Health Care and Asthmatic Symptoms

Millions of people suffer from asthma or asthmatic symptoms, and the condition is characterized by inflammation of the bronchial tubes with increased production of sticky secretions inside the tubes. People with asthma experience symptoms when the airways tighten, inflame, or fill with mucus. 

In the United States asthma affects an estimated 26 million people including children, teens, and adults � many of whom aren�t aware that they have it, especially if their symptoms are not severe. Asthma does not discriminate against age, race, or sex.

Asthma causes a variety of symptoms that can worsen at any time, making breathing difficult. Asthma is a disease that cannot be cured, but it can be managed. Some days you may not have symptoms, but this doesn�t mean your asthma has gone away. Asthma doesn't have to slow you down.

You may still need to pay attention to how your asthma makes you feel, even when you don't have many symptoms. The more severe the inflammation and constriction become, and the longer they go untreated, the worse your asthma symptoms may be and the harder they may be to control. You may need to monitor your asthma symptoms every day, because the disease is always with you.

According to the American College of Allergy, Asthma, and Immunology (ACAAI), the most common symptoms are:

         Coughing, especially at night, during exercise or when laughing
         Shortness of breath
         Chest tightness
         Wheezing (a whistling or squeaky sound in your chest when you breathe, especially when exhaling)

Any asthma symptom is serious and can become deadly if left untreated. Symptoms may be triggered by exposure to an allergen (such as ragweed, pollen, pet hair or dander, or dust mites), irritants in the air (such as smoke, chemical fumes or strong odors) or extreme weather conditions. Illness � particularly a respiratory illness or the flu � and exercise can also make you more susceptible.

A physical display of strong emotion that affects normal breathing patterns � such as shouting, crying or laughing � may also contribute to an asthma attack. Panic can prevent a person with asthma from relaxing and following instructions, which is essential during an attack. Scientists have found that rapid breathing associated with strong emotions can cause bronchial tubes to constrict, possibly provoking or worsening an attack.

Like any chronic condition, asthma can cause emotional strain. As a leading cause of work and school absences, it can have a significant effect on livelihood, education and emotional well-being. Depression may set in when people diagnosed with asthma believe that they are unable to participate in normal activities.

Asthma symptoms can happen at any time. Mild episodes may last only a few minutes and may be resolved spontaneously or with medication; more severe episodes can last from hours to days. For more details about the ACAAI and asthma, visit this site:

However, not every person with asthma has the same symptoms in the same way. You may not have all of these symptoms, or you may have different symptoms at different times. Your asthma symptoms may also vary from one asthma attack to the next, being mild during one and severe during another. Some people with asthma may go for extended periods without having any symptoms, interrupted by periodic worsening of their symptoms. Others might have asthma symptoms every day. One good aspect is that the disease is not contagious.

In addition, some people may only have asthma during periods of exercise, or asthma with viral infections like colds. Mild asthma attacks are generally more common. Usually, the airways open up within a few minutes to a few hours. Severe attacks are less common but last longer and require immediate medical help. It is important to recognize and treat even mild asthma symptoms to help you prevent severe episodes and keep asthma under better control.

Also, recent research by the Asthma and Allergy Foundation of America showed that 97% of allergists consider a pest-free home to be vital to avoid the symptoms related to asthma and allergies. Despite this fact, many consumers are unaware of the implications of the common dust mite and many other pests have on their health.

Making matters worse, many bugs and pests are hidden from people and encouraged by the reduced cleaning caused by increasingly busy lives. For more information about this topic, visit this website: 

Asthma is especially tough on kids. To control asthma, partner with your doctor to manage your asthma or your child's asthma. Children aged 10 or older�and younger children who are able�should take an active role in their asthma care, according to the National Institutes for Health (NIH). . Taking an active role to control your asthma involves:

         Working with your doctor to treat other conditions that can interfere with asthma management.
         Avoiding things that worsen your asthma (asthma triggers). However, one trigger you should not avoid is physical activity. Physical activity is an important part of a healthy lifestyle. Talk with your doctor about medicines that can help you stay active.
         Working with your doctor and other health care providers to create and follow an asthma action plan.

An asthma action plan gives guidance on taking your medicines properly, avoiding asthma triggers (except physical activity), tracking your level of asthma control, responding to worsening symptoms, and seeking emergency care when needed.

Asthma is treated with two types of medicines: long-term control and quick-relief medicines. Long-term control medicines help reduce airway inflammation and prevent asthma symptoms. Quick-relief, or "rescue," medicines relieve asthma symptoms that may flare up. Your initial treatment will depend on the severity of your asthma. Follow up asthma treatment will depend on how well your asthma action plan is controlling your symptoms and preventing asthma attacks.

Your level of asthma control can vary over time and with changes in your home, school, or work environments. These changes can alter how often you're exposed to the factors that can worsen your asthma. Your doctor may need to increase your medicine if your asthma doesn't stay under control. On the other hand, if your asthma is well controlled for several months, your doctor may decrease your medicine. These adjustments to your medicine will help you maintain the best control possible with the least amount of medicine necessary.

Asthma treatment for certain groups of people�such as children, pregnant women, or those for whom exercise brings on asthma symptoms�will be adjusted to meet their special needs. For much more information, visit this website:

If you have asthma, you may have developed ways of coping with your symptoms that you may think are working quite well, according to this website: . However, you may not be controlling your asthma symptoms. Work with your healthcare provider to develop your personalized asthma management goals. Here are some examples:

         Few, if any, asthma symptoms
         Few, if any, awakenings during the night caused by asthma symptoms
         Little or no time off from school or work due to asthma symptoms
         No limits on your participation in physical activities
         No asthma-related emergency department visits
         No asthma-related hospital stays

Unfortunately, asthma to date has no cure. But, it can be managed. Your family doctor or health care provider can help diagnose the symptoms and create a treatment plan for you or someone in your family that has been diagnosed with asthma or who has asthmatic symptoms. Don�t self-diagnose. See your health care practitioner. Ignoring the symptoms can be catastrophic.

Until next time.

Help us improve our Medicare webpages!

We are in the process of conducting a usability study on the Insurance Commissioner's Medicare webpages. We want to hear from consumers how we can organize the pages and content in a way that makes sense to you. All it takes is 10-15 minutes to take a simple online survey. The survey is open through May 1. 

Your feedback is very important, so please take a few minutes to help us improve our site!

Online services unavailable Saturday, April 25

The Insurance Commissioner's online services will be unavailable Saturday from 6 a.m. to 6 p.m. Our website,, will be available, but people will not be able to access the following applications accessed through our site:

  • Licensing services
  • Complaints
  • SHIBA online
  • Insurance company and agent lookup
  • Rate transparency
The city is relocating the underground fiber network cables as part of a road construction project, which will disrupt our computer networks. 

Medicare To Remove SSN From Beneficiary ID Cards

Per April 20 New York Times article, Medicare will begin to integrate a 8-year plan to replace current Medicare ID cards with new cards.  The current Medicare ID card contains the beneficiary's (or spouse's) social security number and uses that number as the ID number for services.  

The new ID cards will remove the SSN and replace with a new ID code.

Medicare officials have up to four years to start issuing cards with new identifiers. They have four more years to reissue cards held by current beneficiaries. They intend to replace the Social Security number with �a randomly generated Medicare beneficiary identifier,� but the details are still being worked out.


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Health Care and Angioplasty

Millions of Americans suffer from various forms of heart disease�ischemic, rheumatic, hypertensive, inflammatory, congenital, and cerebrovascular. According to the World Heart Federation, there are multiple reasons for each of these medical diagnoses. The heart is a critical organ and is responsible for pumping life giving blood throughout your body from birth until death. Your heart is the size of your fist and the strongest muscle in your body.

Your heart started beating about three weeks after you were conceived. If you live to be 70 your heart will have beat 2.5 billion times. Each heartbeat pumps blood around the body, pushing it from the left heart chambers, through arteries of ever-decreasing size, finally reaching the capillaries in all parts of the body. Once your body has taken oxygen and nutrients from the blood, it is returned to the heart via the veins to the right chambers of the heart. On its way back, the blood passes through the liver and waste products are removed.

As marvelous as this system is, it is very vulnerable to damage from the things we do to it, like smoking, eating an unhealthy diet or putting it under stress. Or you may be born with a heart condition. When your heart�s functions become compromised, this is known as cardiovascular disease, a broad term that covers any disorder to the system that has the heart at its center. For much more detailed information about heart disease in general, visit this site:

One way to help improve some types of heart disease, and to help prevent heart attacks, is through a medical procedure called angioplasty--a term describing a procedure used to widenvessels narrowed by stenoses or occlusions, according to the There arevarious types of theseprocedures and theirnames are associatedwith the typeof vessel entry andequipment used.

For example, percutaneoustransluminal angioplasty (PTA) describes entrythrough the skin(percutaneous) and navigates to the areaof the vessel of interestthrough the samevessel or one thatcommunicates with it (transluminal). In the caseof a procedure involving the coronary arteries,the point of entrycould be the femoralartery in the groinand the catheter/guidewiresystem is passed throughthe aorta to theheart and theorigin of the coronaryarteries at the baseof the aorta justoutside the aorticvalve. For more technical aspects of angioplasty, visit this website:

According to the National Institutes of Health (NIH), you have angioplasty in a hospital. The doctor threads a thin tube through a blood vessel in the arm or groin up to the involved site in the artery. The tube has a tiny balloon on the end. When the tube is in place, the doctor inflates the balloon to push the plaque outward against the wall of the artery. This widens the artery and restores blood flow.

Doctors may use angioplasty to reduce chest pain caused by reduced blood flow to the heart and to minimize damage to heart muscle from a heart attack. Many people go home the day after angioplasty, and are able to return to work within a week of coming home. More details are located at this website for your research:

Angioplasty with or without vascular stenting is commonly used to treat conditions that involve a narrowing or blockage of arteries or veins throughout the body. When undergoing this procedure, there are definitely benefits and risks to be considered for angioplasty. Angioplasty should be considered with your physician, cardiologist, or medical heart specialist. Not to be taken lightly, the procedure saves lives, but is not without risk. Consulting your health care team for this event is critical for your long term survival if you suffer from any heart disease. A significant amount of detailed information concerning angioplasty can be found at this website:

According to this website,, if cardiologists can reopen blocked blood vessels with an angioplasty balloon within a couple of hours after a heart attack begins, blood flow can be restored and heart damage prevented. Time from arriving at the hospital to receiving angioplasty is called �door-to-balloon time� and in the past few years many hospitals have made significant strides in shortening �D2B� time, often treating patients with angioplasty within an hour.

Angioplasty within 90 minutes of arriving at the emergency department is the gold standard of treatment for heart attack, recommended by all the major medical societies. If you or a member of your family is at risk for heart attack (have coronary artery disease, a family history of heart disease, or risk factors such as high cholesterol or high blood pressure), it makes sense to educate yourself ahead of time, and make a heart attack emergency plan as noted below from :

1)    Learn the Symptoms: Listen to Your Body. Familiarize yourself with the range of heart attack symptoms. Heart attacks can involve slow and subtle warning signs; people rarely collapse to the floor clenching their chest as in the movies. Pay attention to your body and what it is telling you -- no one wants to be a hypochondriac, but when it comes to heart attack, it�s way better to be safe than sorry. Most heart attack victims wait hours before going to the hospital, greatly decreasing their chance to benefit from angioplasty. For angioplasty to be most effective, the quicker you get to the hospital to get checked out the better.

2)    Call an Ambulance: Know the number to call an ambulance and don�t be embarrassed to use it; don�t drive yourself or have a family member drive you unless it�s your only option. Ambulances are usually equipped to begin administering tests and emergency care en route, saving you precious time. And, you will be attended to more quickly when you get to the ER if you arrive by ambulance. Time is muscle; you don�t want to be delayed by traffic or bureaucracy. While you wait for the ambulance, take an aspirin, which can help thin your blood and discourage clotting.
3)  Plan Ahead to get the Best Care: Do some research ahead of time to determine which hospital in your area offers the best heart attack treatment. It�s good to know what your options are. In some parts of the country, sophisticated systems have been set up to transfer heart attack victims from community hospitals to regional centers that have cath labs. You want to go to the closest ER that has a catheterization lab, or if there are no cath labs in your area, go to a community hospital that has an effective system for quickly diagnosing and then transferring heart attack victims to a facility that offers angioplasty services.

Angioplasty when performed in a timely basis can save your life. Living with heart disease isn't simple. But it's something millions of people manage to do. Knowing your body, and your family heart history definitely helps with learning the warning signs and developing an action plan.

Until next time.

Insurance needs are a factor in retirement planning

This week is National Retirement Planning Week, organized by the National Retirement Planning Coalition. The group aims to help people create a comprehensive plan for retirement, which can seem daunting or, for some, too far away to contemplate. Its website,, offers tools based on your age, retirement and saving calculators and plenty of information about ways you can be prepared for retirement.

Insurance needs also should be factored into your retirement plans. Medicare plans carry a cost for premiums, doctor visits, prescription drugs and hospitalizations. However, Medicare typically does not cover long-term care, so some people opt for long-term care insurance to pay for home health care, adult day care, nursing home care or group-living facility care.

If you are considering annuities as part of your retirement planning, we have information about the benefits, the types of annuities and payouts.

Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Thank you to our SHIBA volunteers!

Insurance Commissioner Mike Kreidler meets SHIBA volunteers from South Sound Outreach in October 2014

In honor of National Volunteer Month, we�re recognizing the more than 400 people who volunteer their time to our Statewide Health Insurance Benefits Advisors (SHIBA) program. SHIBA's outstanding volunteers are an integral part of the consumer protection work we do at the Office of the Insurance Commissioner. In 2014, they helped nearly 65,000 Washington consumers understand Medicare in plain English, resolve Medicare disputes and choose a plan that best fits their needs in a timely manner.

Our volunteers donated nearly 90,000 hours in 2014 to helping their fellow citizens. We honor and celebrate our volunteers for their dedication and kindness. Thank you SHIBA volunteers for your time, dedication, commitment and service.

Read more about SHIBA services and where to find help in your area.

Blue Shield CA To Issue One-Time Refund on Grandfathered IFP Plans in California

Received notice from Blue Shield that they will be issuing a one-time premium refund to approximately 31,500 grandfathered individual & family plan members.  This is a result of 2015 rate review by the CA Dept of Insurance.

Refund will be applied to the May billing and represents a one-time 26.6% credit to those members May 2015 bill.  The amount due back will appear as a credit in the summary section on their May bill which will arrive around mid-April. There is no action required for these members to receive the credit.

Letters to the affected members will be sent out prior to the arrival of the May bill.


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New Medicare cards are coming starting in April

The Centers for Medicare & Medicaid Services (CMS) will start mailing redesigned Medicare cards to beneficiaries in Washington state aft...