COPD Treatment Tips to Keep You on Track

Managing COPD means staying on track with a good treatment plan. Get tips for managing symptoms, exacerbations, and other COPD issues.

By Chris Iliades, MD

Medically reviewed by Lindsey Marcellin, MD, MPH

You can live well with chronic obstructive pulmonary disorder (COPD) if you get the right COPD treatment plan and stick to it. The goals of a good COPD treatment plan are to manage and avoid COPD symptoms, slow the progression of the disease, manage COPD exacerbations and emergencies, and improve your general health and well-being.

It's important to learn as much as you can about your condition and work closely with your treatment team. That means taking all your medications on time and keeping all of your treatment appointments.

Medications that your doctors prescribe — bronchodilators, steroids, and antibiotics — help keep your COPD symptoms under control, but there is also a lot you can do on your own to stay on the right track.

COPD Treatment Action Plan

The American Lung Association recommends that people with COPD work with their doctor to develop an action plan based on their specific COPD symptoms. Every plan is different, and your plan may change over time. But an action plan should outline specific steps depending on your symptoms. Here is an example:

• Green zone. You are in this zone when your symptoms are under control. Take all your daily medications, keep all your scheduled doctor appointments, and follow your exercise and diet regimens.
• Yellow zone. COPD symptoms like feeling breathless, increased cough, increased phlegm, decreased appetite, and trouble sleeping could be symptoms of a COPD exacerbation. Your action plan should outline how to take your rescue medications, when to use oxygen, and how to use breathing exercises such as pursed-lip breathing. It should also discuss when to call your doctor.
• Red zone. If you have COPD symptoms like severe shortness of breath, chills and fever, confusion, chest pain, or coughing up blood, your action plan goes into emergency mode. Have your emergency contacts ready, call 911 if you need to, increase your oxygen, and get help right away.

COPD Tips to Stay on Track

In addition to following your treatment plan, you can help keep your COPD under control by avoiding potential complications, watching out for anxiety and depression, and making sure you have a good support system. Here’s how:

• Preventing COPD flares. Quitting smoking and avoiding secondhand smoke are two of the most important things you can do to help control COPD symptoms. Air pollutants, allergens like dust and mold, and chemical fumes can also cause a COPD exacerbation. Keep your windows closed and stay indoors as much as possible when pollen and pollution levels are high. Also, make sure to get flu and pneumonia vaccines to help avoid the complication of infection.
• Avoiding depression. Having COPD can make it hard to sleep, enjoy food, and do many of the activities you once enjoyed. Feeling down occasionally is normal, but clinical depression — when feelings of sadness and other symptoms last for more than two weeks — is dangerous. Depression may keep you from sticking to your treatment plan. Learn the symptoms of depression and ask for help if you need it. Treatment for depression may be an important part of managing your COPD.
• Understanding COPD anxiety. Your brain has a region that sets off an alarm signal when oxygen levels are low. For people with COPD, this region can become overly sensitive and send off alarm signals that feel like an anxiety attack. If you are worrying about your breathing all the time, especially if you are afraid to leave the house because of it, you may need help managing anxiety. Treatments such as breathing exercises, counseling, and medication can help keep anxiety under control.
• COPD support. Managing COPD can be tough, but you don't have to do it alone. Talk to your friends and family about your physical and emotional needs. Many find that joining a COPD support group offers an opportunity to share with others who understand. A support group can be a source of experience, strength, and hope, and can help you keep your COPD treatment on track.

Your COPD treatment plan is a lifelong process. Sticking with the plan is the best way to keep living well with COPD, and staying in close touch with your health care team will allow you to adjust your COPD treatment plan over time.

http://www.everydayhealth.com/health-report/chronic-obstructive-pulmonary-disease/copd-treatment-tips.aspx

Caring for a Loved One With COPD

What's involved in home care for the COPD patient?

By Krisha McCoy, MS

Medically reviewed by Lindsey Marcellin, MD, MPH

When you care for someone with chronic obstructive pulmonary disease (COPD) at home, you may have numerous responsibilities.

One of the most important things to do when your loved one is diagnosed with COPD is to learn as much as you can about the disease, says Barry Make, MD, co-director of the COPD program at National Jewish Health and professor of medicine in the division of pulmonary sciences and critical care medicine at the University of Colorado in Denver. COPD caregivers "need to understand the disease as well as the patient does," he says.

Talk to your COPD patient's doctors about what tasks you will need to perform. It is also important to seek support from your loved one's medical team, and other friends and family members.

COPD Home Care: Specific Tasks

Some tasks you may need to perform as a COPD caregiver:

• Encourage pulmonary rehabilitation. Pulmonary rehabilitation consists of prescribed exercise, nutrition counseling, and disease education. Rehab can improve quality of life, increase strength, and reduce shortness of breath and other COPD symptoms. As a caregiver, you can encourage your loved one to go to rehab and even attend rehab sessions with your loved one. "Not only should the patient be in [pulmonary rehabilitation], but their spouse or significant other should attend as well," says Dr. Make.
• Help with medications. Depending on your loved one's symptoms and severity of disease, he may need to take multiple medications at a variety of times throughout the day. You can help keep track of these medications and make sure your loved one is taking them by creating a chart that tracks each medication, its dosage, and time of day it is to be taken. You can use the chart to check off when the medication is taken as directed.
• Attend doctor's appointments. "I think that the spouse or significant other of the COPD patient should go into the physician visits as well as the patient," says Make. You can help your loved one remember what the doctor said and make sure all questions are answered. "One of the best things a caregiver can do before they bring home their newly diagnosed COPD patient is ask a lot of questions," says Kitty Weary, of West Yellowstone, Mont., who provided COPD care for her father, husband, and mother.
  Weary suggests writing down all of the questions you and your loved one have in a notebook and leaving spaces to fill in answers from the medical team. "All of this new stuff is getting fired at you, and there is a good chance you won't remember anything," she says. At the visits, you can learn how to use any prescribed equipment, which may include supplemental oxygen, a handheld bronchodilator inhaler, or a nebulizer.
• Monitor your loved one's condition. Talk with the medical team about the warning signs of an exacerbation (an episode of worsened symptoms), and when you should seek medical help. In general, you should call the doctor when your loved one has:
• 
  
  • Excessive trouble breathing during everyday activities
  • Greater than usual coughing or coughing-related chest pain
  • Increased mucus production or change in appearance of mucus
  • Swelling in the hands or feet
  • Cramping of muscles
  • Tiredness or weakness
  • Trouble sleeping that is related to shortness of breath

Caring for a COPD patient at home can be challenging. But by following the medical team's instructions and encouraging your loved one to adhere to her COPD treatment regimen, you can play an important role in improving your loved one's quality of life.

http://www.everydayhealth.com/health-report/chronic-obstructive-pulmonary-disease/caring-for-loved-one-with-copd

Sudden Cardiac Death: Are You at Risk?

Source: Article first appeared in "Know Your Man Inside Out" by SingHealth / Her World

Did you know?

Heart attacks are not confined to the old. Even young men can get a heart attack leading to sudden death.  80 per cent of all sudden cardiac death are related to coronary heart disease which, in most cases, can be prevented.

What causes young men to die suddenly?The most common cause is sudden cardiac death (SCD), of which 80 per cent is related to coronary artery disease (CAD) (see box below), with or without a heart attack.

Unfortunately, over half of sudden cardiac death victims have no prior symptoms. Some patients have chest pain, breathlessness or sweating. When these occur in a patient at risk of heart problems, treatment should always be sought immediately.

An SCD attack is not the same as a heart attack. SCD is caused by an abnormal heart rhythm due to an abnormal ‘electrical circuitry’ of the heart. A heart attack is caused by blockage of the arteries supplying blood to the heart. The subsequent damage to the heart muscle may or may not lead to an SCD attack. It is estimated that 1,000 Singaporeans die from SCD every year, about half of whom are below 60 years old.

Learn to recognise these symptoms

• Central or left-sided chest pain often associated with sweating, nausea or breathlessness. The pain is described as something weighing heavily on the chest and is usually brought about by physical or emotional stress. It usually goes away within minutes when the stressful activity is stopped.

• Shortness of breath. Because the heart muscles are damaged by the shortage of blood supply or from a heart attack, it can’t pump blood efficiently to meet the body’s needs.

• Discomfort on exertion, jaw tightness on exertion or after meals. These symptoms immediately subside on resting.

In anyone at high risk for heart disease (eg diabetics, high cholesterol, hypertension, strong family history of heart disease), any chest symptom, even atypical, should be investigated. Diagnosis is made with an electrocardiogram and blood tests.

Treatment may involve hospitalisation and ways to restore blood flow in the coronary artery (by angioplasty or thrombolysis).

If you are around...

1. Call the ambulance immediately. Early treatment increases survival rate.

2. Perform chest compression CPR. This will also improve the chances of survival.

Cardiac Artery Disease (CAD) CAD is a common type of heart disease where fatty deposits accumulate in the coronary artery and impede the blood flow. Reduced blood flow to the heart can cause chest pain (angina). A sudden, complete blockage can lead to a heart attack. Many people who have this form of heart disease are not aware they have it. CAD develops slowly and silently over decades. It can go virtually unnoticed until it produces a heart attack. You can prevent or slow down CAD by taking steps to improve your heart health. Drugs and surgical techniques can open up narrowed coronary arteries, but the best long-term solution is to make the right lifestyle choices.

Are You in the High-Risk Group?Age: Age increases a person’s susceptibility to heart disease. Gender: Men are three to five times more likely to have coronary heart disease than women. However, the risk for women increases after menopause. Five to 10 years after menopause, women have the same risk for coronary heart disease as men. Ethnicity: Compared with Chinese, South Asians (Indians, Sri Lankans, Pakistanis, etc) are three times more likely to suffer from coronary heart disease. Malays have double the risk compared with Chinese. Obesity: People who have excess body fat – especially located around the waist – are more prone to heart disease and stroke even if they have no other risk factors. Excess weight increases the strain on the heart. It also raises blood pressure, blood cholesterol and triglyceride levels, and lowers HDL, ("good" cholesterol levels). It is also associated with the development of diabetes mellitus. Family history: You can be at higher risk of heart disease if your immediate family members (parents, children, brothers and sisters) have a history of premature heart disease. Certain risk factors tend to run in some families. If there is a history of heart disease in your family, you should try very hard to control your other risk factors. "In general, adults should know their family history of heart disease or sudden death. They should know their cholesterol level and know if they have diabetes mellitus and abnormal blood sugar levels. If you have any high-risk factor, get your doctor’s advice on how to improve those risk factors, change your lifestyle and dietary habits, and embark on a safe exercise programme."  Dr Teo Wee Siong, Senior Consultant Cardiologist, National Heart Centre http://www.healthxchange.com.sg/healthyliving/SpecialFocus/Pages/Sudden-Cardiac-Death-Are-You-at-Risk.aspx?

WOMEN CAN PREVENT HEART DISEASE

FDA.gov - A lot of people think that women do not get heart disease. More women die from heart disease than from anything else. Any woman can get heart disease.

When you think about heart disease, you probably think about chest pain. Women might not have chest pain. If they do, they might call it an achy, tight or "heavy" feeling instead of pain. The pain might even be in the back between the shoulder blades, instead of the chest.

Women might think these signs are no big deal because they don't "sound" like a heart attack. Don't ignore these signs. Go to your doctor of clinic right away.

What are the signs of heart disease in women? 
The most important sign is feeling really tired--even if after enough sleep. Other signs of heart disease in women are:

Trouble breathing
Trouble sleeping
Feeling sick to the stomach
Feeling scared or nervous
New or worse headaches
An ache in the chest
Feeling "heavy" or "tight" in the chest
A burning feeling in the chest
Pain in the back, between the shoulders
Pain or tightness in the chest that spreads to the jaw, neck, shoulders, ear, or the inside of the arms
Pain in the belly, above the belly button
There is good news: You can take steps to keep your heart healthy.

Don't wait to get help!
Go to your doctor or clinic if you have any warning signs.

Lower Your Risk of Heart DiseaseFind out if heart disease runs in your family.
Visit your doctor or clinic often. Find out if you are at risk.
Don't smoke. Stay away from other people who are smoking.
Get your blood pressure checked often. You might need medicine to keep it at the right level.
Control your diabetes.
Get your cholesterol checked often.
Stay active. Walking every day can lower your chances of a heart attack.
Eat right and keep a healthy weight.
Eat less salt.
If you take birth control pills, don't smoke.
Hormones for menopause should not be used to prevent heart attacks.
Being stressed, angry or sad a lot may add to your risk of heart attack.
If you've had a heart attack, talk to your doctor about medicine. Some medicines can help cut down the risk of having another heart attack.

High Blood Pressure
High blood pressure adds to the chance of having heart disease.
High blood pressure is called the "silent killer". Most people who have it do not feel sick and don't know that they have it.
Have your blood pressure checked each time you go to the doctor or clinic.

To learn more:FDA's Office of Women's Health website:
www.fda.gov/womens/ 

National Institute of Neurological Disorders and Stroke Information Office
Phone: 301-496-5751
Web site: http://www.ninds.nih.gov/

National High Blood Pressure Education Program c/o NHLBI Information Center
Phone: 301-592-8573

http://www.bennyhinn.org/yourlife/healthy-living/your-health-today/6692/women-can-prevent-heart-disease