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Your Airways Clear: Ways to Manage Your Airway Mucus

Posted on July 22, 2022   |   

This article was written by Michael W. Hess, MPH, RRT, RPFT


For many people with COPD, frequent coughing that produces sputum (the “junk” you cough out) is a fact of life. It can be uncomfortable, embarrassing, and very hard to control. However, there are things you can do to help manage your airway mucus. These are known as airway clearance techniques.

Coughing and Breathing Techniques

Many airway clearance techniques do not require any special equipment or tools. One of the most common techniques is called huff coughing, as seen in this video from the Cystic Fibrosis Foundation (CFF). With huff coughing, you simply sit down, take a breath deep enough to fill up your lungs, then "huff" the air back out in short bursts. Keep your mouth open so that it sounds like you are saying, "ha, ha, ha." Repeat these steps a couple of times, and you will probably find yourself coughing more strongly. Be sure to keep some tissues handy to cover your cough!

Another airway clearance method combines huff coughing with other breathing techniques. As you'll see in the following CFF video, this is called the active cycle of breathing technique, or ACB. With ACB, you start by taking five or six gentle breaths while placing one hand on your stomach. Purse your lips while you exhale to keep the airways open longer. After that set of breaths, take a very deep breath and hold it for three seconds. This helps get air deeper behind the sputum, helping to drive it out. After the breath hold, use huff coughing to bring the sputum up and out of your lungs.

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Categories: Education, Resources and Studies Medications, Treatments and Therapies Tips for Healthy Living

Exacerbations: What to Expect When You Call 9-1-1

Posted on June 14, 2022   |   

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


Have you ever had to call for an ambulance because of a COPD exacerbation? If you haven't had that experience, you may wonder what you can expect if you ever do need to call. I contacted a former colleague of mine, Anthony Turner, RRT, who was an emergency medical technician (EMT) for several years before he became a respiratory therapist. We talked about what to do when you make the phone call, what the paramedics will do when they arrive, and what will happen when you get to the hospital. We hope you never need to call 9-1-1 in an emergency, but if you do, we want to let you know what you can expect.

Q: When someone calls 9-1-1, is it recommended to stay on the line until the ambulance gets there?

A: Generally speaking, yes, the trained medical dispatcher will request that the caller remain on the line for several reasons. The dispatch operator will want updates on how the patient is doing and can give further directions if needed. They can be available to advise and reassure the patient on the status of the ambulance and help the person feel they are not alone.

Q: If someone calls with difficulty breathing, or a COPD exacerbation (flare-up), what can they expect to happen when EMTs arrive?

A: Treatment can vary somewhat, however; the patient can generally expect the emergency medical services (EMS) crew to complete a quick assessment, The EMS crew will then give support to the patient. This support can include oxygen therapy if needed, an IV, and place them on a heart monitor. The EMTs can also give medicines like bronchodilators with a nebulizer or sometimes even continuous positive airway pressure (CPAP) therapy. Occasionally medications may be given to reduce patient anxiety, which is common with severe COPD exacerbations. In very rare instances, the EMS crew may sedate and intubate the patient, which helps to stabilize the patient and takes the stress off the patient by taking over their work of breathing and reducing their shortness of breath.

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Categories: Education, Resources and Studies

Plain Language Summaries for Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation Articles in Volume 9 Issue 2

Posted on May 17, 2022   |   

This article was written by Cathy Gray Carlomagno, BS


Articles recently published in Volume 9, Issue 2 of Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation have corresponding plain language summaries.

The summaries are short and written in simple, non-technical language with the goal of providing a helpful overview of the published original research, review, or perspective articles. These articles (and their short summaries) cover a variety of COPD-related research topics including triple therapy, pulmonary function tests, attitudes about the COVID-19 vaccine, COPD symptom fluctuations and more.

Plain language summaries are available for each of the following articles:

Evaluating a Different Pulmonary Function Test
Usually, the pulmonary function test which measures the volume of air exhaled in the first second—FEV1—has been the main measurement used with individuals with COPD. However, in the article, "Forced Expiratory Flow at 25%-75% Links COPD Physiology to Emphysema and Disease Severity in the SPIROMICS Cohort" researchers examine the value of a different lung function parameter: forced expiratory flow at 25% to 75% of capacity (FEF25-75%,) which measures airflow in the middle portion of an individual's exhalation and may help detect changes in the small airways of the lungs.
For the complete plain language summary, click here

Disparities in COPD Hospitalization Between American Indians and Non-Hispanic Whites
The article, "Disparities in Hospitalized Chronic Obstructive Pulmonary Disease Exacerbations Between American Indians and Non-Hispanic Whites" compares COPD hospitalization among Native American populations to that of non-Hispanic White COPD individuals.
For the complete plain language summary, click here

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Categories: Journal of the COPD Foundation

Will we have effective antibiotics in our future?

Posted on May 05, 2022   |   

This article was written by Jamie Sullivan, MPH, and COPD Advocate.


At some point in life, nearly everyone will need antibiotics, yet for those with lung disease, antibiotics are often a vital component of treatment plans, whether it be for regular use to prevent and treat exacerbations or to treat nontuberculous mycobacterial (NTM) infections. Despite their essential nature, growing issues with antibiotic resistance and economic disincentives to develop new, innovative antibiotics could mean that soon, some individuals with previously treatable conditions will have nowhere else to turn.

Finding new ways to spur investment in novel antibiotics is the focus of the Pioneering Antimicrobial Subscriptions to End Up Surging Resistance Act of 2021, otherwise known as the PASTEUR Act. The bill, introduced in the Senate in June and included in legislation known as Cures 2.0 in the House, authorizes the Department of Health and Human Services (HHS) to carry out several new activities designed to change the model for antibiotic purchase and simultaneously fund new programs focused on combating antibiotic resistance.

Interest in carrying out the long and expensive processes required to develop novel antibiotic options is limited. One estimate showed there are a mere 43 antibiotics in development. In comparison, there are over 1,000 drugs in development for cancer. This lack of interest is due, in part, to the volume-based way we pay for treatments. Generally, when treating with an antibiotic, the goal is to use any novel therapy as a last resort, only if all the older treatments have proven not to work. While best for individual and public health, companies developing the treatments will do so anticipating that very few people will have to use their antibiotic.

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Categories: Advocacy Health Policy and COPD

Intimacy and Living Well With COPD

Posted on April 24, 2022   |   

A diagnosis of COPD or other lung disease does not mean that you have to say goodbye to intimacy. While there may be challenges such as shortness of breath, coughing, or other symptoms that impact your activity level and how you feel each day, it is possible to maintain intimate relationships while living well with COPD.

Dr. Barbara Yawn and I discuss some common questions about intimacy and COPD.

What if I am nervous to speak to my partner about intimacy?

Remember, your partner is likely just as nervous about intimacy as you are. Most partners want to make sure they can continue sharing intimacy without causing harm. Many may have concerns about hurting you, or making you more short of breath. Talking is key. Remember, intimacy is much more than just sexual intercourse. Intimacy can be hugging, cuddling, kissing, rubbing, or massaging anything from your scalp to your feet. Let your partner know you want to continue being intimate. Talk about your needs, desires, and concerns and ask your partner about theirs.

It can help to ask your health care team about intimacy. You can talk about it in the office, pulmonary rehabilitation, or education programs. The discussion can help support ideas you have and reassure you and your partner about safety and satisfaction.

What are some tips for overcoming challenges with intimacy?

First, make sure you and your partner know how to tell when the other person wants intimacy. If it is uncomfortable to ask, come up with some clear hints like holding hands or guiding your partner to hugging, cuddling, or kissing. Find a private place where you can be comfortable sitting or reclining. Try positioning your body so that you feel comfortable and less short of breath, such as lying on your back or side with your head and chest elevated. If you are using supplemental oxygen, make sure you have a long enough tube to be comfortable. You may also want to use nasal prongs to help with kissing, rather than a mask. As a couple, think back on your history together before COPD. Talk about what intimacy looked like then, and how it can be adapted to your current opportunities and limitations.

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Categories: Caregivers and Caregiving Education, Resources and Studies Tips for Healthy Living

Integrative Medicine: Why did I incorporate yoga into my clinical practice?

Posted on April 18, 2022   |   

This month on COPD360Social, we discussed integrative medicine as an additional tool for the management of COPD. I had the opportunity to interview a former colleague of mine who has recently incorporated yoga into her work as a licensed counselor. While counseling and therapy by themselves can be very helpful to people living with chronic illness, there can be added benefit by including other types of complementary therapies, such as yoga.

I connected with April Hibdon, LCSW, and asked her several questions about yoga and integrative medicine. She said she was happy to share this information with health care professionals because she believes that this type of “breath work” could be helpful to those living with COPD and other lung conditions. She says the practice of yoga can be of particular help to people experiencing anxiety. April was generous with her time and answered the following questions:

Q: Can you tell me what kind of practice you are in? Individual counseling? Families?

A: I am a Licensed Clinical Social Worker. My practice is with individuals ages 16 and up. Currently, I see clients via telehealth as it is providing opportunities for those with busy schedules and in rural areas to seek care.

How did you learn about incorporating yoga into your work?

A: I have been interested in yoga for years because it is calming and relaxing. Actually, my chiropractor recommended it to me for my lower back pain. Yoga allows me to be more centered and connected. Several years ago, I became aware of therapists that were using it in their practice to help clients that have anxiety and histories of trauma.

Q: What did you have to do in order to provide that kind of treatment to your patients?

A: In order to provide yoga-informed care to clients, the provider has to complete the necessary training. There are many programs available; however, I chose to participate in the Yoga Fit program. I started with a level one training that teaches the basics, and I added different classes until I met all the requirements.

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Categories: Education, Resources and Studies Medications, Treatments and Therapies Tips for Healthy Living

Beyond the Lungs: How COPD affects the body

Posted on April 04, 2022   |   

A lot of time is spent by educators teaching others about how COPD affects the lungs. We know that COPD can cause breathing problems for a couple of reasons. The airways can be constantly swollen which causes air moving from the lungs to be blocked or trapped. Or maybe the air sacs (alveoli) have lost their ability to completely release the air they hold which can also trap air in the lungs. Frequent symptoms can include feeling short of breath, cough, mucus (sputum) production, and wheezing. However, it is important to learn how COPD may affect the rest of the body beyond the lungs. The medical community refers to how the whole body responds to a condition as "systemic." By knowing this information, you can take a proactive approach to monitoring your body and explore issues as they may arise.

Nutrition

Unplanned weight loss affects about 50% of people with COPD.1 The main type of tissue that is lost in people with COPD is muscle with fat being second.1 Why is this? When you have COPD, you use more energy to breathe. Because people with COPD use more energy to breathe, they burn more calories at rest than those with healthy lungs. Also, the body uses calories to fight flare-ups that occur.2 For both of these reasons, this can cause unplanned weight loss in those with COPD. Making sure you are eating the right foods can help you to have energy, fight infection, and feel your best.

Heart and blood vessels

Most people are aware that in the body, the heart and lungs work closely together. Because this relationship is so "close," the heart and blood vessels can be affected when someone has COPD. People who have COPD are at two to three times the risk of having cardiovascular disease.1 "Cardiovascular disease," means to have problems with the heart and blood vessels. People with COPD should work closely with their health care team to monitor their heart function.

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Categories: Education, Resources and Studies

Nothing But The Truth: Myths About Pulmonary Rehab or Exercise

Posted on March 25, 2022   |   

Ask the experts and they will tell you that exercise is an important part of feeling your best when you have COPD, bronchiectasis, and other lung conditions. There are so many benefits to exercising. Exercise is known to help with anxiety and depression, which is common in people living with a lung condition. Exercise has also been linked to a better quality of life. Doing activities that increase your strength and fitness can help you do everyday tasks with less breathlessness.

This month we have taken some time to review pulmonary rehab (rehabilitation), which is a wellness program created specifically for people with lung conditions like COPD, bronchiectasis, and NTM lung disease. Pulmonary rehab programs combine what people living with these conditions need the most: exercise, support, and education. Pulmonary rehab can help improve your fitness level and allow you to enjoy your favorite activities. It can also be a wonderful tool to build confidence with exercising on your own.

Knowing all the wonderful things that pulmonary rehab and exercise can do for the body, it is a wonder why there are so many myths about exercise and pulmonary rehab. In this blog, I am going to review some common myths or untruths about exercising and pulmonary rehab. The best part is that I am going to give you “nothing but the truth.” So, let's get into it!

Myth: People with lung conditions like COPD should not exercise because it will make them short of breath.

The truth: There is no doubt that shortness of breath can be one of the biggest barriers to exercising. Frankly, it can be scary to feel breathless when you are exercising. However, when you choose to exercise, you build strength that will help you with your favorite activities and chores around the house like carrying a laundry basket, bathing, and vacuuming. Pulmonary rehab can help to build confidence in managing your shortness of breath while exercising. Pulmonary rehab can teach you skills like how to recover quickly and how to safely increase your activity. Avoiding exercise can weaken your body and therefore make you feel more breathless. The less you do now, the less you are able to do later.

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Categories: Education, Resources and Studies Tips for Healthy Living

Update on Philips Respironics Recall

Posted on March 23, 2022   |   

Since the recall of Philips Respironics respiratory devices last year, the U.S. Food and Drug Administration (FDA) has been gathering information and listening to feedback from a variety of sources, including the people who were most impacted by the recall - the patients. The FDA then shared that information with Philips Respironics to emphasize that there are some people who depend on their respiratory equipment more than others, that there are great risks associated with certain people not using their respiratory devices as prescribed by their doctors. Because of this awareness, Philips has established an online portal-site and a phone number so that patients can get placed on a “prioritized placement” list. That portal can be accessed here, or by calling 1-877-907-7508.

For more information about the recall, please visit the FDA recall information page, or the Philips Respironics recall page.

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Categories: Community Announcements

What is Pulmonary Rehab and Why is Everyone Talking About It?

Posted on March 04, 2022   |   

As you look through the posts on our online community, COPD360Social, you may notice that pulmonary rehab is a "hot topic" among our members. When you read those posts, you may be wondering what pulmonary rehab is and why it's so popular. Let's find out what makes pulmonary rehab so helpful to people with COPD and other chronic lung conditions.

Pulmonary rehabilitation, or "pulmonary rehab," is a wellness program that combines exercise, emotional support, and education to help you to better manage your COPD symptoms. Often, pulmonary rehab programs are found in hospitals or other facilities. Don't worry if you can't participate in person. Some pulmonary rehab programs have a virtual or "tele health" option.

In pulmonary rehab, you will learn how to live and feel better with COPD. Everyone's experience with COPD is different, but all pulmonary rehab participants will learn important skills for managing their COPD and preventing flare-ups (exacerbations).

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Categories: Education, Resources and Studies

COPD Foundation Launches Global Tobacco Survey

Posted on March 03, 2022   |   

Thank you for your interest in our survey. The survey ended on March 25, 2022. We will share the results of this survey soon. If interested, please sign up for our newsletter to be notified about the survey results and other Foundation news:

 

The use of smoked tobacco remains the largest and most preventable cause of COPD in most parts of the world. In the United States, over 75% of COPD cases are related to cigarette smoking.

Tobacco smoke contains thousands of different chemicals that cigarette smokers inhale into their lungs, including over 50 known cancer-causing agents as well as nicotine, the addicting chemical that keeps people smoking.

Tobacco companies make a great deal of profit. In recent years, some companies have used this money to expand their business beyond smoked cigarettes to include vaping devices and cannabis. In 2021, the tobacco company Phillip Morris International bought Vectura, a British company that develops devices used to deliver inhaled medications. This company is also working to develop other platforms that could be used to deliver therapies to patients with respiratory disease.

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Categories: Advocacy COPD Foundation Initiatives and Activities Surveys

A Look at What is New in COPD Research and Innovation

Posted on February 25, 2022   |   

The science of medicine is always evolving. In the past, innovation has pushed us forward, resulting in treatments and even cures for diseases that once held a not-so-positive outcome. Today we will be exploring a few treatment innovations on the horizon for those living with COPD. Dr. David Mannino discusses the positives, as well as the potential cautions associated with these innovations.

Q: Can you discuss some of the promising innovations that are on the horizon for COPD treatment and research?

A: Most current treatment innovations for COPD focus on advanced disease. There is currently a procedure under investigation called bronchial rheoplasty. This procedure uses electrical energy, delivered via bronchoscope, to kill mucus-producing cells, in hopes that when the lung cells regenerate there will be fewer of these cells, and less mucous. A similar innovation that is also under investigation is called targeted lung denervation. This procedure interrupts the nerve reflexes that constrict the air tubes, with the intent of inducing a type of permanent bronchodilation.

One intervention that is now approved for use in advanced COPD is lung volume reduction using valves or coils (the use of valves has been widely approved, coil approval varies by country). Valve and coil procedures are done bronchoscopically, or with a tube inserted down the airways, rather than surgically like traditional lung volume reduction. These procedures attempt to reduce emphysematous parts of the lung so that more normal parts of the lungs can expand.

Work is also being done to look at the use of non-invasive ventilation in patients with high levels of carbon dioxide. These and related techniques aim to help improve ventilation of the lungs.

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Categories: Medications, Treatments and Therapies

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