Being on the north side of 40 years old, I’ve become more mindful of the need to pay attention to my health.  Long gone (and long missed) are the days when I could eat what I wanted and not gain any weight or feel any ill effects.  A routine health assessment earlier this year suggested that I could stand to lose a few pounds and rebuild some muscle mass.  I had never encountered this before, I’m athletic, active and generally in good shape or at least I thought.  A range of questions came flooding to my mind upon hearing those words – where do I start, how do I begin, do I need a diet, South Beach or Mediterranean, anaerobic vs. aerobic, yoga or free weights, PX90 or Insanity.

It was clear that I needed a plan to achieve my weight loss goal and make it a key priority.  In the same way, we all need to ensure we are building our financial strength and making it a key priority.  In these days of shrinking pension plans, increasing healthcare cost and questions about the solvency of Social Security and Medicare, financial self-reliance has become the new order of the day.  Financial experts suggest taking some keys steps could help build your financial strength.

Have and emergency fund

• Having a stash of cash is a good way to prepare for the inevitable rainy day and achieve some piece of mind.  Avoiding the use of your credit card during a financial crisis such as a job loss, injury or unexpected major expense can also prevent aggravating the problem further.  Consider building an emergency fund that can sustain you for four to six months of living expenses.

Pay down credit card debt

• According to NerdWallet’s analysis of Federal Reserve data, credit card debt is the third largest source of US household debt.  US households maintain nearly $900M in credit card or $7,281 per household.  Eliminating this debt and ceasing to use your credit card for non-essentials can help improve your financial position.  Once paid off, pay yourself by increasing your savings or building that emergency fund.

Contribute to your 401k plan

• Contributing to your company’s 401k plan can quite beneficial particularly if your company makes matching contributions which amounts to receiving free money.  Your contributions are also tax-deferred which can help you reduce your current tax liability. Make sure you’re maximizing your 401k plan to the extent possible and also take a look at your company benefits in general to see if there are other saving opportunities that you can leverage.

Make a budget and stick to it

• Whether you make a little or a lot, you need to know where your money is going and stay on top of it. You’ll never get ahead if you spend more than you earn and it’s far easier to spend less than it is to make more.

Involve your family

• Similar to getting back in shape, financial strength is not achieved overnight and it’s better to have partners join with you in helping you live up to your commitment and achieve your goals.  Likewise, involving your family in strengthening your finances can help get everyone on the same page and moving in the same direction. Even your children can help by managing their needs versus their wants in order to achieve financial discipline.

There are probably several dozen other areas you could focus on in building your financial strength but it is important to start somewhere.  Even picking one or two of these items could go a long way in getting you on the right path and you can always incorporate others on your journey.

Nicole Gordon
2014 MD Candidate
American University of Antigua School of Medicine

Asthma is a disease that affects the lungs. It is defined as an airway obstruction that is reversible with a bronchodilator. It is one of the most common long-term diseases of children, but it can affect adults as well. Asthma can present as wheezing, which is a high-pitched whistling sound produced by airflow turbulence. Other symptoms include shortness of breath, chest tightness and coughing that occurs at night or early in the morning.  Although wheezing is the main symptom that many people experience, having wheezing alone does not mean that the diagnosis is Asthma.

DIAGNOSIS

Diagnosing asthma can be difficult, as it is not only based on clinical signs and symptoms. Other tools used to diagnose asthma include a pulmonary function test, exercise challenge test and allergy testing. Pulmonary function test is where a physician asks you to exhale into a machine called a spirometer, that measures the amount of volume you exhaled before and after you use asthma medicine. The exercise challenge is measuring the baseline spirometry followed by exercise and measure the lung volumes again.  Allergy testing can be done to identify allergic factors that may contribute to asthma. In addition, to these tests, the physician will ask questions about coughing, family history of asthma,  and difficulty breathing after strenuous activity to determine your risks factors for the disease.

HOW ASTHMA AFFECT THE AIRWAYS

Asthma exacerbation or attack include coughing, chest tightness, wheezing and difficulty breathing. These symptoms happens in response to certain triggers or allergens in the environment and affect your airways in the lungs that carry air. There are three main ways that these triggers can affect your airways  causing less air to get into and out of your lungs. The first is that your airways may contract and become smaller, making it difficult for air to go through your lungs. Secondly, your airways can become filled with mucus, and debris from the allergens that get stuck in the lung, which also makes it difficult to have air exchange. Finally, the airways can be irritated from the allergens and become inflamed, which makes the airway narrow.

ALLERGENS

It is important to identify the triggers or allergens of  Asthma, so that you can avoid them. Listed below are some of the main triggers.

1)      Tobacco Smoke. There are over 4000 chemicals and carcinogens in smoke. If you have asthma and you smoke, you should quit. Try to avoid being around people who smoke and areas where smoking may be.

2)      Pets. Pet dander can trigger an asthma attack.  If you have asthma and have a pet, consider finding a new home for the pet, or keep it out of your bedroom. Bathe the pet regularly and get it trimmed. Also remove carpets, to reduce the pet dander from being trapped in them. Vacuum often and clean hard floors such as wood and tile weekly.

3)      Indoor Allergens. Such as cockroaches and molds. Get rid of cockroaches in your home by removing food sources, and try to clean at least every 2 to 3 days.

4)      Outdoor Allergens.  Seasonal allergies can be caused by many different types of trees and grasses. Try going to an Allergist to determine what specific type of tree or grass you are allergic to and try to avoid contact with them. Pay attention to the television or internet to determine when pollen levels will be low.

MANAGEMENT

Asthma is reversible, and is managed with the use of agents for control and agents for relief.

Control agents 

Inhaled Corticosteroids

Leukotriene Modifiers

Long-acting broncho dilators

Relief medications

Short-acting bronchodilators  eg. Albuterol pump

Systemic corticosteroids

If you think you may suffer from asthma, or you know that you have asthma but it is not currently controlled, visit your doctor to discuss the options available to you.