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The Action is Hot Lungs – Part 2 of 3

The Action is Hot Lungs –Part 2 of 3

Harrison’s Better Breathers second speaker, Kinestiologist Aaron Norton, specialist in ‘Energy and Movement’ followed Leah Werner, Dietitian Harrison Medical Center in speaking to the crowd of pulmonary patients, COPDers and caregivers in the Rose Room at Harrison Silverdale last Wednesday.

Aaron works as an exercise coach at Sub base Bangor for the Navy and Marines to be “Mission Ready” and brought to us by Mei-Lin who is Harrison’s coordinator for the series of cardiopulmonary rehabs Harrison is establishing throughout Kitsap County.

Capri, a program I attended over a decade ago is now under the Harrison Medical Center umbrella for cardiopulmonary rehabilitation. I hope the program includes a maintenance program and has – at least – one recumbent elliptical machine – great for lung patients with hip issues. The program should include water workouts for exceptional flexibility, strengthening and aerobic.

Aaron was born with asthma and had childhood exercise induced asthma until he gradually, over a two-year period worked himself through it and over it. Aaron’s asthma is long gone and he teaches exercise, Mission Ready’ Energy and Movement’ to Navy and Marine men and women.

NOW I understand how my young Norwegian cousin, Malin managed to get over her exercise-induced asthma – she exercised through it!

“SMART Principle”–

Specific, Measurable, Attainable, Realistic, Timely –

I failed to meet the SMART Principle. My goal of beginning a self-supported recumbent trike tour for COPD – 5 June – two weeks before the 2011 American Lung Association’s Big Ride Across American began didn’t get off the ground..no left foot to the pedal rotation..

The Big Ride Cyclists left Seattle today.

I was Specific, the intense water workouts beginning 1 February showed Measurable improvement in my left hip and leg and whole body. Attainable – Yes! (Most people do not believe I can or will make this ride) Realistic -Yes. (The issue is that my left hip will still not do a full forward pedal stroke. The issue is that my bone on bone left hip joint will not let my leg fully rotate – yet. Timely – No. The fact is I cannot pedal my regular trikes. I can get on them now, can lift my left foot on the pedal and can do a half rotation with the pedal pendulum, but cannot carry it over. Yet. Now I have a trike to use – the recumbent hand cycle trike – and will work toward leaving here on it NEXT 5 June 2012 – NEXT year..a heartfelt thanks to a great recumbent trike shop in Florida for the pedal pendulum tip ..more later.

Thank you, Aaron! It was a shock to see my personal physical goal predicament easily explained right there on the screen.

http://pugetsoundblogs.com/copd-and-other-stuff/2011/06/20/the-action-was-hot-lungs-part-1-of-3/

…Part 3 of 3 tomorrow… thanks for reading…Sharon O’Hara

Sorry for the poor photos…

Part 3 of 3 tomorrow… thanks for reading… Sharon O’Hara

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A New Study for COPDers: Mechanism of Greater Oxygen Desaturation during Walking Compared with Cycling in COPD.

Sharon O'Hara

Do COPDers desaturate more walking than they do cycling? I’ve said ever since I discovered the recumbent trike existed that the recumbent trike was God’s gift to the COPDer…indeed, anyone with physical limitations.

Pedaling around the bay from the ferry on Whidbey Island with the American Lung Association of Washington’s Trek Tri Island three day cycling trip one early morning a few years ago was the first time I felt ‘normal’ again in about 7 years and the same length of time I’d gone anywhere overnight since a stay in Harrison Medical Center in 1997.

In those days I didn’t have a hip problem so I could walk without a problem other than shortness of breath but the recumbent trike lets us take our comfortable seat everywhere we pedal and stop whenever we need to take a break. It also builds the legs muscles better and faster (my opinion) than walking and it is sure more fun and faster.

My point is wondering what the following study means in practical terms – to us, the patient. I am one of those who do not desaturate enough for oxygen while awake.

Is cycling less strain or easier on our lungs than walking?

************

“Chest. 2011 Jan 27. [Epub ahead of print]

Mechanism of Greater Oxygen Desaturation during Walking Compared with Cycling in COPD.

Mahler DA, Gifford AH, Waterman LA, Ward J, Machala S, Baird JC.

1 Section of Pulmonary & Critical Care Medicine Dartmouth Medical School, Lebanon, NH, USA.

…

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) exhibit greater oxyhemoglobin desaturation during walking than with cycling. The purpose of this investigation was to investigate differences in ventilatory responses and gas exchange as proposed mechanisms for this observation.

METHODS: Arterial blood gases and lactate were measured in 12 patients with COPD (age, 68 ± 6 years) during incremental treadmill and cycle exercise. The primary outcome to assess the ventilatory response to exercise was the partial pressure of alveolar oxygen (P(A)O(2)). The primary outcome to assess impairment in exercise gas exchange was the difference between partial pressures of alveolar and arterial oxygen (P(a)O(2)) (AaPO(2)).

RESULTS: P(a)O(2) was significantly lower at peak exercise for treadmill walking (51.4 ± 6.8 mmHg) compared with cycling (60.4 ± 10.7 mmHg) (p = 0.002). The initial increase in P(A)O(2) with cycling occurred prior to the onset of the anaerobic threshold. At peak exercise, P(A)O(2) was significantly higher with cycling compared with walking (p = 0.004). The anaerobic threshold occurred at a lower VO(2) during cycling than walking (p = 0.001), and peak lactate levels were higher with cycling (p = 0.019). With progressive exercise, AaPO(2) increased similarly during treadmill and cycle exercise.

CONCLUSIONS: The higher P(A)O(2) during cycling minimized the magnitude of oxyhemoglobin desaturation compared with walking. The enhanced respiratory stimulation during cycling appears due to an initial neurogenic process, possibly originating in receptors of exercising muscles, and a subsequent earlier onset of anaerobic metabolism with higher lactate levels during cycling.”

PMID: 21273296 [PubMed – as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/21273296?dopt=AbstractPlus

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I do not have a financial interest in any bike company including the recumbent trike.

More later…. Sharon O’Hara

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Googling for COPD Finds an Old Letter

Sharon O'Hara

I wrote the following about 2004 for the American Lung Association and re-found it goggling for COPD. I’m posting it here in hope you will see the value in early detection Spirometry testing.

“Hungry for Air: Breathing Better Together

“Living with COPD/Emphysema and Sarcoidosis was a living death. I existed. I struggled to breathe, when I moved I panted, gasped for air like a fish out of water.

As I slowly showered and dressed, ready to go somewhere, I couldn’t sit down to rest. I fell asleep.

I went from a physically active life landscaping, restoring a wonderful property in Port Townsend to a blob who existed in front of her computer.

I searched the world web to discover what COPD/Emphysema was – what Sarcoidosis was, everything, anything I could find out about my diseases and the medications I took.

I couldn’t sleep in a bed – I couldn’t breathe – I dozed sitting in a chair.

By the time I arrived at the Pulmonary Department at the University of Washington Medical Center, I believed my days were numbered. Previously diagnosed with COPD/Emphysema, an open lung biopsy showed the fibrosis and granulomas of Sarcoidosis evenly throughout both lungs.

Without energy, I felt isolated, without a purpose, a shell, a mockery of the person I used to be.

I regretted a 40-year smoking habit, but didn’t dwell on it. The single most difficult thing I’ve ever done is stop smoking. I craved cigarettes and for the first time understood a drug addict’s ‘craving’ for a drug. I craved a cigarette many times a day, then almost daily for more than two years. Even today, occasionally the urge to smoke a cigarette becomes almost overwhelming.

That is how I felt then. Today I’m energized with purpose.

I found a support group online – the non-profit EFFORTS, begun by COPD’rs, run by COPD’rs and filled with folks like me working to change the world’s awareness of COPD. I want other lung folks to know they are not alone and how they can lead the best quality of life possible.

I want to see Spirometry tests for patients. common place among physicians – to catch COPD early – before it is too late. Other than stop smoking, the single most important thing Lungers can do for themselves is exercise.

And from the time I learned of the American Lung Association® of Washington’s Big Ride Across America, it is my dream – my goal.” – Sharon”

Part 2 of 4 More later… Sharon O’Hara

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Recumbent Trikes and Good Health Hand in Hand

Sharon O'Hara

The recumbent trike is God’s gift to the physically challenged.

The 3-day Trek Tri Island bike trip with the American Lung Association of Washington a few years ago was the first time I had left the house overnight in 7 years. Not since COPD and then Other Stuff began to hit. Pedaling around the bay from the Port Townsend/Keystone ferry toward Oak Harbor was the first time in 7 years I felt normal again. The recumbent trike set me free.

The Mason county couple in the “What is COPD” tee, ride for good health, fun and exercise.

Hey, Trikes are Fun!

He doesn’t let Hip Dysplasia in both hips stop him from moving but at a much slower pace than his wife. His wife is a fast walker challenging herself to move even faster.

Until he began riding the recumbent trike delta, (two wheels in back), she had to move slowly, at her husband’s pace or he quickly was left behind.

I was told the recumbent trike gives him the edges to not only keep up with her; he challenges her to move those hips even faster. The recumbent trike lets them exercise together for good health in fun and harmony.

I took a video of them…unedited…so you can see how they ride.

A family affair… the gentleman on the delta is only 92.

Following are more photos. My mother’s first time on a bike in about 75 years when she learned to ride the delta at 88 years old.

Ask your doctor about riding the recumbent trike for exercise and fun adding to living a quality life and follow her/his recommendations. Check with the local bike shops and bike clubs for further information or ask here on COPD and Other Stuff.

For COPDers – muscle utilizes oxygen better than flab and the legs are the largest muscles in the body. The bike is a great form of exercise and the recumbent trike can be a kinder, gentler form of cycling…the comfort mode…or not.

The West Sound Bike Club may have two recumbent trikes to show on the 18th. One trike is a delta with an electric assist. The other is a tadpole. Swing by the booth and check them out.

WEST SOUND CYCLING CLUB AUG, 2010
BOARD OF DIRECTORS
PRESIDENT Lee Derror 360 271-4838
lderror2@yahoo.com
VICE PRESIDENT Don Czeczok 360 405-1834
dczeczok@wavecable.com
TREASURER Laurie Clayton
SECRETARY Roberta Berry 360 638-1685
beeryra@centurytel.net
RIDE COORDINATOR Tim Baker 360 340-5944
rides@westsoundcycling.com
bakertj@hotmail.com
Freewheeler: Frank Lane 253 857-6044
editor@westsoundcycling.com

Tour de Kitsap: tdk@westsoundcycling.com
WSCC website: www.westsoundcycling.com

Wed. 8/18 11:00am – 6:00pm – Thurs. 8/19/2010 0800 – 2:00pm

West Sound Safety and Health Expo 2010 Free!

Kitsap Conference Center & Bremerton Boardwalk
100 Washington Avenue
Bremerton, WA 98337
Contact: Linda Fulton 360.473.5918

LOCAL BIKE SHOPS

More than one of the following bike shops may sell and service trikes.

BI Cycle Shop 206-842-6413
Classic Cycle 206-842-9191
Kitsap Key and Bike Shop 360-373-6133
Olympic Bike and Skate 360-895-2127
One Way Down Biking 360-633-6649
Rainier Cycle Sports 253-756-2117
Silverdale Cyclery 360-692-5508 (Sells and services trikes)

Gregg’s Greenlake Cycle
The free clinic will start at 6:30pm and go until around 7:30pm. There will be light refreshments provided.
info@greggscycles.com or call (206) 523-1822 ext. 119

The following URL contains the most cycling URL information of any blog I’ve seen.

http://www.recumbentblog.com/ Scroll down on the right until you find Dealers.

More later…. Sharon O’Hara

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Meet Alec

Sharon O'Hara

Alec is the flip side of the dancing COPDer you see in the television commercial. For the COPD TV commercial dancer, all it takes is one inhaler, a few puffs and like magic, the lungs are okay and off to the dance floor.

Alec is a COPDer on oxygen, living right here in Kitsap County. .Alec doesn’t dance, he is barely able to walk. The other day he walked for less than two minutes before he was exhausted and had to sit down. He has a doctor appointment with his primary in the next week or two and wonders if he can get strong enough by then to make the appointment.

When he called for an appointment with a lung specialist in town, he was told that he missed five appointments during the past twelve months and she wouldn’t give him another appointment. Ouch. I can relate to missed and late appointments with my doctors. None, so far, has refused to give me another appointment.

My phone rang last week and a man asked for me by name. He gave his name and went on to say he had gotten my name and phone number from a article Chris Henry wrote one month short of five years ago. The article mentioned physical fitness and EFFORTS, my online support group.
I told him about the years I wasted not knowing what I could do to help myself. It wasn’t until I found EFFORTS (Emphysema Foundation For Our Right To Survive) online and learned to go BEYOND my shortness of breath to gain strength and muscle that life began again.
I encouraged Alec to begin rehab to get strength back and talk with the doctor he has a good relationship with to begin a team effort to regain as much muscle and fitness possible,..unless there is some medical reason he cannot exercise.

Alec didn’t know about Pursed Lip Breathing, the oximeter, none of the basic tools COPDers NEED to be the best we can be for the best quality life possible. He has not seen a doctor for his oxygen use in a year!.
We exchanged email addresses and this is where I became aware of unintentional gross neglect of a COPDer by not educating him in the most basic how to PLB breathe! He didn’t know why a COPDer has to exhale twice as long as he inhaled! Why not? How many other folks do we have in Kitsap County, feeling alone and trapped without knowledge and encouragement to work toward a better quality life?

I’m guessing Alec is the tip of the iceberg of ignored people right here who need help! COPD can be a gradually isolating disease.

I suggested he join ‘Walkers’ on EFFORTS, contact the American Lung Association of Washington and the Shortness of Breath Self-Management Study at the University of Washington.

Following are emails I exchanged with Alec and his permission to use here.
________________________________________
11/27/2009 8:32 AM

Hi Sharon..I contacted my doctor’s office, although he was off, and the nurse said go ahead and keep my appointment and discuss with him about being my medical partner in my quest with EFFORTS. Hope you are doing well.

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On Sun, 29 Nov 2009 09:29:29 -0800
…
Good morning Sharon….I am having a tough day today and have become discouraged ,a little. I thought I would exercise by walking slowly as many minutes as I could..If I didn’t have my faith in God, I don’t know where I would be! I started walking and realized just how bad of shape I’m in. I couldn’t make it 2 minutes ,with my 02 !!. Then I realized I hadn’t prayed or eaten or anything….and that’s not like me. So I prayed and ate and started again. I could barely make it over 2 minutes walking slowly. I realize you probably don’t want to hear all this, but I will leave you alone after this. I have a week from tomorrow to get in some kind of physical shape to make it to the my doctor’s appointment. I do want a better quality life. You have given me the inspiration to do that. I didn’t have much luck finding an exercise regimen on EFFORTS, so I will look on ALA for some ideas. I am going to keep moving forward no matter what happens, even if they are slow, or as you put it, one foot in front of the other! I just get down sometimes, but my God always picks me up and says…keep your eyes on Me, not your circumstances.. I’m sorry to unload all this on you, but I won’t bother you anymore. I will continue today to increase my minutes. Thanks for listening…..

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To: “…
Sent: Sunday, November 29, 2009 11:07 AM
Subject: Re: Discouragement

…..call 911! Or your doc. No one should be in the kind of shape you mention and by yourself…no one!

Please…call for help…NOW. Sharon

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On Sun, 29 Nov 2009 09:48:00 -0800
…
Sharon…I’m okay if I’m sitting down and not walking for a lengthy period.I don’t believe I need 911, as I breathe okay if I’m not walking or exercising.I’ll be okay.I think it sounded worse than it is! I’m alright! Please don’t worry yourself. Believe me, I know when I need 911……..Please…I’m so sorry I startled you …….

…
Sent: Sunday, November 29, 2009 11:26 AM
Subject: Re: Discouragement

Alec…Thank you for sharing with me. I’m astounded that no one has helped you build muscle and that you are alone through this and I wonder how many more of us are out ‘there’ that are in the same boat? We need to help each other with encouragement … will you give me permission to use this email exchange (I won’t use your name)to emphasize the NEED for education for COPDers in my blog?
Sharon

11/29/2009 12:12 PM
We’ll do it together, Alec…okay? AND, one day, you’ll be riding a recumbent trike…one step at a time, one cycle wheel turn at a time and have fun too.
God has a sense of humor, I am convinced of it. Do you have a goldfish, bird, birdfeeder…any pets?
You are not alone.
Sharon
**************************************************************
11/29/2009 9:34 AM

Yes, you are right Sharon. God is in control and has a sense of humor! There’s never been a doubt in my mind about that. I didn’t know you would get so worked up about it or I wouldn’t have e-mailed you. I’ve been here for over 4 yrs. by myself! I had a dog, but he got attacked by raccoons and had to be put down. I still cry about that one! Malcom. Great dog. Half Akita, half Spaniel. Big! He was 12 and had a hole tore in his throat by the raccoons over some dog food. Malcom stood his ground, but it cost him his life. Reminds me of ….yea….Jesus! The Vet said he could patch him up, but he was 12 and bigger dogs don’t live as long as smaller ones. He said he probably wouldn’t last long if he couldn’t eat. He couldn’t get up to eat. It was all so sad. I called the Humane Society and they came and carried him away. I’ll never forget the look in his eyes. But I’ll see him again when I join him in heaven.But it still hurts.Poster Child? Never considered myself one of those. I don’t want to lose what little freedom I have. Can you understand that? I hope so! If I told people just how bad I was they would freak out.We do need education in the rehab area. People caring about other people! My family lives out of state and I hate to ask someone to call me everyday or drop by because they all have families, except Louis, and he’s very busy at the church.My goal is to get healthy enough to ride my recumbent bike, go to church, prayer warrior’s on Thursdays, and to go and tell people how much their God loves them! Not to much to ask is it? Nothing is to big for God! I can do all things through Christ who strengthens me! I am going off-line to read my Bible and study. So I’ll talk to you later.One step at a time…you’re right. And fun….I used to love to swim. Couldn’t get me out of the water in the summer. You are a dear, with a big heart. Talk to you later…..Blessings…….

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On Sun, 29 Nov 2009 09:21:42 -0800
…
Sharon…alot of people have said that I am brave to be on my own and in the shape I’m in. No one has even offered to help me get in shape. Maybe that tells me something about who my real friends are! I’m sure there are other people like me who are alone. If something serious happened I would be in a jam ,especially if I couldn’t dial the phone! But then again, most people I know have families and can’t come help me, plus I feel like I’m intruding, and I am, if I ask them to help. I have a single friend at church who is very busy with the holidays this time of year, but I don’t think he realizes how out of shape I’m in. Yes, you can use the e-mail exchange. I don’t know if I want to read it or not, but yes,use it. It’s just one of those things. I just happened to be alone when this all happened. What else can I do? I don’t think I’m bad enough to be in the hospital, but I do need someone to check on me daily or come by and see how I’m doing.. My friend came over yesterday and looked at my computer. I left a message for him to call me at his convenience when he gets home from church today. I’m going to ask him his opinion about whether I need to be in the hospital or a care center, since I live alone. He’ll be honest with me. …

The following article provides a good reason why COPDers tend to have panic attacks as they get more and more short of breath….

“The portion of our brains that is responsible for registering fear and even panic has a built-in chemical sensor that is triggered by a primordial terror — suffocation. A report in the November 25th issue of the journal Cell, a Cell Press publication, shows in studies of mice that the rise in acid levels in the brain upon breathing carbon dioxide triggers acid-sensing channels that evoke fear behavior.” More at http://www.sciencedaily.com/releases/2009/11/091125134651.htm

Goals:
1. Education and rehabilitation for the COPDer.
2. Find the COPDers like Alex…let them know they are not alone and what they can do to help themselves to a more active life.
3. We can help each other if for nothing else but a cheery “Hi, How are you?” voice on the phone.
4. Where are you?

More later… Sharon O’Hara

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A Recumbent Trike Legs and Lung Beginning

Sharon O'Hara

Chronic patients are lucky, too.

I have a story to tell about this year’s 2009 American Lung Association of Washington’s Trek Tri Island’s three-day bike trip – but to tell it, you need to understand the beginning first.
I hope I am permitted to do this…the story is not about me, it never has been.
It is a story about a person who went from fit and health and physically active into a patient who couldn’t breathe and thought she was dying.
*****************************************************************************
Sharon’s Ride
September 2005
________________________________________
A dream come true. I worked hard for pledge dollars and LOVED EVERY MINUTE of it. For the first time since 1997 I dared to go on a trip… and had no idea how I would manage without my BiPap, my water pills … put up a tent, take it down… carry my stuff around…

At the start I felt like a breathless beached whale… wondering what I was doing with a group of – clearly – fit people on a three day American Lung Association of Washington three day bike ride on a trike I’d never ridden before. It seemed all my exercise work wasn’t enough. EFFORTS – thoughts of EFFORTS – all you – kept me going!

The outstanding help and assistance I received from the volunteer crew enabled me to keep going, but it was a fellow trike rider, Dan… who must have seen I was struggling and rode up behind and asked if he could help. He patiently taught me how to shift gears, including the big gears until I could ‘feel’ the shifting… as well as see the speedometer computer jump to reflect speed… proof to me shifting pays off.

COPD has given me the opportunity to slow down and discover incredible kindness of folks that I never had time to notice before. EFFORTS gave me my life back – exercise lets me function…

Ferry schedules are kept – ferries wait for no one. The outstanding volunteer group helped me ‘keep up’… in particular, Don.

On the last day Don drove me and my trike far enough out to get a head start and I began pedaling the final 19.2 miles into Victoria B.C. and the Victoria Clipper. Pedaling up hills I stopped whenever I needed to – sometimes every couple of feet – for a minute or two. I sat on my trike until I could go again.

Foot by foot I pedaled to the top of the hills and barreled down the other side. Until…close to Victoria – a hill came into sight that appeared almost vertical. I couldn’t see the top. I stopped when I got to the bottom and stared up. I was outfaced. If I started up I couldn’t stop to rest until I got over it. It was steep, yes, but I was too close to stop now. I started up.

The top of the hill got closer until I was just below it my legs shook from the strain and I couldn’t breathe – I labored to keep going. All of a sudden the trike felt light and we raced upward. A voice yelled, “Keep pedaling”!

My feet flew –we hit the summit and started down the other side. I yelled back, “Thank you!” Someone saw I was in trouble and pushed me up! I let the trike race down until I could pedal and breathe again and my heart quit jumping and thumping.

It was Don one of the ALA of WA’s extraordinary volunteers … I’d passed him parked on the side of the road several times during the 19.2 mile ride. He’d ask if I wanted to stop? I”d answer, “No, I’ll keep going for now.”

Thanks to many people I rode my trike 19.2 miles into Victoria and when I got there I couldn’t stop tears from welling behind my sunglasses.

You did it, EFFORTS. You taught me how to live again, gave me my life back. And to see the bright red EFFORTS tee-shirt and meet the man inside, Chris, EFFORTS Ambassador to Canada and his lovely wife was pure joy. Chris is so EFFORTS oriented, so energetic, so giving… he gave me his watch when I said I didn’t have one. And our watch says it is now 3:49pm.

God Bless. Thank you for helping me live again. EXERCISE FOLKS please help yourself…. and join me next time?
Sharon O’Hara
http://www.effortsmembers.org/Happenings/shar_ride_p1.htm

More later… Sharon O’Hara

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Huffers & Puffers Notice Air Quality

Sharon O'Hara

Rhythm Aren’t Just Pretty Names › Back to COPD and Other Stuff
Huffers & Puffers Notice Air Quality

COPDers often hear of or read about “COPD Flare-Ups.” The exacerbation means a worsening of symptoms – breathlessness, cough, sputum and usually treated with antibiotics though the reasons for the flare-up may not be known. The symptoms are similar to those of pneumonia or infection of the lung … sort of a guess, thanks to the mystery and lack of research for COPD.

Call your doctor and discuss with her/him a plan of action for future exacerbations or flare-ups. Some COPDers keep antibiotics on hand…it all depends on the plan the doctor and COPDer have in place for future attacks. Good health care for the patient is a partnership with her/his doctor.

http://www.thoracic.org/sections/copd/for-patients/what-is-an-exacerbation.html

COPDers are different in response to different ‘triggers’. Heavy air makes breathing difficult for some of us…other COPDers might not notice.

The different forms of air quality affect most of us though and it pays to be aware of the changing weather conditions. If needed, make changes in the day’s plan for those especially sensitive to the changes.

According to the American Lung Association of Washington, while tomorrow’s air is labeled “Good”, today’s air quality is only Moderate. www.alaw.org

The following explanation of a Flare-Up by the nation’s #1 hospital, Johns Hopkins, (according to US News & World Reports) is a good ‘keep on hand.’

COPD Flare-Up Advice

COPD complications can be serious. Johns Hopkins specialists provide bottom line advice to help you recognize a COPD problem before it turns dangerous.

If you have COPD, how do you know when you’re not merely in discomfort, but in danger? Here are some danger signs that you shouldn’t ignore.

· COPD flare-ups and infections. If you feel increasing shortness of breath, more mucus in your throat, and greater wheezing and coughing than usual, you may be experiencing a COPD flare-up — something you need to share with your doctor. You should also call if the material you cough up changes color or if you have a fever lasting more than 24 hours. COPD flare-ups often result from a bronchial infection, which may be treatable with antibiotics, or from breathing fumes, dust, or pollution.

· COPD and heart failure. Swelling of the legs, ankles, and feet is a warning that someone with COPD may have developed a type of heart failure called cor pulmonale, or right ventricular failure. Because COPD makes the heart work harder (particularly the right side, which pumps blood into the lungs), that side of the heart may enlarge. As the blood pressure in the lungs rises, the right ventricle contracts less efficiently. Cor pulmonale increases the risk that a blood clot will develop in a leg vein.

· COPD and pneumothorax. A hole that develops in the lung, allowing air to escape into the space between the lung and the chest wall, pneumothorax causes the lung to collapse, leading to severe shortness of breath. People with COPD have an increased risk of pneumothorax, because changes in their lungs cause air to be emptied unevenly from the lungs. Symptoms of pneumothorax include: sudden shortness of breath; painful breathing; sharp chest pain, often on one side; chest tightness; dry, hacking cough; rapid heart rate.

· COPD and too many red blood cells. Weakness, headaches, fatigue, and light-headedness may indicate the presence of an uncommon condition known as secondary polycythemia, which arises when there isn’t enough oxygen in the blood. Someone who develops polycythemia may have visual disturbances such as blind spots, distorted vision, and flashes of light. Gums and small cuts may bleed, and there may be a burning sensation in the hands and the feet.

Bottom line advice on COPD: If the problem is a flare-up of COPD, quick treatment can prevent serious breathing problems that might send you to the hospital. Call your doctor immediately if:

· You have COPD and you have shortness of breath or wheezing that is rapidly worsening.

· You have COPD and are coughing more deeply or more frequently, especially if you have an increase in mucus or a change in the color of the mucus you cough up.

· You have COPD and cough up blood.

· You have COPD and have increased swelling in your legs or abdomen.

· You have COPD and have a fever over 100 degrees F.

· You have COPD and have severe chest pain.

· You have COPD and develop flu-like symptoms.

· You have COPD and feel that your medication is not working as well as usual.

http://www.johnshopkinshealthalerts.com/alerts/lung_disorders/JohnsHopkinsHealthAlertsLungDisorders_3055-1.html?ET=johnshopkins_blog:e26696:541334a:&st=email&st=email&s=ELH_090806_005

Yours for healthy air… Sharon O’Hara

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Huffers & Puffers Notice Air Quality

Sharon O'Hara

COPDers often hear of or read about “COPD Flare-Ups.” The exacerbation means a worsening of symptoms – breathlessness, cough, sputum and usually treated with antibiotics though the reasons for the flare-up may not be known. The symptoms are similar to those of pneumonia or infection of the lung … sort of a guess, thanks to the mystery and lack of research for COPD.

http://www.thoracic.org/sections/copd/for-patients/what-is-an-exacerbation.html

COPDers are different in response to different ‘triggers’. Heavy air makes breathing difficult for some of us…other COPDers might not notice.

According to the American Lung Association of Washington, while tomorrow’s air is labeled “Good”, today’s air quality is only Moderate. www.alaw.org

The following explanation of a Flare-Up by the nation’s #1 hospital, Johns Hopkins, (according to US News & World Reports) is a good ‘keep on hand.’

COPD Flare-Up Advice

COPD complications can be serious. Johns Hopkins specialists provide bottom line advice to help you recognize a COPD problem before it turns dangerous.

If you have COPD, how do you know when you’re not merely in discomfort, but in danger? Here are some danger signs that you shouldn’t ignore.

· COPD flare-ups and infections. If you feel increasing shortness of breath, more mucus in your throat, and greater wheezing and coughing than usual, you may be experiencing a COPD flare-up — something you need to share with your doctor. You should also call if the material you cough up changes color or if you have a fever lasting more than 24 hours. COPD flare-ups often result from a bronchial infection, which may be treatable with antibiotics, or from breathing fumes, dust, or pollution.

· COPD and heart failure. Swelling of the legs, ankles, and feet is a warning that someone with COPD may have developed a type of heart failure called cor pulmonale, or right ventricular failure. Because COPD makes the heart work harder (particularly the right side, which pumps blood into the lungs), that side of the heart may enlarge. As the blood pressure in the lungs rises, the right ventricle contracts less efficiently. Cor pulmonale increases the risk that a blood clot will develop in a leg vein.

· COPD and pneumothorax. A hole that develops in the lung, allowing air to escape into the space between the lung and the chest wall, pneumothorax causes the lung to collapse, leading to severe shortness of breath. People with COPD have an increased risk of pneumothorax, because changes in their lungs cause air to be emptied unevenly from the lungs. Symptoms of pneumothorax include: sudden shortness of breath; painful breathing; sharp chest pain, often on one side; chest tightness; dry, hacking cough; rapid heart rate.

· COPD and too many red blood cells. Weakness, headaches, fatigue, and light-headedness may indicate the presence of an uncommon condition known as secondary polycythemia, which arises when there isn’t enough oxygen in the blood. Someone who develops polycythemia may have visual disturbances such as blind spots, distorted vision, and flashes of light. Gums and small cuts may bleed, and there may be a burning sensation in the hands and the feet.

Bottom line advice on COPD: If the problem is a flare-up of COPD, quick treatment can prevent serious breathing problems that might send you to the hospital. Call your doctor immediately if:

· You have COPD and you have shortness of breath or wheezing that is rapidly worsening.

· You have COPD and are coughing more deeply or more frequently, especially if you have an increase in mucus or a change in the color of the mucus you cough up.

· You have COPD and cough up blood.

· You have COPD and have increased swelling in your legs or abdomen.

· You have COPD and have a fever over 100 degrees F.

· You have COPD and have severe chest pain.

· You have COPD and develop flu-like symptoms.

· You have COPD and feel that your medication is not working as well as usual.

http://www.johnshopkinshealthalerts.com/alerts/lung_disorders/JohnsHopkinsHealthAlertsLungDisorders_3055-1.html?ET=johnshopkins_blog:e26696:541334a:&st=email&st=email&s=ELH_090806_005

Yours for healthy air… Sharon O’Hara

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Air Quality for Air Breathers

Sharon O'Hara

The American Lung Association of Washington has many great services for lung challenged folks – sending air quality alerts to those who sign up for it is one of them.

Until KS’s own weather fellow, Matthew Leach, “Forecasting Kitsap” blog http://pugetsoundblogs.com/forecasting-kitsap/2009/07/26/excessive-heat-watch-issued-the-heat-and-humidity-has-arrived-folks/
begins announcing the daily and forecast air quality with his reports, I will do it here, thanks to the ALAW notice.

Maybe Matt can tell us what “Numerical Value” means. For a moderate breathing day, it is 51 – 100.

Many lung challenged folks cannot breathe in hot moist air. For me, a humid hot day is like trying to breathe through a warm soaking wet thick wool blanket and then I move.

Many of us carry a small battery operated fan – I attached them to my dog crates when we had to travel on a hot day and they helped move air on days without a breeze when we stopped and had the doors wide open for ventilation.

Today’s air quality is green – good.
Tomorrow is not so good. Following is the moderate forecast for tomorrow and brief description..

“Air quality is Moderate. Sensitive people should take necessary health precautions during this time. Weather changes can affect air quality quickly so please pay attention to your local weather forecasts.

For more information about air quality and your health, visit website at www.alaw.org, or call us 1-800-LUNG-USA.
Air Quality Index

Level of Health Concern Numerical Value
51-100
Meaning
Air quality is acceptable; however, for some pollutants there may be a moderate health concern for a very small number of people who are unusually sensitive to air pollution.

Weather Conditions:
…
Summer – Hot and sunny conditions. A temperature inversion exists, creating stagnant air and trapping pollutants close to the ground. Conditions may include light/moderate winds. High pressure system, haze or partly cloudy skies.

Health Information:
Sensitive individuals and people with respiratory disease should consider limiting prolonged outdoor exertion.
If you have asthma make sure you have an Asthma Management Plan to follow.

Action You Can Take Now:

• Avoid using your woodstove or fireplace and burning outdoors to reduce health harmful particulates in the air.
• Drive Less. Automobile exhaust and diesel emissions account for the bulk of harmful particles in the air.
• Leave your car at home. Work at home, take the bus or carpool to work.
• “Trip-Link” errands to reduce vehicle trips.”

In addition, the American Lung Association of Washington offers free air quality home assessments by their volunteer driven program, Master Home Environmentalist. alaw@alaw.org (206) 441-5100 or 800-LUNG-USA.

…thanks for dropping by… Sharon O’Hara

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