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PDF Editor FAQ

When do you call 911 for an asthma attack?

A person who has asthma should have a written Asthma Action Plan - it’s a document that escalates intervention with escalating symptoms. Example for my son - he has cough variant asthma which means he’ll start to cough when he’s having an attack. Our action plan doesn’t vary much from others I’ve seen online or that friends have for themselves or their kids.At some point in the middle of a cold or a lot of coughing, I’ll listen to his lungs and hear the wheezing. I can hear it with my ear if I put my head on his back, but I’ve obtained a stethoscope to make it easier - wheezing, clicks, groans, or other noises other than wind are all concerning. Another physical symptom is called stridor - the bottom of the neck below the adams apple will pull in with each breath. The chest might also be pulling in, retracting desperately with each breath.At this point we either do his inhaler or a nebulizer with the same medication in it. This should relieve his cough substantially (though it might not stop it - if it’s not stopped, I listen to his lungs to ensure the medicine cleared it significantly).If he’s not better, we repeat the inhaler/nebulizer 20 minutes later. Repeat above and if needed, repeat the inhaler/nebulizer for a total of three doses in one hour. At this point, I give him an oral steroid to kick—start helping his lungs.In 20 minutes if he’s not better, it’s 911 time. There are different medications EMTs and hospitals use to help stop an asthma attack.This is our action plan - I’ve called 911 a number of times. In each case, my son’s oxygen level was never below 85% (which is low, but not terrible). But he was obviously in distress, unable to get a clear breath.I think my son’s reaction to an asthma attack is much more mild than others. I had a friend who would do a second dose of medication within five minutes if it wasn’t helping - and it was less than five more before she was calling 911 as she continued her medication. This is why the action plan - individualized for the person with asthma and their own reactions to an attack - is key.

How do doctors handle their friends asking for medical advice?

It depends on whom you define as a "friend."Many different approaches to this situation.In areas of medicine that do not pertain to my primary fields of specialization-- oncology and cancer care, radiation oncology, prognostication and end-of-life-- I will advise that my knowledge base is likely limited, and that they would be best served by consulting with a physician who has greater knowledge within that particular area of expertise, be it internist, family practitioner, or specialist. But I will generally listen to the question asked.In areas of my expertise, and again, depending on my level of friendship with the individual inquiring, I will ask a few pertinent questions, then advise on what some good "next steps" might be for acquiring the further information needed to better craft an action plan for evaluation and management.In general, physicians are held to a different standard with respect to expectations on provision of complementary (free) advise by the public than other professionals with specialized knowledge. There are even expectations by many that free advise and services be offered over the telephone. Unlike lawyers, for example, who can bill for their time once they pick up the phone, physicians are not allowed by many third party payers to bill for phone calls or work done on behalf of a patient without the patient being present.

Why do legal forms constantly ask for what's between my legs?

Excellent question.In a very small number of cases the form is genuinely interested in your sex (including but not restricted to your genitalia): medical forms are the obvious example. The question in this case should (but typically doesn't) include an intersex option, and either include a trans* option or make clear that the question is not about gender.In some cases the form is purely interested in what pronouns to use when writing about you. If this is the case the question should really just ask that and provide an option beyond he or she, though again this doesn't normally happen.In many cases a question about gender is included either for marketing and research purposes or as part of an affirmative action plan. In these cases the question should be optional and include more options than just female and male, though again this isn't always the case. (Ideally it wouldn't put male before female either, given the fact that it comes later in the alphabet.)This clearly doesn't cover all cases though. Why does a driving license list a gender, for example? A photograph is already present for identification. There may well be legal aspects of which I am not aware, or it may be simply because people expect to ask this, viewing gender as an intrinsic identifier alongside name. I don't know.Update: there has recently been some discussion to remove gender from British passports and driving licenses. See Call to remove gender from UK passports and driving licences for details.

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