Chronic Obstructive Pulmonary Disease COPD

By Bonnie Jenkins, Advanced Natural Medicine
My mother-in-law smoked for nearly 35 years before she finally gave it up more than 15 years ago. The problem is, however, that the damage to her lungs was already done – and now she’s living with a diagnosis of Chronic Obstructive Pulmonary Disease, more commonly known as COPD.

The dog days of summer, with its thick and stagnant weather, can leave her literally gasping for air. She’s not alone. More than 30 million Americans live with a chronic lung disease and, for them, breathing can be a chore every day of the year.

3 Ways to Boost Your Lung Power

By David Blyweiss, M.D., Advanced Natural Medicine

Take a deep breath.
For most people, it’s not a big deal. But if you suffer from chronic obstructive lung disease (COPD), breathing may be one of the most difficult things you do.

COPD is a group of conditions that includes emphysema, chronic bronchitis and asthma. Smoking is the most common cause of COPD. But pollution and chemical fumes can also set you up for respiratory problems later in life.

Gasping For Breath

By David Blyweiss, M.D.

The other day, my office got a frantic call from Jane. The night before she had suffered a frightening bout of breathlessness. You see, Jane had been a pack-a-day smoker for much of her life. And, although she quit more than 10 years ago, she was left with a devastating case of COPD. 

Long-time tobacco smokers like Jane have the highest risk of developing COPD, also called Chronic Obstructive Pulmonary Disease. It’s a major cause of disability, affecting at least 12 million people, and the fourth leading cause of death in the U.S.

COPD Triggers: How to Prevent a Flare

Host: Carolynn Delany

Guest: Robert T. Schreiber, MD
February 27, 2012

Carolynn Delany:

Welcome to this Everyday Health podcast, “COPD Triggers: How to Prevent a Flare.” I'm your host, Carolynn Delany. Anyone coping with chronic illness knows there are good days and bad days. We're here today to become more aware and hopefully prevent those bad days from happening as often. Joining us today is Dr. Robert Schreiber, a pulmonary medicine specialist at Nassau Chest Physicians and director of the surgical ICU at St. Francis Hospital in Roslyn, New York. Dr. Schreiber and Nassau Chest Physicians are also actively involved with the American Lung Association in New York. Thanks for being with us today, Dr. Schreiber.

Dr. Schreiber:

I'm very glad to be here with you today, Carolynn.

Carolynn Delany:

Dr. Schreiber, we hear the terms "trigger" and "flare" quite often. Can you please help us understand what they mean and why certain elements cause COPD symptoms to flare?

Dr. Schreiber:

Carolynn, we use the words "flare" and "exacerbation" interchangeably for our patients with COPD, and what this really refers to is a temporary worsening of their emphysema [or chronic bronchitis]. Patients will have increased shortness of breath, wheezing, and coughing, and frequently we'll see increased sputum production. The sputum may change and be increased in terms of amount, thickness, color, going from clear to gray or yellow, and even sometimes bloody.

Carolynn Delany:

Dr. Schreiber, what are some common COPD triggers that can actually cause the flare‑up to happen?

Dr. Schreiber:

Carolynn, I think the number one trigger that we see would be infections. This can be anything from a cold to more serious things like bronchitis or pneumonia. Other things that we commonly see causing flare‑ups can be exposure to smoke, whether primary smoke from the patient smoking themselves or inhalation of secondhand smoke if they are out in a restaurant or some other venue where other people are smoking and they inhale other people's smoke.

Of course, other things like weather, whether it be hot or cold or humid or dry air, can also affect many people. Air pollution is a common trigger for many of our patients, particularly in those hot, humid days during the summer when the air quality gets very bad. That's a frequent cause of triggers during those air polluted days. And just general stress sometimes can bring on an exacerbation.

Carolynn Delany:

Well, you know, you mentioned avoiding smoking and being around others who are smoking. Is it also important to stay away from chimney smoke and stovetop smoke?

Dr. Schreiber:

Certainly for some people this can also be an irritant and trigger for a COPD exacerbation. Smoke is composed of a variety of chemicals, including particulates of carbon and all sorts of chemicals, and may have carbon monoxide sometimes, so our patients with COPD have to be careful around any type of smoke. Usually chimney smoke and stovetop smoke aren't toxic, but they can act as irritants.

Carolynn Delany:

Well, a flare‑up can happen at any time and all of the triggers you've mentioned are good ones to look out for, but are there others that only affect some people? If so, how should they learn to identify, watch out for, and deal with them?

Dr. Schreiber:

Different people will flare up from different triggers. The most important thing that I can do as a doctor is not sit down and say to someone, “you have to avoid,” and then give them a list of things. You have to tell them, “Listen, you have to pay attention to what bothers you.”

I don't play ice hockey, but I love to watch it, and there's a phrase that you have to skate with your head up, which really means that you have to look around you and be aware of your environment and see what's going on all the time, and that's really what it's about for our patients. You have to tell them, “Pay attention to what's going on, see what bothers you, and then, of course over time, you can learn what you can and cannot be around so that you can breathe more easily.”

Carolynn Delany:

That's a good point. I mean, some people might be more sensitive to extra dust in their home or scented laundry detergents, but it may not bother anybody else.

Dr. Schreiber:

That's exactly correct. I think in general, most people need fresh, circulating air so that nothing particularly settles or irritates their lungs. Other triggers, though, you have to kind of learn about those things, as you mentioned, like the scented laundry or fragrances and stuff, and see what really bothers you or not.

Carolynn Delany:

Well, why is it important for someone with COPD to maintain his or her overall health?

Dr. Schreiber:

The current state of the art in pulmonary medicine suggests that COPD exacerbations can gradually cause further loss of lung function, and clearly as healthcare professionals we all want to preserve our patients' lung function so that they can stay healthy, remain independent, and continue to perform their activities of daily living as best as possible. I think everyone feels that that should be a goal for themselves, and we as physicians want to try to do that for our patients.

Trying to stay healthy is really the most important thing here. As I said, infections are probably the number one cause of triggers, so hand washing and sanitizers will help prevent picking up colds. Obviously, if you know somebody is sick it's best to stay away from them. And immunizations are important to try to help prevent people catching influenza and pneumonia.

Carolynn Delany:

I see. I see. All great tips. Well, if you do find yourself in a flare what's the first and perhaps best thing you can do to help treat it and get you back to feeling normal?

Dr. Schreiber:

I think we all have to think of having a plan and that life is not just full of surprises, so patients with COPD have to recognize that things are going to happen, and what am I going to do when it happens. So the first thing to do is to remove yourself from the trigger if it's possible.

There is a way of breathing we call pursed-lip breathing where you breathe in through your nose and out through your mouth with your lips together when you exhale, and this helps to control the breathing pattern. It helps you breathe more efficiently. If you do it slowly, you get actually more oxygen in with less work of breathing, and that's a very helpful technique that your healthcare provider could probably teach you to do.

When the trigger happens, I tell my patients to drink extra fluids and try to get some extra rest. I almost always will have them have available a quick‑acting medication. Usually it's an inhaler, although sometimes it's a nebulized medicine that they can inhale that should help to open up the bronchial tubes.

And of course, if these things don't help they should really get in touch with their healthcare provider to see if there can be an adjustment of their medicines, see if they need a stronger bronchodilator or an antibiotic or possibly a course of prednisone. If those things fail, sometimes emergency room treatment or hospitalization even is required, but hopefully we can cut that off at the pass and try to keep people away from the hospitals.

Carolynn Delany:

Right. Well, Dr. Schreiber, thank you for sharing great information about how to recognize and prevent a flare when you're living with COPD.

Dr. Schreiber:

Well, Carolynn, as always it's my pleasure to speak with you and help our patients. And don't forget our patients should also contact their local chapter of the American Lung Association for further tips because they're a great resource for more information, too.

Carolynn Delany:

They certainly are. You've been listening to an Everyday Health podcast, “COPD Triggers: How to Prevent a Flare.” For more information on COPD, visit EverydayHealth.com. I'm Carolynn Delany for Everyday Health. Thanks for joining us.

http://www.everydayhealth.com/copd/podcasts/how-to-prevent-a-copd-flare-transcript.aspx

COPD Myths and Truths

COPD is often misunderstood because symptoms can be caused by three different diseases. Separating fact from fiction will help you live better and better manage COPD.

By Chris Iliades, MD

Medically reviewed by Lindsey Marcellin, MD, MPH

Chronic obstructive pulmonary disease (COPD) can be confusing because it isn’t a single condition — it actually refers to a group of lung diseases that makes it difficult to breathe.

"COPD is an umbrella term for three different diseases," says Timothy R. Wu, MD, director of the COPD Center at Lahey Clinic in Burlington, Mass. Emphysema, chronic bronchitis, and chronic asthmatic bronchitis can all cause COPD symptoms. What these diseases have in common is obstructed air flow through the lungs.

Common misunderstandings about COPD include that it only occurs in older smokers and that nothing can be done about it. However, that’s not necessarily the case. To better understand COPD and how to live with it, start by learning how to separate the myths from the facts.

Myth or Truth: Only Smokers Get COPD

COPD symptoms such as cough, shortness of breath, and frequent lung infections are among the most common symptoms experienced by long-term smokers. While emphysema, chronic bronchitis, and asthmatic bronchitis are usually caused by smoking, there are other causes as well. "Smoking is almost always the cause of COPD in the United States, but in many parts of the world, COPD may be more commonly caused by wood smoke from cooking fires," says Dr. Wu. Other non-smoking causes include:

• Some progressive forms of asthma
• Being born without a protein called alpha-1 antitrypsin
• Workplace exposures to gases and fumes
• Heavy exposure to secondhand smoke or air pollution

Myth or Truth: COPD Only Occurs in Older People

COPD is more common in older people who have smoked for many years, but a simple test called spirometry may detect early changes from COPD in younger people. Spirometry is a lung function test that involves blowing into a small machine that measures lung capacity. This test can be read immediately, and it is a reliable way to make a diagnosis.

"Even before COPD symptoms develop, the early changes of emphysema or bronchitis may be present," says Wu. "If younger smokers are screened with spirometry, COPD may be diagnosed in people as young as 30 or 40."

Myth or Truth: People With COPD Need to Slow Down

COPD symptoms may make some types of activity difficult, but slowing down is not good for those with COPD. Physical therapy, including breathing exercises and exercises to strengthen the arms and shoulders, can be an important part of treatment. Regular exercise along with a healthy diet helps muscles stay strong, and that reduces the demand placed on the lungs.

People with COPD should also try to stay active socially. Isolating yourself at home can lead to depression, which can make symptoms worse. It is important to stay in touch with friends and family and maintain a good support network. Many people with COPD also benefit from participating in support groups.

Myth or Truth: There Is No Treatment for COPD

The biggest myth about COPD is that you can't do anything about it. Although there is no cure for COPD, it can be treated and managed in many people. "How well COPD can be treated depends on how advanced it is and what other diseases may be present, such as hypertension and heart disease," says Wu. You can slow down the progression of COPD by:

• Taking medication as directed
• Getting pulmonary rehabilitation
• Using oxygen as needed
• Stopping smoking

With these changes, many people are able to manage their COPD symptoms well. If you smoke, even if you are still in your 30s, ask your doctor to check your lung capacity. Many of the irreversible effects of chronic bronchitis, emphysema, and chronic asthmatic bronchitis can be avoided with early diagnosis and treatment.

"It is never too late to stop smoking. As soon as you quit, your lung function starts to improve," says Wu, although lung function will never get back to normal once COPD starts. COPD symptoms develop over time, and changes in your lungs may have already started without you knowing it. The best time to stop smoking is right now.

http://www.everydayhealth.com/health-report/chronic-obstructive-pulmonary-disease/copd-myths-and-truths.aspx

Cured meats linked to exacerbated respiratory illness symptoms: study

AFP Relax

Eating too much cured meats like salami, chorizo and bacon can worsen symptoms of respiratory diseases like emphysema and chronic bronchitis and lead to a trip to the hospital, says a new study.

Published in the European Respiratory Journal last week, a team of Spanish researchers say they've found a link between the consumption of cured meats and the increased number of hospital admissions among people suffering from chronic pulmonary disease (COPD).

The umbrella term is used for a number of respiratory illnesses caused by inflammation in the lungs.

For their study, researchers worked with 274 COPD patients from their first hospital admission and monitored them for the next two years. Participants also provided information on their cured meat consumption.

Their conclusion? People who eat large quantities of cured meats -- identified as more than a slice of ham or equivalent a day -- were more likely to experience exacerbated symptoms and be admitted to hospital.

Researchers believe the problem lies in the nitrites which act as preservatives and anti-bacterial agents in the meats -- substances which have also been shown to cause a reaction and damage tissue in the lungs.

While previous research has shown that increased consumption of cured meats like hot dogs and salami can lead to an increased risk of developing COPD, the Spanish researchers say theirs is the first to show that eating processed meats can also inflame and worsen symptoms.

Processed and cured red meats, which are high in sodium and nitrites, have also been linked to the development of Type 2 diabetes, heart disease and bowel cancer.

http://bit.ly/vZsDvU

http://ph.news.yahoo.com/cured-meats-linked-exacerbated-respiratory-illness-symptoms-study-143050895.html

Why Women Need to Know about COPD

Learn more about one of the surprising killers of women, and get the facts that could save your life 

By Teresa Dumain

It kills more women than breast cancer,Alzheimer’s disease, and diabetes. If that’s not enough to get your attention, consider this: More women than men die from Chronic Obstructive Pulmonary Disease, or COPD. Smoking is the primary cause of COPD, an umbrella term that covers chronic bronchitis, emphysema, and other diseases that involve progressive damage to the lungs. 

“It used to be an all-boys party,” says Neil Schachter, MD, medical director of the respiratory care department at Mount Sinai Medical Center in New York City. “But the burden of the disease recently crossed over.” One reason: Women started smoking later than men. “It wasn’t until the 1970s and 80s that smoking rates picked up for women,” explains Schachter. “And now we’ve reached the time where we start to see the effects.” COPD is number four on the list of top lady-killers; here are seven more things you need to know and reasons you should care about this deadly disease. 

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1. You could have it, and not know it. An estimated 12 million Americans are walking around winded, blaming old age and added weight. Shortness of breath is the cardinal symptom of COPD, says Timothy R. Wu, MD, director of the COPD Center at Lahey Clinic in Burlington, Mass. But because the disease develops slowly, mild signs are sometimes easy to miss; plus, people tend to adapt their behavior to compensate. “If you can’t catch your breath going up a flight of stairs, next time you’ll probably take the elevator and not give it a second thought,” he says. Persistent coughing and chest congestion or excess phlegm are also indicative of COPD; for most people, symptoms start to surface around age 40.

2. You could have it, and your doctor might not know it either.Studies have shown that when men and women presented the same symptoms, men were more often correctly diagnosed with COPD. Women were incorrectly diagnosed with asthma, says Wu. Currently, more than 12 million people in the US know they have COPD, and while the screening test literally takes seconds, it’s grossly underutilized, adds Schachter. All you have to do is take a deep breath and blow into a machine for a count of six seconds. The machine (called a spirometer) measures how “big” your lungs are and how fast you breathe air out of them. The test—known as spirometry—can detect COPD even before symptoms appear, and help determine its severity. “It’s important for anyone over age 40 with a history of smoking, or any symptoms at all, to talk to their doctor and ask to be screened,” says Wu, but women should be extra vigilant. “Though we’re getting better at diagnosing the disease, many doctors still lean toward assigning COPD to men.”
 
3. Smoking might cause your lungs more harm. That’s because women have narrower airways than men, so the toxins in cigarettes may have a stronger effect, even if they smoke the same amount, explains Wu. Still, heavy and long-term smoking is the most significant risk factor for both men and women, it’s the most common cause of COPD, and it’s responsible for up to 90% of related deaths. Breathing in other irritants, such as secondhand smoke, air pollution, and chemical fumes or dust from the environment or workplace can also inflame the lungs and contribute to increasing your risk.

4. Breathing in bad stuff isn’t the only way to get COPD. Researchers are studying different potential predispositions to the disease—genetic or otherwise; one known genetic disorder called alpha 1-antitrypsin deficiency is the source of a few cases of COPD. Also under investigation: if female sex hormones may make women more prone to developing the disease. 

5. You’ll need to see your doctor more often. There’s no cure for COPD, but the right treatment plan can help control symptoms and delay the progress of the disease. Frequent checkups are important so your doctor can monitor your medications and keep you informed of new options (last March, the FDA approved a drug to reduce flare-ups and symptoms in some patients). Your doctor may also recommend nicotine replacement products and drugs to help you quit smoking; discuss different COPD therapies (such as pulmonary rehabilitation or oxygen treatment); talk to you about getting the flu or pneumonia vaccines (both of which can cause complications); and keep an eye on your overall health. “COPD is a systemic disease that’s linked to an increased risk of heart disease, depression and number of other conditions,” says Wu.

6. You shouldn’t stop exercising. Regular physical activity can ease COPD symptoms and boost energy, strengthen your heart and respiratory muscles, help you lose weight, fight depression, and most importantly, help your body use oxygen better. Just don’t push yourself too hard: “Walking 30 minutes, three times a week, for example, is a healthy amount of exercise,” suggests Schachter. Stretching is also a good option to reduce injuries and improve flexibility; upper body strength training is especially helpful to build respiratory muscles. “Anything that gets you moving is good, but talk to your doctor before starting any workout program,” advises Schachter.

7. You might need to redecorate. “Think minimalist,” says Schachter. Cut down on the knickknacks and trinkets, rethink long drapes, wall-to-wall carpet, and roll up some throw rugs—“They’re all collecting dust and allergens that can irritate your airways and increase breathing problems,” he says. More tips to help keep indoor air clean: Open the windows to help ventilate your home after using smelly cleaning products, bug sprays, and paint; and ban smoking indoors. 
 


Do you know anyone who might have COPD? 

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