It`s that time - Pulmonary Paper

The
PulmonaryPaper
Dedicated to Respiratory Health Care
September/October 2014 Vol. 25, No. 5
It’s Time to Get Your Annual Flu Vaccination!
Table of Contents
We are hiding The Pulmonary Paper logo on our front cover. Can you find it?
Featuring
03 | Editor‘s Note
04 | Calling Dr. Bauer
18 | Ask Mark
10 | Fibrosis File
20 | Sharing the Health
30 | Respiratory News
Your Health
17 | Palliative
Care Options
12 | Tai Chi: A Gentle
Exercise
For Fun
16 | Pulmonary
Horizons
Conference News
24 | Smoking
News
28 | SeaPuffer Cruises
Plan a vacation and
leave your cares
behind you!
We salute couples who have
been together in good times
and bad! Send us your photo!
26 | COPD
Basics
Winterizing
Home Air
19 | Maintain
Good Air
Quality
14 | Liquid Oxygen
Update
Joy
Fran
Fran and Joy Lynch of Edmonds, WA, have
not let respiratory problems slow them down!
Live Longer! Breathe Easier!
Improve Quality of Life! Even Look Better!
Talk to your doctor now about
the benefits of Transtracheal
Oxygen Therapy!
• Improved mobility
• Greater exercise capacity
• Reduced shortness
of breath
• Improved self-image
• Longer lasting portable
oxygen sources
• Eliminated discomfort
of the nasal cannula
• Improved survival
compared to the nasal cannula
You’ve suffered long enough. Ask your doctor about TTO2!
For information call: 1-800-527-2667
or e-mail drscoop@tto2.com
www.pulmonarypaper.org
Volume 25, Number 5
Editor’s Note
W
e naturally dress to protect ourselves from the
weather – we wear a scarf and gloves if it is cold and
wear sunscreen and hats when it is hot. To prevent
injury, we wear seatbelts in the car and use helmets and pads
during sports activities. When our children start school, we make
sure they are protected against childhood diseases by getting
them vaccinated.
It is perplexing to consider that approximately half of the Ameri­
can population does not protect themselves against influenza
which, worldwide, causes three to five million cases of severe
illness and 250,000 to 500,000 deaths every year.
“The doctor of
the future will
give no medicine,
but will instruct
his patient in
the care of the
human frame,
in diet and in
the cause and
prevention
of disease.”
Thomas Edison
September/October 2014
You cannot get the flu from the flu shot! The virus
in your recommended vaccine is inactivated, it
cannot grow or cause disease. Be sure to see our
articles about protecting yourself this flu season and
the prevention of flu on the next pages.
Education is the best form of prevention and treatment we have
for chronic lung problems.
Protecting yourself does not mean keeping yourself in isolation
from the rest of the world. Be sure to stay involved with friends and
family or if they do not live
close to you, look for groups
that have similar interests
that you do – playing bridge,
gardening, trains, planes or
automobiles! Simply go
outside to sit on the porch
to relax and soak up the
sunshine. Enjoy a local park
or museum. Getting out of the house can decrease your stress
levels. At the end of the day, you will feel proud of what you
accomplished!
www.pulmonarypaper.org
3
Calling Dr. Bauer …
I
Dr. Michael Bauer
Question for Dr. Bauer?
You may write to him at
The Pulmonary Paper,
PO Box 877, Ormond
Beach, FL 32175 or
by email at info@
pulmonarypaper.org.
t’s that time of year again! By the time you read this edition
of the Pulmonary Paper in your home or doctor’s office, I hope
you have asked for your annual flu vaccine. Persons with chronic
pulmonary problems such as COPD, asthma and Interstitial Lung
Disease are at high risk for influenza complications. Most serious
concerns for my patients would include increased lung secretions,
wheezing and shortness of breath and reduced oxygen levels.
Bacterial or viral pneumonia complications can be life threatening.
The vaccine composition this year is the same as last flu season.
Most adults should receive the inactivated trivalent or quadriva­lent
vaccine. This is a killed virus preparation that fights off either three
or four of the virus proteins and offers significant protection against
getting the flu and its complications. With this inactivated vaccine,
there should be no chance of “getting the flu” right after the shot.
Some patients are often concerned about this. It’s usually “never
too late” to get your flu vaccine.
While we are talking about “pain in the arm”, let me also recom­
mend you get your pneumonia vaccine! Regardless of age, all
patients with chronic lung disease should receive the PPSV23
(Pneumovax) shot which protects against 23 strains of pneumo­
A
single injected dose of a new drug, Peramivir, by
BioCryst Pharmaceuticals, can safely and effec­tively
relieve influenza symp­toms when administered within 48
hours of the onset of symptoms, according to the results of
clinical trials from the University of Alabama at Birming­
ham. Peramivir has been approved in Japan and Korea since
2010, and it is estimated that one million people have received
the drug. If approved by the FDA, Peramivir would be the
only single-dose and injection treatment for influenza approved in the United States
in more than a decade. The two currently avail­able treatments, Tamiflu and Relenza,
are both taken twice daily for five days. (Relenza is an inhaled medication and not
recommended for people who have chronic lung prob­lems.) The CDC recommends
antiviral treatment as soon as possible for any patient with confirmed or suspected
influenza.
4
www.pulmonarypaper.org
Volume 25, Number 5
coccal pneumonia. This is the most
common bacterial lung infec­
tion causing
pneumonia. The vaccine will not prevent
other types of bacterial pneumonia, or viral
infections including the common cold. It’s
still recommended and for those over 65, we
currently do not recommend revaccination.
Finally, the new vaccine on the block is the
Zostavax® vaccine. This one-time vaccination
can be effective in preventing an out­break
of painful shingles. In about one out of
five people who have had chickenpox, the
varicella-zoster virus may reactivate, often
many decades after a childhood chickenpox
infection. It is not known what causes this
reactivation which causes the virus to travel
into the skin and causes shingles. There
are about one million cases of shingles in
the United States every year, which cause
extreme sensitivity or pain followed by
a raised rash. The shingles vaccination is
recommended for patients older than 60
years of age with chronic medical conditions
including COPD. It should not be given to
patients on chronic steroids (prednisone)
since this is a live virus vaccine. Talk to your
doctor before you get this one!
The Advisory Committee on Immunization
Practices, part of the Centers for Disease Con­
trol and Prevention, has not significantly
changed their recommendations for the
2014–2015 flu season from last year. All
Americans older than 6 months of age
should receive an influenza vaccine. A new
suggestion is that the live nasal vaccine
should be used for healthy children aged 2 to
8 years. The live vaccine is not indicated for
patients aged younger than 2 years or older
than 49 years.
You need to get vaccinated before you are
exposed to influenza for the vaccine to work
by building up antibodies against the strains
of flu in the serum.
Stanford researchers report promising
steps toward the creation of a universal
flu vaccine, one that could be produced
more quickly and offer broader protection
than the virus-specific vaccines available
today.
Information from the CDC tells us there
are a number of flu vaccine options for the
2014–2015 flu season:
Trivalent flu vaccine protects against
a total of three viruses – two influenza A
viruses (an H1N1 and an H3N2) and an
influenza B virus. These trivalent flu vaccines
are available:
• Standard dose trivalent shots that are
manufactured using virus grown in eggs.
These are approved for people ages 6
months and older. There are different
brands of the standard dose trivalent shot
and each is approved for different ages.
• A standard dose intradermal tri­valent
shot, which is injected into the skin
instead of the muscle and uses a much
smaller needle than the regular flu
shot. It is approved for people ages 18
through 64.
• A high-dose trivalent shot approved for
people 65 and older. A study published
recently in the New England Journal of
Medicine, finds that Fluzone High-Dose
does prevent influenza in older adults,
reducing cases of the flu by 24 percent
compared with the standard version.
The High-Dose formula contains four
times the amount of antigen which
Continued on page 6
September/October 2014
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5
Continued from page 5
stimulates the immune system to
develop antibodies.
• A standard dose trivalent shot con­
taining virus grown in cell culture, which
is approved for people ages 18 and
older.
• A standard dose trivalent shot that is
egg-free, approved for people ages 18
through 49.
The quadrivalent flu vaccine protects
against a total of four viruses, two influenza A
viruses and two influenza B viruses. Children
tend to catch the fourth added strain more
often than adults. These quadrivalent flu
vaccines are available:
• A standard dose quadrivalent shot.
• A standard dose quadrivalent nasal spray,
approved for people ages 2 through 49
and recommended for healthy children
ages 2 to 8. (It is not recommended for
people with chronic lung disease.)
You should talk to your doctor:
• If you ever had Guillain-Barré Syndrome.
• If you are not feeling well. It is advised
not to get your vaccination if you have
an active infection.
• If you are allergic to eggs.
• If you have weakened immune systems
or if you care for someone who is
severely immuno-compromised (people
who have HIV, certain cancers, includ­
ing leukemia, lymphoma, or multiple
myeloma.)
• If you have taken influenza antiviral
drugs within the previous 48 hours or
have gotten any other vaccines in the
past four weeks.
Recognizing the importance of vaccina­
tion, Healthy People 2020 has created a goal
to increase the percentage of healthcare
personnel who are vaccinated annually
against seasonal influenza to 90 percent.
Hospi­tals and other healthcare facilities have
started implementing policies mandating
vaccination of their healthcare workers as a
condition of employment. Research studies
do show that having mandatory vaccination
policies are very effective in raising vaccina­
tion rates to above the 90 percent goal in
healthcare personnel.
The flu vaccine is covered by insurance and
Medicare. Please protect yourself!
We Have Celebrity Help!
Actress Judith Light, known for TV’s Who’s
the Boss?, Dallas and Ugly Betty, is joining the
National Council on Aging to raise awareness
about the flu this season.
Light will appear in a Flu + You public
service announcement that will share
information about the increased risk of
flu in adults 65 years of age and older and
the importance of understanding their flu
vaccine options and getting the annual flu
vaccination.
6
www.pulmonarypaper.org
Volume 25, Number 5
Provided in Many Settings
Palliative Care Can Improve the Quality of Your LIfe
T
he National Institutes of Health describe
palliative care as comprehensive treatment of the discomfort, symptoms and stress
of serious illness, whatever the diagnosis. It
is estimated six million people in the United
States need palliative care – you can be at any
stage of your disease to receive this benefit!
Palliative care is different from hospice care
which provides comfort care to the dying
person and their family. Candidates for
hospice care are those who are expected to
live less than six months.
Visit the Internet site http://getpalliative
care.org to learn how palliative care can
improve the quality of your life and how and
where to find it. It involves a team of professionals to control your pain and symptoms,
make sure the lines of communication are
open between you, your family and primary physician so everyone contributes to the
goals of therapy and emotional support for
both you and your caregiver.
Shortness of breath affects your physical,
psychological and social functioning and
working to minimize difficult breathing is a
goal of palliative care. Your primary physi-
September/October 2014
cian will still be in charge of your treatment
management.
The National Hospice and Palliative Care
Organization is the largest nonprofit organization representing hospice and palliative
care programs and professionals in the
United States. Visit their web site at www.
nhpco.org and click the “Resources” tab and
then “Find a Provider”. You may also call
1-703-837-1500 for assistance.
Palliative care focuses on symptoms such
as pain, shortness of breath, fatigue, constipation, nausea, loss of appetite, difficulty
sleeping and depression. It also helps you
gain the strength to carry on with daily life.
It improves your ability to tolerate medical
treatments and helps you have more control
over your care by improving your understanding of your choices for treatment.
Palliative care can be provided in any setting, including hospitals,
nursing homes, outpatient palliative care
clinics, other specialized
clinics or at home. All
Veterans Health Administration hospitals now
have a palliative care
program.
www.pulmonarypaper.org
7
Ask Mark …
Mark Mangus, RRT
EFFORTS Board
Ann from Canada, whose physician told her she has Stage III COPD,
wants to know if anyone has found Roflumilast (aka, Daliresp)
beneficial. She thinks anyone who has COPD would love to take
a pill that really helps. She tried this and it didn’t seem to make a
difference!
Mark says, with Stage III COPD, you cannot reasonably expect
significant “improvement” in your breathing from any medication
alone. That’s simply not possible. The kind of improvement you
would see with taking drugs like Roflumilast for a month would be
in terms of subtle improvements in some of your pulmonary function
test (PFT) measurements. The overall effect of Roflumilast might take
much longer for you to realize – three to six months would not be
unreasonable – because the kinds of changes it causes are slow to
develop over time.
The single greatest influencer for improved breathing with COPD,
in any stage, is exercise and pushing yourself to achieve significant
windedness and then learning to continue pushing to work within
that windedness to the point that it doesn’t slow you down or stop
you as much or as soon. It may sound counterintuitive. But, that’s
what works and has been shown over and over again, for many
decades now. It’s also the hardest thing to do – keep moving when
your breathing is terrible and makes you feel like it’s going to bring
you to your knees any second!
Mark Mangus RRT,
BSRC, is a member of
the Medical Board of
EFFORTS (Emphysema
Foundation For Our
Right To Survive, www.
emphysema. net). He
generously donates his
time to answer members’
questions as well as for
COPD Canada, www.
copdcanada.ca.
8
Daliresp doesn’t work for everyone. It is a very specific medication for
only one aspect of COPD – although a very important aspect. When
it works, it seems to work well, though its effect may be slow to build.
When it doesn’t work, it can take six months to find out for sure. You
may want to give it another try for a few months and see if it doesn’t
help over the long run. In the meantime, you’ve got to get up and get
moving to help yourself to reach better breathing from that vantage
point.
There are no pills that can cure your COPD. Inhaled medications
offer relief from some degree of the symptoms you experience.
I would say you should be taking Spiriva and either Symbicort or
Advair as your maintenance inhaled medications. You might also
benefit from Xoponex or Albuterol/Salbu­temol as a rescue inhaler.
www.pulmonarypaper.org
Volume 25, Number 5
Nancy from Canada had questions after
reading about the side effects of Spiriva,
Symbicort, DuoNeb and Albuterol from the
inserts that come with the medication. She
also asked if she is doing any harm when
her oxygen saturation hovers in the low 80s
from her usual 92 percent, when walking on
a pulse dose setting of three on her home fill
cylinder.
what you are currently using – a flow of 3 on
pulse dose from your home fill device. See if
you can’t get either a device that pulses up
to 6 or more, with larger doses per pulse, or a
continuous flow device that will go to at least 8
liters. That may be an E-cylinder or something
different than your home-fill device. I suspect
that you need to boost your flow during
exercise to as high as 8 L/minute in order to
keep your saturation at or above 88 percent.
Mark reassures Nancy that any “side effects”
she fears are those which rarely occur.
Understand that the side effects listed on
package inserts are required for any and all
potential side effects. Just because they are
listed, doesn’t mean they usually occur, much
less are always attributable to the drug.
Repeatedly dropping that low will strain the
right side of your heart, causing it to fail. While
it is very important for you to exercise and to
do so as intensely and vigorously as you can
tolerate, it is also imperative to support your
oxygenation as best you can while exercising.
If at all possible, you really need to stay above
88 percent, 90 percent would be a more
preferable bottom point.
Spiriva (tiotropium bromide) is one of the
more benign drugs in actual worldwide use.
It has extremely few side effects when any do
occur. The worst of the common complaints
would fall into the area of dry mouth and, for
men, difficulty with completely emptying the
bladder. For folks with narrow angle glaucoma,
Spiriva poses a danger of worsening it. But
if you do not have it, you should not worry
about it. There are no implications for those
with cataracts. Spiriva is the only medication
shown to slow the progression of COPD. You
should consider Spiriva a safe maintenance
drug.
Your albuterol should be reserved for those
times, if and when, you feel short of breath.
Again, its side effects are few and far between,
the most common complaints are feeling like
your heart is pounding and shakiness. These
subside within an hour of using the Albuterol.
It seems that your oxygen use is adequate
except during exercise. If your oxygen
saturation is dropping into the “lower 80s”
during exercise, you need more oxygen than
September/October 2014
DuoNeb is a combination of ipratropium
bromide and albuterol sulfate, drugs that
work in a similar way that Symbicort and
Spiriva do. It would appear you are doubledosing yourself which would likely cancel
out the beneficial effect of the medication.
Adding your rescue inhaler could potentially
make your symptoms worse, instead of better.
My recommendation would be to decrease the
number of times you take the DuoNeb. Take
the treatment as your “rescue medication” as
you would your rescue inhaler. Use one or the
other, but not both – don’t use the DuoNeb
on a scheduled or regular-dosing basis. Spiriva
and Symbicort would be your “maintenance”
or main management medications. You want
to achieve the best control
of your symptoms as
possible. Be sure
to discuss your
concerns with
your physician.
www.pulmonarypaper.org
9
Fibrosis File
R
esearch from the European Respiratory Society’s International Congress
tells us some cases of Idiopathic Pulmonary
Fibrosis (IPF) may be linked with asbestos
exposure. Asbestosis is developed by people with a known (or unknown) history
of exposure to asbestos with symptoms
which can be identical to IPF – shortness of
breath, a dry, hacking cough, unexplained
weight loss and general fatigue. People
with asbestosis are not currently eligible
for new treatments for IPF, which could
be very beneficial for them.
Asbestos has been used in many products,
including: car brake shoes and clutch pads;
building materials as ceiling and floor tiles;
paints, coatings and adhesives; plastics; and
vermiculite-containing garden products.
Due to health concerns, asbestos use has decreased significantly. Workers exposed may
have inadvertently brought asbestos fibers
on their clothing to their homes. Asbestos
was used in the construction of the North
Tower of the World Trade Center in New
York City; hundreds of tons of asbestos
were released into the atmosphere during
the attack on September 11, 2001.
Lead researcher, Dr. Carl Reynolds
from the National Heart and Lung Institute
at Imperial College London said, “The
findings are consistent with the hypo­thesis
that a proportion of IPF cases are likely
to be caused by unknown exposure to
asbestos.”
10
Medication Update
The first IPF treatment options available,
InterMune’s Pirfenidone and Boehringer
Ingelheim’s Nintedanib (trade name now
Vargatef), are being evaluated by the Food
and Drug Administration (FDA) and may
become available as early as this fall. Roche
Pharmaceuticals announced it will buy
InterMune and merge into one company.
On the horizon, Sorrento Therapeutics,
Inc. announced that it has received funding to investigate an immunotherapy for
the potential treatment of IPF. Other than
new medication options, only 1% of those
diagnosed with IPF receive a lung transplant
as treatment for the disease.
Actress Barbara
Barrie has joined the
campaign to raise
awareness of Pulmonary Fibrosis by revealing that she also
has been diagnosed with the disease.
She has been in Broadway productions,
TV and movie roles including Private
Benjamin. Barbara is working with the
CPF by encouraging Americans living
with the disease. She says, “I am living
full steam ahead and am now trying to
help other people do the same.”
Actor/singer Robert Goulet, actors
Mar­
lon Brando, Gordon Jump from
WKRP in Cincinnati, James Doohan
from Star Trek, as well as Jaws author
Peter Benchley and stuntman Evel
Knievel, had all been diagnosed with
pulmonary fibrosis.
www.pulmonarypaper.org
Volume 25, Number 5
Pulmonary Fibrosis Awareness Month Celebrated in September
T
o celebrate Pulmonary Fibrosis Awareness Month, the Coalition for Pulmonary Fibrosis focused its resources and
efforts to make Pulmonary Fibrosis a
nationally recognized, treatable and ultimately curable disease.
There were nationwide activities
planned with a focus on Capitol Hill the
week of September 22–26 where volunteers met with members of Congress. The
FDA conducted a public meeting on drug
development that included medication to
treat Pulmonary Fibrosis as Pirfenidone and
Nintedanib. The PF community let their
wants, needs and experiences with dealing
with Pulmonary Fibrosis be known!
The Pulmonary Fibrosis Foundation
(PFF) (pulmonaryfibrosis.org or 1-844825-5733) also launched a full month of
events and initiatives for September’s Global Pulmonary Fibrosis Awareness Month.
Visit their web site’s education and support
section to access informative webinars on
living with Pulmonary Fibrosis. The PFF
Ambassador Program empowers patients,
caregivers and health care professionals
to become spokespersons for the PF com­
munity. PFF Ambassadors share current
disease information, personal stories and
inspiration with audiences across the country and are available all year round for
speaking engagements.
To help spread the word, we found
an Internet site (http://skreened.com/
pulmonaryfibrosis) where you may order
many different styles of t-shirts to support
September/October 2014
Pulmonary Fibrosis Awareness, or you
may also
call 1-888579-4455
to order.
For those of you who belong to the social
media network, Facebook, there are many
pages dedicated to support those whose
lives have been affected by Pulmonary
Fibrosis. You may find and give tips and
encouragement to those with the disease
and their caregivers and loved ones.
Doing a search for Pulmonary Fibrosis
on Facebook brings up these public groups:
• Pulmonary Fibrosis Foundation
• Pulmonary Fibrosis Awareness
• Coalition for Pulmonary Fibrosis
• Idiopathic Pulmonary Fibrosis
• Canadian Pulmonary Fibrosis
Foundation
In a closed group, administrators must
approve members and only group members
can see posted content:
• Pulmonary Fibrosis Spread Awareness
• Pulmonary Fibrosis A Day to Day
Survival to Breathe
• Pulmonary Fibrosis Support Group
by Breathe Support
• Pulmonary Fibrosis UK
www.pulmonarypaper.org
11
Gentle Exercise to Reduce Stress and Anxiety
Tai Chi for COPD
P
racticing Tai Chi may not only increase
your flexibility and balance but can be
a great way to reduce anxiety and built up
stress. It is a gentle form of exercise where
you perform slow, flowing movements and
stretching. Originally Tai Chi (pronounced
TIE-CHEE) was developed for self-defense.
exercise capacity and diaphragm strength
for people with COPD. After 12 weeks,
participants of Sun-style Tai Chi could walk
longer distances and reported better quality
of life compared to those whose treatment
did not include any exercise training.
How Do You Get Motivated to Exercise?
Safe for All Ages and Fitness Levels
There are many different styles of Tai Chi
with variations within each style, some that
focus on health as Sun-style, some on the
martial arts aspect of Tai Chi. The Sun-style
omits the more physically vigorous crouching and leaping of some other styles. The
footwork is unique, when one foot advances
or retreats, the other follows. The exercise
is low impact and puts minimal stress on
muscles and joints, making it generally safe
for all ages and fitness levels. It is inexpensive, requires no equipment and can be done
indoors or out, either alone or in a group.
When your doctor or family tells you to
be more active, it can seem an overwhelming
feat. How can I exercise if I can’t breathe?
Does this make common sense to anyone?
The truth is that starting and maintaining an
exercise routine will not cure you, but it will
make you feel better mentally and physically.
The key is to find something you like. Tai
Chi is an activity you may enjoy but hadn’t
thought of doing. Daily walks outside or on
a treadmill can build your endurance and
muscle strength. Exercise may also help your
immune system fight off infections. You have
to be in it to win it!
Benefits Enhance Lung Function
The Mayo Clinic notes there is evidence
that Tai Chi may help:
• Enhance quality of sleep and the immune
system
• Lower cholesterol and blood pressure
• Improve joint pain
• Improve symptoms of congestive heart
failure
• Improve overall well-being in older
adults
• Reduce risk of falls in older adults
Researchers from Australia and New Zealand found Tai Chi enhances lung function,
12
www.pulmonarypaper.org
Volume 25, Number 5
Find A Tai Chi Class Near You!
To find a Tai Chi class near you, contact
local fitness centers, health clubs and senior
centers and ask for their recommendations.
Although Tai Chi is slow and gentle, with
virtually no negative side effects, it’s possible
to get injured if you don’t know how to do
it properly. As always, ask your physician’s
opinion before starting any exercise program.
If you cannot find a program in your area,
look on the Internet for instructions. We
found several videos on www.youtube.com
on Sun-style Tai Chi that you can do at your
own pace. You may also purchase relatively
inexpensive DVDs on Ebay showing the benefits of Tai Chi or find DVDs at local stores.
Look in your local newspaper for listings
of support groups. For example, the Chronic
Illness Group meets at Lutheran Church in
Oakhurst, CA at 10 am on the first and third
Thursday of every month to practice Tai Chi. If
you would like to attend, call 1-559-658-1394.
The American Lung Association in West
Virginia is sponsoring a Respiratory Rally for
people with lung disease, caregivers and their
supporters on October 28 at the Charleston
Area Medical Center in Charleston, WV. The
theme is Hall-O-Wheeze, so have fun and
dress up in your costumes! A Tai Chi presentation will be given. Call 1-304-342-6600 to
learn more.
The Garden City Hospital Health Enhancement Center in Michigan offers an array of
fitness classes, such as yoga, Tai Chi, Zumba,
hula and Polynesian aerobics to keep you
moving or to help you relax. For more information, call 1-734-458-3242.
September/October 2014
Cold Weather Effects
When the weather gets cold, people spend
more time indoors but you may still be able
to keep up your exercise routines.
Instead of Bad Hair Days, we have Bad
Air Days! Cold air and strong winds may
cause increased shortness of breath, cough
and mucus production. Those with asthma
and sensitive airways may go into bronchospasm (constriction of the airways) when
breathing in a blast of cold air. Protect your
airway with a scarf and be sure to breathe
through your nose to warm the air.
Not only COPD is affected by the seasons.
Those who get migraine headaches may also
find they are happening more frequently
with changes in the weather. Those with
arthritis often say they can predict the
weather by the way their bones and joints
feel!
You may want to track barometric readings, humidity and the dew point on the days
that you are having trouble breathing. The
barometric reading is a measurement of air
pressure. When air pressure decreases, it will
be cloudy and rainy. Humidity is the amount
of water vapor in the air. Higher humidity
reduces the effectiveness of sweating in
cooling the body. The dew point is a temperature at which the air becomes saturated.
The higher the dew point, the more difficult
breathing may become.
“Snow birds” are lucky enough to have
the best climates to choose from – cooler
weather in the North and warmer days in
the South. Many move out West where there
is less humidity. Unfortunately, there is no
correct answer when asking, “Where is the
best place to live if you have chronic lung
disease?”
www.pulmonarypaper.org
13
Gas Source for Long Term Oxygen Therapy
Liquid Oxygen – Convenient, Costly
L
iquid oxygen (LOX) as a gas source for
long term oxygen therapy (LTOT) has
been around for nearly as long as LTOT
itself. Oxygen was first liquefied around
the turn of the 20th century, and quickly
became used in all kinds of industrial and
medical applications. By 1965, a “small”
LOX system could be used in the home.
Liquid oxygen portables were introduced
in the 1970s and by the 2000s many liquid
portables were small enough to carry over
the shoulder while lasting the user for
several hours. LOX has shown itself to
be an efficient and lightweight method
of oxygen storage and option for oxygen
therapy, especially for those with high flow
oxygen needs where other systems prove to
be bulky (cylinders) and/or limited in output
(Portable Oxygen Conentrators).
prefer that their portable oxygen system be
the longest lasting, lightest weight system
possible, and LOX systems have the ability
to meet that need.
That said, LOX is also expensive to
produce and distribute. It is generated
through a process called cryogenic distilla­
tion, where air is cooled and the oxygen
is separated out and then stored as LOX.
This is a very simplified description. Suffice
it to say that this process isn’t something
that you’d be able to do on
your own! Once the LOX is
created and stored,
systems are in place
to keep the storage
tanks cool and
limit evaporation.
LOX can then be
There Are Advantages
LOX is advantageous in LTOT primarily
because you can get a lot of high purity
oxygen gas from a small amount of LOX.
For a given liter of LOX, in ideal conditions,
this one liter will convert to 860 liters of
breathable oxygen gas. Compare that to the
standard compressed oxygen “E”-cylinder
which converts to around 660 liters of
breathable oxygen. Think about that –
those large, clunky metal tanks many of
you have had to lug around at some point
or another are about two to three times the
size of one liter of portable LOX, and much,
much heavier than one liter of portable
LOX would be, and they can only give
you about three-quarters of the breathable
oxygen! Most if not all oxygen users would
14
www.pulmonarypaper.org
Volume 25, Number 5
transported, and many home care providers
have LOX facilities where LOX transported
from a plant can be stored. From there,
trucks and base units can be filled and the
driver can deliver the LOX to the user’s
home. As one might expect, the overhead
costs inherent in this entire process can be
significant when compared to the costs of
providing compressed oxygen cylinders
and/or self-generating oxygen systems like
concentrators (with or without homefill portable capabilities). With Medicare
recently cutting the amount of dollars
it pays to providers for oxygen services,
home care dealers are looking for ways to
minimize costs, and unsurprisingly LOX
was one of the first services to be looked
at reducing.
A Stationery and Portable Option
As I’ve mentioned, LOX systems have
been an option for patients for a long
time. Its storage efficiency and lightweight
characteristics make it an extremely viable
option for both stationary and portable
oxygen needs. A user needing 2 LPM
continuous flow can get six to seven hours of
portable time from one liter of LOX, which
is a significantly longer “away” time than
most POCs operating at 2 LPM continuous
flow can offer without needing to swap
batteries. Users with high flow oxygen needs
especially benefit from LOX systems, where
much of the POC and oxygen conserving
technologies that exist today are not capable
of meeting high oxygen demand. Without
LOX, high flow users can be regulated to
large stationary concentrators and high flow
regulators coupled with oxygen cylinders,
which can be far more burdensome than
September/October 2014
having a refillable LOX base unit in the
home that can fill a LOX portable for travel
away from the home.
But with the cost of LOX being a deter­
rent for home care providers to provide
LOX service, namely to those insured by
Medicare, many oxygen users with all
kinds of needs are being told they cannot
receive LOX systems, even if they had been
receiving LOX service prior to the Medicare
cuts. If this sounds like your situation, I
strongly recommend you let Medicare know
how the cuts to oxygen reimbursement to
dealers has directly affected you.
Let Your Voice Be Heard
Call the Medicare Beneficiary Com­plaint
Hotline at 1-800-404-8702. Additionally,
more support can be had by calling the
COPD Information Line at 1-866-316-2673
and letting them know what your situation
is. This hotline is serviced on a daily basis
by folks with COPD, and as they have
already been made aware of several of the
repercussions of the Medicare cuts, they
may be able to give additional advice and
direction in getting the type of equipment
that most benefits your situation and not
the dealer’s. The more people that call and
share their stories, the better chance that the
people making these significant decisions
will listen.
Ryan Diesem is
Research Manager
at Valley Inspired
Products,
Apple
Valley, MN. Contact
Ryan at rdiesem@
inspiredrc.com with
questions or com­
ments.
www.pulmonarypaper.org
15
Conference of Patient Centered Approaches to COPD
Pulmonary Horizons
Jeanne Rommes,
a COPD advo­
cate who is living
with the disease,
summed up the
message of the recent Pulmonary
Horizons conferJeanne Rommes
ence in San Diego,
CA, for health professionals: “Ask the patient
what they want to do or are afraid to do and
then figure out how to help them achieve
their goals! They want to know what is happening to them and why! The medical team
should see the patients as partners instead of
a disease.”
Both sides also agreed that a positive attitude will make a great deal of difference in a
person’s outlook and help avoid depression.
People with lung disease and their caregivers joined physicians, respiratory therapists,
nurses, social workers and medical company
representatives to determine how to better
serve those dealing with chronic breathing
problems. Delivery of care was discussed
with the conclusion that what really is going
to take place depends on who is going to pay
for what. For example, even though a person
may have more mobility with less effort using
a light weight liquid oxygen system, if your
oxygen supplier cannot afford to drive to
your house multiple times a month to deliver
the oxygen, it is not going to happen.
Dr. Brian Tiep, whose ideas led to the
Oxymizer Cannula, participated in the meet16
ing. He is a big supporter of education and
his video on using an oximeter may be found
on www.youtube.com.
Robert McCoy discussed how his com­
pany, Valley Inspired Products in Apple
Valley, MN, tests oxygen equipment and
devices to confirm they are living up to a
company’s claims. McCoy has seen the evolution of oxygen products through the years
and is hoping for the day an oxygen delivery
device will be able to automatically turn the
flow up and down according to your changing oxygen saturation levels. You could set
the desired saturation level you would like to
maintain, say 92 percent, and the machine
would maintain that during your various
levels of activities. We can only wish! Maybe
we can get a built-in pedometer to let us keep
track of our steps. Letting us monitor activity
gives us control of our personal situation.
McCoy, one of the organizers of the meeting,
promoted interaction among all members of
the audience to share ideas and experience
on the many topics brought up.
It was recognized that COPD begins a
life-long experience starting from the point of
diagnosis. Everyone agreed that there needs
to be a continuum of care and education that
accompanies it, not only for the person who
has COPD but for the caregivers, doctors,
therapists and anyone else who is involved
in their lives. Invite everyone to the party but
keep control of your life without giving it up
to a caregiver.
www.pulmonarypaper.org
Volume 25, Number 5
If you are more short of breath than usual
with the same amount of exertion, be aware
you could be headed for a flare up (exacerbation) and should have a rapid action plan
in place. Talk to your doctor about starting
an antibiotic, prednisone and/or using a
bronchodilator. If treated quickly, you can
prevent a more serious problem. A five-day
admission to the hospital for COPD costs
about $10,000 with an average re-admission
rate within thirty days as high as 22 percent.
Some programs that actively engaged the
patient and family members have decreased
that rate down to two percent. Since you are
often discharged from the hospital “sicker
and quicker” than in the past, home visits
from a health professional can be very valuable as well as seeing your physician within
days of discharge.
Many medical-related company representatives gave short presentations on their
products including Evermind. The company
has a device that looks like an electrical plug
adapter that monitors the activity of devices
normally used in the home as television, coffee makers, lamps and also oxygen concentrators and sleep apnea equipment. If there
are any changes in normal routines, a family
member or designated person is notified.
September/October 2014
The AIRVO™ 2 was displayed by Fisher
& Paykel Healthcare. The unit is a high flow
oxygen therapy system which delivers a high
flow air/oxygen mixture through a nasal
cannula. By providing flow rates of up to
60 LPM, high humidity and precise oxygen
delivery, this type of therapy may reduce
the need for advanced types of ventilation
assistance.
There was a discussion of Telemedicine
and Telehealth. Telemedicine allows you and
your doctor to see and talk to each other as
you would in a video chat or Skype session
on the computer. There are also different
monitoring devices that can be uploaded to
your doctor for review. These systems can
be extremely valuable in remote areas and
where there are no medical facilities available
to the local population. Representatives from
the Vsee system discussed their product. Visit
http://vsee.com to learn more about it.
Mark Your Calendar!
The next Pulmonary Horizons meeting
will be in Miami, FL, on July 18–19, 2015.
www.pulmonarypaper.org
17
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18
www.pulmonarypaper.org
Volume 25, Number 5
Minimize Air Pollutants in the Home
Winterize to Maintain Air Quality
Many people are enjoying the fall weather
with open windows but you want to minimize the air pollutants in your home to
maintain optimum air quality. Before the
cold air arrives, be sure to have any openings fixed that allow outside air to enter the
house. If you have not already, test your
home for radon gas, which is the second
leading cause of lung cancer. Receive a kit
(cost is approximately $15) by calling 1-800247-2435 or visit www.radon.com.
People with asthma or allergies should
wash their sheets and blankets weekly in hot
water. Allergen-proof mattress and pillow
covers are available to protect you from
inhaling particles. We all love our pets but
if you can keep them out of the bedroom
and off soft furniture, it may help avoid
breathing problems.
breathing in the fumes. Some products
contain volatile organic compounds (VOCs)
which go into the air as gases. Choose products that are marked low or no VOC and
consider liquids or pastes instead of sprays
for cleaning because they disperse fewer
particles into the air.
Have your heating/air conditioning systems as well as fireplaces checked to be sure
vents are open and there is no danger of
breathing in carbon monoxide. If you use
a gas stove, you might also want to have it
checked periodically.
Sophisticated air purifiers do well at filtering pollutant particles such as dust, tobacco
smoke and pollen. Portable units are effective for those who do not have a full house
system. They remove particles at quiet, high
speeds allowing you to breathe easier.
Breathing in mold may
cause respiratory difficulties. Moisture control is
the key to mold control!
Inspect your home for any
leaks or dampness that
can cause molds to grow.
You should dry waterdamaged areas within 24 to
48 hours to prevent mold
growth. Of course the
num­­ber one rule is not to
allow cigarette or cigar
smoking in your home. Be
careful where you store
cleaning, garden and automotive solutions to avoid
September/October 2014
www.pulmonarypaper.org
19
Sharing the Health!
AARP, formerly known as American
Association of Retired Persons, reports if
you are over 50 years old, you may find free
college courses in your area! We thought this
would be a great way to stimulate your mind
and social skills. The Osher Foundation
website has information on their Lifelong
Learning Institutes which they describe as
non-credit educational programs specifically
developed for seasoned adults who are aged
50 and older.
Programs have university support, volunteer leadership and a variety of intellectually
stimulating courses. Online courses may also
be available.
Visit www.osherfoundation.org or call
them in San Francisco at 1-415-861-5587.
AARP also advises that you do an Internet
search for “free college and senior citizens”
and add your state to see what is available
in your area.
Lifelong learning keeps us stimulated,
interested and allows us to grow – even at
an advanced age! Learning doesn’t have to
take place in a classroom, you may find a
book that interests you at the local library
or book store and even join a book club.
20
Protect yourself during the upcoming
winter months! Pulmonary Paper member
and oxygen user since 2001, Nancy Pearsall
is pleased to announce BreathWarmers are
now available in nine different colors.
The cold weather protection scarf is specifically designed for people with breathing
and cardiac problems. Each BreathWarmer
is hand-crafted out of specialty polar fleece
with adjustable Velcro for unsurpassed
breathability and warmth. Its moisture wicking fabric technology keeps BreathWarmers
light and dry in all conditions.
Cost of the cold air warming scarf including shipping charges is $19.94.
For more information, please visit www.
breathwarmers.com or call 1-810-653-8006.
You are never too old to dress up for
Halloween – your family and friends will
appreciate your efforts! Don't forget your
pets or your oxygen tank! Many oxygen
users routinely dress up their portable tanks
for the changing seasons or holidays. (Many
also give a name to their oxygen buddy!)
www.pulmonarypaper.org
Volume 25, Number 5
September/October 2014
www.pulmonarypaper.org
21
[
Call Toll Free (877) 699-8439
or visit www.oxyview.com
Isn’t it time you took the Road Less Traveled?
Oxy-View Oxygen Therapy Eyeglass Frames
“Two roads diverged in a woods,
and I – I took the one less traveled by,
And that has made all the difference.” Robert Frost
Oxygen Therapy
for the 21st Century
]
Sharing the Health! continued
I have two things that have really helped
me enjoy meals more without being so
short of breath! Someone told me to eat
more frequent, smaller meals rather than
the traditional three main meals a day. I
thought it would only make more work for
me. Finally I decided to test it out for one
week and what a difference it made! I enjoy
going out to lunch with my friends and often
eat half the meal and take the rest home to
eat later. This keeps me active socially and
I only have to heat up the leftovers without
spending time and energy preparing meals.
I try to avoid fried and spicy foods as they
make me feel bloated and I also drink a lot
of water during the day.
I have found that when I eat my big meal
for lunch instead of supper time, I sleep
better. Since I also have problems with acid
reflux, this also helps with my indigestion
and heartburn.
The second thing I found was smoothies!
I waited for a NutriBullet to go on sale
and now look forward to
the delici­
ous drinks
and they are full of
nutrition and easy
to make.
You can make up
your own recipes –
most people use fresh fruit, I like using
frozen fruit because the smoothie tastes like
I have been to an ice cream parlor! Sometimes I use Boost or Ensure that has extra
supplements or yogurt. Spinach or kale is
also good to add. There are many recipes
to experiment with and find the ones that
are your favorite!
Denise L, Atlanta, GA
22
I’ve been on oxygen 24/7 for 13 years. For
the first time ever I recently went kayaking
on a local lake in the Wallkill River National
Wildlife Refuge. It has been offered free
every Thursday morning for two hours so I
decided to take advantage of it! I took Oscar
(my Marathon liquid oxygen portable unit)
with me. I was provided with a life jacket
and binoculars so I could also do some bird
watching. It was a great way to get exercise
for my arms.
Smiles, Bunny Music, Sussex, NJ
We strongly disagree with a report from the
Government Accountability Office that said
advocacy groups it has talked to expressed no
widespread concern over the recent changes
to Medicare oxygen reimbursement. The report stated the competitive bidding program
“did not appear to have adversely affected
beneficiary access.” John Tucker of New
York also disagrees! He waited all day for
his oxygen company to deliver six cylinders
only to be told late in the day they would
come tomorrow. Then only four tanks were
delivered because there was not enough to
go around! Unfortunately, he had to cancel
an outing for fear of running out of oxygen.
www.pulmonarypaper.org
Volume 25, Number 5
Trish Baron from McKean, PA shares her
stress management approach:
A young lady confidently walked around
the room with a raised glass of water while
explaining stress management to an audience. Everyone knew she was going to ask
the ultimate question, ‘half empty or half
full?’ She fooled them all … “How heavy
is this glass of water?” she inquired with a
smile. Answers called out ranged from 8
ounces to 20 ounces.
She replied,
“The absolute
weight doesn’t
matter. It depends
on how long I
hold it. If I hold
it for a minute,
that’s not a problem. If I hold it
for an hour, I’ll
have an ache in my right arm.”
“If I hold it for a day, you’ll have to call
an ambulance. In each case it’s the same
weight, but the longer I hold it, the heavier
it becomes.” She continued, “And that’s the
way it is with stress. If we carry our burdens
all the time, sooner or later, as the burden
becomes increasingly heavy, we won’t be
able to carry on.”
Halloween Rhyme Time Quiz
We have had many requests to have
another quiz just for fun! In honor of the
Halloween season approaching, see if you
can come up with the rhyming answer to
the questions here. For example, What do
you call a wealthy sorceress? The answer of
course is a “Rich Witch”!
• What do you call an Abominable Snowman named Elizabeth?
• What do you call a cart used by a monster who breathes fire?
• What do you call a fake monster
wrapped in linen?
• What do you call a sugary candy?
• What do you call a serious monster made
of clay?
• What did the grave keeper use to sweep
the graveyard?
• What is a fast prank?
• What is a scare in the evening?
• What is a great incantation?
• What is a thin furry animal that flies?
We will have the
answers in our
next issue!
“As with the glass of water, you have to
put it down for a while and rest before holding it again. When we’re refreshed, we can
carry on with the burden – holding stress
longer and better each time practiced.”
“So, as early in the evening as you can,
put all your burdens down. Don’t carry them
through the evening and into the night.”
September/October 2014
www.pulmonarypaper.org
23
Alert! Renew Medicare Prescription Drugs and Advantage Plans
The Alpha One Foundation wants to
remind people who suffer from this genetic
form of emphysema that it is will soon be
time to sign up or renew your Medicare
prescription drug and Advantage plans
for coverage beginning January 1, 2015.
Enrollment begins October 15 and ends
December 7, 2014.
Medicare announced the Advantage plans
may be canceled this year without the 90day notice that normally applies. This could
affect an Alpha’s augmentation therapy
infusions and other essential coverage.
Compile a list of all your prescribed medications and dosages to be sure they will be
covered on next year’s plan. Verify that your
medications are covered on next year’s plan.
Call Medicare at 1-800- 633-4227 or contact the State Health Insurance Counseling
and Assistance Programs at www.medicare.
gov/contacts/
Smoking News
Alternative to E-cigarette Approved in the United Kingdom
We suppose they have to keep trying to
stay in business! A new nicotine inhaler by
British American Tobacco (BAT) has been
licensed as a medicinal product since it
could be prescribed
by physicians for
people trying to quit
smoking. As a competitor to the e-cigarette, the Voke inhaler, is expected to be
launched in the first half of 2015.
The inhaler has a small aerosol can
containing a pressurized nicotine solution
and a stick device that needs to be filled from
the can. Once filled, the stick device is breathoperated and the nicotine is inhaled, delivering much of the experience smokers expect
from a cigarette, but supposedly “without
the serious health risk of smoking”. There
are no batteries or power involved as in
e-cigarettes and the Voke does not produce
a visible vapor when inhaled.
24
BAT, the world’s second-biggest cigarette
maker, already sells an e-cigarette called
Vype. The device is seen as a competitor to
both e-cigarettes and nicotine-replacement
therapies, such as gum, patches, as well as
Johnson & Johnson’s Nicorette® Inhalator.
The tobacco companies seem to be finding
alternatives to feed their multi-billion dollar
industry.
The potential risks from e-cigarettes
were highlighted by the World Health Organization recently, which called for stiff
regulation as well as bans on their indoor use, advertising and sales to minors.
Currently e-cigarettes are not regulated
although the number of users worldwide
is thought to have doubled in the 2008
to 2012.
A bill that would require liquid nicotine
vials that refill the electronic cigarettes to
have childproof caps is being considered in
the Senate.
www.pulmonarypaper.org
Volume 25, Number 5
You are what you breathe.
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• Produce no ozone, ions,
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• Superior technology and value
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For more than 50 years, IQAir has remained
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September/October 2014
www.pulmonarypaper.org
25
A Review of a COPD Diagnosis
Back to Basics
S
ince everyone has had different experiences after they were diagnosed with
a chronic respiratory problem, we
would like to review the basics.
One person might have attended a comprehensive
pulmonary rehabilitation program while another might have been
given a prescription for
Albuterol and set up on
oxygen with instructions
to “call if you need anything”.
With Chronic Obstructive Pulmonary Disease (COPD), the main problem
lies in the fact that you cannot move air in
and out of your lungs quickly enough. It is
not because you can’t get any fresh air in,
it is because you can’t get the stale air out!
If you think of your lung sacs (alveoli) as
balloons, it may help understand what is going on. A new balloon snaps right back into
place when it is stretched – like an alveoli
does when you exhale. Exhalation pushes
26
out the stale air that has already given up
its oxygen to your bloodstream.
If you blow up that balloon and
then let the air out of it, it is
left with weak, floppy walls.
This is what happens to
your alveoli, after you
inhale and the air sac is
full, because it cannot
push the air out when
you start to exhale, the
stale air becomes trapped
inside.
Pursed lip breathing should
be practiced until it becomes second
nature. Pucker up your lips and breathe out
through the restriction for twice as long as
you inhaled. This simple trick will allow air
sacs to empty more fully. Pucker up and
blow out in shorter exhalations as you step
up a stair or do something strenuous.
Classifying the Stage of COPD
Measuring your flow rate – how quickly
the air can move through your lung – is how
health professionals classify the stage of
your COPD. The measurement most often
looked at is your FEV1 – Forced Expiratory
Volume in one second – how much air you
can forcefully blow out in the first second
of your exhalation.
Your FEV1 is compared to a “normal
reading”, one that a person of your sex,
age, height and nationality achieved. It is expressed as a percent – if the normal reading
was 4 liters/sec and you exhaled 2 liters/sec,
you are said to have a FEV1 of 50 percent.
www.pulmonarypaper.org
Volume 25, Number 5
The Stages of COPD
There are four stages of COPD as classified by the Global Initiative for Chronic
Obstructive Lung Disease or GOLD standards. Besides your FEV1, physicians consider your present symptoms – cough, shortness
of breath and sputum production – and if
you have had any infections or hospitalizations during the year.
Stage 1: Your FEV1 is 80 percent or more
of the predicted value. At this stage, you
usually do not have many problems; some
shortness of breath may be present. If people
become aware at this stage that changes are
occurring in their lungs, they could make
lifestyle changes as quitting smoking or
changing their environment.
Stage 2: Your FEV1 is 50 percent to 80
percent of the expected value. You notice
September/October 2014
more that you are having difficulty breathing
during any exertion and make an appointment with your physician to find out why.
Stage 3: Your FEV1 is 30 percent to 50
percent of the expected response. At this
point, you become very short of breath and
tired during daily activities and often limit
your lifestyle.
Stage 4: Your FEV1 is less than 30 percent of the expected response. Your trouble
breathing affects every aspect of your life.
Please don’t feel overwhelmed if you find
your FEV1 is in the stage 4 category. People
live very satisfying lives for many years with
a FEV1 below 30 percent of predicted. It is
just a number.
Your attitude and coping skills are what
matter!
www.pulmonarypaper.org
27
2015
Sea Puffer Group Cruises
Mexican Riviera 7 DAYS
January 17–24, 2015
Start the New Year right with a 7-day cruise
on the Grand Princess, round trip from Los
Angeles. Enjoy relaxing sea days and
West C
visits to Puerto Vallarta, Mazatlan
Depar oast
ture
and Cabo San Lucas!
Southern Caribbean 10 DAYS
March 20–30, 2015
Enjoy 10 days of Spring on Holland America’s
Noordam, leaving round trip from Fort
Lauderdale.
Oxygen Guru Ryan Diesem
will be our guest speaker!
Alaska Inner Passage 7 DAYS
July 25–August 1, 2015
Explore Alaska’s Inner Passage, round trip
from Seattle on our annual vacation to Alaska,
aboard Holland America’s Westerdam!
Panama Canal 11 DAYS
October 18–28, 2015
Take this incredible 11-day journey round trip
from Fort Lauderdale to the Panama Canal –
an undisputed bucket list trip aboard the Coral
Princess!
Visit www.seapuffers.com for more information!
28
www.pulmonarypaper.org
Volume 25, Number 5
Mexican Riviera
Southern Caribbean
Alaska Inner Passage
Panama Canal
TAKE A WORRY-FREE
VACATION AND
EXPLORE THE WORLD!
CALL TODAY!
FST–ST39068
Join the Sea Puffers on one of
our group cruises escorted by
respiratory therapists!
Call 1-866-673-3019 to also
arrange your own cruise or
tour!
Member
September/October 2014
We make it easy to travel with
oxygen! Join the Sea Puffers family
for life-long friendships and support.
www.pulmonarypaper.org
29
Respiratory News
T
o keep up on the latest pulmonary
news, click on the link on the home
page of www.pulmonarypaper.org.
The FDA has approved the once-daily
bronchodilator inhalation spray olodaterol (Striverdi Respimat) for the long-term
treatment of airflow obstruction in patients
with COPD.
People with asthma who were treated
with vitamin D and asthma controllers had
significantly improved airway function after
24 weeks compared with those treated with
asthma controllers alone, according to a
recent study from Iran. Controller medications, also called preventive or maintenance
medications, work over a period of time
to reduce airway inflammation and help
prevent asthma symptoms from occurring.
A study in the Journal of American Med­
ical Association (JAMA) reports for older
adults with COPD, combination therapy
with long-acting bronchodilators (LABAs
as Serevent, Foradil, Arcapta) and inhaled
corticosteroids (ICSs as Pulmicort, Qvar,
Flovent) produces better outcomes than
treatment with LABAs alone.
30
In the news is a rare virus strain, enterovirus 68, causing severe breathing problems
in children. Enteroviruses are very common,
causing between 10 million and 15 million
infections each year. This particular strain
has not appeared very often since it was first
isolated in California in 1962.
German scientists have developed a miniature lung designed to personalize drug
treatments for lung cancer patients. The
researchers say the device will give doctors
a way to more accurately pinpoint the most
effective treatment options by testing different drugs on their patients own cancer cells.
Research in CHEST showed high-dose
N-Acetylcysteine, 600 mg taken twice a
day for one year, reduced flare-ups or exacerbations in high-risk patients with COPD
in China.
An Israeli company is developing a wristworn “watch” oximeter called Oxitone. It
is a continuous monitor and will connect to
the Internet, smartphones and tablets. The
device will be able to send real-time alerts
and data to emergency services, family members and doctors. The device is expected to
cost about $200.
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Volume 25, No. 5
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September/October 2014
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