamox 250 mg online. Phone conversations with responsible agents indicate that many states simply lack sufficient enforcement resources and others try to suppress information about inconvenient facts z pak medications order diamox 250 mg otc. Several billboards appeared in 2016 in another state asking motorists to consider whether their dentist was honest. The phone number of the state association was displayed at the bottom of the message inviting drivers to phone and find out. I know exactly what happened, but no one I talked with in the state or nationally seems to have any knowledge of this ethical secret. There are two levels of ethical knowledge: What one knows and what one is allowed to know. These are tough cases, but generally it works well to keep the secret when there is a potential for harm to others. If it is really a tight situation, confront the person or organization that is responsible for the gag order and challenge them to be ethical. The reputation of the profession matters just as the reputation of its members does. It is a double ethical challenge to act based on what we know unless we have permission to know that sort of thing. Ethical principles are sometimes used as an excuse to cover systemic ethical weakness. Dugoni School of Dentistry, San Francisco, and the editor of the American College of Dentists. The nanoparticles break apart dental plaque through a unique pH-activated antibiofilm mechanism. Because cariescausing plaque is highly acidic, the new therapy is able to precisely target areas of the teeth harboring pathogenic biofilms, without harming the surrounding oral tissues or microbiota, according to the study. Though some scientists have questioned whether coatings used on ferumoxytol and other nanoparticles used for medical applications would render them catalytically inert, the researchers demonstrated that they maintained peroxidase-like activity, activating hydrogen peroxide. After testing the ferumoxytolhydrogen peroxide combination on a 610O C T O B E R 2 01 8 Preoperative oral care by a dentist may help reduce postoperative complications, such as pneumonia that may be caused by aspiration of oral and pharyngeal secretions, in patients who undergo cancer surgery, according to a new British Journal of Surgery study conducted by Miho Ishimaru, PhD, of the department of clinical epidemiology and health economics, School of Public Health at the University of Tokyo in Japan. The retrospective cohort study was undertaken to assess the association between preoperative oral care and postoperative complications among patients who underwent major surgery for head and neck, oesophageal, gastric, colorectal, lung or liver cancer between May 2012 and December 2015. Of 509,179 patients studied, 16 percent received preoperative oral care from a dentist. After adjustments, preoperative oral care by a dentist was linked with a decrease in postoperative pneumonia (3. While scientists know much about the bacteria Streptococcus mutans, which also causes cavities, little has been known about S. The research was published in the journal Microbiology Resource Announcements in June 2018. Jensen and his students are building computational models to better understand how the two bacteria interact and why S. Additionally, nearly three-quarters of surveyed older adults would support limits on how many opioid pills a doctor could prescribe at once. And even more supported other efforts to limit exposure to these medications and potentially combat the national epidemic of opioid misuse due to medication diversion, according to the poll. The poll results suggest that health care providers who prescribe or dispense opioids should do more to help patients understand how to safely use and dispose of them, in language that patients understand, the article states. This should include a disposal plan that helps patients understand why and how they should dispose of extra medications. Similarly, we need to educate our patients on what to expect following pain, the role and risks of opioids and important alternatives such as overthe-counter analgesics, breathing, exercise and sleep," Dr. Tobacco use remains a leading cause of oral cancer but the tobacco landscape is evolving with increasing use of noncigarette tobacco products and dualuse of multiple product types. Data was analyzed from the Population Assessment of Tobacco and Health, which included a sample of U. Those in their late teens and 20s had the highest odds of persistent opioid use, compared with those of middle-school and high-school age, the researchers report in a research letter published in the August 2018 issue of the Journal of the American Medical Association. We now see that a sizable number go on to fill opioid prescriptions long after we would expect they would need for recovery, and the main predictor of persistent use is whether or not they fill that initial prescription. Participants were categorized according to use of combustible, which includes cigarettes, cigars, water pipes, pipes, blunts (marijuana-containing cigars), smokeless, which includes moist snuff, chewing tobacco and snus, e-cigarettes and nicotine replacement products. For each product, recent use was defined as within the prior three days and non-use defined as none within 30 days. The findings, published in August 2018 in the Journal of Dental Research, came from a review of 33 academic papers on starch and oral health. Although researchers found no association between the total amount of starch eaten and tooth decay, they did find that more processed forms of starch increased the risk of cavities. This is because they can be broken down into sugars in the mouth by amylase found in saliva, according to the research. Further findings, although based on Doctors Prescribed Fewer Opioids After Learning of Patient Overdose A study published in the journal Science in August 2018 found that when a clinician learned one of their patients had suffered a fatal overdose, they reduced the amount of opioids prescribed by almost 10 percent in the following three months. The study leveraged behavioral insights and psychology to give prescribers personal experience with the risk associated with opioids. Doctor and his colleagues conducted a randomized trial between July 2015 and June 2016 of 861 clinicians who had prescribed to 170 patients who subsequently suffered a fatal overdose involving prescription opioids. Half the clinicians were randomly selected to receive a letter from the San Diego County medical examiner notifying them that a patient they had prescribed opioids to in the past 12 months had a fatal overdose. The letter, which was supportive in tone, also provided information on safe prescribing guidelines from the Centers for Disease Control and Prevention, nudging clinicians toward better prescribing habits. Furthermore, clinicians who received the letter were 7 percent less likely to start a new patient on opioids and less likely to prescribe higher doses. Paula Moynihan, PhD, professor of nutrition and oral health at Newcastle University, U. In the review, 33 papers were included of studies on foods containing what were characterized as rapidly digestible starches. Free sugars are sugars that are added to foods by the manufacturer, cook or consumer, plus those naturally present in honey, syrups, fruit juices and fruit juice concentrates. O C T O B E R 2 0 1 8 613 introduction C D A J O U R N A L, V O L 4 6, Nє 1 0 To Graft or Not To Graft? He is the former editor of Periodontal Abstracts and past president of the California Society of Periodontists and the Western Society of Periodontology. Nagy, a diplomate of the American Board of Periodontology, is currently the vice president of the California Dental Association. P atients present to our practices with either localized or generalized gingival recessions that they may or may not be aware of. These patients usually are most concerned about the effect the recessions have on aesthetics and/or they are dealing with sensitivity issues on these teeth. Then there is you, the dental practitioner, who feels teeth with recessions as well as teeth with thin unattached tissues regardless of recession need to be addressed due to concerns for either tooth loss or restorative issues. These patients are typically not aware of their recessions or mucogingival problem. As a periodontist, I often get questions from general dentists and dental hygienists on when to perform gingival grafting: Who are the acceptable candidates, what are the treatable defects and what are the available and most predictable techniques? It is important that not just the periodontist but all members of the dental team understand the thought process of how to address recessions and other mucogingival defects so that all dental practitioners can help explain to patients the diagnosis and treatment options for the best and most predictable outcomes, whether the clinician will be doing the corrective procedure or referring the case to a specialist. These treatment modality papers attempt to discuss surgical technique and posttreatment outcomes. Cases are used to emphasize the appropriate use of surgical approaches and to provide readers with examples of the aesthetic improvements. It is hoped this issue will provide readers with a greater understanding of the diagnosis, treatment planning and treatment modalities associated with recessions, mucogingival defects without recession and gingival grafting. The 2012 National Health and Nutrition Examination Survey study reported a prevalence of gingival recession in 50 percent of those aged 18 to 64 and that 88 percent of those 65 and older have at least one site.
Diseases
3C syndrome, rare (NIH)
Aplasia cutis congenita recessive
Cataract congenital with microphthalmia
Cassia Stocco Dos Santos syndrome
Apraxia, Ideomotor
Acute idiopathic polyneuritis
If colds or flu tend to trigger your asthma symptoms rheumatoid arthritis diamox 250mg amex, your health care provider can recommend asthma medications to begin taking early during the viral infection to help prevent an asthma episode symptoms after conception buy diamox 250 mg cheap. For colds in children medicine abuse discount 250mg diamox amex, call for advice if fever persists and cold symptoms are very bothersome after three days medications 1 buy diamox 250mg low price. Irritants Are not resolved after 14 days Keep healthy with nourishing foods, lots of fluids, regular exercise and plenty of sleep It may be impossible to prevent getting a cold, flu or other upper-respiratory infection entirely Avoid close contact with those who have colds or flu, especially during the first few days of illness Wash your hands regularly Ask your doctor if you should get a flu shot in the fall of each year; remember that flu immunizations provide protection against the strains of influenza present that year only and must be repeated each fall Asthma symptoms are aggravated by many factors, both outdoors and indoors. Examples of irritants include: Smoke from tobacco or wood Various dirt particles in the air Viral infections generally must take their own course. Using a decongestant, however, may help relieve stuffiness and congestions that can irritate your asthma. As with allergens, you can use an asthma diary to help you identify which irritants, if any, tend to trigger your asthma. Tobacco smoke is a particular concern, especially in homes with children who have asthma. Studies have shown that very young children who live in homes where someone smokes are more likely to develop asthma and to have asthma episodes that require emergency room care. School-age children also have more school absences if parents or other members of the household smoke. In addition, smokers themselves are known to develop more frequent upper-respiratory infections. Short of packing up and moving to Arizona, those with asthma can prepare for fluctuations in the weather by dressing appropriately. In very cold or windy weather, wear a scarf or face mask over your mouth to ward off cold blasts. Watch the weather reports, and avoid strenuous outdoor activities on days when the pollution level is high. Exercise the most common activities that can cause an asthma episode are aerobic activities, such as jogging or cross-country skiing, which involve continuous movement sustained over a long period. This air is colder and drier when it reaches the lungs than air that is inhaled through the nose. In those with exercise-induced asthma, the colder, drier air acts as an irritant to the lower airways, causing them to spasm. Brisk walking can provide aerobic exercise without the need to breathe through the mouth. Swimming is often recommended as one of the best aerobic activities for people who have asthma. Though it does involve breathing through the mouth, the surrounding water tends to humidify the air, making swimming less likely than other activities to trigger asthma. If you choose to jog or participate in activities that can trigger your asthma, ask your health care provider to recommend pretreatment medications to avoid asthma episodes, then allow yourself an adequate warm-up period. Be sure to have appropriate medications available in case you have an asthma episode. Aspirin and other anti-inflammatory medications In years past, exercise-induced asthma led people to believe that those with asthma could not participate in sports or physical activities. We now know that by carefully choosing activities and using pretreatment medications when needed, people who have asthma can be just as physically active as anyone else. Read labels carefully, or ask your pharmacist before taking any non-prescription medication, especially pain relievers and cold remedies. Choose products containing acetaminophen (Tylenol) for treating fever or pain, such as headaches. In reality, however, the emotions themselves are not the direct trigger; rather, the asthma episodes occur as a result of more rapid or heavier breathing brought on by crying, laughing or feeling anxious. Draw in a deep breath through your nose, and hold it for five seconds (count to five slowly). Slowly count to eight while inhaling through your nose (count "1-and-2-and-3-and," to eight). If you are breathing as you should from your diaphragm, your chest should barely move, but your abdomen will expand and contract. Practicing stress management techniques can be an effective way of reducing asthma episodes triggered by emotional upset. Both techniques involve deep diaphragmatic breathing (breathing from the diaphragm, so your abdomen - not your chest - moves in and out). In addition to promoting relaxation, these techniques are useful during asthma episodes to help you get more air while waiting for medications to begin working. You will be able to use these techniques best during asthma episodes or times of emotional upset if you practice them regularly during non-stressful times. Relaxation techniques Here are some specific techniques that can aid in relaxation and stress management. The more you practice these relaxation techniques, the more they can help reduce asthma episodes. Daily practice, especially at first, will help make these relaxation techniques become second nature for you. When this happens, it will be even easier for you to use the techniques when you need them most - during an asthma episode or when you are under a lot of stress. Parents can coach their children through these exercises and encourage them to use them if they feel an asthma episode beginning. A written asthma management plan can also offer reassurance and confidence for people with asthma. Just knowing that you can effectively treat the episode and continue to breathe can help prevent an episode from worsening because of fear. Once you know what triggers your asthma, you can begin to find ways to avoid triggers. Allergic triggers House dust (dust mites) Seasonal allergens - pollens from trees, grass, ragweed or other plants Mold outdoors, mildew indoors Other Irritants Tobacco smoke Weather conditions - extremes or sudden changes in temperature, barometric pressure or humidity Air pollution Indoor pollution (smoke from fireplaces or wood-burning stoves; fumes from building products, carpeting, paint; etc. A good asthma management plan should be able to reduce the severity and frequency of asthma symptoms, as well as prevent unscheduled visits to the doctor or hospital. This inexpensive, hand-held device measures the maximum or "peak" speed at which air can be exhaled from the lungs. During an asthma episode, the peak flow is slowed because the airways are constricted and partially blocked. As early as 24 hours before asthma symptoms appear, your breathing capacity may already begin to drop. The peak flow meter can detect this drop so that you can start taking appropriate medications before wheezing or coughing even begins. Some people are very good at recognizing early signs of asthma episodes and treating them appropriately. Early detection of an asthma episode can also make it easier to identify your asthma triggers. Learning self-care techniques, including when and how to use medications, puts you in control of your asthma. A routine peak flow measurement taken on Saturday, however, may make it easier to identify the real trigger. Peak flow meters can help you recognize triggers that otherwise might be overlooked. Even some children as young as three years old can learn to use a peak flow meter. Your health care provider may initially recommend that you take a peak flow meter reading two or more times a day. Usually the readings are taken right after waking up in the morning and again before going to bed. You may also be asked to take a breath before and after taking inhaled medications. Hold the peak flow meter, being careful not to block either the mouthpiece or the air exit. Repeat steps 1 through 7 two more times (unless the test has provoked a coughing attack).
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Annual smoking-attributable mortality, years of potential life lost, and productivity losses-United States, 1997-2001.
