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Allied Health: Articles of Interest Asthma and the College Student Going off to college and living independently can be a challenge to any student, especially those with a chronic disease like asthma that requires self-management. Before heading off to college, students with asthma and allergies should prepare by scheduling a visit with their allergist to review allergy skin test results and asthma triggers, and prepare an Asthma Action Plan. Knowing specific allergy triggers will help students make good choices when checking into the dorm or moving into a new apartment. Roommates with cats, apartments with a previous cat-owning occupant, cigarette smoke, mold in the ceilings, floors or cabinets, a lack of air conditioning, or gas furnaces or appliances can all lead to “allergy trigger hell” for students with asthma. Frequently, students are so excited about living on their own or with a group of friends that they ignore their known, significant asthma triggers. They move in anyway, only to spend the semester staying elsewhere or needing to visit the doctor frequently because of very active and unmanageable allergy and/or asthma symptoms. If you’re a student, you and your allergist will want to work together to prepare an Asthma Action Plan so you can step up your prescribed asthma medication promptly as soon as warning signs signal that your asthma is increasing. These early signs can include waking from sleep and needing to use an MDI, a decreased tolerance for exercise or an increased need to use rescue medications in addition to your controller medication. Monitor your breathing. Peak expiratory flow (PEF) monitoring with a peak flow meter is the cornerstone of the Asthma Action Plan. Peak flow should be checked several times a week when symptoms are very stable, but should be monitored more frequently when asthma is acting up. When treatment is not producing significant improvements in PEF, or if symptoms are increasing and health deteriorating despite treatment, it’s time to seek prompt attention by a physician. This can help you prevent an emergency room visit or hospitalization. Be prepared. Consider having a “med case” on hand containing your essential asthma supplies and medications, such as PEF monitors, spacers, nebulizer, a copy of your Asthma Action Plan, and toll-free phone numbers (if available) to your allergist and pharmacist so medications can be refilled and advice regarding symptoms can be provided. The “med case” is intended to always be ready to travel when you are, so you won’t be caught off guard with forgotten medication or equipment. Knowing the names and doses of your medications is very helpful to student health and emergency room physicians if you need to see them when symptoms are not responding to the Asthma Action Plan. Additionally, discuss all of your medications with your allergist. Drug interactions are a major concern, so be sure to consult your physician before you decide to make changes that may greatly increase your risk of such interactions. A common drug interaction would be theophylline and erythromycin, an antibiotic. Too much partying and alcohol ingestion can also put you at high risk for a theophylline/alcohol interaction. Most newer medications for asthma utilize the topical (inhaled) route rather than the oral (pill) route. Fortunately, due to both the administration route and lower doses, your chances of a serious drug interaction and side effects are drastically decreased, while your chances of controlling your asthma are greatly increased. Know your insurance plan. Obtain insurance and prescription card copies from your parents. This information will allow you to receive medical care and refill prescriptions more cost-effectively. Discuss the medical plan with your parents so you understand which services and prescriptions it covers and what your deductible is, if any. A deductible is the amount you pay for health care or prescriptions before insurance starts to pay. Sometimes these deductibles can be quite high (such as $1,000) and could put financial stress on the cash-poor student trying to keep medications filled or see health care providers. In such situations, student health plans offered by colleges or universities can be more sensible and cost-effective, and will ensure that you are able to obtain adequate care and medications. Get vaccinated. Influenza A is a major virus affecting those with asthma. An effective vaccine is available in the fall, usually October through November. Early immunization before the flu season, namely late fall and winter in the U.S., can prevent a major asthma exacerbation. A new intranasal vaccine that will soon be available for children may also be available for adults, making it easier for those with asthma to protect themselves from the flu. Allergy vaccine shots, also called immunotherapy, are prescribed for many people with allergic asthma. These shots work only if you continue to receive them for the recommended time period. Thus, it makes a lot of sense to be consistent and regular with this treatment when you go to college. Not only will it help control symptoms in conjunction with any prescription medications you may be on, but when you graduate, you will be ready to enter the working world feeling better and ready to take on a career without persistent or recurring allergy symptoms. Take care and organize. Make sure to sleep regularly, drink plenty of clear liquids (two quarts a day is recommended), eat regular, balanced meals and get regular exercise. Although it’s “Mom talk,” these recommendations really can improve your general well-being, assist your body in fighting off acute viral illnesses and help decrease asthma flare-ups. Additionally, organization is key to reducing stress and decreasing asthma exacerbations. Ideally, students have prepared themselves for college with good study habits. Planning and completing projects and papers on time and studying regularly—not pulling last-minute “all-nighters”—for tests can significantly reduce stress and drastically reduce the possibility of acute asthma attacks. Hopefully, this information can help you put your Asthma Action Plan into full effect so that your college years will be happy and healthy. Be sure to work with your allergist, primary care physician and college health staff to ensure your asthma is optimally managed. |
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