There's nothing better than hearing your loved one with COPD say, "I feel good today." It's a relief that the care plan is going well and brings a possibility that tomorrow will be the same. The feeling that treatment is going well should spark confidence, hope, and encouragement. In a diagnosis that can be full of ups and downs, those living with COPD and caregivers appreciate these moments. But the question is, "What can caregivers do to help your loved one with COPD stick to their medical routine when they are feeling well?" In other words, how do we maintain the momentum of a treatment plan?

Recognize most medications are for "maintenance"

Sure there are quite a few inhaled medications that can be used to quickly relieve shortness of breath in people with COPD. However, many of the medicines prescribed are what we refer to as "maintenance" medications. These inhaled medicines are used to prevent and control symptoms. They can reduce the frequency and severity of exacerbations, enhance lung function, and improve exercise tolerance.¹ I liken this to maintaining your vehicle. We don't just put gas in it to make it go and expect not to have any issues. We have to perform routine maintenance like changing the oil, replacing the brake pads, and rotating the tires to make sure it is in good condition to drive. Encourage your loved one to use their maintenance medicines as prescribed. If you aren't familiar with which medicines may be used for maintenance there is a list of medications available on our website. These medicines are typically scheduled for every 12 hours or once a day. Ask your loved one's doctor or pharmacist to be sure.

Use confidence to do the things you love

"Seizing the day" when your loved one with COPD is feeling good can be great for maintaining good mental health and building confidence. Whether it be a visit with friends they haven't seen in a while, a trip to a park on a beautiful day, or a drive through the countryside to enjoy the landscape… use those "good days" as a boost for mental health. People living with COPD have a higher risk of developing anxiety and depression.² As a caregiver, encouraging your loved one with COPD to do the things they love when they are feeling their best will help them to maintain momentum with their treatment plan.

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Two of the most common questions that I hear from people with multiple health conditions (comorbidities) are, "How do I know what is wrong when I am not feeling well?" and "What can I do about it?" These can be hard questions to answer sometimes, especially when you have more than one health concern. Let's talk about some things that can help you find out which condition is causing your symptoms, and some tips for what you can do about it.

One of the most important things that help to identify what type of exacerbation (flare-up) is occurring, is knowing your body. While there are common symptoms to each condition, your body may not respond the same way your neighbor's does. For example, when my blood pressure is high, I will get short of breath with exercise, but when my daughter's blood pressure is high, she will get a bad headache. Both of us are showing symptoms of high blood pressure, but we don't experience the changes in blood pressure the same way. It is important to know how your body normally reacts.

It is also important to understand that your body's response to illness can change over time as conditions progress, so you need to be aware of the common symptoms of your conditions in case you begin to experience symptoms differently. For example, when you first receive a diagnosis of COPD you may have trouble walking around the mall because you are short of breath, but as the years pass when you try to walk to the mailbox you begin to feel chest tightness and are very short of breath. You also begin coughing up a lot of mucus that looks different than before. These are changes in the way you are experiencing symptoms of COPD and should not be ignored. As always, if you are not sure about what you are feeling or are experiencing new or changing symptoms reach out to your doctor.

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This post was written by MeiLan Han, MD, MS, Professor of Pulmonary Medicine at the University of Michigan and member of the COPD Foundation Board of Directors.

This month at the COPD Foundation we’re focusing on goal setting. But what does that mean for you? I thought it might be fun to share with all of you some tips from my new book, Breathing Lessons, A Doctor’s Guide to Lung Health that you can consider for your own health journey. So what are some easy healthy habits you can adopt in 2022 to protect your respiratory health and boost your lung function?

Exercise

I know this is something all of you already know a lot about, but it bears repeating. Many of my patients haven’t been doing too much exercise because of the pandemic. But to remind you, exercise can help the lungs in several ways. Exercises that focus on strengthening the respiratory muscles themselves, the diaphragm as well as the muscles that surround the neck, shoulders and back, can improve lung function, particularly among those that have underlying issues with muscle weakness. While there are specific inspiratory muscle training devices that can be used to help strengthen the diaphragm, I have the majority of my patients focus first on upper body strengthening exercises.

Even more importantly, I strongly recommend incorporating regular aerobic exercise into one’s daily routine. Aerobic exercise can be thought of as sustained activity that increases your heart and breathing rate. If you don’t currently have a good exercise routine, start by doing something easy such as walking or using a stationary bike or even foot pedaling device.

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This post was authored by Jane Martin, BA, CRT.

We will soon start a new year. What does it hold for you, a person with COPD? Increased shortness of breath? Being less active? Having exacerbations (flare-ups) that send you to the hospital? Or, how about having stable COPD with no, or minor, flare-ups and more control over your breathing— and your life. Is this even possible? Yes. Yes, it is. And here are three steps to get started.

1. Look ahead

When I was working in pulmonary rehab, new patients came in on their first day, some of them feeling broken and defeated. Those who had COPD caused by cigarette smoking were often filled with shame and regret. They walked through our door that day expecting to be given a lecture, a lecture they’d heard too many times already - that they caused their COPD. But they didn’t hear that. Instead, I asked, "Can looking in that rear-view mirror help you see where you’re going? No, it can’t. So, here, today, it’s time to look ahead. What’s done is done. It’s in the past. No matter what your situation is, no matter how or why you have COPD, what’s most important is that you’re here, with us, at pulmonary rehab, today. And you can make a fresh start."

But even if you don’t ever go to pulmonary rehab, the message is the same. You can begin by reminding yourself that you’re still you. You may have COPD, but that does not change the person you are. You can accept yourself as a person with COPD who has every right to set goals—and see a future!

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This article was written by Bret Denning, JD

Exacerbations: there’s a lot to learn and we want everyone affected by COPD to be aware of what to do in the event of an exacerbation or flare-up. Whether you are new to COPD or have been living with it for years, it is important to know what you can do to spot the warning signs and take action before it leads to a hospitalization.

Did you catch this material related to exacerbations?

• A webinar on how to break the cycle of exacerbations.
• Our new Exacerbations Guide for Better Living.
• This yoga video to help reduce stress.
• The "Have You Ever?" exacerbation game.

How much do you know about exacerbations?

Here is a fun and easy to test yourself and to see what you know about exacerbations. At the bottom of this post is a short quiz for you to take and evaluate your own knowledge. We have also included links to some helpful resources for anyone who wants to learn more.

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This article was written by Angie Brunkhardt, RRT.

So, you have COPD. These words scare even the strongest people. What does having COPD mean? How does your doctor know this is truly the problem? How will COPD affect your life, your future? You probably have a few questions. Let us start by talking about what to expect when it comes to testing.

There is only one diagnostic test that can really confirm if you have COPD. That test is called a pulmonary function test (PFT). One part of the PFT is called a spirometry test. When you schedule your PFT, the testing center will remind you not to take your respiratory medications the day of your test.

For this test, a respiratory therapist will guide you through a series of breathing/blowing exercises while you have a nose clip and your mouth on a large mouthpiece connected to a spirometer to measure air flow. You will take in very deep breaths through the mouthpiece and blow out very hard and fast for several seconds. You will feel that you are really pushing yourself, and that is exactly the kind of effort needed for this test. You will repeat this test several times to make sure the results are as accurate as possible. When you finish the first part of the test, the respiratory therapist will give you a bronchodilator either by using inhaler or nebulizer, and you will repeat the breathing test again. By repeating the test after using the medication, the doctor can determine if your lung disease reacts to the medication. A positive reaction will show an increase in your numbers and less difficulty with the breathing test exercises you repeat.

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This article was written by MeiLan Han, MD, MS, COPD Foundation Board Member.

Many of us don’t stop to think about how our environment impacts our lungs. While tobacco smoke contributes to the development of COPD, there are many other environmental factors that contribute both to the development of lung disease and can also make respiratory symptoms worse for those who do have lung disease.

To begin, it is now believed that air pollution not only contributes to the development of COPD but can also make respiratory symptoms worse and trigger exacerbations (also known as flare-ups). Hotter temperatures and drought increase the amount of dust and particle pollution we are exposed to. Wildfires in particular have become a major source of extremely high particle levels, noticeable even hundreds of miles from the fires themselves. Since air pollution can vary significantly on a daily basis, websites such as airnow.gov allow you to look up the Air Quality Index in your area at any given time. On unhealthy air quality days, you may want to stay indoors if possible, while keeping doors, windows, and fireplace dampers shut. Air cleaning devices with high efficiency particulate air (HEPA) filters can provide additional protection. If you must spend time outside, ordinary masks are unfortunately not that helpful for filtering the smaller, more dangerous particles. In these cases, an N-95 type mask is most effective; however, as many now know, these can be uncomfortable to wear and breathe through. When driving on unhealthy air days, another tip is to roll up your windows and operate the recirculate setting for your vehicle’s ventilation system.

We know that air pollution can also come from inside the home. Sources of indoor air pollution include asbestos, paint and cleaning supplies, as well as mold and radon. Strategies to reduce air pollution in the home include trying to use safer products. For instance, “low-VOC” (volatile organic compound) paints are now readily available. Cleaning products unfortunately often contain chemicals harmful to the lungs. Ammonia and bleach can irritate the airways. It is important to never mix bleach or any bleach-containing product with any product containing ammonia. This combination can create a gas which can cause significant breathing problems and even death. The Environmental Protection Agency (EPA) has a list of cleaning products that meet their new "Safer Choice" requirements.

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This article was written by Stephanie Williams, BS, RRT.

I hate to admit this, but I can be cynical—especially when it comes to therapies and treatments for the patients I care about. When I was the Director of Respiratory Therapy in the acute care (hospital) setting, there would be the occasional visit from a salesperson who would try to convince me that the product they were selling was the latest and greatest thing to help me care for my patients. Sometimes the product would be a good addition to our collection of tools we used, but sometimes it was all show and no substance.

I share this with you is because I want you to know how strongly I feel about the Harmonicas for Health program. It truly does rank in my top five of products and programs that I believe can actually improve the quality of life of the participants.

When we started this program five years ago, I had no idea how much it would help people living with breathing problems. We knew it was going to be a good program, but I didn’t know how much people would love it or how much it would mean to them. Boy, was I surprised!

There are many reasons that people give for joining Harmonicas for Health. I recently spoke with Doug Martin, State Captain, and a long-time H4H participant and instructor about his experience with the program and how it helped him.

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This article was written by Stephanie Williams, BS, RRT.

This week our focus has been on nutrition. For some people living with COPD, it can be challenging to eat right and get the calories and nutrients you need, either because you don’t feel confident in your cooking skills or maybe because you don’t have much energy to cook.

If you have been on COPD360social for a while, you have probably seen posts from DebbieB.-Connecticut State Captain where she posts pictures of her yummy meals. She usually posts a food that can be made ahead of time and eaten for several meals to come. What a great idea! Cook once and have plenty for a few days – it sounds good to me!

A few months ago, I asked Debbie B. if she would help me by sharing some of her recipes with us. She was happy to help, and she sent over dozens of recipes. I am sharing a few of them here, and hope that maybe you will have some to add in the comments section.

Before we get started, here are a few notes from Debbie B.:

"We all want to eat healthy, satisfying meals. Sometimes we have to substitute canned or frozen foods for fresh. It is ok to substitute other proteins in place of meat. When reading recipes, it is important to realize that you can substitute ingredients if there are things you cannot eat or don’t like. Think of the recipe as a basic guideline. You can make adjustments to suit your needs.

On days that you feel good, you might cook a one-time meal, or you might take that opportunity to make a little extra or a large meal and plan other meals using the leftovers. You might even freeze portions to eat at a later date.

Enjoy preparing your meals as much as you enjoy eating them!"

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Dear Coach,

My wife has had COPD now for several years. In the past few months, she seems to get ill after eating with a lot of gas causing her to belch a lot. She also seems to have problems breathing afterwards, too. What would you suggest we do?

Dear Concerned Caregiver,

The problem you describe could be from a health problem other than COPD so she should talk to her doctor know about these new problems to make sure she can get any testing or treatment she needs. In people living with COPD, it is always smart to think about diet and food.

Having COPD presents many challenges and eating can be one of them. Nutrition is very important for everyone but with COPD it is not only important but often critical that we not just consume food, but in the process get the needed protein, fiber, fats, and carbohydrates. Something to keep in mind is that the simple act of breathing requires calories. But people living with severe COPD use many more (often hundreds more) calories to breathe than someone without COPD. If these calories are not replaced it can result in weight loss, fatigue and even more shortness of breath.

Instead of eating large meals a couple times a day your wife should try eating several smaller meals throughout the day. These smaller meals should be high calorie and protein such as cheese, peanut butter, protein shakes and meats. In my case, I find it easy to eat peanut butter crackers and sandwiches, small meat and cheese slices, and a high calorie nutritional shake. When I eat the smaller meals, I feel far less bloated and breathless.

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This article was written by Bret Denning, JD and Christina Hunt, BS, RRT-NPS

Brian Simpson is a registered respiratory therapist (RRT) who has lived with severe chronic asthma for more than 30 years. He has worked in pulmonary rehabilitation and as a COPD Navigator and case manager. When his bronchiectasis led to a rapid deterioration in lung function, Brian could no longer work with patients. He began working as a CDI (clinical documentation improvement specialist), reviewing inpatient accounts. Even with severe lung disease, Brian has completed 18 full marathons, more than 30 half marathons, and a 50K mountain trail race.

Thanks for talking with us today Brian. Can you tell us when you first started noticing signs of your bronchiectasis?

I first started noticing symptoms of bronchiectasis a little over four years ago. I had a rapid and severe decrease in lung function after finishing two marathons within a two-week period. Prior to that, I was running at least five to eight miles every day. My lung function dropped from just under 30% to 15% and I noticed muscle fatigue with any activity. Even coughing was a struggle.

What tests did the doctors do to confirm your diagnosis?

My physician ordered a CT scan of my chest and pulmonary function tests as part of a pre-lung transplant assessment. When my pulmonologist reviewed the results with the radiologist, they made the diagnosis of bronchiectasis.

I’m sure it was quite a shock to hear that. How did you initially react to the diagnosis?

I remember feeling somewhat overwhelmed being diagnosed with bronchiectasis. I’m a non-smoker who has suffered from severe chronic asthma my entire life. Over time, that developed into stage 4 COPD, and now I was adding bronchiectasis to the list of diagnoses.

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This post was written by Jane Martin, BA, CRT

In this blog post we talk more about living with bronchiectasis and taking care with three different aspects of your health (and that everybody should keep in mind): exercise, nutrition, and sleep.

This is the fifth in a series of six blog posts to bring more awareness to bronchiectasis and things you can do. Follow these links to read more:

• Bronchiectasis: The Phantom Menace
• Bronchiectasis: Symptoms and Diagnosis
• Women and Bronchiectasis
• Bronchiectasis and COVID-19

Disclaimer: Always check with your health care provider before making any changes in exercise, activity, or diet.

Exercise

Exercise training is linked to improvement in exercise ability, shortness of breath, and less fatigue (tiredness) for people with bronchiectasis. It is also shown to be effective in decreasing exacerbations (flare-ups)¹. You might be thinking, "Well, that’s fine, but I can’t exercise. I get short of breath just walking to my car!"

If you feel that way, you’re not alone! You should know, though, that exercise is possible. A pulmonary rehabilitation program can help you learn to exercise safely with the guidance of a special team of health care professionals. Some are now offering remote classes. Ask your doctor about referring you to pulmonary rehab.

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