What Is COPD and What is the Treatment?

Chronic Obstructive Pulmonary Disease (COPD)

What Is It?
Chronic obstructive pulmonary disease (COPD) refers to a group of disorders that damage the lungs and make breathing increasingly more difficult over time. The two most common forms of COPD are chronic bronchitis and emphysema. Both are chronic (long-term) illnesses that impair airflow in the lungs. Currently, COPD affects at least millions of people in the United States, causing more than 100,000 deaths each year. In more than 80% of cases, the illness is related to cigarette smoking.


Chronic Bronchitis

In this respiratory disorder, the air passages in the lungs are inflamed, and the mucus-producing glands in the larger air passages of the lungs (bronchi) are enlarged. These enlarged glands produce too much mucus, which triggers a cough. In chronic bronchitis, this cough lasts for at least three months of the year for two consecutive years.
Chronic bronchitis affects about 3% of the people in the United States, most commonly men older than 40. You are more likely to develop chronic bronchitis if you:


Smoke tobacco
Are exposed to air pollution
Are exposed in the workplace to airborne organic dusts or toxic gases, especially in cotton mills and plastic manufacturing plants
Have a history of frequent respiratory illnesses
Live with a smoker
Have an identical twin with chronic bronchitis


Chronic bronchitis may have different symptoms in different people. In milder cases, a cough produces only a small amount of thin, clear mucus. In other people, the mucus is thick and discolored. Symptoms similar to asthma may develop, including wheezing and shortness of breath. Eventually, the airways become narrowed, limiting the amount of oxygen that gets to the air sacs. Blood vessels constrict in an attempt to divert the blood to better-oxygenated areas of the lung. This increases blood pressure in the arteries that feed the lungs, and strains the right side of the heart. Eventually, if blood pressure remains high enough in the lungs, heart failure develops, and blood backs up in the liver, abdomen and legs.


Emphysema

In this disorder, the tiny air sacs in the lungs, called alveoli, are destroyed. The lungs are unable to contract fully and gradually lose elasticity. Holes develop in the lung tissue, reducing the lungs' ability to exchange oxygen for carbon dioxide. As a result, breathing may become labored and inefficient, and you may feel breathless most of the time.
You are more likely to develop emphysema if you:


Smoke
Are exposed to passive ("secondhand") smoke
Are exposed to airborne irritants or noxious chemicals (lead, mercury, coal dust, hydrogen sulfide)
Live in an area with significant air pollution (high levels of sulfur dioxide and particulates)
An estimated 100,000 people in the United States have an inherited form of emphysema in which the lungs lack a protective protein called alpha-1-antitrypsin. In people with this form of the disease, lung damage can appear as early as age 30, decades sooner than smoking-related emphysema usually starts.


Symptoms


People with COPD commonly have symptoms of both chronic bronchitis and emphysema.


Chronic Bronchitis

Your first symptom may be a morning cough that brings up mucus and that occurs at first only during the winter months. As the illness progresses, the cough begins to last throughout the day and throughout the year, and produces more mucus. Eventually, about 15% of people with chronic bronchitis develop a continuous cough, breathlessness, rapid breathing, or a bluish tint to the skin from lack of oxygen.


Chronic bronchitis also makes you prone to frequent respiratory infections and to potentially life-threatening flare-ups of severe breathing difficulties that often require hospitalization. If heart failure develops, there may be swelling in the ankles, legs, and sometimes the abdomen.


Emphysema

If you have emphysema, you may first feel short of breath during activities such as walking or vacuuming. Because lung function decreases slowly in emphysema, you may hardly notice as breathing becomes more and more difficult. With time, you may develop increased shortness of breath, wheezing, coughing, a tight feeling in the chest, a barrel-like distended chest, constant fatigue, difficulty sleeping, and weight loss.


Diagnosis
Your doctor will examine you, looking for evidence of COPD by checking for rapid breathing; a bluish tint to your skin, lips or fingernails; a distended, barrel-shaped chest; use of neck muscles to breathe; abnormal breath sounds; and signs of heart failure, especially swelling in the ankle and legs.
To confirm the diagnosis, he or she may order the following tests:


Pulmonary function test — In this test, you will breathe into a special mouthpiece, and a machine will take measurements to test how much your airways are blocked and how much your lungs inflate.


Blood tests — Blood tests measure the different types of blood cells or the amount of oxygen and carbon dioxide in the blood. Others are used to check for low alpha-1-antitrypsin levels, especially in a nonsmoker who shows symptoms of emphysema.



Chest X-rays — These help to rule out pneumonia and lung cancer, and they also show heart size. If you have emphysema, chest X-rays can pinpoint areas where lung tissue has been destroyed.



Electrocardiogram — This test measures the electric activity of the heart and usually is done to make sure your symptoms are not caused by a heart problem.


Sputum analysis — A small amount of mucus is collected and tested for respiratory infection

.
Exercise stress test — In this test, you walk on a treadmill while a specialist monitors the intensity of your exercise. This test looks for any signs of coronary artery disease.


If you are diagnosed with the inherited form of emphysema, family members, including children, also should be tested to determine if they have a deficiency of alpha-1-antitrypsin.


Expected Duration
Symptoms of chronic bronchitis tend to begin in smokers after age 50. These symptoms persist and gradually worsen for the rest of the smoker's life unless he or she quits smoking.
Most cases of emphysema are diagnosed in smokers in their 50s or 60s. People with the inherited form of emphysema can show symptoms as early as age 30. Regardless of the cause, emphysema has no cure and lasts a lifetime.


Prevention
Because the majority of cases of COPD are related to smoking, you can drastically reduce your risk of this illness by avoiding cigarettes. If you smoke, get the help you need to stop. If you don't smoke, don't start. You also may reduce your risk of COPD by limiting your exposure to secondhand smoke and by avoiding outdoor activities when air pollution levels are high.


If you have been diagnosed with chronic bronchitis, avoid contact with anyone with symptoms of an upper respiratory tract infection, because even a mild cold can trigger a flare-up of bronchitis symptoms. Wash your hands frequently and avoid touching your face with your hands during the cold and flu season. Also, anyone with COPD should be vaccinated against influenza and pneumococcal pneumonia.


Treatment
No treatment can fully reverse or stop COPD, but steps can be taken to relieve symptoms, treat complications, and minimize disability. First, your doctor will tell you to quit smoking, the most critical factor for maintaining healthy lungs. Although quitting smoking is most effective during the early stages of COPD and can reverse some early changes, it can also slow down the rate of decline of lung function in later stages. Other COPD treatments may include:


Environmental changes — If your doctor believes that your COPD is caused by work-related exposure to dusts or chemicals, he or she will recommend that you ask your employer to find an alternative work environment. In general, people with COPD also should avoid exposure to outdoor air pollution, secondhand smoke, and airborne toxins (deodorants, hair sprays, insecticides) in the home.


Medications — Doctors generally prescribe medications that open up the airways, called bronchodilators, taken as a spray that is inhaled or in pill form. Antibiotics also may be necessary to treat acute respiratory infections, such as bacterial pneumonia. Daily inhaled corticosteroids may be given to reduce airway inflammation. For flare-ups, an oral corticosteroid called prednisone often is prescribed.


Exercise programs — Regular exercise builds stamina and will improve your quality of life, even if it does not directly improve lung function. Pulmonary rehabilitation programs have been shown to lower the need for hospitalization.


Good nutrition — A balanced diet can help maintain stamina and improve resistance against infection. Also, getting enough water and other fluids can help to keep mucus watery and easy to drain.


Supplemental oxygen — If your lungs are not getting enough oxygen into your blood, oxygen therapy can improve your quality of life, increase your ability to exercise, help to relieve heart failure, prolong life, improve mental function, and lift your spirits.


Lung volume-reduction surgery — In carefully selected patients, surgery to remove the most severely diseased portions of the lungs allows the less damaged areas of the lungs to expand better. The long-term value of this procedure is unknown.


Lung transplants or heart-lung transplants — Transplants are rarely an option, except in very selected cases of early onset, severe COPD

When To Call a Professional
If you smoke or if you work in a job that carries a high risk of COPD, you should see your doctor once a year to be checked for early signs of lung disease. If you have family members with alpha-1-antitrypsin deficiency, tell your doctor so that you can be tested for the problem, too. If you already know that you have alpha-1-antitrypsin deficiency, your doctor can monitor your breathing regularly for early signs of emphysema.
Call your doctor whenever you have shortness of breath, a chronic cough with or without phlegm, or a significant decrease in your usual ability to exercise.


Prognosis
There is no cure for COPD, but quitting smoking, sticking to your treatment program, and exercising daily can significantly improve your function and sense of well-being.


People with COPD who continue to smoke can expect progressive deterioration of lung function. Quitting completely is the best chance of stopping or at least slowing down the process. It is never too late to quit. Even with severe chronic bronchitis, symptoms can improve. The lung damage from emphysema cannot be reversed. However, quitting smoking can decrease the risk of additional harm to the lungs.


http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/20740.html#treat

This is for informational purposes only and is not to be construed as medical advise. Always check with your personal physician prior to making any changes in your medical treatments.

Why Not Just Suck on a Tailpipe?

Doctors: Stay off Peachtree while prepping for race

Those of us with Emphysema, Asthma, COPD, lung and heart dis-ease are all too familiar with the affects of poor air quality. We have come to recognize and respect that the pollutants can and will shut us down quickly. In this article, pulmonologists from Emory University Medical explain the pollution and how it can affect us. They also give us informational direction on where to get our outdoor exercise. Oh! The O-Zone, the particulates, the pollen, the mold! Someone pass the bong~I get sob just typing those things here! :)

On a side note ~ Best of success to all you Peachtree Road Racers and Possum Trotters! You totally Rock!!!
Hugs,
Luna
~~~~~~~~~~~~~~~~~

Runners take in more bad air while training along major roads


By STACY SHELTON


The Atlanta Journal-ConstitutionPublished on: 06/18/08



With the 39th annual Peachtree Road Race fast approaching, a lot of runners are tuning up by running the course. But if you're hitting Peachtree Road during rush-hour for a jog, says an Emory pulmonologist, why not just suck on the tailpipe of a passing car instead?



That's about the equivalent of what you're doing to your heart and lungs, says Dr. W. Gerald Teague, professor of pediatrics at Emory University and director of the Emory Pediatrics Asthma Clinical Research Center.



"When you are running near a busy thoroughfare you not only are exposed to the pollution already in the air, you are also going to be exposed to particles, tire debris and exhaust emissions at the source, so you could get much more exposure versus exercising in a park," Teague says in a Q & A published by the Clean Air Campaign, a public-private partnership to reduce traffic congestion and improve air quality in metro Atlanta. Teague is a member of the Campaign's board of directors.



Instead of exercising along a busy road, Teague suggests jogging, bicycling or walking in a park, or on side streets. And when a rare red alert is issued for smog, either work out in a gym or exercise in the morning or late evening. (Go to www.cleanaircampaign.com to sign up for e-mail alerts).



On Wednesday, forecasters issued an orange alert for the third day in a row, meaning that Thursday's air is expected to violate federal smog limits. That's particularly bad for children and people with heart and lung disease, no matter where they are in metro Atlanta. Public health experts advise them to limit prolonged outdoor exercise to the morning and late evening.
The threats to public health come from the generalized ground-level ozone, an ingredient in smog formed when man made pollution mixes with heat, and the localized tiny particles from vehicle exhaust.



Dr. David Schulman, chief of pulmonary critical care at Emory University Hospital, said Wednesday that long-term exposure to traffic pollution can decrease lung function, but it can also lead to heart problems — and even heart attacks. A study out of Scotland showed "during exercise, people who inhaled diesel exhaust increased the stress on their hearts three-fold as opposed to exercising in clean air," Schulman said.



Rich Heidal, a 29-year-old auditor who lives near Lenox Square mall and plans to run the Peachtree Road Race, said he's noticed a big difference between running Peachtree and bicycling in the North Georgia mountains, where the air is cleaner. On Peachtree, "the buses will knock you over. The heat from the pipes makes it more difficult to breathe. You definitely want to get off the [main] road."



The exception, of course, is running or walking in the July 4 race with 55,000 other people. The mass body odor can get downright nasty, but with only foot traffic, Atlanta's busy artery is far less hazardous to your health.



Joggers are not the only ones gagging in metro Atlanta's fumes. Study after study has shown a link between vehicle traffic and asthma in the general population, including an oft-quoted study from the 1996 Atlanta Olympics. When metro Atlantans cleared the roads during the games, hospital visits for asthma attacks plunged between 11 percent and 44 percent, according to various health data.



It may not look like it, especially on days when Atlanta's skyline is blurred by a gauze of brown air, but the region's air quality has markedly improved in the last 30 years as power plants, industries, vehicle engines and fuels have gotten cleaner.



Still, asthma rates among children and adults are on the rise, a dichotomy that's often explained in academic studies as increased exposure: More people breathing in traffic pollution. The latest Georgia data from the state Division of Public Health estimates 10 percent of children have asthma and 7 percent of adults.



The problem is, we can't get away from our own pollution. Even in the enclosed environment of a car, we're still breathing in the toxins spewed by the vehicles in front of us, said Roby Greenwald, a post-doctoral researcher in Emory's Department of Pediatrics who is studying the effects of urban air pollution on asthma in children.



And the absolute worst thing you could do for your heart and lungs is live within about 100 yards of an interstate highway. As metro Atlanta grew, more residences — with balconies — were built next to major thoroughfares.
"I wouldn't live in those," Greenwald said. "A condo right on Peachtree is going to be much, much better than an apartment overlooking the Connector."



In an interview last year, Teague said just growing up near a major freeway can limit lung growth. Particle pollution has also been linked to emphysema, stroke, lung cancer and heart disease, he said.




But living on a cul-de-sac in the suburbs doesn't necessarily make you immune. Harmful pollutants have been measured all over metro Atlanta.


"Really, you can't move away from it," said Sonya Lunder, a senior analyst for the Environmental Working Group, a Washington-based advocacy group for public health and the environment. "It's hard for policy makers or the public to know what to do about it."
Some of the solutions, Lunder said, include better public transportation, anti-idling laws, and building schools, parks and residential developments away from major thoroughfares.





http://www.ajc.com/sports/content/sports/peachtree/stories/2008/06/18/avoid_peachtree_while_training_for_race_0619.html

Stem Cell Success in Lung Disease

Canadian Scientists Deliver On Promise Of Stem Cell Therapy For Lung Disease

MONTREAL, June 19 /CNW Telbec/ -

Two Quebecers suffering from pulmonary hypertension, a rare but debilitating lung disease, were treated in Montreal with their own gene-modified stem cells. This experimental treatment was administered at the Jewish General Hospital's Centre for Pulmonary Vascular
Disease.

"Our present therapies for pulmonary hypertension may control the disease
for a few years, but often fail and do not represent a cure," said Dr. David
Langleben, Director of the Centre for Pulmonary Vascular Disease and the local
Principle Investigator for this study. "We need new approaches such as this
cell-based therapy."

The therapy, developed by Dr. Duncan Stewart, CEO of the Ottawa Health
Research Institute, and founding scientist of Northern Therapeutics Inc., is
unique in the world as it is the only clinical study employing patient stem
cells genetically modified for clinical use in lung disease.

A team of scientists at the JGH led by Dr. Jacques Galipeau, Hematologist
and stem cell researcher, genetically engineered the stem cells with synthetic
DNA in an ultra specialized laboratory to produce nitric oxide, a critical
molecule involved in the repair and protection of blood vessels. With the
sponsorship of the Stem Cell Network, the study has moved forward and the
highest cell dose ever given to a human subject was administered to one of the
patients.

"These enhanced stem cells are given in a heart catheterization suite,
and lodge in the lung where it is hoped they will stimulate the repair and
regeneration of blood vessels in the lung," explained Dr. Galipeau, Associate
Professor of Medicine and Oncology at McGill University.

This procedure has cured laboratory rats with pulmonary hypertension, and
this study in Canadian volunteers afflicted with pulmonary hypertension seeks
to assess the safety of this type of stem cell treatment. This study, which
includes a site in Toronto as well as in Montreal, is the only one of its kind
in Canada, and rests at the cutting edge of stem cell therapies worldwide.

Two patients, enrolled in Toronto, were treated but received a lower dose
of cells. This research team is also planning to use a very similar enhanced
stem cell treatment in the near future to treat patients suffering from heart
attacks. These new therapies offer hope for better patient outcomes.

About the JGH
Since 1934, the Sir Mortimer B. Davis - Jewish General Hospital, a McGill
University teaching hospital, has provided "Care for All," serving patients
from diverse religious, linguistic and cultural backgrounds in Montreal,
throughout Quebec and beyond. As one of the province's largest acute-care
hospitals, the JGH has achieved a reputation for excellence in key medical
specialties by continually expanding and upgrading its facilities for clinical
treatment and teaching, as well as research at the Lady Davis Institute for
Medical Research. For more, please visit JGH.ca.

The Stem Cell Network, established in 2001, brings together more than
70 leading scientists, clinicians, engineers, and ethicists from universities
and hospitals across Canada with a mandate to investigate the immense
therapeutic potential of stem cells for the treatment of diseases currently
incurable by conventional approaches. Headquartered at the University of
Ottawa, the Stem Cell Network is one of Canada's Networks of Centres of
Excellence funded through Industry Canada and its three granting councils.
(www.stemcellnetwork.ca)

Networks of Centres of Excellence are unique partnerships among
universities, industry, government and not-for-profit organizations aimed at
turning Canadian research and entrepreneurial talent into economic and social
benefits for all Canadians. The NCE program is managed jointly by the three
federal granting agencies- Natural Sciences and Engineering Research Council,
the Canadian Institutes of Health Research, and the Social Sciences and
Humanities Research Council.

For further information: Glenn J. Nashen, Director; Reena Kudhail,
Communications Specialist, Public Affairs & Communications, Jewish General
Hospital, (514) 340-8222 x 4120, rkudhail@jgh.mcgill.ca,
communications@jgh.mcgill.ca; JGH.ca

http://www.newswire.ca/en/releases/archive/June2008/19/c5874.html

COPD Patient-to-Patient Tips on Living Well

PATIENT TO PATIENT TIPS

For many people, the toughest challenge is not controlling symptoms such as coughing and shortness of breath, but rather coping with the relentless march of the disease as it slowly encroaches on daily activities. Knowledgeable as your doctor and other health professionals are, they can't advise you on the many small but significant ways that COPD can impair your ability to function. This is the sort of advice you can get only from resourceful patients who have faced the same problems you have and found ways around them. The following are tips gleaned from COPD patients.

Bathing
If you find a shower or bathtub difficult, try using a bath stool. For bathing, use a hand sprayer, which may be attached to the tub faucet or shower head. When excess humidity bothers you while bathing, leave the bathroom door open and use your bathroom exhaust fan. If you feel weak, don't take a bath or shower when you are alone. People who use oxygen may find that bathing is easier if they wear the apparatus during their bath or shower. The tubing can be draped over your shower curtain rod.

Grooming
Shaving and putting on makeup is much easier if you have a low mirror so that you can sit down. Women should avoid elaborate hairdos that require tiresome setting and extended use of dryers. Try to avoid toiletries that are heavily perfumed; many patients find them irritating.

Dressing
It's a bad idea to restrict chest and abdominal expansion; avoid belts, bras, and girdles that are tight. Men may find that suspenders are more comfortable than belts. Most women find that slacks and socks are much easier to put on than pantyhose. You can place your underwear inside your pants and put them on together. Wear slip-on shoes. Putting on any kind of shoe is much easier if you use a long shoehorn (12–28 inches). You may find that cotton underclothing is more comfortable than synthetic in both warm and cold climates.

Household gadgets
One of the handiest gadgets is a pair of pickup tongs (these look like giant scissors) for retrieving things from hard-to-reach places. Most medical supply houses stock these. Another pickup device is a magnet on a short string. It's great for getting thumbtacks, hairpins, etc., that have fallen on the floor. If you must vacuum, use a machine with a disposable bag or a filtering method to keep dust from escaping. A small hand vacuum is easy to use for spot cleaning.

Emergency planning
A matter of concern to those who live alone is how to get help quickly when needed. Make arrangements to have a relative or friend call at the same time every day to make sure you are okay. Consider buying a cordless phone and carrying it around with you. This way, if you run into trouble, you can call for help. Many companies offer monitoring services. They provide a panic button, worn on a chain around the neck, that can summon emergency help.

Traveling with oxygen
People who use oxygen can travel to most places, but it requires some advance planning.
Call your local oxygen supplier one to two weeks in advance to arrange for your oxygen supply while you are traveling. Your needs will vary according to your mode of transportation (see "Using oxygen on an airplane") and length of stay at your destination.

If traveling by air, book far in advance because airlines allow only a limited number of people traveling with oxygen per flight.

Take antiseptic hand-washing packets or gel to help avoid picking up bacterial or viral infections. Also wash hands with soap and water frequently.

If you are traveling to an area of high altitude, plan ahead for an oxygen supply at your location.


Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.
This information is not intended to replace the advice of a doctor.

http://www.aolhealth.com/respiratory-health/learn-about-it/living-well-with-lung-disease/patient-to-patient-tips

Finger Clubbing Puzzle Solved - Lung Disease

UK Medics Solve Ancient Riddle Of 'Finger Clubbing'

ScienceDaily (Jun. 5, 2008) —


A puzzling medical condition, identified more than 2,000 years ago by Hippocrates, has finally been explained by researchers at the University of Leeds.

The phenomenon of "finger clubbing", a deformity of the fingers and fingernails, has been known for thousands of years, and has long been recognized to be a sign of a wide range of serious diseases – especially lung cancer.

"It's one of the first things they teach you at medical school," explained Professor David Bonthron of the Leeds Institute of Molecular Medicine. "You shake the patient by the hand, and take a good look at their fingers in the process."

Lung cancer, heart disease, hyperthyroidism, various gastrointestinal diseases and many other conditions all result in finger clubbing. But exactly why swollen, reddened fingers should be an indicator of serious illness has remained a mystery – until now.

"There are benign cases of clubbing, where it isn't associated with other illnesses, but particularly because of the link to lung cancer, it is generally regarded as rather sinister," said Bonthron. "You look at the range of conditions connected to finger clubbing and wonder what on earth they could have in common."

The researchers found clues in the medical literature, detailing past cases and previous research. "We knew that in cystic fibrosis patients who have undergone a lung transplant, their finger clubbing goes away. The same goes for empyema patients who have had their lungs drained. It suggested that impaired lung function was somehow crucial to finger clubbing – but we didn't understand how."

Prof Bonthron, Dr Chris Bennett of the Yorkshire Regional Genetics Service and their colleagues studied a group of patients suffering from inherited primary hypertrophic osteoarthropathy (PHO), a genetic disorder in which the finger clubbing is accompanied by painful joint enlargement and a thickening of the bone.

Their findings implicated a fatty compound called PGE2, which is produced naturally by the body to mediate the effects of internal inflammation. Crucially, once it has done its work, PGE2 is broken down by an enzyme 15-HPGD, produced in the lungs. The patients followed by the Leeds study were found to have a genetic mutation which prevented the production of 15-HPGD, resulting in up to ten times as much of the PGE2 in their systems.

"If you don't have this enzyme the PGE2 isn't broken down normally and simply builds up," said Bonthron, whose findings are published online this week in Nature Genetics.
In lung cancer patients, it is most likely overproduction of PGE2 by the tumour that causes the clubbing. In congenital heart disease, blood bypasses the lungs, where PGE2 is normally broken down by 15-HPGD.

The researchers have suggested that a straightforward urine test for levels of PGE2 may be a useful first step in the diagnosis of individuals with unexplained clubbing, and to understanding whether it is the symptom of something far more serious. The results also suggest that existing drugs such as aspirin, which are already used to prevent PGE2 production, may be effective in reducing the painful symptoms of finger clubbing.

It has taken 2,000 years to make the connection, but Bonthron adds: "Actually, when you look back, it's rather obvious. When we found this gene, everything else fell neatly into place – it was like a smack on the forehead."

Journal reference:
Uppal S, Diggle CP, Carr IM, Fishwick CWG, Ahmed M, Ibrahim GH, Helliwell PS, Latos-Bielenska A, Phillips SEV, Markham AF, Bennett CP, Bonthron DT. Mutations in 15-hydroxyprostaglandin dehydrogenase cause primary hypertrophic osteoarthropathy. Nature Genetics, 2008; 40 (6): 789 DOI: 10.1038/ng.153
Adapted from materials provided by University of Leeds.

http://www.sciencedaily.com/releases/2008/05/080529163120.htm

VIDEO CONFERENCING REHAB SUCCESS FOR COPD'ers

Video-Conferencing Program Helps Patients Breathe Easy

Allows staff to provide direction, support to chronic respiratory sufferers outside Edmonton
Sara Ditta, The Edmonton JournalPublished: 1:28 pm

Seventy-five-year-old Carmen Tien-kamp is buying a treadmill this week.
After completing half of an eight-week program to help her manage her chronic lung disease, she's more mobile than she has been in years.

The Breathe Easy program, provided by the Caritas Centre for Lung Health at the Edmonton General Hospital, is designed to help patients manage chronic lung disease through exercise and education. Fitness keeps the rest of the body healthy and takes the load off of the diseased lungs.

Tienkamp was diagnosed seven years ago with chronic obstructive pulmonary disease, also known as COPD. Last August, she was put on supplementary oxygen.

"I had no energy," she said of her life before starting the Caritas program. "I was like a couch potato."

Patients across central and northern Alberta can also participate in the same program via live video through Capital Health's Telehealth network.

Art Measor, who lives in Wainwright, has taken the program twice. The first time, about 10 years ago, he drove 21/2 hours, twice a week, to participate.
"It was worth it," he said.

In 2006, he needed it again after being treated for lung cancer and found the trip was no longer necessary. He only needed to travel five blocks to the Wainwright Health Centre.
Measor, who was part of a two-year pilot project, consulted with a pulmonologist, listened to lectures and followed-up with doctors via live video. Exercise was overseen by rural therapists trained by Caritas staff.

After completing both versions of the course, he said there was little difference.
"The video one is fabulous. It's exactly the same thing," Measor said. "I received a similar amount of attention and the same followup."

Dr. Fred MacDonald, who created and runs the program, tried to reach rural patients with his rehabilitation program for years. Technology finally provided him the opportunity in 2005. Since then, it has reached about 120 rural patients in Peace Country, Aspen, David Thompson and East Central regions.

"Country patients have done very, very well," said MacDonald. "We have the patients now telling us what a joy it is that they don't have to go into Edmonton and can exercise in their own community."

Reaching more regions is key because only 1.2 per cent of Canadians have access to a rehabilitation program to deal with COPD.
"Most patients are given an inhaler and a lecture on COPD and told to deal with it," MacDonald said. "And that's it."
A Canadian dies every hour from complications related to COPD. To keep chronic patients healthy, it's necessary to provide more direction, he said.

"It has to become a way of life," he said. "The only way you can achieve that is to physically bring them into a program and coerce or encourage, browbeat or whatever it takes, to get them to do the things that are necessary to improve their health."

This is believed to be the only rehabilitation program available through video-conferencing in Canada.

MacDonald says patients also wait less time to see a pulmonologist by using the program. Without it, many patients must wait about six months.

The program's exercise component includes stationary bicycling, treadmill, step-ups and simple breathing exercises. The lectures include topics on eating right, goals, relaxation, travel and homecare.

Myron Peterson took the program 10 years ago and still regularly visits the gym at Caritas to lift weights. He said he would probably be in "bad shape" now if he had never met MacDonald.
"If it wasn't for him, a lot of us would be dead. I'm sure of that."

It's not unusual for patients to become more fit and active very quickly, said Tina Jourdain, a program respiratory therapist.

"Some of them put us to shame," she said. "It's embarrassing when an 80-year-old can do more on a treadmill than you and they have lung disease."

sditta@thejournal.canwest.com
http://www.canada.com/edmontonjournal/news/story.html?id=002a84e0-b6f8-40f6-9612-90fb1c318b65

EXAM FOR COPD, OTHERS

Exam Overview
Your medical history provides important clues that can help your health professional diagnose chronic obstructive pulmonary disease (COPD).

In taking your medical history, your health professional will ask questions about:

Shortness of breath.
When were you first short of breath (at exercise or at rest)?
How often are you short of breath?
How long have you been short of breath? Is it getting worse?
How far can you walk and how many steps can you climb before having to stop because of shortness of breath?
Coughing.
How often and when do you cough?
How long have you been coughing? Is it getting worse?
Do you cough up mucus (sputum)? What color is it?
Have you ever coughed up blood?
Your and your spouse's or housemate's use of tobacco: whether any of you smoke, how long you've smoked, how many cigarettes a day you smoke, how long ago you quit smoking, whether you feel you can quit smoking, and more.
Exposure to airborne irritants, such as dust or chemicals, on the job.
Childhood respiratory illnesses.
Family history of respiratory disease.
Other medical conditions you may have and their treatment.
How your condition is affecting your quality of life: missed work, disrupted routines, and depression, for example.
What type of family and social support you have.

During the physical examination, your health professional will examine your body for other clues that may explain the cause of your symptoms. A physical exam involves:

Taking your temperature, weight, and body mass index (BMI), which measures weight for height and provides a way to estimate the effect of weight on health.
Examining your ears, eyes, nose, and throat for signs of infection.
Listening to your heart and lungs with a stethoscope.
Checking for signs that blood is backing up in your neck veins, which may indicate a heart problem such as cor pulmonale.
Pressing or tapping on your abdomen (abdominal palpation).
Examining your fingers and lips to see whether the skin has a blue tint (cyanosis).
Checking your fingers to see if their ends swell and the nails bulge outward (clubbing).
Evaluating your legs and feet for swelling (edema).
A physical examination is not painful, but parts of it (such as abdominal palpation) may feel slightly uncomfortable.

Why It Is Done

A history and physical exam help your health professional make a diagnosis. They are a routine and important part of any visit to a health professional.

Results

Your history may reveal risk factors that suggest you have COPD or an increased risk for developing COPD, such as:

Cigarette smoking.
Family history of emphysema.
Work-related hazards.
Frequent, severe respiratory illnesses.
Long-term (chronic) cough with or without mucus.
Progressive shortness of breath.
Your physical examination may also suggest COPD. Findings indicating COPD include:
An expanded chest (barrel chest).
Wheezing during normal breathing.
Taking longer to exhale fully.
Decreased breath sounds or abnormal breath sounds such as crackles or wheezes.

Certain physical exam findings will help your health professional assess the severity of your condition. These include:

The use of "accessory" muscles, such as the neck muscles, during quiet breathing.
Breathing through pursed lips.
The inability to complete full sentences without stopping to take a breath.
Bluish discoloration of the fingertips or nailbeds (cyanosis).
Swelling in the legs or abdomen.

Any or all of these findings may suggest severe impairment.

A careful history and examination of your heart should also be done to exclude heart disease that can either be associated with or cause symptoms similar to those of COPD. This is especially important because smoking is an important risk for heart disease as well as COPD. The heart exam may reveal a rapid heart rate or show signs of heart failure.

The liver may be increased in size, which sometimes can occur because of right-sided heart failure (cor pulmonale).

The result of the physical exam varies. Not every person will have all the possible symptoms or signs of COPD.

What To Think About

There are no special considerations for the history and physical examination.
Complete the medical test information form (PDF) (What is a PDF document?) to help you prepare for this test.

For More Information: http://body.aol.com/procedures/history-and-physical-examination-for-copd

LUNGS, COPD & SMOKING ~ 40 YRS LATER, RK'S WORDS STILL LOUDLY RING OUT

While a century ago lung cancer was so rare that medical residents were called into the operating room to "see a condition you'll probably never see again," thanks to tobacco companies it has reached epidemic proportions, said Eriksen. The famous 1964 US Surgeon General's report commissioned by President John F. Kennedy - which concluded that smoking is a serious health hazard and requires urgent remedial action - was released on a Saturday because the government feared the news would crash the stock market due to the power of tobacco companies.

"WE IN the US still have not taken appropriate action," Eriksen declared, "and neither have you in Israel." In the US alone, over 160,000 deaths from lung cancer occur each year - more than the next four leading cancers (colon, breast, pancreas and prostate) combined. "This is unacceptable. It is a man-made form of cancer and preventible. "

The cumulative number of deaths by smoking around the world has reached 70 million. This figure is projected to reach 520 million by 2050 if nothing significant is done, Eriksen concluded.

A short time before New York senator Robert Kennedy was assassinated in 1968, the former US attorney-general stated: "The cigarette industry is peddling a deadly weapon. It is dealing in people's lives for financial gain. The industry we seek to regulate is powerful and resourceful. Each new effort to regulate will bring new ways to evade. Still, we must be equal to the task, for the stakes involved are nothing less than the lives and health of millions all over the world.

"But this is a battle [that] can be won. I know it is a battle [that] must be won."

Indeed, 40 years later, it still must.

Full article: http://www.jpost.com/servlet/Satellite?apage=2&cid=1212659681334&pagename=JPost%2FJPArticle%2FShowFull

Deep Breathing Exerciser Spirometer for COPD/Emphysema

Hudson TriFlo II Incentive Deep Breathing Exerciser Spirometer

Hudson RCITriFlo II Incentive Deep Breathing Exerciser

The TriFlo II Incentive Spirometer is ideal for developing, improving, and maintaining respiratory fitness.

The TriFlo II Incentive Deep Breathing Exerciser has been scientifically constructed as a means of encouraging you to take a slow Sustained Maximal Inspiration (SMI).

A Sustained Maximal Inspiration is vitally important to your general well-being. Deep breaths expand the small air sacs of your lungs and help clear the air passages of mucus. This, in turn, can help prevent the build up of fluid in your lungs.

Normally, you take many deep breaths each hour--usually without being aware of it. They are spontaneous and automatic, and occur in the form of sighs and yawns.

In certain instances, however, your normal breathing pattern can change. When you are experiencing pain following chest or abdominal surgery, for example, breathing tends to become shallow, and deep breaths are suppressed in an effort to minimize pain. In these instances, it is important that you strive to resume your normal breathing pattern--despite any discomfort you may have. Taking the deep breaths that you might ordinarily suppress will help prevent the possibility of respiratory complications.

By carefully following your physician's instructions and the directions provided with your TriFlo II Spirometer, you should be well on your way toward better breathing.

Features:
Manufacturer: Hudson RCI
Product: TriFlo II Incentive Deep Breathing Exerciser
Product Number: 8884717301

Instructions for Use:

With the unit in an upright position, exhale normally and place your lips tightly around the mouthpiece.
To achieve a Slow Sustained Maximal Inspiration (SMI), inhale at a sufficient rate to raise only the ball in the first chamber, while the ball in the second chamber remains at rest.
For a higher flow rate, inhale at a rate sufficient to raise the first and second balls, while the ball in the third chamber remains at rest.
Exhale after performing the exercise, remove the mouthpiece from your lips and exhale normally.
Relax following each prolonged deep breath, take a moment to rest, and breathe normally. Then, repeat the exercise as directed by your physician.

http://www.metromedicalonline.com/8884717301.html

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Please note that I have no relationship whatsoever with the manufacturer(s) and/or distributors of this product. This is informational use only for those with COPD, Emphysema and other breathing issues. Remember to check with your doctor before implementing any form of exercise into your routine.

We Must Help To Heal Our Selves

I want to share this with you. Since the COPD and asthmatic bronchitis diagnosis, I have realized that we are all responsible for the self healing part of body, mind, spirit healing. Without the self healing, the conventional treatments can only go so far. We must dig in, make and keep the commitment to self heal in partnership with our medical team. It is My body and no one knows it better than I.

I am healing and recreating myself day by day.

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Many of us go through life seeking healing from other people when really the only person who can heal us is ourselves. We run to doctors or healers to have them "heal" us. Yet, the body is the one which heals itself with the assistance of whatever remedies or assistance it receives.

The body is the one which knows what to do with the calcium, the vitamins, the enzymes, the healing energy... If it didn't have its own innate intelligence, it would not know how to utilize these healing substances that we ingest and accept into our being.

The medicines or the medical staff are not the healers... the body itself is the healer.

You can do "hands-on" healing on yourself. All you need is the willingness to accept that this is indeed possible and give permission to have Divine energy flow through you.

Thus, the responsibility for healing oneself returns to its only true home, yourself.

EXCERPTED FROM: Increase Your Healing Ability
by Marie T. Russell