Brenda Robinson: What Seemed Hopeless

TESTIMONY

By Christine Wilson

The 700 Club

CBN.com – It began with a small headache. Then 24-year-old Brenda Robinson dismissed the pain, blaming it on fatigue.  The last thing she remembers was sitting down for dinner at her sister’s.

“When I came to, I said, ‘What’s going on? Did we eat dinner?’  And she said, ‘It’s been two weeks since that dinner. You’ve had probably about 100 seizures, gran mal epileptic seizures in two weeks.’ I started to move, and I couldn’t move. I was paralyzed. She said, ‘Your speech has even been paralyzed. You’ve been trying to talk to us for two weeks, and you couldn’t.’”

Two weeks, including several visits to the hospital, had vanished from her memory. She was diagnosed with gran mal epilepsy, which brought on violent, debilitating seizures.  The seizures were difficult for her whole family, including her husband Dan.

Getting Refueled

 "Very early in the morning, while it was still dark, Jesus got up, left the house and went off to a solitary place, where he prayed" (Mark 1:35-36).

How do you get refueled? When our cars run low on fuel, we simply drop by the local filling station to get more fuel. When our bodies are hungry, we feed them. How do we refuel our spiritual lives? We can learn from the example Jesus modeled in His life.

In the New Testament we see that Jesus had a very demanding schedule. He traveled from town to town, often walking many miles between the towns. He spent a lot of time with people. As a speaker and teacher I can tell you that it is very draining to minister for extended periods. Your body and your spirit becomes fatigued.

The day before the above scripture was recorded, Jesus had a full day of ministry healing the sick, delivering people from demons and walking to different cities (Mark 1:29-37). The following day it says Jesus got up before the sun rose and went to pray. The disciples were wondering where He was.

The Female Sexual Dysfunction Myth

Can a Little Pill Cure FSD?

Lizzie Flynn, Yahoo! Contributor Network

The Cleveland Clinic defines sexual dysfunction as "a problem during any phase of the sexual response cycle that prevents the individual or couple from experiencing satisfaction from the sexual activity". The sexual response cycle is defined as having four phases: excitement, plateau, orgasm, and resolution. What are some of the problems that can interfere with the sexual response cycle?

What It Takes to Struggle with Something Hard

By Rachel Olsen

"No, in all these things we are more than conquerors through him who loved us." Romans 8:37 (NIV)

Beginning in my twenties, I wrestled each day with chronic pain and fatigue. The first few years of it, doctors had no idea why.

Then came the diagnosis: fibromyalgia.

I was told this condition was poorly understood, not very treatable, and also not reversible. In fact, they called it "degenerative," meaning it would worsen as I aged. In short, doctors said I had no chance to conquer this pain.

The pain worsened for a couple years and I couldn't image what my life would be like five, ten or fifty years down the road. I prayed for deliverance.

What Do Women Want?

Doug Rosenau New Man - Sexual Purity

Husbands desire to be great lovers with a truly skillful and passionate sex life. What happens that so many men fall short of this grand goal? Here are two of the most common skill deficits that sabotage these lofty dreams: (1) Men don't truly understand women; and (2) Men don't realize that they don't truly understand women.

These seven keys will unlock passion in your marriage.

Sexuality and Breast Cancer Treatment

How Breast Cancer Treatment Can Affect Your Sexuality and Sex Life

By Cory Silverberg, About.com Guide

Updated September 28, 2010

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

There are many different treatments for breast cancer and each of them can have multiple effects on your sexuality in general and your sex life in particular. But sexuality and breast cancer are not fundamentally opposed to each other, and increasingly the medical system is considering, at least a little bit, the sexual side effects of various treatments for breast cancer. Unfortunately talking about sex is still something most health care professionals are not comfortable doing, and you'll likely have to ask if you want to know what to expect from your specific course of treatment for breast cancer. Also, because the medical model focuses almost exclusively on sexual functioning, it is left to you (and partners, if you have them) to really think about the big picture ways that treatment for breast cancer is affecting your sexuality, and how you'd like to deal with that.

You get to choose how much or how little sex matters at any given time in your life. If sexuality feels like the last thing you want to deal with right now, that's okay. If it's the first, that's okay too. Because most of us carry some shame about sex to begin with, it can feel easier to ignore it. But just as sexuality can be a site of shame and pain, it can also make us feel wonderful about ourselves and our bodies, and can be a source of strength when dealing with something like breast cancer treatment.

Every experience is going to be unique, but some of the predictable ways that breast cancer treatment can affect your sexuality and your sex life include:

Fatigue : You may find yourself more often, and more easily, tired. This may be the effect of medications and/or the rigors of treatment. Waiting around is a big part of most medical treatments, and waiting can be exhausting. Feeling too tired to have sex, or even think about sex, is common and understandable. Obviously this can result in having less sex, but it can also have a secondary effect since having sex is, for many of us, a time when we feel connected to our bodies and to our partners, and when we go for long periods without it, we can easily feel less desirable, less desired, and less connected.

Pain : Treatments themselves may cause pain. Pain may lead you to not want sex, or not be sure how to have sex without causing yourself more pain. Treatments may also lead to changes in your body that make certain kinds of sex painful. For example reduced vaginal lubrication is a common side effect of some breast cancer treatments, and without addressing the issue it can mean that intercourse is too painful to engage in.

Changed Body, Changed Body Image : Most breast cancer treatments change your body in one way or another. Changes may be visible to the world (e.g. surgery to remove parts of your body, losing your hair as a result of chemotherapy) or they may not be visible to others. In either case these changes can feel sudden and extreme, and it takes time to catch up. Unlike changes that happen as we age, with breast cancer treatment are bodies are changed by others, sometimes in ways we weren't fully prepared for. Or even if we are, it can still feel like something that's being done to us, without our choice. This element of feeling as if our body is being poked, prodded, and altered, may bring back memories of other times we felt as if our bodies, or sexuality, was being controlled by others.

If you have a partner they can also be affected by the ways your body is changing. They may have fears about causing you physical pain, or making a situation worse, or simply reminding you of the breast cancer with their desire to touch you. They may feel as if they knew how to touch you before, but now they are starting from scratch, and fearful of knowing the right way to touch.

Change in Sensations : Scarring from surgery can result in post-operative pain, but it may also result in temporary or permanent changes in the sensitivity of parts of your body that were previously sites of sexual pleasure. When these changes are so sudden we can be left feeling like sexual pleasure is lost to us for good. In truth what's often required is exploration to discover new places to feel pleasure.

Reduced Desire : All of the above, particularly fatigue and pain can not only have an effect on what sex feels like, but on your desire to have sex in the first place. Additionally, breast cancer treatments may result in changes in hormones which are involved in sexual desire, and leave you feeling less interested in sex. While there are no easy answers to dealing with reduced sexual desire, if you know you'd like to have more interest in sex, or more sex itself, there are ways to begin to address it.

What You Can Do
We like to believe we can do things on our own, particularly private things that we're raised to be embarrassed about, like having sex or going to the bathroom. Dealing with breast cancer treatment and trying to lessen the negative sexual effects really does require some help. You'll need to get at least one of your health care providers on board. Someone who is willing to talk to you about sexual side effects of treatments, and who ideally is open to adjusting treatments when possible to reduce the negative sexual effects.

If you have a partner, it helps if they can be in on some of those conversations and at least have a sense of what to expect. You need to take things at your pace, but if you have a partner you need to let them in the loop somewhere, even if it's only as far as saying that you'll share more when you're ready. Partners can easily blame themselves or feel like you're leaving them behind, at the very time when you may be feeling the same. So keeping communication as open as possible is key.

Fatigue isn't something that can avoided, but realizing that it's not "you" but rather what you're dealing with that is leading to a reduced interest in sex can help. It's easy to take responsibility and think that it's our fault. It's also easy for partners to take the blame, or interpret a lack of interest as sexual rejection. Simply naming fatigue and the causes of it can be helpful. Beyond that, if having sex is something that's important, you can think about timing a sex date to the time of day when you feel most awake. You may have always been a sex-at-night person, but now may be the time to explore the wonders of morning sex.

If you're experiencing significant and/or prolonged pain, know that it's something you can talk with your doctor about, and even though it might feel embarrassing at first, remember that wanting to have sex is a completely legitimate reason for wanting to find out how you might be able to manage your pain. And there are some solutions to reducing pain during sex play. With some pain, like that caused by vaginal dryness, there can be relatively easy solutions, such as using a personal lubricant if you want to have vaginal intercourse. Other times it may be a question of finding the right sex position to reduce and avoid pain. The place you're receiving treatment may have resources other than medication (e.g. yoga, meditation) that some people find helps in managing pain and, if not reducing it, at least reducing the extent to which it's affecting something like your sexuality.

Changes in physical sensation and sensitivity as well as changes in body image offer an opportunity to explore your body anew. It isn't that your body is fundamentally different, although it has changed. Ignoring those changes and just hoping you can keep things going as they were won't end as well as trying to discover sexual pleasure in your body as it is. Whether or not masturbation was a regular part of your sex life before breast cancer treatment, if you're interested in being sexual and having sex, sex educators would say that touching yourself is the best place to start. If you are experiencing your body as changed (on the outside, on the inside, or both) you will need to explore your new body and how it responds to touch. Places that used to feel good may not feel as good, and may find new areas of sexual sensitivity that you hadn't discovered before. Give yourself, and if you have a partner, your partner, the right to not somehow magically know everything about your body during treatment. For some people this can evoke an earlier time in life when they were discovering their sexual selves for the very first time. This becomes an opportunity to explore the many different kinds of sex beyond intercourse, something you may not have ever done before, but which can bring many benefits in the end.

If you are experiencing less desire for sex than you had in the past, remember that it's both predictable and completely reasonable. If you're okay with your lack of desire, don't make it into a problem based on some idea of what healthy sex should be. Healthy sex is staying tuned into your own experience and body. A reduction in desire during treatment does not mean that it's permanent. If you're in a relationship and this is a concern, agree to check in with each other at specific times (e.g. three weeks from now, two months from now, etc…). If you have reduced desire and you'd like to do something about it, certainly one place to start is by talking. Talk with your partner, talk with your health care providers, find out if there's something in your treatment that is known to affect desire, and whether or not there are alternatives. Expanding your definitions of what sex is can also be hugely helpful (although it's a lot easier said than done). Often times we feel stuck because we have a narrow idea of what real sex is.


gotquestions  http://sexuality.about.com/od/Cancer-and-Sexuality/a/breast-cancer-treatment-and-sexuality.htm

Lung Cancer and Sexuality

How Will Lung Cancer Affect My Sex Life?

By Lynne Eldridge MD, About.com Guide

Updated March 27, 2012

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Sexuality is an important part of what makes us human, but with lung cancer, the rigors of treatment can push physical intimacy to the back burner. You may be tired from treatments, or your loved one may feel uncomfortable broaching the subject as she focuses on concerns about your health. Despite its importance, healthcare professionals are often hesitant to bring up the subject of sex due to time constraints, consideration of privacy, and even their own comfort level in discussing sexuality. But we know that sexuality affects quality of life and psychological well-being for those living with cancer. What are the issues that affect sexuality with lung cancer, and what can you do to foster sexual (and subsequently emotional) intimacy during cancer treatment?

Issues That Can Affect Sexuality If You Have Lung Cancer
Lung cancer can affect sexuality in many ways, both due to the disease itself and the side effects of treatment. Understanding some of the issues can help you address those that you have some control over, and help your loved one know how he or she can best support you. Some of these include:

Physical issues: 

Changes in physical appearance – Your physical appearance (for example hair loss or weight changes) during treatment may make you feel less attractive or desirable as an intimate partner.

Symptoms of lung cancer – Common symptoms of lung cancer, such as a cough or shortness of breath, may worsen during sexual activity.

Fatigue – Fatigue is an almost universal concern with lung cancer. This can stem not only from the cancer itself and side effects of treatments, but from the demands of doctors visits and traveling for treatment.

The presence of visitors – Time spent with family and friends is very important, but they may forget that you need time to be alone with your partner.

Psychological issues: 

Anxiety about your condition, your treatments or more.

Depression and grief – Studies show that mood has a significant effect on physical function.

Loneliness – You may feel emotionally separated from your loved one as you now face different challenges.

Role changes – Taking on the role of caregiver changes the dynamics of intimate relationships. A spouse may view a cancer patient more as a child than as a sexual partner, and feel uncomfortable with physical intimacy. You, the patient, can also be affected by assuming a role of accepting care more than giving it.

Guilt – Guilt due to the stigma of lung cancer, feeling that somehow an individual caused their disease and somehow deserves it, is common with lung cancer and can interfere with sexuality.

Tips For Enjoying Your Sexuality During Lung Cancer Treatment

Talk openly with your loved one
Share your needs and acknowledge one another's concerns. Anticipate that physical intimacy may need to be expressed in a different way as time goes on. Talk about how you can express your love if you are too fatigued for intercourse, or if coughing requires you to engage in quieter activities.

• How to Talk to Your Partner About Sexual Issues or Concerns

Share intimate physical moments that don’t involve intercourse
Be generous with touch. Hold hands during doctor’s visits. Sneak a kiss while the lab tech draws blood. Look back to the days when you first fell in love, and the special “little things” you did that drew you closer.

• Sexual Activities That Don't Involve Intercourse

Adapt according to your limitations
Positions such as side-by-side may require less energy. Have the partner without cancer take the more active role. Plan to have sex when you are well-rested and not directly following a heavy meal.

Give yourselves a special treat
Think of things that make you feel good and attractive to each other. A new outfit, a pampering massage, a special cologne, even a new hair color (assuming you have hair) may add a little spice. This is important for both of you, as caregivers often feel guilty pampering themselves while caring for a loved one with cancer.

Skip the booze
Alcohol can interfere with a healthy sex life even if you don't have lung cancer. That said, a glass of red wine might add a sparkle to the moment.

• Sexual Effects of Alcohol

Set “visiting hours”
One lung cancer survivor told me that trying to find time alone with her husband reminded her of when they had young children. Now they ask friends not to call or visit during “nap time.”

Nurture your spiritual life
An active spiritual life is associated with a healthier mood and greater emotional well-being, which in turn are linked with a more satisfying sex life with cancer. Spirituality means different things to different people -- organized religion, communing with nature, meditation, or the like.

Most importantly, express your love daily in as many ways as you can. A relationship that is based on love and respect and that is continually nurtured is the best foundation for sexual intimacy during cancer treatment.

Sources:
Gilbert, E. et al. Renegotiating Sexuality and Intimacy in the Context of Cancer: The Experiences of Carers. Archives of Sexual Behavior. 2008. Dec 9. (Epub ahead of Print).

Goodell, T. Sexuality in chronic lung disease. The Nursing Clinics of North America. 2007. 42(4):631-8; viii.

Kotronoulas, G. et al. Nurses’ knowledge, attitudes, and practices regarding provision of sexual health care in patients with cancer: critical review of the evidence. Supportive Care in Cancer. 2009. Jan 9. (Epub ahead of print).

Lindau, S. et al. Communication about sexuality and intimacy in couples affected by lung cancer and their clinical-care providers. Psychooncology. 2011. 20(2):179-85.

Shell, J. et al. The longitudinal effects of cancer treatment and sexuality in individuals with lung cancer. Oncology Nursing Forum. 2008. 35(1):73-9

Shwartz, S. and J. Plawecki. Consequences of chemotherapy on the sexuality of patients with lung cancer. Clinical Journal of Oncology Nursing. 2002. 6(4):212-6.

gotquestions  http://lungcancer.about.com/od/livingwithlungcancer/a/sexuality.htm

Chemotherapy Side Effects

What Side Effects Might I Have With Chemotherapy?

By Lynne Eldridge MD, About.com Guide

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

What are common chemotherapy side effects? Chemotherapy medications work by interfering with cell division. Cancer cells are continuously dividing and are therefore most susceptible to these medications, but some normal cells that divide frequently (such as those lining the stomach and mouth, hair follicles, and bone marrow) are also affected.

Everyone experiences chemotherapy differently depending on the medications used and other factors, such as age, sex, and general health. You may have several of the below symptoms, or you may not experience any symptoms at all.

Be sure to let your cancer team know about any symptoms you are experiencing during chemotherapy, so they can work with you to make the journey as comfortable as possible. Management of chemotherapy side effects has come a long way over the last few decades, and many of these can be controlled with medications and other therapies.

Bone Marrow Suppression

Red blood cells, white blood cells and platelets are continuously produced in the bone marrow and often affected by chemotherapy. Your oncologist will monitor these cells with blood counts during your therapy.

• Coping With Anemia (Low Red Blood Cell Count)
• Coping With Neutropenia (Low White Blood Cell Count)
• Coping With Thrombocytopenia (Low Platelet Count)

Digestive Symptoms

Nausea is one of the most dreaded side effects of chemotherapy, but ways of managing this symptom have come a long way in recent years. Your doctor may prescribe anti-nausea medications at the time of your treatment in an effort to prevent nausea from occuring altogether. Diarrhea can be a dangerous symptom, often prompting a change in the dose of chemotherapy or discontinuing treatment. Dehydration is also a concern if diarrhea is present. Loss of appetite may occur as a side effect of chemo, but may also be due to the cancer itself.

• Coping With Nausea and Vomiting
• Coping With Loss of Appetite

Hair Loss

Hair loss is usually more of a nuisance than a symptom, but it can be distressing nonetheless. According to research, hair loss is one the most feared side effects of chemotherapy. Some medications are more likely to cause hair loss than others, and hair loss can range from a little thinning to total baldness. It helps to be aware (and frequently comes as a surprise) that all hair can be affected, and it is not uncommon to lose eyebrow hair, facial hair, and even pubic hair. Hair loss usually begins a week or so after the start of chemotherapy and begins to grow back 6 to 8 weeks after completing therapy. Talking about options such as wigs and other head coverings before you loss your hair can ease some of the anxiety at this time.

• More About Chemotherapy Induced Hair Loss

Fatigue

Of all the chemotherapy side effects, fatigue is one of the most distressing. Unlike ordinary tiredness, chemotherapy-related fatigue is frequently described as tiredness that does not resolve with rest, “whole body” tiredness or a feeling in which even the most mundane activities require effort. Fatigue may begin shortly into treatment and can persist for up to a year following completion. The first step toward coping with cancer-related fatigue is to understand that it is normal and common.

• What is Cancer Fatigue?
• Tips for Coping With Fatigue During Chemotherapy

Oral Symptoms

Both mouth sores and taste changes can make eating difficult for some people during chemotherapy. Mouth sores often develop a week or so after beginning chemotherapy and resolve soon after treatment is finished.

• Coping With Mouth Sores
• Coping With Taste Changes

Peripheral Neuropathy

Some chemotherapy medications can cause symptoms of numbness, tingling or burning in the hands and feet. With lung cancer, this is most commonly seen with Platinol (cisplatin),Navelbine (vinorelbine), Taxotere (docetaxel) , and Taxol (paclitaxel). These symptoms may occur early on in treatment and go away, or they may occur weeks to months after treatment, and in some cases may be permanent. Clinical trials are in progress to find ways of preventing peripheral neuropathy related to chemotherapy.

• Coping with Chemotherapy-Induced Peripheral Neuropathy

Sources:

National Cancer Institute. Chemotherapy and You: Support for People with Cancer. 06/29/07.http://www.cancer.gov/cancertopics/chemotherapy-and-you

National Cancer Institute. NCI Bulletin. Chemotherapy-induced peripheral neuropathy. 02/23/10.http://www.cancer.gov/ncicancerbulletin/022310/page6

gotquestions  http://lungcancer.about.com/od/treatmentoflungcancer/a/chemosideeffect.htm

6 Chemotherapy Side Effects Patients Don't Expect

The Chemotherapy Side Effects Most People Don't Know About

By Lisa Fayed, About.com Guide

About.com Health's Disease and Condition content is reviewed by our Medical Review Board 

Before undergoing chemotherapy, most people come to expect certain side effects like fatigue, nausea and hair loss. We hear about these side effects so often in pharmaceutical commercials, television shows, and from our loved ones with cancer, that we automatically associate chemotherapy with them. However, the list of possible side effects is long and isn't just exclusive to hair loss or stomach upset. Chemotherapy is a systemic treatment, meaning it affects the whole body with a myriad of possible side effects, some of which aren't easy to talk about during water cooler banter.

When people start experiencing side effects like low libido or yeast infections, it can come as a total surprise. These are the side effects that not many people really talk about. Your doctor most likely gave you an encyclopedia-sized book of information about possible side effects, but because you may not have heard about them beforehand or known someone who experienced them, it's easy to overlook the possibility that you may experience these side effects.

Common Unexpected Chemotherapy Side Effects

1. Low LibidoTo the dismay of many, low libido, or the loss of sexual desire, can be a common chemotherapy side effect. Not all chemotherapy drugs cause a decrease in libido, however, and other types of cancer treatment and related side effects are also a culprit.

A change in libido can also be a psychological side effect of treatment -- hair loss, weight loss or gain, and general lack of self-esteem can cause people to lose their sex drive during treatment.

• More Sexual Side Effects of Chemotherapy

2. Chronic Vaginal Yeast InfectionsWhile vaginal yeast infections do not pose a health risk for women, they can be irritating. 

Chemotherapy drugs, along with steroids or antibiotics that may be prescribed during treatment, can cause women to develop vaginal yeast infections. Under normal circumstances,yeast infections are easy to treat, but the effects of chemotherapy make it difficult for the body to fight off infections.

During treatment, it is important for women to take steps to prevent yeast infections and treat them properly. Most women find relief with over-the-counter medication, but some women may require prescription medication. Learn more about yeast infections during chemotherapy.

3. Chemo BrainCognitive deficit, referred to as "chemo brain" among patients and survivors, is a side effect of treatment that affects cognitive functioning, such as memory and concentration. Affected patients and cancer survivors have reported difficulty concentrating, shortened attention spans, and changes in memory. Research concerning cognitive decline related to chemotherapy is ongoing, but we know little about why it may occur and who is most at risk.

• What Chemotherapy Patients Need to Know About Chemo Brain

4. Nail DamageFingernails and toenails can also be affected by chemotherapy. Nails may become dry, brittle, discolored, or develop lines or ridges. In more severe cases, the nails may even fall off. Not all chemotherapy drugs cause nail damage, but those belonging to the taxane group are most affected by it.

A 2005 study in France found that those who wore special frozen gloves during chemotherapy sessions were less likely to suffer from nail damage than those who did not. Some patients place frozen vegetables or ice packs over their hands and feet to prevent nail damage and also reduce the severity of hand-foot syndrome, another side effect of chemotherapy. Read more about nail damage during chemotherapy.

5. Taste ChangesTaste changes are generally not a common side effect of chemotherapy, but can be with certain chemotherapy drugs. Carboplatin, cisplatin, doxorubisin, gemcitabine, and paclitaxel are known to cause taste changes. These changes can be a loss of taste or experiencing metallic, bitter, or sweet taste sensations. This side effect can make eating and drinking difficult, leading to the development of food aversions, which can cause weight loss. There are no medications to prevent or treat taste changes, but there are things you can do to help food and drinks taste better.

• Coping with Taste Changes During Chemotherapy

6. Acid RefluxAcid reflux is a common condition, even in people who don't have cancer. It can be a common side effect of chemotherapy and a major source of discomfort. For most people, OTC medications alleviate the problem, but for those who suffer from moderate to severe acid reflux, prescription medication may be needed. Acid reflux usually starts within a few days of beginning treatment and can continue after treatment ends. 

Read more about acid reflux during chemotherapy.

Sources:

Florian, Scotté, Jean-Marc Tourani, Eugeniu Banu, Michel Peyromaure, Eric Levy, Sandrine Marsan, Emmanuelle Magherini, Elisabeth Fabre-Guillevin, Jean-Marie Andrieu, Stéphane Oudard. "Multicenter Study of a Frozen Glove to Prevent Docetaxel-Induced Onycholysis and Cutaneous Toxicity of the Hand." Journal of Clinical Oncology 2301 July 2005 4424-9.

Gressett et al. Management of hand-foot syndrome induced by capecitabine. J Oncol Pharm Pract.2006; 12: 131-141
Minisini, A. M. , A. Tosti, A. F. Sobrero, M. Mansutti, B. M. Piraccini, C. Sacco and F. Puglisi. "Taxane-induced nail changes: incidence, clinical presentation and outcome." Annals of Oncology Vol 14, No 23 July 2003 3333-337....

http://cancer.about.com/od/chemotherapysideeffects/a/Chemotherapy-Side-Effects.htm?nl=1

Everyday Tips to Make Living With COPD Easier

Host: Carolynn Delany
Guest: Robert T. Schreiber, MD
February 27, 2012

Carolynn Delany:
Welcome to this Everyday Health podcast, “Everyday Tips to Make Living With COPD Easier.” I'm your host, Carolynn Delany. Chronic obstructive pulmonary disease, also known as COPD, affects your breathing and can make it harder to do everyday activities. That's why it's so important to learn habits that can help make your life easier.

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. Thank you for being with us, Dr. Schreiber.

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

Carolynn Delany:
Dr. Schreiber, why do people with COPD need to be especially mindful of conserving their energy?

Dr. Schreiber:
Patients with COPD have damaged lungs. In general, you use more oxygen when you exert yourself, so it's important for them to pace themselves and to decide to use their muscles and oxygen for really important things and not for things that could be skipped and put off or done by someone else.

Carolynn Delany:
As COPD progresses, people will become more aware of what taps their energy levels. How can planning ahead help with the fatigue?

Dr. Schreiber:
You can plan rest periods and you can plan naps. You can plan time to take your medicines, including nebulizer treatments, so that you can work around your schedule and help keep things under control and do the things that you want to.

Carolynn Delany:
Well, I'm sure that you and your nurses have learned a few tricks from your patients about energy‑saving shortcuts. Can you share a few of those with us, please?

Dr. Schreiber:
Yes. My nurses were very eager to give me lots of tips for patients for today's recording when I told them I was doing this because they actually spend more time with the patients about some of these issues than I do.

So one thing, which I think is a great idea, is when you go to the grocery you can buy precut‑up fruit and healthy prepared food. And when you cook, make extra food, that is, make enough for two or three meals but then go ahead and freeze some. For about the same amount of energy expenditure cooking one meal, you can make a few, and then you don't have to go through the whole bother of cooking every day for several days.

A couple other tricks that I was taught was to eat small, frequent meals and eat them slowly and to pick foods that are easy to chew. All these things don't tax the respiratory system so much. The small meals won't distend your abdomen as much and push up on the diaphragm. And with easy‑to‑chew foods, you don't have to work so hard to get food chewed and ready to be swallowed.

I was told that a good idea is to avoid long lines. So you don't want to go to the Saturday night movie, when you could go to a Thursday afternoon matinee. So, you know, anything you can do like that, or not going to the grocery store at the most popular shopping times, so that you avoid long lines and just standing there. Where you're not doing anything but standing on a line can sometimes be very tiresome for our patients.

And another good trick I was told was to wear loose clothes that are not restrictive so the respiratory muscles can work easily. Loose‑fitting clothes are also easier to put on. You don't want things that have lots of little snaps and buttons and things like that. You want stuff that's easy to get on and off.

Another tip that someone told me was that you could try using an absorbent robe instead of drying yourself with a towel, so you don't have to bend over and reach all around your body, and you can just put on a simple robe. And that will also be a little bit easier and less energy expenditure for yourself.

Carolynn Delany:
Great tips. Well, how can organizing things in your own home make life a little bit easier?

Dr. Schreiber:
Again, finding simple ways to do our chores is probably the most important thing. All this is about doing things efficiently so you don't have to go back and forth and back and forth. Being organized, leaving things in the same place so that you don't have to waste time and energy using up your oxygen looking for things. If you leave your keys or your shoes or your clothes or whatever it is in the same place all the time it's a lot easier for you, and you don't have to waste the energy trying to track these things down.

Also keeping frequently used items within reach is a good tip that I was told. That way you don't have to go straining and stuff to try to find a pot or pan or a book or commonly used clothes or cosmetics. So keep them in a place that's easy to get to. If you have to move stuff from room to room or around a room, having a small table on wheels or a cart and putting it on that and then moving the item will save you energy rather than carrying it. I thought that was wonderful tip for people.

One other one I was told is don't hang your mirrors high. If they're lower then it's easier for you in terms of combing your hair or dressing because you can sit down and do it in front of a mirror rather than standing to do the same thing. For patients with more severe emphysema, you know, standing up and combing your hair can actually be very energy taxing.

Carolynn Delany:
There are mobility aids that can help conserve energy too, like shower chairs are very helpful, recliners that assist with helping you get out of a chair, and even electric scooters. Do you recommend these to your patients?

Dr. Schreiber:
I think shower chairs are great because again you can sit rather than stand, and it's less energy taxing for patients with advanced emphysema. In terms of recliners and walkers, these are good mobility aids to try to keep you independent and moving and doing the things you want to, which will all help you get the things done with less energy use and do it in a safe way.

In terms of wheelchairs and scooters, I try to discourage most of my patients from using them on a regular basis unless they have very advanced COPD and cannot get someplace or do things without them. What I'm always afraid of is once somebody has a wheelchair or scooter that they're going to start relying on it more and more and using their own muscles less and less.

Carolynn Delany:
Are there any special tricks that you'd like to share about reducing stress and anxiety for people living with COPD?

Dr. Schreiber:
Well, we all have stress, and I think we all have to learn how to deal with it and find healthy outlets for it. There are unhealthy outlets for stress, things like smoking, drinking, taking illicit drugs, yelling at your spouse or loved ones. These are all destructive things to do with stress.

On the other hand, there are healthier things you can do with stress. Exercise is a wonderful thing that can be a stress reliever for some people, and it's good for your heart and lungs and your muscles. So I think that's a wonderful choice. For other people, yoga, meditation, listening or playing music are also wonderful ways of reducing stress.

There are other things to help people with stress like support groups, which I think are wonderful because it gives a chance for people to talk about the issues that they share with other people who have the same disease. Ideas are passed around, little tips with each other. And I think it also helps people to know that they're not alone, that there are other people who face the same challenges.

Of course, being educated helps reduce stress. Listening to podcasts, reading, getting information from your healthcare provider I think are all wonderful things to help reduce stress because knowledge about what's happening to me and what should I expect, I think there's a fear of the unknown.

And of course as a last resort there are medications for people who feel stressed. I personally don't like to prescribe medications for stress, but there are some people who need them, and sometimes that's an option that you could talk to your doctor or other healthcare provider about, too.

Carolynn Delany:
Well, Dr. Schreiber, you've shared so many useful tips with us today. Thank you so much.

Dr. Schreiber:
Well, Carolynn, once again it's my pleasure to be with you and share these tips with patients with COPD. I also want to just take one moment to thank the nurses in my office, Lee, Joan, and Karen, who gave me some of these tips I shared with you today.

Carolynn Delany:
That's great. Thank you, nurses, you're always such a huge help. And also it's a great tip to get in touch with the American Lung Association because they're a great asset and resource, as you've said.

Dr. Schreiber:
I agree a thousand percent. Thank you, Carolynn.

Carolynn Delany:
You've been listening to an Everyday Health podcast, “Everyday Tips to Make Living With COPD Easier.” 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/tips-to-make-copd-easier-transcript.aspx

COPD: 8 Ways to Avoid Infections

Patients with COPD must be extra careful to prevent infections that could affect their lungs.

By Krisha McCoy, MS

Medically reviewed by Cynthia Haines, MD

For people who have COPD (chronic obstructive pulmonary disease), avoiding infections such as colds and the flu is extremely important, because these illnesses can harm their lungs and possibly cause pneumonia.

COPD: Importance of Preventing Infections

Staying healthy is important for COPD patients because being infected with viruses, bacteria, and other infectious organisms can make you more susceptible to getting lung infections, which can lead to breathing difficulties. When you have a lung infection, your shortness of breath, coughing, fatigue, and other COPD symptoms can quickly get worse. And when you have any type of respiratory infection, there is a chance it could progress to pneumonia, which can be life-threatening.

COPD: Tips to Prevent Infections

Here are eight tips that can help you reduce your risk of developing an infection:

• Wash your hands. Regular hand-washing is one of the most important things you can do to reduce your risk of infection. Wash your hands thoroughly and often, especially when you are around a lot of people (for example, in a hospital or doctor's office, or at school or work).
• Avoid infections. "Stay away from people who you know have an infection," says Jane Whalen-Price, PT, director of rehabilitation services at National Jewish Health in Denver. Ask people who are sick not to visit until they are well again, and wear a face mask if you do have to come in contact with someone who has an infection.
• Clear your airways. "COPD patients should make sure they keep their airways open and clear of mucus," says Whalen-Price. Your doctor can provide you with devices and your respiratory therapist can teach you maneuvers that can make your coughing more productive, which helps to clear your airways.
• Stay hydrated. Whalen-Price says drinking plenty of fluids is part of practicing good bronchiole hygiene, which can reduce your risk of infection. Bronchioles are small airways deep in the lungs.
• Clean your equipment. All equipment that you use, including humidifiers, oxygen masks, and flutter valves, should be properly cleaned and maintained to ensure that they don't harbor infectious organisms.
• Get vaccinated. Talk with your doctor about which vaccines you should get. In general, people with COPD should get a pneumococcal vaccine (Prevnar) once, as well as a flu vaccine every year. Revaccination for pneumococcal disease is controversial, but it may be right for you. Talk to your doctor to find out.
• Stay away from crowds. When possible, avoid large crowds, especially during cold and flu season. For example, "go to the store when it is less busy," says Phyllis Dibbern, PT, physical therapist at National Jewish Health, who has more than 30 years of experience in pulmonary rehabilitation.
• Treat infections as early as possible. Call your doctor at the first sign of infection, so it can be treated before it progresses to a more serious infection of your lungs. "When COPD patients notice a change in color of their sputum from white or clear to yellow or dark, they should go to their doctor before a major infection develops," says Dibbern.

Avoiding infections doesn't mean that you have to live in a bubble. You can still lead a normal, productive life when you have COPD, but you just need to take some extra precautions to protect yourself from getting sick. There is no way to completely prevent an infection, but by following these simple guidelines, you can increase your chances of staying healthy.

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

Enjoy Sexual Intimacy With COPD

Don't let fatigue and shortness of breath rob you of intimacy.

By Krisha McCoy, MS

Medically reviewed by Niya Jones, MD, MPH

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For people with chronic obstructive pulmonary disease (COPD), sexual intimacy can be difficult. COPD can lead to fatigue and limit your ability to exert yourself. COPD can also cause you to feel emotionally distant from your partner. With a little extra effort, though, you can still enjoy sexual intimacy despite COPD.

COPD: Effects on Sexual Activity

There are a number of reasons why COPD can impact your sex life, including:

• Shortness of breath: The most obvious way COPD impacts sexual relations is that it can cause shortness of breath when people with COPD overexert themselves. This makes it difficult for a person with COPD to enjoy intimacy.
• Fatigue: People who have COPD often have less energy, which can also make it tough to "get in the mood" for sex.
• Emotions: COPD can lead to depression and anxiety, which can be emotional barriers to sex.
• Nerves: The pressure of having to perform during sex and concern that your symptoms might flare up can cause you to feel nervous about having intercourse.

COPD: Tips to Stay Intimate

If you have COPD, here are some suggestions to help preserve your sex life:

• Think outside the box: "It is important to think about sex in a broader perspective," says Barry Make, MD, co-director of the COPD program at National Jewish Health and professor of medicine at the University of Colorado in Denver. Dr. Make recommends kissing and cuddling when you don't feel up to having actual sexual intercourse. Simply touching each other can be just as fulfilling as, and sometimes even more intimate than, intercourse for you and your partner.
• Use less energy: "Think about how to reduce the work that is being done by you if you are the COPD patient," says Make. He suggests you find a position that is the least physically demanding for you. Have your partner do a little more of the work so you are able to preserve your energy.
• Take medications: Taking prescribed medications and using supplemental oxygen prior to sex can be beneficial, says Make. Some people are able to manage their symptoms by using bronchodilators right before having sex.
• Get educated: Take your partner to one of your medical appointments and talk with your doctor, nurse, or respiratory therapist about whether sex is safe for you and what modifications will make having sex easier. Sometimes your medical team can help alleviate your or your partner's fear that sexual activity could harm you.
• Exercise: Regular exercise can build up your strength and endurance so that you will be able to tolerate the physical exertion of sexual activity with less shortness of breath.
• Rest when you need to: Get plenty of rest before you have sex, and take breaks during sex so that you don't overexert yourself.
• Clear your airways: Try to rid yourself of any excess bronchial secretions before sex.

You shouldn't have to give up sex because you have COPD. Talk openly with your partner and your medical team and make adjustments so that your sex life doesn't go by the wayside because you have COPD.

http://www.everydayhealth.com/health-report/chronic-obstructive-pulmonary-disease/sexual-intimacy-with-copd.aspx