Tag Archives: chest

Kitsap County African-American and Asian-American COPDers Are Missed in Lung Patient Meetings

What role does ethnic ancestry (race) have to do with COPD? Yesterday’s information packed Harrison Medical Center/Better Breather’s support group meeting brought home the work ethic of the Norwegian immigrants I knew growing up and remember thinking I am glad to be born Norwegian American of immigrant parents.

That said, I thought of other races/ethnic immigrants to this country and their same work ethic and realized that I don’t recall seeing a person of obvious racial differences at any COPD meeting I’ve attended in the years I’ve had COPD. (1997)
We all share the same American pride of heritage but none of it matters with COPD or any chronic disease. Under the skin, we all look the same: brain, heart, lungs, liver and so on. Disease generally does not know race, religion, gender or age and does not stop at borders. We are sisters and brothers under the skin – our lungs are damaged, not our varied cultures and pride in them.
We have damaged lungs – permanently damaged yes, but we can get educated how to help ourselves live a quality life – all of us.
Yesterday’s Better Breather’s meeting was a ‘don’t miss!’ for lung disease patients and I would like to know why non-Caucasians were missing?

I feel lucky in my heritage, as I know everyone feels about his or her heritage and culture. We share lung disease and should be equally educated as patients. As a Norwegian/American lung patient, what can I do to get you to these incredible meetings?

Speaker Aaron spoke to how he, as an exercise induced asthmatic child got over it in two years -I’ll tell you in the story I’m writing and posting soon, but you should have been there.

Take care of yourself, get educated because Harrison is getting hot to educate patients. Hope to see you at next month’s meeting.
Following is the African-American COPD story in Chest in 2009 and the Asian-American COPD story 2011.

African-Americans with COPD Use Fewer Health Services
New research shows that African-Americans (AA) with chronic obstructive pulmonary disease (COPD) use fewer health services than Caucasians with the condition. Researchers from the University of Maryland compared health services utilization and cost outcomes in 4,723 AA patients and 4,021 Caucasians with COPD, asthma, or both. After controlling for age, gender, cohort allocation, and comorbidities, results showed that AA adults with COPD, asthma, or coexisting asthma and COPD used fewer medical services and accounted for lower medical costs than Caucasians.

The authors speculate that the differences in utilization and medical costs may provide an explanation for the racial disparities in outcomes of patients with COPD and asthma. The article is published in the August issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
http://www.chestnet.org/accp/article/african-americans-copd-use-fewer-health-services

Ethnicity and Risk of Hospitalization for Asthma and Chronic Obstructive Pulmonary Disease.
Tran HN, Siu S, Iribarren C, Udaltsova N, Klatsky AL.
Departments of Medicine (H.N.T.) and Pulmonary Medicine (S.S.), and the Division of Research (C.I., N.U., A.L.K.), Kaiser Permanente Medical Care Program, Oakland, California.
PURPOSE:

To identify ethnic differences for risk of hospitalization for asthma and chronic obstructive pulmonary disease (COPD).
METHODS:

We undertook a cohort study with 126,019 participants: 55% whites, 27% blacks, 11% Asians, and 4% Hispanics. To estimate asthma and COPD risk, we used Cox proportional hazards models adjusted for age, sex, body mass index, education, smoking, and alcohol intake. End points were hospitalizations for asthma or COPD.
RESULTS:

Compared with whites, relative risks (RR) with 95% confidence intervals (95% CI) for asthma among other groups were: blacks, 1.7 (1.4-2.0); Hispanics, 0.9 (0.6-1.4); and Asians, 1.6 (1.2-2.1). Among Asians, increased risk was concentrated in Filipino men and women and South Asian men. For COPD, whites were at highest risk; RR of blacks was 0.9 (0.7-1.0); Hispanics, 0.6 (0.3- 0.9); and Asians, 0.4 (0.3-0.6). COPD risk among Asians was lowest in Chinese with RR of 0.3 (0.1-0.5).

CONCLUSIONS:

Ethnic disparities in risk of asthma and COPD as well as between both diseases exist, especially for Asian Americans, who have high asthma risk and low COPD risk. While residual confounding for smoking or other environmental factors could be partially responsible, genetic factors in Asians may be involved in decreased COPD risk.
Copyright © 2011 Elsevier Inc. All rights reserved.
http://www.ncbi.nlm.nih.gov/pubmed/21414801

The bottom line is anyone with lung/pulmonary disease needs to become educated so that we can live the best life possible as long as possible. Exercise makes a difference.
More later…thanks for reading… Sharon O’Hara

Lungs Win the Fight Against Fat

If we are in a boxing match, Fat in one corner, and Lungs in another, Fat wins every time.
Why?
Fat takes up the chest room Lungs need to expand and for lung patients, fat compromises our ability to breathe.

The fat v lungs slammed home to me a couple weeks ago when a granddaughter, taking a new class on her way to becoming an RN, told me she just learned that each pound of excess fat is fed by SEVEN MILES of blood vessels.

I went online that night and found an airport-scanned photo (Digg) of a 250-pound woman next to a 120-pound woman. Fat filled her stomach and chest crowding her lungs and heart. Heaven knows what all that fat is doing as it surrounds and crowds the kidneys, bladder and other organs….it cannot be good!

Look, fellow Tubby’ettes and join me. To date, I have lost 133 miles of excess blood vessels supporting nineteen pounds of excess fat.
Regular Tubby’ettes is lucky if their health is not yet compromised.

Lung patients, easing the fat surrounding our lungs will not change the PFT numbers, but we are bound to feel a sigh of relief from our lungs as the fat around them retreats and they can finally expand to capacity and add to our quality of life.

********************
Obesity and the lung: 5 • Obesity and COPD
Thorax 20 08;63:1110-1117 doi:10.1136/thx.2007.086827
Abstract
Chronic obstructive pulmonary disease (COPD) and obesity are common and disabling chronic health conditions with increasing prevalence worldwide. A relationship between COPD and obesity is increasingly recognized, although the nature of this association remains unknown. This review focuses on the epidemiology of obesity in COPD and the impact of excessive fat mass on lung function, exercise capacity and prognosis. The evidence for altered adipose tissue functions in obesity—including reduced lipid storage capacity, altered expression and secretion of inflammatory factors, adipose tissue hypoxia and macrophage infiltration in adipose tissue—is also reviewed. The interrelationship between these factors and their contribution to the development of insulin resistance in obesity is considered. It is proposed that, in patients with COPD, reduced oxidative capacity and systemic hypoxia may amplify these disturbances, not only in obese patients but also in subjects with hidden loss of fat-free mass. The potential interaction between abnormal adipose tissue function, systemic inflammation and COPD may provide more insight into the pathogenesis and reversibility of systemic pathology in this disease.”
• Review series
1. F M E Franssen1,
2. D E O’Donnell2,
3. G H Goossens3,
4. E E Blaak3,
5. A M W J Schols1
1. 1
Department of Respiratory Medicine, University Hospital Maastricht, Maastricht, The Netherlands
2. 2
Division of Respiratory and Critical Care Medicine, Department of Medicine, Queens University, Kingston, Ontario, Canada
3. 3
Department of Human Biology, Nutrition and Toxicology Research Institute (NUTRIM), Maastricht University, Maastricht, The Netherlands
1. Dr A M W J Schols, NUTRIM School for Nutrition, Toxicology and Metabolism, Department of Respiratory Medicine, University Hospital Maastricht, P O Box 5800, 6202 AZ Maastricht, The Netherlands; a.schols{at}pul.unimaas.nl
• Received 15 February 2008
• Accepted 30 April 2008
• **************************
• http://digg.com/health/Body_Scans_of_a_250_lbs_Woman_vs_120_lbs_Woman
More later… Sharon O’Hara

Fat Airport Scan