Houston asthma rates show rural areas suffering the most Does where you live affect how well you breathe?

Data for Houston region find higher asthma hospitalization rate in rural areas

YANG WANG
, HOUSTON CHRONICLE

From Dana Janczak's home in a secluded rural area east of Cleveland, it's a 40-mile ride to the nearest asthma doctor in Kingwood, so she tries to keep trips to a minimum by stocking up on nebulizers: four in her house and two in her car.

Janczak is one of 25 million Americans who suffer from asthma, but what distinguishes her and other rural residents in the Houston region — which has the highest prevalence of asthma in Texas — is that, despite her best efforts, she still has ended up in the hospital three times.

A Houston Chronicle analysis of state health records found that rural Cleveland in Liberty County has the highest rate of hospitalization for asthma-related conditions in the 10-county region. In the Houston area overall, nearly 10,000 people were hospitalized between 2007 and 2009 for asthma, according to data provided by the Texas Department of State Health Services.

"We had to live in the ER for a while," Janczak recalls of her most serious attack in 2007. "I felt like my airway was closed. I heard my husband's voice was getting farther and farther away."

Liberty County health professionals say several factors contribute to the elevated hospitalization rate, such as a high percentage of smokers and the fact that much of the area is densely covered by woods and their naturally aggravating allergens. But the primary factor, they say, is likely the lack of access to medical care.

"We have few pediatricians in Liberty," said Alexis Cordova, president of the Liberty County Health Awareness Coalition. "We have limited health care, which means people don't take their children to doctors as often so their respiratory problems become more serious."

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Pediatric Asthma, Pulmonary & Sleep Specialist Serves Houston Suburbs with Personal Attention - Dr. Sarat Susarla joins Texas Medical & Sleep Specialists

Houston is the fourth-largest city in the country, but the suburbs continue to face a shortage of full-time pediatric specialists. Texas Medical & Sleep Specialists proudly announces that Dr. Sarat Susarla has stepped into that void to meet the needs both of infants as well as children/teens with asthma and other lung disorders.

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Working closely with families and primary care doctors while providing timely access, we can make a difference.

Houston, TX (PRWEB) July 23, 2012

Imagine driving your distressed child with asthma through 1 to 2 hours of traffic to see her specialist. Until the summer, patients and families had to face an hour or more traffic to access pediatric specialists in the Houston medical center. No more.

Texas Medical & Sleep Specialists is proud to announce that Dr. Sarat Susarla has joined our practice to provide both pediatric pulmonary & asthma care as well as sleep medicine services to the Greater Houston area.

With dual board certification in pediatric pulmonology and sleep medicine, Dr. Susarla cares for young people with a wide spectrum of respiratory disorders. Dr. Susarla welcomes consultation for infants, children, and young adults with asthma, chronic cough, wheezing, pneumonia, exercise intolerance, and respiratory problems related to prematurity.

Dr Susarla brings an expert perspective to asthma care, “I want to work with parents and community physicians to get children with asthma out of the hospital and emergency room. Working closely with families and primary care doctors while providing timely access, we can make a difference.”, said Susarla.

A pediatric pulmonologist specializes in a wide range of common and rare respiratory disorders. Dr. Susarla describes the scope of his work “Asthma is very common, but chronic respiratory problems in kids can have numerous causes. Sometimes children have symptoms very similar to asthma, but it turns out their real diagnosis is actually very different.”

Dr. Susarla offers advanced onsite lung function testing, exercise testing, as well as same-day urgent appointments. Dr. Susarla is the only private pediatric pulmonologist serving The Woodlands, Sugar Land and Memorial / West Houston area. He has staff privileges at a number of local hospitals including Texas Children's Hospital, Children's Memorial Herman Hospital, and The Woman's Hospital of Texas.

Dr. Susarla serves many of Houston's neonatal intensive care units assisting in complex cases and easing the transition to home. One of his special areas of expertise is apnea and in infancy and chronic respiratory disease in former premature infants.

Dr. Susarla also cares for children and adults with snoring, sleep apnea, excessive daytime sleepiness, and insomnia. With advanced training at Texas Children’s Hospital / Baylor College Medicine and board certification in adult and pediatric sleep medicine, he brings a unique perspective to the field as a specialist in respiratory disorders.

“We don’t recognize sleep problems in children as readily as we do in adults. They are more likely to show signs of inattentiveness and hyperactivity. Often children with sleep problems behave very similarly to children with attention deficit hyperactivity disorder (ADHD)”.

As a sleep specialist, Dr. Susarla works with a rare combination of neurology and pulmonary sleep specialists.    Dr. Susarla joins Dr. Joshua Rotenberg , pediatric neurologist. “Dr. Susarla adds breadth to our pediatric specialty team. “ said Rotenberg. “We offer a unique and personal service to our community.”

....READ MORE HERE

For further inquiries call Dr. Sarat Susarla at Texas Medical & Sleep Specialists at 713-464-4107 orhttp://www.txmss.com

Hot Sticky Summer Days Can Pose Risks for Children With Asthma

In Houston, we experience a high number of ozone days during the summer.  For some children and adolescents, prolonged outdoor exposure can trigger asthma attacks.  Watch for "ozone alert" days.  Dr. Susarla

Avoiding asthma dangers on hot, humid days

It’s been hot all week -- okay, make that all summer -- in Boston, with air quality alertsissued as the temperature and humidity level climb. Poor air quality can pose particular dangers for those who have asthma and other lung diseases.

Hot humid air traps ozone and particulate matter, which can irritate the lining of lung airways, triggering wheezing and breathing difficulties in asthma patients, according to Dr. Elliot Israel, director of the respiratory therapy department at Brigham and Women’s Hospital.

“For some patients, irritation builds over time and they experience problems after several poor air quality days, but for others it takes just one blast,” Israel said.

Asthma sufferers shouldn’t run around outdoors on humid days that hit 90 degrees or above, Israel recommended. “Don’t do a 40-minute run if that’s what you usually do. Stick with a 10-minute run in the morning and a 10-minute run in the evening.”

In fact, he offers that same advice for anyone during hot sticky weather. Humidity increases the possibility of heat-related illnesses because our body’s cooling mechanisms don’t work as well on humid days. Instead of our sweat evaporating, as it would in dry heat, it clings to our skin, trapping heat.

But it’s tough to tell a 9-year-old with asthma that he can’t play capture the flag or soccer at an outdoor summer camp for days on end.

On “yellow” air-quality days like today -- which means the air quality is acceptable for most but may pose some problems for those with lung conditions -- kids with asthma can probably continue their normal actitivities but should keep their inhaler on hand just in case they need to use it more. But if it’s a hazardous air quality day -- an orange or red on the air quality index -- they should head for sitting activities in the shade and stick to indoor exercise in an air conditioned facility, Israel recommended.

An estimated 4,500 Americans die every year from asthma attacks, including former Globe reporter Anthony Shadid.

“Commonsense is what’s needed on those bad air days,” he said, “and an ounce of prevention is worth a pound of cure.” Those who experience an aggravation of their lung condition due to the heat -- uncontrolled wheezing, shortness of breath, or an inability to speak in complete sentences -- should seek immediate medical attention.

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UK Child Dies From Fatal Asthma Attack

We don't think of asthma as a cause of death in the modern world.  Unfortunately, it still happens even though it is almost always preventable.  Dr. Susarla

MILLOM BOY, 9, DIED FROM BAD ASTHMA ATTACK

A NINE-YEAR-OLD boy died as a result of a serious asthma attack at his Millom home, an inquest heard.

Rylan Cosgrove, who was a Year Five pupil at Black Combe Junior School, died on February 21 this year.

The keen rugby player was taken by ambulance to Furness General Hospital but was already dead upon arrival.

The inquest into his death was told yesterday that he was only diagnosed with asthma in December.

Doctor Mohamed Anass Olabi told the hearing in Barrow Town Hall it was not unusual for children to be diagnosed with the condition a little later, but it was more common to have symptoms such as wheezing in their early years.

The pathologist’s post-mortem report confirmed acute asthma attack as the cause of death.

Dr Olabi said the report revealed no infection was found, but one of Rylan’s lungs was very full of mucus.

Dr Olabi said: “It’s prevented the lungs from functioning and this has caused him to have shortness of breath and not much oxygen going through the system and then he collapsed.

“I think the likelihood of what caused his sad death is lack of oxygen, which affected his heart and eventually he was not able to cope – this is the most likely.”

Dr Olabi had researched similar cases in children and studied a report, published in March this year, titled Risk Factors for Childhood Asthma Death.

The report looked at children who died of asthma in the UK between 2001 and 2006.

Half of the children who died were labelled as having mild to moderate asthma, and one was not even known to have asthma.

Most were aged 11 to 13.

Dr Olabi said: “There are some factors here that have similarities – had it late, not very unwell, admitted once to hospital, and then sadly have a very bad asthma attack.

“What I’m trying to say is, it is not unheard of.”

In 2009, 12 children aged 14 or under died in the UK from the disease.

Dr Olabi said he did not believe there was anything that could have been done differently to prevent Rylan’s death.

But he added: “It’s a sad case, but it does exist.

“And until we get full education for families and the health care people, we won’t be able to prevent this completely.

“There are 12 cases of asthma deaths in children every year and we still think, of these 12 cases, possibly half of them could be prevented, so lots of hard work needs to be done in that area.”

Mr Ian Smith, South and East Cumbria coroner, recorded a verdict of death by natural causes.

He confirmed a police investigation was carried out, but there was nothing officers were concerned about.

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Howie Mandel - America's Got ADHD and OCD

Link to Howie on 20/20 - "Hand rails are my enemy" says "Deal or No Deal" 

By JESSICA HADDAD, ERIC M. STRAUSS (@ericmstrauss) and DAVID MUIR (@DavidMuir)

Nov. 24, 2009

People know Howie Mandel as a comedian, actor and game show host. But what many fans don't know is how much he suffers from a crippling fear of germs -- something he has joked about before, but never spoken seriously about until now.

The 54-year-old "Deal Or No Deal" host suffers from obsessive compulsive disorder or OCD -- a debilitating anxiety disorder that produces inescapable repetitive thoughts.

Like many of the 4 million adults who suffer from OCD, Mandel's most frequent obsession is germs, but can manifest itself in countless ways that trigger a silent loop of the question 'What if...' in his mind.

"I'm always on the verge of death in my head," he told "20/20."

ABC News' David Muir followed Mandel for two weeks behind the scenes on the set of "Deal Or No Deal" in Connecticut, at his beautiful California home, and in his spotless Las Vegas penthouse suite at the MGM Grand, where he performs 40 nights a year.

It is quickly evident that Mandel is a gracious family man who loves to entertain, is living his dream, albeit in constant fear.

On the set, instead of shaking hands, Mandel does the fist bump -- his trademark greeting on "Deal Or No Deal" -- to work around his germ anxiety.

Courtesy Random House

Howie Mandel is going public with his struggle with his OCD in a humorous autobiography entitled, "Here's the Deal: Don't Touch Me," which hits bookstores today.

"In my mind [my hand] is like a petri dish. ... Otherwise I would spend the day, as I have in the past in my life in the men's room rubbing and scrubbing and scalding," he said.

Mandel lays out the fist bumping rules to all the contestants that stick out their hands to meet him on the show. But his OCD goes far beyond that.

Off stage, it's all consuming. His makeup artists must use brand new sponges every day. He won't touch his money unless it's been washed. He avoids hand rails like the plague. "Hand rails are my enemy. I never go near a hand rail," he said. Even Mandel's trademark bald head is this way by choice. "This feels so streamlined and so clean," he said.

At times, his "irrational" fears can strike at the most inopportune moments.

"The biggest fear I have is being triggered," he said. "And if I'm triggered and I get some sort of weird thought in my head that can't go, then my day is, is stopped. My life stops."

Mandel is going public with his struggle with his OCD in a humorous autobiography entitled, "Here's the Deal: Don't Touch Me," which hits bookstores today. He reveals the unusual set of rituals and the terrifying role that OCD consumes in his life.

"I once missed an appointment because I left my house, I locked the door. And then I thought, like anybody else, you know, I don't think I locked the door. I just kept going back to the door. And I couldn't stop myself from checking and checking," he recalls.

Mandel checked the lock 32 times before he took his fist and punched the handle.

"I thought if I felt the pain in the door, then I know for certain. But intellectually, I know I had checked the door. So why am I going back? I can't get past the thought, whether it's thoughts that go into your head. Fears. Thoughts, horrible images, or whatever," he said.

Mandel Battles OCD, ADHD as Kid

Born and raised in Toronto, Mandel grew up in a self-described loving family. As long as he can remember, he had an unhealthy fear of germs. He said kids made fun of him because he couldn't tie his shoes.

"Well, I could, but I didn't want to touch it. But I don't want to say I'm afraid to touch it because it's dirty, so I didn't," he recalled.

Howie Mandel on Dr. Drew

OCD Story part 1


Part 2