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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At this point in time, most everyone is aware of the dangers of smoking cigarettes, pipes, and cigars. But there is some confusing and misleading information about vaping and e-cigarettes, and we want to make sure everyone knows the facts.

We know that some people encourage using e-cigarettes as a way to quit smoking. Vaping devices are not approved by the United States Food and Drug Administration (FDA) as a tobacco cessation tool. There is research that shows that too often, people will use e-cigarettes without stopping the use of regular tobacco products. This is a problem because it gives a person more exposure to dangerous, unhealthy chemicals. Research also shows that vaping products in the United States have more nicotine than regular cigarettes, which makes them more addictive. If someone is trying to quit tobacco using a product with more nicotine, it can make quitting smoking harder.

Another issue is that some vaping liquids are flavored, which can give the false sense that the products are harmless. Menthol is one of these flavors. Not only does the menthol flavor cover up the bad taste of the liquid, but it also encourages people to take deeper breaths. It can also create a false sense of well-being because it gives a feeling of the airways opening up.

We know that quitting tobacco is a very important thing to do, but the COPD Foundation does not support using electronic cigarettes to quit smoking - or for any other reason. If you or someone you know is interested in quitting smoking, we encourage you to visit the FDA website and find a tobacco cessation product that will work for you. And as always, we are here to help support you on your journey to become a non-smoker.

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If you have explored the COPD Foundation website, you may have noticed that in the Foundation’s mission statement that "the organization is committed to preventing COPD, bronchiectasis, and nontuberculous mycobacterial (NTM) lung disease, and to seeking cures while improving lives and advocating for all affected." Because of this, in 2016 the Foundation expanded its bronchiectasis and NTM efforts by establishing the Bronchiectasis and NTM Initiative, which brought an emphasis on disease awareness and community education, in addition to research. As part of the Initiative, the Foundation launched BronchandNTM360social, an online community (similar to COPD360social) for individuals affected by bronchiectasis and/or NTM, including patients, family members, caregivers, physicians and other health care providers. In years that followed, the Initiative developed educational materials and resources and hosted live events in order to educate and engage the community.

As mentioned, BronchandNTM360social, is a community unto itself that provides education, community feedback, and research opportunities to its members focused on bronchiectasis and NTM lung disease. The BronchandNTM360social newsletter provides education and opportunities for involvement. Although the number of community members within BronchandNTM360social is just a fraction of the 50,000+ COPD360social, membership is growing quickly as interest in the bronchiectasis and NTM lung disease space is quickly taking hold.

Over the years, it had become increasingly clear that the Foundation’s commitment to the Bronchiectasis and NTM community could not be defined in a single initiative. Following the lead and the needs of the bronchiectasis and NTM community the Initiative has now evolved into Bronchiectasis and NTM 360. Additional educational resources on diverse topics like airway clearance techniques, testing and diagnostics, and exacerbations have been added to help support this community. All of the educational material provided on Bronchiectasis and NTM 360 is vetted and reviewed by a Content Review and Evaluation Committee which includes various experts in the fields of bronchiectasis and NTM (many volunteering their time) to ensure that the community receives quality up-to-date information on how to manage their diagnosis.

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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 position statement was reviewed by the COPD Foundation COPD Foundation Medical and Scientific Advisory Committee.

Background

Several online alternative and complementary health and wellness websites claim that nebulizing hydrogen peroxide (H2O2) will kill viruses in the lungs. These websites claim: "The goal (of nebulizing hydrogen peroxide) is to stop the virus before it gets deep in the lungs where it causes severe inflammation and can progress to serious illness."¹ They go on to state that nebulizing hydrogen peroxide is "useful for non-viral illnesses such as asthma in patients with chronic lung disease."¹ These claims are unproven and inaccurate. Serious injury can occur to the airway if high concentrations of hydrogen peroxide are inhaled and can cause subglottic stenosis and laryngospasm, which can lead to intubation and mechanical ventilation.² In addition the US Food and Drug Administration has not approved the nebulization of hydrogen peroxide for medical use or even the treatment of COPD and other chronic lung diseases.

COPD Foundation Position

Nebulizing or ingesting hydrogen peroxide is dangerous. Nebulized hydrogen peroxide therapy is not recommended for the treatment of COPD. The COPD Foundation does not recommend the use of nebulizing hydrogen peroxide in the treatment of COPD or other lung disease until there is more rigorous scientific and medical proof of its effectiveness. Instead, the COPD Foundation encourages individuals to follow their doctor’s recommendations for therapy and not pursue this form of alternative medicine/therapy.

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This series of questions and answers on COVID-19 was authored by Stephanie Williams, BS, RRT and reviewed by Dr. David Mannino.

This article was updated on August 18, 2021

If a person received the COVID-19 vaccine, will a booster shot be needed, and when?

The Department of Health & Human Services (HHS) and other U.S. medical experts released a joint statement on August 18, 2021, announcing that a COVID-19 vaccine booster shot is recommended eight months after receiving the second dose of the Pfizer or Moderna mRNA vaccine.

The booster shots will be available starting September 20, 2021, subject to the Food & Drug Administration (FDA) conducting an independent evaluation and determination of the safety and effectiveness of a third dose and the Centers for Disease Control (CDC) Advisory Committee on Immunization Practices (ACIP) issuing booster dose recommendations following a thorough review of the evidence.

Immunocompromised patients can receive a third dose sooner than the general public. Visit the CDC website for details and eligibility.

People who have taken the Johnson & Johnson (J&J) vaccine may also need a booster. The CDC expects to provide data and recommendations on the J&J Covid-19 vaccine in the next few weeks.

Why do some vaccines only need boosters after a few years, but others need to be given more frequently? For instance, the Tdap (Tetanus, Diphtheria, and Polio) vaccine vs the influenza vaccine?

Some viruses don’t mutate as much over time. Examples of these would be polio, mumps, and measles. You most likely had these vaccines administered when you were young and have only had to have one or two booster shots since then.

Other viruses change frequently. An example of this would be influenza. The flu virus changes from flu season to flu season. So, in order to have the most protection against the flu, a flu vaccine is needed every year. We are finding that we will most likely need COVID vaccine boosters to provide the maximum protection.

This need for boosters should not be viewed as different from the way other vaccines are administered. Babies and young children have immunization schedules that we follow, and school-aged children receive boosters at various times in their school careers. We will likely need to follow similar immunization schedules and then receive boosters every so often in our fight against COVID.

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This article was reviewed by the COPD Foundation Content Review and Evaluation Committee.

• On July 9, the tobacco company Philip Morris International Inc. (PMI) and Vectura, developer and manufacturer of inhalers widely used by patients with COPD, agreed on PMI’s offer to acquire Vectura Group plc., subject to the approval of shareholders and the United Kingdom (UK) government.
• Smoking has been scientifically proven to cause COPD, lung cancer, and other diseases resulting in over 8 million deaths per year worldwide. This means the same company that has profited from manufacturing cigarettes and other tobacco products now looks to benefit from the medications used to treat the lung diseases caused by their product.
• On July 10, the COPD Foundation started working with US and UK professional and advocacy organizations to consider its response.
• On July 30, The Foundation issued a press release condemning the sale of Vectura to PMI. The statement was developed by COPDF leadership in partnership with its Medical and Scientific Advisory Committee (MASAC).
  • Read the release: COPD Foundation Condemns Big Tobacco Acquisition of Pharmaceutical Company
• On July 31, the COPD Foundation press release was covered by UK press and various social media channels.
• On August 24, Vectura shareholders will vote on whether to accept or reject the PMI purchase.

If you have concerns, here’s what you can do:

• If you live in the United Kingdom, share your concerns with your local government/ parliament leaders and broadly via social media:
  • UK Parliament: https://www.parliament.uk/ (Via Twitter: @UKParliament)
  • UK’s business secretary: Kwasi Kwarteng (Via Twitter: @KwasiKwarteng)
• In the United States, share your concerns via social media and other networks.
• Don’t forget to tag us @COPDFoundation!

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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 reviewed by the COPD Foundation Content Review and Evaluation Committee.

The COPD Foundation lost one of its most admired champions on July 5, 2021. Bob Harris will be remembered not only for his entrepreneurial skill and passion for improving people’s health, but also for his tireless efforts advocating for awareness of chronic obstructive pulmonary disease and the millions of patients and caregivers it impacts each and every day.

Robert Myron ("Bob") was born on December 16, 1925 in New York City and died at home in Englewood, NJ surrounded by his family. Predeceased by his beloved wife, Cecily, he leaves behind a wealth of treasured memories and a model for realizing a full and loving life.

After a successful career as an advertising and marketing executive, Bob struck out on his own, becoming an unparalleled entrepreneur. Because of his family history of heart disease, he was driven to develop products that would improve people's health. Someone for whom the term “health and wellness” was part of his DNA long before it became a phrase in popular culture, Bob created companies whose products had a profound impact; Nutrition Industries, Weight Watchers, Heart Beat, Smart Balance and Grain Berry Cereals.

Just a few years ago Bob, along with his son Peter, President of Grain Berry, sat down with Dr. Mehmet Oz on the Dr. Oz Show to highlight the benefits of Grain Berry ONYX sorghum and Grain Berry cereals and products. Dr. Oz asked Bob, "At 91 years old why did you decide now to create a whole new way of eating cereal?" He replied, "I didn't decide now. I've done it all my life. My father died at age 40, my brother died at age 50. I just spent my entire life creating foods that would make you live longer and stronger." His tireless efforts to develop Grain Berry's 3-D antioxidant products, driven by his passion to fight diabetes, cancer, heart disease, continued to his very last days.

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This series of questions and answers on COVID-19 was authored by Dr. David Mannino.

What is happening right now with COVID-19 in the U.S.? How many people have been vaccinated?

While numbers of COVID-19 cases, hospitalizations, and deaths are going down, this depends on where you live, and is related to how many people have gotten vaccines there. Those counties with fewer vaccinated people have more cases of COVID-19, hospitalizations, and deaths. Right now, about 67% of adults in the U.S. have gotten at least one dose of a COVID-19 vaccine (although this is also different by county and age). More older adults are getting vaccinated than younger adults.

• https://covid.cdc.gov/covid-data-tracker/#vaccinations-cases-trends

What does "fully vaccinated" mean? Is that important?

"Fully vaccinated" means having had two doses of the two-shot vaccine or one shot of the single-shot vaccine. Studies looking at protection against COVID-19 (including the new variants we will talk about below) show the most protection among people who are fully vaccinated.

Is there a relationship between COPD and COVID-19? If so, what do I need to be aware of?

The relationship between COPD and COVID-19 is not clear. Research studies show different results – some show a higher risk of COVID among COPD patients and others do not. Similarly, the risk of poorer health outcomes for COPD patients who get COVID-19 is also not clear. We do know that COPD exacerbations (flare-ups) and deaths went down in 2020, probably due to social distancing and mask wearing decreasing the spread of respiratory infections.

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This position statement was reviewed by the COPD Foundation Medical and Scientific Advisory Committee.

Background: Claims for using marijuana for treatment of COPD

There are several websites that make claims that marijuana can be an effective treatment for COPD. These websites state that "smoking marijuana may help (COPD) patients manage acute airway constriction attacks caused by inflammation and provide a preventive measure."¹ They go on to state that medical marijuana can "possess antimicrobial properties, support the immune system, provide pain relief, reduce phlegm by acting as an expectorant, and promote better sleep."¹ These websites make claims of effectiveness, but these claims are unsubstantiated and cannot be proven. Smoking, vaping, and dabbing marijuana can harm the lung tissues causing scarring and damage to small blood vessels.² Marijuana smoke contains many toxins and irritants as tobacco smoke and can lead to greater risk of hyperinflation from increased mucus production.³ In addition the US Food and Drug Administration has not approved marijuana to treat COPD.

COPD Foundation Position

Medical marijuana is not recommended for the treatment of COPD. The COPD Foundation does not recommend the use of medical marijuana in the treatment of COPD or other lung diseases until there is rigorous scientific and medical proof of its effectiveness. Instead, the COPD Foundation encourages individuals with COPD to talk to their pulmonary physician about other scientifically proven treatment options for COPD.

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