Asthma Awareness in Children by Dr. Patricia Avila, Pediatrician

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“Asthma in children is one of the most common long term (chronic) diseases. It is estimated to affect 1 in every 10 children in the US. If your child has Asthma one of the most important things you must do is to learn as much as you can about Asthma. Being educated about your child’s Asthma will help you work together with your child’s doctor to control their Asthma and have the absolute best outcome.”

Dr. Patty Avila, Pediatrician

What is Asthma?

  1. It is a disease of the lungs that causes the airways or tubes that bring air into the lungs to become swollen and inflamed. The muscles around the airways become tight and it makes it hard to breathe. This leads to episodes of coughing, wheezing, feeling breathless, chest pain/chest tightness, and feeling more tired than usual.
  2. It is more common in children with a parent or sibling or close relative with Asthma, Allergies, and/or Eczema. Children with Asthma often develop Allergies or Eczema as well. These are sometimes present before they develop Asthma.
  3. There is no cure for Asthma. There are medications and things you as a parent/caregiver can do to help control it. Know what the signs/symptoms of Asthma are, how to avoid triggers, and follow your doctor’s treatment plan. This is especially important to prevent and decrease the damage to your child’s lungs. It will also help avoid your child needing emergency medical treatment.

What causes an Asthma Attack?

  • An Asthma attack happens when your child is exposed to “triggers” things that cause your child’s Asthma to get worse.
  • An Asthma attack also happens when a child does not take their medications as prescribed.

Common triggers include:

  • Allergens – including outdoor allergens like pollen, animal dander, dust mites, mold, and cockroaches.
  • Infections – including the common cold, the flu, sinus infections, and cases of pneumonia.
  • Irritants – including cigarette smoke or other smoke, pollution, strong odors like perfumes or scented candles, and cleaning products.
  • Changes in weather – cold and dry, very humid, or extremely hot weather.
  • Exercise.
  • Stress and strong emotions.

How can you help control your child’s Asthma and how is it treated? Avoid triggers. It may not be possible to completely avoid all possible triggers, but there are some changes you can make that will help.

  • Allergens. Have your child take their allergy medications during allergy season. Keep windows and doors shut during allergy season. Avoid outdoor activities when pollen counts are high.
  • Dust mites. Use mattresses and pillow covers. Vacuum and dust regularly. Wash bedding once a week. Limit and wash stuffed animals.
  • Furry pets. Keep pets out of your child’s bedroom. Wash pets more often.
  • Use HEPA filters.
  • Fix any water leaks that could lead to mold.
  • Infections. Make sure your child and family receive their yearly Flu vaccine. Having Asthma increases your child’s risk for severe Flu illness that can trigger an Asthma attack.
  • Use good hand hygiene.
  • Irritants. Do NOT allow anyone to smoke in your home or car. Avoid public places where smoking is allowed. Avoid the use of perfumes, scented candles, incense, paints, and cleaning supplies that can irritate your child’s lungs. Check your local forecast for air quality and keep your child indoors when the pollution is bad.
  • Weather. Avoid outdoor activities in extreme weather conditions.
  • Exercise. If your child’s Asthma is triggered by exercise have your child take his/her Albuterol 15-30 minutes prior to activity to prevent these symptoms. Encourage your child to exercise and participate in sports. Know what medications help control his/her Asthma so that they can continue to be active.
  • Medications. Includes inhaled medications in the form of MDIs also known as inhalers or “pumps” and nebulizers that are given by a machine. Rescue or quick relief medications like Albuterol help during an Asthma attack. They help open the airways or tubes that bring air to the lungs. Long-term controller medications like inhaled corticosteroids help improve the inflammation of the lungs. When these medications are used daily your child is less likely to have an Asthma attack.

Develop an Asthma Action Plan.

This plan is made with the help of your child’s doctor. It will help you and your child know what medications to use and when. It will also help you and your child know what to do in the case of an emergency. Share this plan with the school as well. It is important because your child spends a good amount of time there and the school will know exactly how to help your child.

By becoming knowledgeable about your child’s Asthma, avoiding triggers, and following a good Asthma Action Plan you are taking important steps in keeping your child healthy. Have your child see his/her doctor at least 2 times per year to ensure their Asthma is under control. Do not forget to make sure your child and family receive a yearly Flu vaccine. Your child should be able to enjoy everyday activities and participate in sports without any problems breathing if their Asthma is under control.

Mental Health Awareness Toolkit

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Improving Self Esteem by Zach Clay, LMFT

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Let’s face it, we are our own best critics. Most everybody has some sort of area in their life in which they doubt themselves. If you’re saying “no I don’t” or “I’m perfect,” then you can stop reading here. LOL. The rest of us have some measure of self-worth. Self-affirmations are a great way to trick your brain into truly recognizing those things that make you unique.
Positive self-affirmations are a way to strengthen aspects of ourselves that have constantly been playing on constant negative beliefs which are seemingly on a loop in our heads, typically from an early age. Short, positive messages can combat these long-held beliefs. These new, positive messages can be rewritten to rewrite your new life story.

Here are just a few simple positive self-affirmation techniques for you to try at home:

  • Write index cards or post-it notes you can put in an area that you frequently look at (ex. a mirror, refrigerator, or on your car dashboard).
  • Write a daily journal to be more aware in those positive aspects and personality traits which can boost your self-esteem (see ‘Self-Esteem Journal’ handout below for a printable copy you can use).
  • For those who enjoy a poetic method to increase awareness of your ‘good-stuff,’ you can fill in the blanks on the printable “I Am” poem below and put it where you can see it or better yet, take a cell picture to look at daily from anywhere you are.
  •  Sing these self-affirming messages to one of your favorite songs.
  • Say these positive messages out loud, in your head silently or record them on your phone to play back later.
  • Identify some common personality traits which most of us aspire to achieving.

These short, positive statements benefit:

  • Physical health.
  • Improve success and wealth.
  • Challenge self-defeating behaviors.
  • Aid and heal emotional pain or trauma.

Try them! What do you have to lose?

Self-Esteem Journal
I am … (Poem)

At NOAH, we offer behavioral health consulting and traditional outpatient counseling programs and services where these highly skilled and trained behavioral health staff work alongside our #medical and dental teams to assess, diagnose and effectively treat the core-symptoms of our patients.

Phone Apps to Use for Mental Health by Katelyn Millinor, LPC

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In recent months, there’s been quite a few mental health apps available to smart phone users. These, most often free apps, offer a wealth of resources at your fingertips. Our behavioral health expert, Katelyn Millinor, LPC, recommends the following apps for you to try out at home.

Anxiety/Depression

  • Happify – help reduce stress, overcome negative thoughts.
  • What’s Up – utilizes cognitive behavioral therapy and acceptance commitment therapy to cope with anxiety, stress, and depression.
  • Sanvello – teaches cognitive behavioral therapy through journeys that combine videos, audio exercises, mood and health tracking.
  • Mood Kit – utilizes cognitive behavioral therapy for mood improving activities.
  • Worry Kit – short (under 2 minute) activities designed for those in between moments in life where you need to reset your brain.
  •  MoodFit – create/track daily goals, understand relationship between mood and lifestyle factors, gratitude journal, mindfulness.
  • Mind Shift – designed for teens and young adults with anxiety that focuses on riding out intense emotions and facing challenging situations.
  • IMoodJournal – record everything from mood symptoms, sleep, medications, and energy.
  • Panic Relief – better manage and move through panic attacks.
  • Breathe2Relax – teaches breathing techniques to manage stress.

Meditation

  • Calm – guided meditations, sleep stories, breathing programs, and relaxing music.
  • Headspace – meditation and mindfulness.

Other

  • Quit That! – help users beat habits or addictions (drinking, smoking, drugs).
  • eMoods – designed for people with bipolar disorder to track symptoms.
  • notOK – suicide prevention app that users can add trusted contacts and let them know they are not okay.
  • PTSD Coach – education, assessing, and offering easy to understand tips to manage common symptoms.

Ten Basic Rules for Emotional Health

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In light of May being deemed Mental Health Awareness Month in the U.S., here are some keys to creating and maintaining emotional wellness.

  1. Take care of yourself. Take time to relax, exercise, eat well, spend time with people you enjoy and activities which you find pleasurable.
  2. Choose to find the positives in life experiences instead of focusing on the negatives. Most clouds have a silver lining and offer opportunities for personal understanding and growth. When you accept that things are sometimes difficult, and just do what you need to do, then it doesn’t seem so hard.
  3. Let go of the past. If you can’t change it, and you have no control over it, then let it go. Don’t waste your energy on things that cannot benefit you. Forgive yourself and others.
  4. Be respectful and responsible.
  5. Acknowledge and take credit for your successes and accomplishments.
  6. Take the time to develop one or two close relationships in which you can be honest about your feelings.
  7. Talk positively about yourself and about others.
  8. Remove yourself from hurtful or damaging situations. Temporarily walk away from a situation that is getting out of control.
  9. Accept that life is about choices and is always bringing change to you. Accept that change also requires personal adjustment.
  10. Have a plan for the future. Develop long range goals for yourself, but work on them one day at a time—or even one minute at a time.

We know these things aren’t always as easy as they seem. We are here for you on your journey to wellness!

Bouncing Back to a Better You by Dr. Alethea Turner, Associate Director – HonorHealth Family Medicine Residency Program

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Many of us deal with stress on a daily basis. Some causes may include pressures at work, unhealthy relationships, medical issues, financial problems and even past traumas. All of it can lead to bad habits, poor health and a general sense of unhappiness.

Resilience is our ability to bounce back and regain control. We might not always be able to change our circumstances, but we can change how we handle stress.

6 Tips for Coping with Stress

  • Relationships – Think about the relationships in your life. Which ones bring you joy? Take time to connect with those who add positivity to your life. Schedule a weekly date night, monthly dinner with your friends, or even call a relative you love.
  • Nutrition – Emotional eating is real! We often use food to celebrate our wins and to drown our sorrows. Yet, unhealthy eating can make us feel tired and bad about ourselves. Try to cut out sugary drinks, pack only healthy snacks, or cut down on portion sizes. If you are eating out choose items that are healthiest on the menu rather than those packed with calories.
  • Mental Health – Stress can lead to feelings of anxiety and depression, like worrying all of the time or feeling hopeless. Talk to your doctor and consider meeting with a counselor. It might change your life.
  • Exercise – We all know that exercise is good for our health, but did you know that it is also a powerful tool for managing anxiety and depression? Turn on some music and dance in your room, or go for a walk over your lunch break. Getting your body moving can help you in more ways than one.
  • Sleep – Good sleep habits are essential for recovering from a stressful day and for keeping your mind and body healthy. Create a bedtime routine that includes sleeping in a cool, dark and quite room. Try to sleep around the same time every night and avoid looking at a screens (TV, cell phone, tablets…) at least 30-60 min before bed. Aim for at least 7 hours of quality sleep each night.
  • Mindfulness – Mindfulness is another way you can achieve calmness and control over your feelings. It is about being completely aware of your thoughts and emotions, being focused on a single moment or action, and accepting yourself. You can practice mindfulness in many ways including writing in a journal, taking a minute to focus on deep breathing, meditating (there are apps for that), or even listening carefully to someone you are talking to.

Tip the scales in your favor! Introducing even ONE of these practices into your daily life will help balance out stress and negativity, and can help you build resilience and a greater sense of well-being.

Signs and Symptoms of Poor Emotional Health

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Mental and emotional illness does not discriminate. It does not care how much money you have, where you live, your age, or the color of your skin. It effects all shapes and sizes of people all over the globe. Do not hesitate to reach out to our team in the event that you or your child are struggling. We are here to help!

Please reach out to us if you or your child experience:

  • Consistent feelings of sadness or hopelessness
  • More than usual irritability, anger, aggression or hostility
  • Tearfulness or frequent crying
  • Withdrawal from friends and family
  • Loss of interest in activities that you used to love
  • Changes in eating and sleeping habits
  • Unusual restlessness and agitation
  • Feelings of worthlessness and guilt
  • Excessive fatigue or lack of energy
  • Difficulty concentrating due to racing thoughts
  • Thoughts of death or suicide
  • Self-Mutilation (e.g. cutting / burns)
  • Declining grades in school or performance at work
  • Substance abuse, including alcohol and drug (illegal and legal drugs) use
  • Neglect in hygiene and other matters of personal appearance
  • Emotional distress which brings on physical complaints (aches, fatigues, migraines, etc.)
  • Risk taking behaviors
  • Suddenly giving away favorite belongings or promising them to friends and family members
  • Extreme cheerfulness following periods of depression
  • Expression of bizarre or unsettling thoughts

At NOAH, we offer behavioral health consulting and traditional outpatient counseling programs and services where these highly skilled and trained behavioral health staff work alongside our medical and dental teams to assess, diagnose and effectively treat the core-symptoms of our patients.

The World Seems Scary – Coping with Anxiety by Andres Jaramillo, LPC

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We all have things that make us feel anxious like giving a presentation or having a job interview but it may seem like in our daily life more and more we encounter extreme, awful, or scary things. It makes it easier for our minds to come up with negative, worst case scenarios that end up turning up the volume on anxiety.

What is anxiety?
It is a normal feeling we experience when we predict that something bad could happen.

Living in today’s constantly connected world, the possibility of something scary, awful, or threatening can pop in our head by just turning on the news or driving our kids to school.

Try these 3 things to turn down anxious feelings so you can continue doing the things you want to do.

1 – Relaxed body is tied to relaxed mind. Even seeing or hearing about awful, scary things – perhaps the news on the latest epidemic – can cause the “fight or flight” response to turn on. Our body makes physical changes like increased heart rate, sweating or tense muscles so it can be prepared to fight or run away from the danger.

When we do activities to purposely deactivate our fight or flight response, or relax our body, our mind plays follows the leader.

Try this, notice: 

  • 5 things you can see – notice shapes, colors, brightness, shadows.
  • 4 things you can hear – notice pitches, volumes, tone.
  • 3 things you can feel/touch – notice textures.
  • 2 things you can smell – notice hints of sweetness, bitterness, pungent, etc.
  • 1 thing you can taste – notice hits of spicy, sweet, sour, etc.

Notice and observe things you have never paid attention to before. Maybe say what you observe out loud, or just to yourself. You can mix it up anyway you like, perhaps you are at a restaurant and you can taste 5 things, or smell 5 things. It is just about using your senses in a purposeful, intentional way. By getting out of your head and engaging your body in a slow, mindful activity it is pretty much impossible to focus on the image that turned anxiety up in the first place.

2 – Remind yourself: What you feel is not always true. I feel like I am going crazy! Perhaps you’ve said something like this to yourself and if we are going to turn down the volume on anxiety, we need to challenge how our feelings “prove” that something is going to happen.
A quick peek at your latest social media feed and you see a story about a family who had a burglar break in their house and murder three people. Quickly shock, fear, horror, or sadness fills your experience. It is valid that you may feel that way but the mind, in its amazing abilities, will use those emotions as proof to make a conclusion that may not be true.
I feel scared so that means something bad is going to happen!

Try this:

  •  Take a few deep breaths – deep enough to see your stomach area expand and contract.
  • Acknowledge you are feeling scared – is it a knot in your stomach? Is it racing thoughts?.
  • Take a few more deep breaths.
  • Focus on the facts.

Facts themselves don’t increase anxiety, the perception that it could be a threat does. By placing time and breathing between what you saw/heard and making any decisions, you allow the intensity of the anxiety to subside like the tide on a beach. You will have a better chance to be calm and focus on the facts not the “coulds.”

3 – Accepting the unpredictable but be prepared. You can’t really know if someone will break in to your house, or use a gun in a violent way, or if you will catch the new virus going around but perhaps we can be prepared the best we know how.

If you have noticed that the news, your social media, or stories you heard from friends have increased your anxiety, you went through 1 and 2 above and you still feel uneasy, then maybe prepared action is the next step.
We have active shooter drills, we get trained in CPR, and we wear our seat belt with the mindset of accepting that we will never know IF something bad could happen and just being prepared anyway.

Have a plan:

  • Create a plan for what you and your family would do if [insert awful situation] happened.
  • Talk with your workplace to double check emergency plans.
  • Have a chat with your children’s school to understand what plans they have.
  • Talk with your doctor about your health concerns.
  • Join a neighborhood watch group.
  • Take a self-defense class.

By moving your focus from “What if’s” to accepting that life is unpredictable and doing your best to be prepared will increase your confidence and readiness just like when we plan and study for what we will say in a presentation or practice for our job interview. If we feel confident and ready, there is no room for anxiety.

Everyone experiences anxiety and yes, it is normal. If we have certain tools, like the three above, we can get through any situation that raises our anxiety and be ok even in today’s hectic, scary world.

An important note: Daily, normal anxiety is different than having an anxiety disorder.

If the anxiety you feel is unmanageable, has been going on for more than two weeks, and it is interfering with your daily life or relationships than perhaps you can think about visiting with a mental health professional and figuring out a best course of action.

6 Anxiety and Panic Coping Skills

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By Katelyn Millinor, LPC | Behavioral Health Quality Manager

For many, coping with change is hard enough, let alone the emotions many may face such as fear and anxiety due to changes in daily routines. Added stress from job loss and inability to cover expenses, illness, and or loss of a loved, one may cause anxiety and panic. Learn 6 tips to help you cope with these emotions and check out some of our highly recommended apps that may help decrease your anxiety.

Breathing slowly and deeply. Anxiety can cause you to breathe very quickly, which makes both the mental and physical symptoms of a panic attack or generalized anxiety even worse. When you start to feel panicky, be sure to take slow, deep breaths to soothe your mind and body. Be sure to breathe using “belly breathing” also known as diaphragmatic breathing.

Stop and think. When your thoughts start spinning out of control, tell yourself to stop. Organize your thoughts and decide what you need to do to get yourself calm again. This is a way to interrupt thoughts and refocus.

Think positively. Push negative thoughts out of your mind, and remind yourself that you are in control. Think about times when you’ve been able to manage situations successfully and reduce anxiety. Stay in the present moment.

Take a break. If you need to leave a situation, do so or tell someone you need to leave. Don’t be afraid to ask for help. Allowing yourself to become more upset will not help if what you really need is to take a walk and blow off some steam. Allow yourself to have space as needed.

Relax your muscles. Anxiety causes your entire body to tense up, so make a conscious effort to relax each muscle from your toes all the way up to your neck and face. This will alleviate tension.

Get physical. Exercise can combat stress and anxiety. It can also improve your overall health and immune system. Even a brisk walk can help.

Tips to remember:

  • Deep breaths.
  • Self-care.
  • Adequate sleep.
  • Exercise.
  • Talk to yourself.
  • Acknowledge your feeling.
  • Mindfulness.
  • Lavender hot baths.
  • Cut back on caffeine/nicotine/alcohol.
  • Stay present.
  • Good nutrition.
  • Muscle relaxation.
  • Slow down.
  • Picture your ‘safe place.’
  • HALT (hungry, angry, lonely, tired).
  • Close your eyes

Apps to help with anxiety:

  1. Calm
  2. Worry Kit
  3. Breathe2Relax
  4. Panic Relief
  5. MoodFit
  6. Headspace
  7. What’s Up
  8. Happify

Mother’s Day Celebration Tips During A Global Pandemic by Katelyn Millinor, LPC

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“All women are mothers because all women bring life to the world in some way.”

Holley Gerth

Mother’s Day is a time to celebrate the mothers of the family as well as those with whom we share a maternal bond. These people can include our mothers, aunts, grandmothers, sisters, role-models, teachers, care-givers, or others. We can also honor those that face the challenge of not being able to have their own children.


Most of the world has a special day or celebration for mothers. In Japan, carnations are a popular gift and considered a symbol of a mother due to their sweetness, purity, and endurance. In Ethiopia, mothers are celebrated with a three day festival which also marks the end of the rainy season. In Peru, celebrants also make special effort to remember mother’s who are no longer with them by gathering at cemeteries.


So, how do we celebrate our maternal figures while experiencing a global pandemic? There are still excellent ways to honor and celebrate even if you are social distancing, in quarantine, or unable to travel to see your mothers.

  • Play a virtual card game.
  • Interview her about her childhood.
  • Make a hand made card.
  • Write a thoughtful letter.
  • Put together a photo album.
  • Sing a song together.
  • Pick wild flowers.
  • Bake a cake or cupcakes together.
  • Use Skype or FaceTime to have a meal together.

NOAH wishes all our maternal figures a happy and healthy Mother’s Day!