Hello Nurse Red, welcome back.
I know that I have posted about this before, but I am especially concerned about asthma on the road, because of the fact that OTR drivers are at times very far away from a medical facility if they are in desperate need of treatment (it's happened to me plenty of times).
What are some tips, or advise you can give for those who have asthma, and are in the middle of nowhere with no medical facility around? Is it possible for a driver who has chronic asthma to have a nebulizer machine with medicine on the truck?
Erik.
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"There is no reason for any individual to have a computer in their home"
-Ken Olsen, CEO of Digital Equipment Corp. 1977
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This is an interesting question Eric.
The reason I say that is because in the 5+ years that my clinic has been in operation, I can't recall one driver with an asthma attack.
My guess would be that most suffering from asthma would carry the prescription inhaler best suited to their needs. But we have never had a driver even ask for a refill of a current prescription inhaler.
In 391.41 (b) (5) It clearly states that a driver with an established medical history or clinical diagnosis of a respiratory dysfuntion that may interfere with the ability to safely operate a CMV shall not operate a CMV.
Now, unless you are having an asthma attack while undergoing a DOT exam or you admit to the examining physician that you have chronic asthma, they will not know.
If you were to be inspected while carrying a nebulizer in your truck, and the inspector finds it, you may very likely be placed out of service. Same goes for the inhalers if you got an inspector that was a real stickler.
Most chronic asthmatics know what triggers their attacks and will go to great lengths to avoid those triggers. Many are related to undiagnosed or untreated allergic reactions.
Many develop asthma secondary to some other respiratory infection.
There are many new medications on the market for the control of asthma these days. Talk with your Dr. about those to see if they are appropriate for you.
As soon as you develop a cold, seek treatment right away to prevent the development of a situation that will trigger an asthma attack.
A driver who finds themselves far from any medical facility and in the throes of a severe asthma attack should radio for help immediately or dial 911 on the cell phone.
Tell us how you have dealt with your asthma as an OTR driver. I am sure you have some valuable info to share with us.
And Thanks for the welcome back.
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Keeping you safe, healthy, and on the road.
Nurse Red
Visit us at www.Truck.net/abmsVisit us at
Answer
There are several problems with asthma, and yes, I have seen drivers suffer an attack.
There are two problems. One is the air hunger and difficulty breathing.
You can always pull over and use the nebulizer. It has to be shaken, held in the proper position, then you exhale completely, spray once or twice as you inhale, and then hold your breath for several seconds with the lungs fully expanded. Keep an alcohol swab/wipe handy to clean the mouthpiece.
There are other treatments for asthma, including some "little pills" which I won't mention by name because I don't want to encourage their use. They do work, but have the side effect of ocasional muscle spasm in the chest which can be so severe you can't move.
The second more serious problem takes place when an asthmatic coughs to remove the secretions. This can trigger what is termed a vaso-vagal syndrome, significantly temporarily lowering the blood pressure and causing momentary blackout. Not the best thing to happen at sixty miles per hour with 80,000 pounds behind you on a dark night. In addition to the possible loss of consciousness the drop in blood pressure reduces oxygen to the optic nerve and your night vision turns to doo-doo for five or six seconds. This problem is likely to develop with older drivers, but can happen at any age.
Many doctors treat asthmatics "one dimensionally", failing to recognize that you can have asthma and a viral lung infection that doesn't show up on an x-ray for example.
The general rule is (1) clear fluid coughed up probably entirely asthma (2) slight yellowish to purulent yellow, bacterial infection (3) milky to solid white, probably viral infection.
Prednisone has fallen into disfavor for asthma treatment, as have all corticosteroids, but between me, you and the wall a very OCASSIONAL prednisone tablet can be very helpful in breaking up an attack.
Asthmatics have one interesting thing going for them in that they have the lowest cancer rates, probably because they have such active immune systems.
[This message has been edited by newyorktwo (edited March 22, 2000).]
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Thanks for that info, and I feel pretty much the same about editing posts. I also figure if you don't use foul language, you are OK.
In the last 2 years of my trucking career, I found myself having problems almost every other day, and I would have these problems mostly in a rural area where there weren't any medical facilities nearby. In my cases, I would always carry my inhalers. They included, but were not limited to:
- Albuterol/Proventil
- Flovent
- Serevent
A doctor once prescribed me Prednizone, but I hardly took it, because I didn't think it would be safe while operating an #80,000 pound vehicle at 60-75 MPH, day or night. I also studied very closely any of the possible side effects, and wouldn't take them if they gave me the slightest discomfort. I have been prescribed Theophiline before, but I couldn't take it because of the severe nausea that came with it, and they usually never did any good. Normally, none of the medications helped except for the Albuterol/Proventil, and that is what I took when I had any trouble. I also found myself going to emergency about once every 3-4 weeks during the last 4-5 months of my trucking career, and the company was screaming at me to "do something about my asthma", like that was really easily possible. [IMG]http://www.truck.net/bbs/mad.gif[/IMG]
Here are some things I would do to keep my asthma from getting to badly out of hand:
- Stay away from the smoking section when in a restaurant, and quitting smoking if you still do (easier said than done of course)
- keep the truck extremely clean, and as free of dust as possible. Usually an electronic dust eater does most of the trick
- keeping the truck ill-maintained, and full of exhaust leaks can play a major roll in triggering asthma, so I would have the truck "red-tagged" by company maintenance for a full inspection, and fixed if there were problems of any kind.
- Stay away from the truck shops if you can. If your truck must be in the shop, see if shop personnel can take it in. If not, get in and out of there as quickly as possible.
- Eating right, that means no grease, and lots of fruits, vegetables, and salads (I know, that's easier said then done)
When I found myself near a fuel refinery, or any other facility that put out lots of exhaust, I would have to put a towel over my nose and mouth, and just bear it until I was out of there. If in a truckstop where it is muggy, and the air is full of diesel exhaust, I would keep the windows closed tight, and leave the A/C on very lightly. All of this would help me in a way, but I'm not guaranteeing that it would help any other driver here, since all cases are different.
Erik.
Answer
Thanks for that info, and I feel pretty much the same about editing posts. I also figure if you don't use foul language, you are OK.
In the last 2 years of my trucking career, I found myself having problems almost every other day, and I would have these problems mostly in a rural area where there weren't any medical facilities nearby. In my cases, I would always carry my inhalers. They included, but were not limited to:
- Albuterol/Proventil
- Flovent
- Serevent
A doctor once prescribed me Prednizone, but I hardly took it, because I didn't think it would be safe while operating an #80,000 pound vehicle at 60-75 MPH, day or night. I also studied very closely any of the possible side effects, and wouldn't take them if they gave me the slightest discomfort. I have been prescribed Theophiline before, but I couldn't take it because of the severe nausea that came with it, and they usually never did any good. Normally, none of the medications helped except for the Albuterol/Proventil, and that is what I took when I had any trouble. I also found myself going to emergency about once every 3-4 weeks during the last 4-5 months of my trucking career, and the company was screaming at me to "do something about my asthma", like that was really easily possible. [IMG]http://www.truck.net/bbs/mad.gif[/IMG]
Here are some things I would do to keep my asthma from getting to badly out of hand:
- Stay away from the smoking section when in a restaurant, and quitting smoking if you still do (easier said than done of course)
- keep the truck extremely clean, and as free of dust as possible. Usually an electronic dust eater does most of the trick
- keeping the truck ill-maintained, and full of exhaust leaks can play a major roll in triggering asthma, so I would have the truck "red-tagged" by company maintenance for a full inspection, and fixed if there were problems of any kind.
- Stay away from the truck shops if you can. If your truck must be in the shop, see if shop personnel can take it in. If not, get in and out of there as quickly as possible.
- Eating right, that means no grease, and lots of fruits, vegetables, and salads (I know, that's easier said then done)
When I found myself near a fuel refinery, or any other facility that put out lots of exhaust, I would have to put a towel over my nose and mouth, and just bear it until I was out of there. If in a truckstop where it is muggy, and the air is full of diesel exhaust, I would keep the windows closed tight, and leave the A/C on very lightly. All of this would help me in a way, but I'm not guaranteeing that it would help any other driver here, since all cases are different.
Erik.
Answer
It sounds like you have been good medical treatment Eric. And you give good advice. You are better off without theophiline, because it can be a very dangerous medication, particuliarly from a cardiogenic standpoint.
I have a special interest in this area because this week I cannot work because of guess what---asthma. I had a severe lung infection (pneumonia) cleaned up by anti-biotics, several weeks elapsed, and suddenly I developed asthma. The asthma has come and gone several times over the last fifty years of my life, sometimes disappearing for years. I don't have to tell you what a severe attack is like, and my bosses are not very happy I have made myself unavailable for work. The good news is it has been getting better over the last two days.
Prednisone has a bad rap for two reasons. Long term use has a psychiatric component, making some people behave bizarrely. It makes people lash out at others. The other thing is the corticosteroids have been overused and long term use leads to a high probability of a malignancy. Long term use is defined as every day for seven to twelve months.
That being said, It is important to stop the syndrome, which can take place when an antigen is sensed in the alveoli. Prednisone works exceedingly well in this respect and it should in no way affect your ability to operate a truck safely provided it is only used ocassionally. More importantly overuse of the inhalents affect ventricular irritability. This means that there tends to be an increase in odd electrical patterns in the heart. Sometimes these irregular electrical patterns associate themselves with irregular contractions and what are called premature venticular contractions, especially when the inhalers are used with excessive caffeine.
I have some other interesting information. An asthmatic attack can become conditioned, just as Pavlov conditioned his dogs to salivate at the flash of a light. If you pair a stimuli long enough, an association develops.
In many cases asthma can be complicated by insulin syndromes. Insulin syndromes may be triggered by high-carbohydrate meals, and greasy foods.
Insofar as the inhalers go you should vary the type of inhaler, using one for a week or two, then switching. This is because there is some evidence a tolerance to the dilation affect can develop with continuous use of one type.
You should also get a prescription for a good cough suppressent and carry that around.
If you have your own rig you should probably invest in a regulator and a small E-tank to stick in the sleeping compartment.
Here's another interesting item. In many apartment buildings with old-fashioned steam heat the water treatment companies dump chemicals in the steam boiler to prevent bacterial growth. These become aerosolized and shoot out the steam vent and in some cases can cause - guess what - an asthmatic attack.
Answer
Oh, I almost forgot passing on an asthmatic remedy I got from an old time physician. Aspirin. It is a systemic anti-inflamatory. The disadvantage is gastric irritation and you lose a half teaspoon to a teaspoon of blood per tablet. I have known Arthritics to take up to eight tablets a day but I wouldn't go more than four. You can also try NSAIDS (non-steroidal anti-inflammatory agents).
The aspirin was helpful to me.
You might also think about keeping a bottle of eye-wash solution around. The reason being is that in addition to the lungs the mucosal membrane on the eye is very sensitive to antigens, particuliarly pollin. In some asthmatics a systemic reaction takes place. Anyways you want to wash the eyes out (which takes place in some measure due to tearing) as soon as possible.
One thing all asthmatics have to be careful of is exposure to MACE, which some drivers carry in the glove compartment. This definitely the bad news bears. I have documented deaths from exposure to CS, the particulate (a powder) that is dispersed in the solution.
Incidentally I wouldn't mind nurse Red clipping my posts, but I would object to Monty, or any non-medically qualified individual. In this case, for example, after the post was altered by somebody with half a bag on, the next thing you know I'd be reading about how MACE is helpful for asthmatics. IT IS NOT!
I refrained from posting here for a while in sympathy with Nurse Red.
Answer
Not to start a fight,but I have an observation and a question, first the observation;
as quoted by NewYorktwo:
And P.S. My position on altering my posts is the same as Nurse Red. One words gets changed in
this forum and I'm out of here with a tort suit in the mail against Truck.net.
Sorry to inform you, but you don't have a tort case. This forum, BBS, and whatever is basicly private property. You should know that going in. Perhaps Nurse Red has a "no change" deal, but I don't think if your posts are altered it would be actionable.
Now the question, a lot of what you are dispensing sounds like medical advice, as opposed to the friendly category. Are you a health care practiconer? If so, are you operating under the guidance of a licenced physician? Without going into detail and research, there have been a time or two that, IMHO, your advice has been borderline questionable, and unless you are willing to jeprodize a lawsuit yourself, or against the board you might want to rethink your postings, or at the least place some manner of disclaimer at the end.
I'm not looking to pick a fight here, just trying to look out for the best interests of everybody (its kinda like a disease, ya know)
Psycho
Assistant golf pro, part time trucker, and retired Paramedic.
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NY2 and Eric, Thanks for sharing your asthma experiences with us. As all can see, there are many varied plans of treatment for asthma. Just as there are many varied causes and triggers of asthma.
What may work for one person, may not work for another.
Many of the remedies offered here (with the exception of references to prescription medications) may help with asthma symptoms. They certainly can't hurt. Eye wash and Aspirin are fairly benign and are worth a try.
Keep in mind with the Non-steroidal anti-inflammatories (NSAID's) and Aspirin, while they are sold over the counter, their one common adverse property is the stomach irritation. If you have any type of stomach problems, use the enteric coated versions.
Inhalers and Prednisone use should only be considered when prescribed and managed by a physician. They too have side effects, which NY2 has appropriately pointed out, which can compromise cadiac activity. Sometimes it is a situation of trading the 'devil for the witch' but that decision is best made with the guidance of your physician.
When purchasing a cough suppressant, be sure to look for one that is also a decongestant and expectorant. Oh yeah, try to purchase one that is alcohol free.
Great question Eric, hope you have gained some helpful ideas from this thread.
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Keeping you safe, healthy, and on the road.
Nurse Red
Visit us at www.Truck.net/abmsVisit us at
Answer
It goes without saying I am not a physician and I personally advise for the official record for anyone to see and seek the guidance of a licensed physician before taking medical advice from anyone. Let that be said now, once and for all.
[This message has been edited by newyorktwo (edited March 22, 2000).]
Answer
Tort
A civil (as opposed to a criminal) wrong, other than a breach of contract. For an act to be a tort, there must be: a
legal duty owed by one person to another, a breach (breaking) of that duty, and harm done as a direct result of
the action. Examples of torts are negligence, battery, and libel (see those words).
I am indeed impressed that you were able to generate 37 K of income for an attorney. How did you make out in the end of that matter?
I dont really have an opinion one way or the other on you. Simply, you write your opinions so well that they could easily be mistaken as advice from a health care professional.
I'm not trying to be the self appointed guardian of the readers, just saw something that needed to be looked into. And basicly was told to mind my own business. Fine, I just hope that no one gets hurt by an errant opinion that doesn't get caught by a moderator in time, on the rare chance that they miss the disclaimer.
BTW, there are NO bad days on the golf course.
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Whoa! I thought I fell into the leagal forum for a second!
As far as legalese goes, I wouldn't know a tort from a tart. That being said, I'll move on.
Psycho, I certainly hope that my e-mail did not translate into "Mind your own business". That is not what I said or implied. As a matter of fact, I beleive I thanked you for keeping an eye on my back.
I will say this, however. Please limit posts in this forum to topics related to the subject of health (or lack of it)in the trucking industry.
If there is a disagreement among posters in this forum that stem from posts made elsewhere, I prefer that they be kept in the other forums. I will not alter or delete any posts, but I will move them to the appropriate areas. And I say this only because I insist that those coming here with medical concerns find what they need and only what they need.
Again, I thank ALL of the posters in this forum for their input and hope that ALL of you continue to visit and post here when you have a topic related to this forum subject.
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Keeping you safe, healthy, and on the road.
Nurse Red
Visit us at www.Truck.net/abmsVisit us at
Answer
Yesterday on the plane (6 hours) and today, I had to use my inhaler about 5 times, and tonight while at my motel room in Louisville, my airways started to close up on me, so I had to have a breathing treatment, and that seemed to halfway open me back up again. I may need another one later tonight though. BTW, my insurance (COBRA) cancelled me as of January 31st after posting my premium check for the month of Feburary. [IMG]http://www.truck.net/bbs/mad.gif[/IMG] [IMG]http://www.truck.net/bbs/mad.gif[/IMG] [IMG]http://www.truck.net/bbs/mad.gif[/IMG] [IMG]http://www.truck.net/bbs/mad.gif[/IMG] I accused them of fraud, and told them they have to refund that last payment to me. Of course as expected, they refused. I have plenty of documentation indicating that they had absolutely no reason to cancel me. I'll be talking with a lawyer about that soon.
Erik.
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Yesterday on the plane (6 hours) and today, I had to use my inhaler about 5 times, and tonight while at my motel room in Louisville, my airways started to close up on me, so I had to have a breathing treatment, and that seemed to halfway open me back up again. I may need another one later tonight though. BTW, my insurance (COBRA) cancelled me as of January 31st after posting my premium check for the month of Feburary. [IMG]http://www.truck.net/bbs/mad.gif[/IMG] [IMG]http://www.truck.net/bbs/mad.gif[/IMG] [IMG]http://www.truck.net/bbs/mad.gif[/IMG] [IMG]http://www.truck.net/bbs/mad.gif[/IMG] I accused them of fraud, and told them they have to refund that last payment to me. Of course as expected, they refused. I have plenty of documentation indicating that they had absolutely no reason to cancel me. I'll be talking with a lawyer about that soon.
Erik.