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Find inspirational stories, tips from the COPD Coach, events, and current news on the COPD community blog. Have a question regarding COPD that you would like to share with our community? Contact our COPD Coach. Coaches Corner is aimed at providing information for individuals with COPD to take to your doctor, and is not in any way intended to be medical advice. If you would like to submit a question to the Coaches Corner email us at coachescorner@copdfoundation.org. We would love to hear your questions and comments.

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Archive: April 2015

Young with COPD?

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Dear COPD Coach,
I was born with lung “issues” growing up, and doctors told my parents I had asthma. Over time my breathing just kept getting worse. As a result, I have never smoked a single cigarette, and I have never been around people who smoked. In 2009 I was in the hospital for pneumonia and doctors took x-rays and CT scans of my lungs. Soon after they dropped the bomb – I had COPD. I was born in 1977, and always thought COPD was a disease that only affected people in their 60s and 70s. I was tested for Alpha-1 and the results came back "abnormal." How rare is for a non-smoker my age to have COPD?

-Perplexed

Dear Perplexed,
It is far more common for young people to be diagnosed with COPD than ever before. This is due in large part to more awareness of COPD in recent years by both healthcare professionals and the public. COPD has historically been perceived as an "old person's disease," but we are learning this is not always the case. In fact, the average COPD patient is between 45-55 years of age. Oftentimes, symptoms of early lung disease are not recognized by the individual until the disease is much more advanced, even to the point of being debilitating later in life. It is very easy to justify our symptoms by thinking we are out of shape, prone to colds and flu. Most often, we become great compensators, and if we get out of breath doing an activity, we make sure to avoid that activity in the future. The truth is that the earlier COPD is diagnosed and treated, the better the prognosis!

Alpha-1 Anti-trypsin Deficiency is one cause of early diagnosis for COPD. Alpha-1 is a genetic form of COPD caused by producing too little anti-trypsin, no anti-trypsin, or a mutated version of anti-trypsin (which often causes liver problems). Anti-trypsin is a protein produced in the liver that travels through the bloodstream and protects our organs from the effects of other proteins, particularly the lungs. The absence of or reduced amount of anti-trypsin can result in early emphysema.

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Tags: age Alpha-1 COPD genetic test
Categories: Coaches Corner

Maximizing Lung Capacity

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Dear COPD Coach,
If I follow my treatment plan, how much lung capacity should I expect to have on an average day?

-Strengthening the lungs

Dear Strengthening,
Generally, once lung function is gone, it is gone for good. While we cannot control this factor, we can control how efficiently our body is able to utilize our remaining lung capacity. A regular exercise program builds our muscles to a point where they work more efficiently and therefore require less oxygen, which in turn causes us to be less out of breath. I know that exercise for many is very daunting and frightening. Let’s face it, when you are having a hard time breathing, the last thing you want to think about is exercising! Even if you have more advanced COPD, there are simple exercises that will not only improve your breathing, but also your overall health. For those with very limited mobility, there are simple chair exercises that can really make a difference. Talk with your doctor or respiratory therapist about exercises you can do that are safe, comfortable and effective for you.

Your lung function can actually vary during various times of the day. Some experience more breathlessness in the mornings while others have difficulty at different times during the day or evening. If you need to do a pulmonary function test, schedule the test at a time when your breathing is usually better. Also, do not schedule a routine pulmonary function test when you are feeling ill or are recovering from an exacerbation.

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Tags: breathing capacity COPD health lung maximize pursed lips
Categories: Coaches Corner

Is Stress Making My COPD Worse?

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Dear COPD Coach,
I have been living with COPD for several years and find that it is getting harder to breathe. This is making me feel very stressed, and I think the stress alone is making my symptoms worse. Do you have any advice on how to stop it?

-Stressed

Dear Stressed,
The mechanism you are referring to works something like this. You have difficulty breathing or get out of breath and breathing become stressed, which in turn causes even more difficulty breathing, which then causes more stress — until it spirals out of control. There is probably no worse feeling than not being able to breathe!

The progression of COPD along with breathing difficulties is often slow, but in some cases progresses more quickly. Adapting to this change can be difficult and might require some action on your part. When you start feeling anxious or stressed, give yourself a “time out.” Sit, relax and try pursed lips breathing until the stress or anxiety passes. You might also try taking your mind off your breathing by reading or watching a movie or TV show.

If you still are not able to control the stress and anxiety, you might consider talking with your doctor about medication to “take the edge off” the stress and anxiety attacks and help you cope better.

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Tags: anxiety breathing COPD exacerbation health lifestyle pursed lips stress tips
Categories: Coaches Corner

Safe to Travel?

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Dear COPD Coach,
I have COPD but do not yet require supplemental oxygen. I am planning to fly to visit my son. The flight is scheduled to be two legs, one lasting 1 hour and the other two hours. Is it safe for me to fly even though I do not use oxygen?

-Ready to Travel

Dear Ready,
Your question is a very good one! Like most of the questions we get, the answer is not simple, and the short answer is a definite "maybe." I'll explain.

In all commercial air travel, the planes are pressurized. How much they are pressurized depends on the size of the plane and the altitude it at which it flies. Most large planes flying above 30,000 feet would be pressurized to an altitude of up to 8,000 feet. To give you some perspective, the altitude of Denver is 5,300 feet and has about 17% less oxygen than cities at sea level. The smaller regional jets generally fly around 20,000 feet and thus usually are only pressurized to around 6,000 feet.

At any pressurization, people with normal lung functions will usually measure a drop in their oxygen saturations, especially on long flights. On the other hand, someone with compromised lungs will usually experience a substantial drop in their saturations. For a person with normal lung function, the worse they will suffer is sleepiness but usually recover their saturations very quickly afterthey land. A person with breathing difficulties will most often experience head and muscle aches, saturations below 90 and require a significant time to recover their oxygen saturations once they land.

Since there are no readily available tests to determine how you will fare in flight, it will require a guess on the part of your pulmonologist. A test has been developed using a formula using an algorithm based on a study of 100 COPD patients with moderate to severe COPD. While the results tend to over-estimate the number of patients requiring in-flight oxygen, they are considered a safe “estimate” as to who can safely fly.

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Tags: BFRG COPD flight hints oxygen pulomonary safety saturation travel
Categories: Coaches Corner

Question about Scooters

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Dear COPD Coach,
I have severe COPD and find it hard to walk for long distances. I saw an ad on television that says some company can get me a scooter paid by Medicare. The ad says if Medicare does not pay for it, it is free. This sounds a little too good to be true. What do you think?

-Questions About Scooters

Dear Questions,
The short answer to your question is that it is too good to be true! What these ads actually say is that if you are approved by Medicare and your claim is later denied, you pay nothing for the scooter. The reality is that Medicare does not pay for mobility scooters. Medicare will at times pay for a motorized wheel chair to allow you some degree of mobility in your own home, but in order to qualify your ability to walk must be severely compromised.

There is a big difference between a motorized wheelchair and a mobility scooter. Mobility scooters are designed for outdoor use, are generally lighter in weight, easier to transport and have longer battery life. The design of the mobility scooter allows it to operate over a variety of terrain. Motorized wheelchairs are primarily designed to operate indoors. They tend to be quite heavy. In order to use a motorized wheelchair indoors, your house must have wide enough doorways to get from room to room. Motorized wheelchairs are not really useful in two story houses. In order to get the wheelchair outside, ramps are usually required. Since they do not break down for transport, you must have a lift on the back of your car. The fact is, because of their design, many people cannot make use of a motorized wheel chair.

There are companies out there who put out ads similar to what you saw on TV. When you call they send a salesman to your home who will get you to sign a contract that in effect says if Medicare does not approve the claim you agree to be responsible for payment. Since Medicare will most likely deny the claim, you will end up being responsible for the payment. The payment plans in many cases involve very high interest payments, and in the end you will have paid far more for your scooter than if you had bought it from a local retailer. Before signing any contract with these companies, enlist the aid of a lawyer or competent legal authority to advise you of just what your obligations would be.

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Tags: breathing COPD help lifestyle Medicare mobility payment scooters tips
Categories: Coaches Corner

What is a "Top Breather"?

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Dear COPD Coach,
I recently heard the term top breather. What does this mean?

-Breath Question

Dear Breath,
The term top breather is a term that indicates an inability to take deep breaths; breathing in a way that seems to use only the top parts of the lungs. This is somewhat common in people with COPD. It occurs because of hyperinflation of the lungs which does not allow us to expel all the air our lungs are holding.

When our lungs are hyperinflated (over inflated or too large) we are only able to expel a small amount of air, which in turn means that we can only take in smaller amounts of air. The problem with this is that the air in the lungs that remains trapped becomes “stale” and therefore not able to keep up our oxygen levels. Top breathing especially becomes a problem when we get short of breath and breathe rapidly because we’re hungry for air. The other problem with top breathing is that it can result in a retention on CO2 further triggering the feeling that we are short of breath. Because top breathing takes less effort, it is very easy to fall into doing it regularly which in turn causes problems with our oxygenation.

It is very important for a person with COPD to practice breathing techniques to optimize the amount of oxygen our injured lungs are able to process. Some of these techniques might be familiar to you, but always worth mentioning. Be advised that the following is for information only. Always consult your healthcare professional before starting any new technique or exercise.

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Tags: breather coach COPD lifestyle pursed lips technique tips top
Categories: Coaches Corner

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