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Lifestyle Changes to Improve COPD Symptoms, Quality of Life

For people living with chronic obstructive pulmonary disease (COPD), asthma or emphysema, oftentimes trouble breathing can make even the simplest of tasks difficult to complete.

While unfortunately there is no cure for these conditions, learning to live with the disease and manage symptoms is a key aspect of treatment and care. Living with COPD will never be easy. However, by making a few simple lifestyle changes, patients can ease breathing, reduce exacerbations and improve their overall quality of life.

Quit Smoking

For patients who have recently been diagnosed with COPD or other chronic lung conditions, the first step to improving symptoms is quitting smoking. With tobacco smoke as the number one risk factor for COPD, quitting smoking will slow the progression of the disease and lessen the toll that it takes on the body.

“While I am not saying that it is easy, quitting smoking will provide a big improvement to lifestyle factors,” said Gina Kaurich, RN, Executive Director of Client Care Services, FirstLight HomeCare, an in-home care network based in Cincinnati, Ohio. “Removing yourself from situations where others are smoking will also provide relief. This is the biggest thing that those diagnosed with COPD should do.”

While quitting should be a top priority, if COPD patients find that they cannot quit, steps should be taken to at least reduce the number of packs smoked per week.

Avoid Air Pollutants

In addition to avoiding cigarette smoke, COPD patients should also avoid air pollutants such as dust, pollen, environmental smoke and chemicals such as insecticides and household cleaners. Lotions or sprays such as sunscreen and bug spray can also exacerbate symptoms.

“People should be very cognizant of their environment and how their breathing is affected by these irritants,” said Kaurich. “Maybe they are experiencing shortness of breath, or maybe it’s just coughing. If this occurs, it is best to move back from that situation.”

Checking the pollen count before going outdoors can also be helpful, as this will help to gauge when it is best to stay indoors. As can avoiding overly humid or dry air as this can often create difficulties breathing.

“Being a respiratory disease, COPD can be affected by so many things and it starts with the seasons – the spring pollen and overly humid or dry air – these all affect breathing,” said Kaurich. “The media has really helped by providing the pollen count and suggestions on when it is best to stay indoors based on the air condition.”

Finally, COPD patients should avoid dusting at all costs, as this kicks pollutants into the air and can cause acute exacerbations.

Maintain a Social Life

While avoiding air pollutants can often leave COPD patients indoors, maintaining a social life should also be a key consideration.

“For some people, in the summer when it’s humid and difficult to breathe, they are going to lock themselves up in their home with air conditioning, but they need to remember the psychology impact of the disease. Socialization is necessary,” said Kaurich. “Get out with family and friends and interact with people.”

To avoid trouble breathing during these times, it is best to reduce environment exposure.

“Go from the air conditioned house to an air conditioned car quickly. And have someone get the car cool before you get in,” said Kaurich. “While these conditions can impact every aspect of life, it is important to keep living.”

Keep a Journal

Lastly, those living with chronic lung conditions should keep a journal of their symptoms. This should include information such as those environmental conditions they faced and how they affected their breathing for each day.

“Much of learning to improve symptoms is a matter of experimenting,” said Kaurich. “Maybe for one person in a certain time of year campfire smoke will bother them. But it may happen again with a different type of wood and this will not affect them. It’s really about catching these symptoms early and learning what causes problems and what does not.”

By journaling, COPD patients will become more aware of what affects their breathing and learn to avoid these irritants in the future.

Consult a Physician

While many of these improvements only require mild changes, speaking with a physician before implementing them is recommended. Further, patients should speak with their physician before they put themselves in situations where irritants may be present, as they may have suggestions regarding how to handle the situation. 

“It’s important for those people living with the disease to remember that this affects their breathing, which is essential to life,” said Kaurich. “Improving symptoms and reducing the chance of exacerbations is key to improving quality of life.”

Reducing COPD Flare-ups

For people living with chronic obstructive pulmonary disease (COPD), breathing can be very difficult and exacerbations can often lead to hospitalization. While exacerbations can be caused by a number of unknown factors, these flare-ups are often the result of air pollution, infections, smoking and improper use of inhaled medications. The good news is, however, that there are ways to limit flare-ups and improve quality of life.

The following tips on reducing COPD flare-ups have been pulled from “Bee Healthy: Understand COPD to Reduce Flare-ups,” an article by Jessica Jackson, a registered respiratory therapist at Sutter Gould Medical Foundation in Modesto, Calif.

  • Learn about the causes of COPD exacerbations.

  • Understand and avoid triggers for exacerbation.

  • Follow a physician-approved diet and exercise plan.

  • Use prescribed medications properly. Understand why you are taking it and how it will improve your symptoms.

  • Take time to unwind.

  • Quit smoking.

The best way to manage COPD and avoid exacerbations is to understand the disease, as well as the causes of flare-ups. Take the time to educate yourself, or speak with your doctor about any questions you may have. It could be an important step in the betterment of your health.

Click Here to Access the Full Article.

 

Frequently Asked Questions About Living with COPD

If you or someone you love has been diagnosed with chronic obstructive pulmonary disease (COPD), you probably have a number of questions, from the causes of COPD to what will happen to your lungs. WebMD has compiled the 10 most frequently asked questions related to COPD. They are as follows:

  1. What happens to my lungs if I have COPD?

  2. What causes COPD?

  3. What are the signs and symptoms of COPD?

  4. How is COPD diagnosed?

  5. What are the treatments for COPD?

  6. What can I do to stay healthier while living with COPD?

  7. Why is good nutrition so important when you’re living with COPD?

  8. What can I do to conserve energy when I have COPD?

  9. What are the complications of living with COPD?

  10. When should I call for help?

For the answers to these questions, click here.

Adherence to Inhalation Therapy May Improve Quality of Life in COPD Patients

Adherence to inhalation therapy may contribute to adherence with overall therapeutic regimens and improved health status in patients with chronic obstructive pulmonary disease (COPD). That is according to a recent study published in the International Journal of Chronic Obstructive Pulmonary Disease.

While critical in the success of COPD management, adherence to inhalation therapy is not common among COPD patients. Further, very little is known about the relationship between medication adherence and quality of life in COPD. With that in mind, researchers out of Japan conducted a cross-sectional analysis of 88 COPD patients using a self-reported adherence questionnaire with responses on a 5-point Likert scale. The purpose of the study was to assess both the factors that contribute to adherence to inhalation therapy and their correlation with quality of life.

The results demonstrate that the only significant factor associated with overall adherence to medication therapy was repeated instruction about inhalation techniques. Of the 55 respondents with usable responses, 22 received repeated verbal instruction and/or demonstrations of inhalation techniques from their respiratory physician. Patients with repeated instruction reported better quality of life scores.

Significant correlations were also found between the overall adherence score and the health-related quality-of-life score, demonstrating that adherence may have a positive effect on overall health.

 

Click Here to Access the Full Study from Dovepress

Future Management of COPD Sees Shift in Approach to Treatment

Chronic obstructive pulmonary disease (COPD) is a leading cause of disability and mortality and is significant strain on the healthcare industry, creating personal and financial burdens that must be addressed. However, according to a recent article published in the International Journal of Chronic Obstructive Pulmonary Disease, evolving scientific evidence on the natural history and clinical course of COPD has fueled a fundamental shift in how clinicians treat the disease.

The article, written by Richard Russell, Antonio Anzueto and Idelle Weisman, states that “the goals of therapy for COPD are no longer confined to controlling symptoms, reducing exacerbations, and maintaining quality of life.” Slowing disease progression is now the main goal of therapy and is becoming an achievable aim.

This shift is a result of multiple findings, including the emergence of data highlighting the heterogeneity in rate of lung function decline, which has altered perceptions of disease progression and understanding of strategies for the management of stable disease.

“A challenge for the future will be to capitalize on these observations by improving the identification and diagnosis of patients with COPD early in the course of their disease, so that effective interventions can be introduced before the more advanced, disabling and costly stages of the disease,” researchers add.

Further, researchers examine the latest understanding of COPD to evaluate the current and potential approaches to long-term treatment. This includes treatments such as early, effective, and prolonged bronchodilation to slow the decline in lung function and reduce the frequency of exacerbations.

Click Here to Access the Full Article from Dovepress

LVRS Surgery

hLung Volume Reduction Surgery Proven Beneficial to Emphysema Patients

Lung volume reduction surgery (LVRS) may improve the quality of life and overall well-being in patients with severe emphysema, according to the National Emphysema Treatment Trial (NETT), the first study to randomize emphysema patients to receive LVRS or non-surgical medical care.

Researchers for NETT recruited 1,218 patients with severe emphysema and randomized them to either undergo LVRS or non-surgical medical treatment which consisted of customized use of medication, oxygen support, smoking cessation and pulmonary rehabilitation. Of the sampled population, 608 patients underwent LVRS and 610 received standard medical care. They were monitored for five years, or until a “composite event” (a serious decline in quality of life or death) occurred. The average time until such an event was one year for medically treated patients and two years for patients who underwent LVRS.

“We found lung reduction surgery is good treatment alternative for selected emphysema patients since it not only improves survival but also meaningfully improves quality of life for a period of at least five years after the operation,” said lead author of the study, Roberto Benzo, M.D., MSc., Mayo Clinic. “Patients who underwent LVRS, with the exception of those who had non-upper-lobe-predominant emphysema, had both a survival and quality of life benefit when compared to similar patients undergoing medical treatment only.”

For patients who received LVRS, a portion of the emphysematous lung tissue was removed to prevent “air-trapping,” where the patient can inhale but is unable to force the air back out of the lung.

“By removing the section of lung that is primarily affected with severe emphysema, we can decrease air trapping and consequently the shortness of breath, which can thereby improve the patient's perceived quality of life,” said Dr. Benzo.

Researchers caution that LVRS carries serious risks. In the study, nearly 5% of the patients who underwent LVRS died following surgery. However, once the post-operative period is over, the patients’ quality of life is improved immediately. Full Story

Gene Therapy May Prevent the Progression of Emphysema

Researchers from Boston University School of Medicine (BUSM) have discovered a new gene therapy that may prevent the progression of emphysema. The study, published online in the Journal of Clinical Investigation, describes a method of treatment that will express therapeutic genes in lung tissues over a lifetime after a single treatment.

The genetic mutation of Alpha-1 Anti-trypsinis, and subsequent deficiency, is the most commonly inherited form of emphysema seen in young people. It predisposes affected individuals to early emphysema and cirrhosis of the liver.

According to researchers, gene transfer into specific cell lineages in vivo remains an attractive yet elusive approach for correcting inherited mutations and preventing subsequent diseases such as emphysema.  In vivo gene transfer has been limited in many types of cells by inefficient gene delivery, as well as the limited life-span of differentiated cell types.

However, using mice, the BUSM researchers have discovered a way to deliver genes selectively to as many as 70 percent of a mouse lung’s alveolar macrophages (AM), a key cell type contributing to emphysema. Researchers applied this approach to achieve sustained in vivo expression of normal human alpha-1 antitrypsin (hAAT) protein levels capable of improving emphysema in mice. As a result, the lung macrophages carrying the therapeutic gene survived in the lung for a two-year lifetime following a single intra-tracheal injection of the engineered lentiviral vector.

"The progression of emphysema in mice exposed to elastase was significantly improved by the gene therapy as evidenced by improvements in lung compliance and alveolar size," said Dr. Andrew Wilson, lead author of the study and assistant professor of medicine at BUSM.

After 24 weeks of sustained gene expression, no humoral or cellular immune responses to the human hAAT protein were detected in the mice, challenging the idea that lung macrophages are short-lived and suggesting that these differentiated cells may be considered for in vivo gene therapy applications such as the sustained correction of hAAT deficiency. Click here to access the full story on ScienceDaily.

Gene Variant said to Protect against Asthma, COPD

A variant of the gene MMP12, which plays a role in inflammation, seems to protect the lungs of children with asthma and adults who smoke, according a recent study. This new gene raises hope that improved prevention and treatment of chronic obstructive pulmonary disease (COPD) will be discovered.

Researchers have found that levels of the MMP12 gene may impact the quality of life for those individuals who suffer from asthma and COPD. They also found that adult smokers with this variant of the gene have a lower risk of developing COPD, a condition often brought on by smoking.

Linked to the development of emphysema in mice exposed to smoke, the gene is thought to be important in the onset of emphysema in humans. It can also be linked with other genes involved in asthma. This information, combined with the fact that factors that can cause the onset of asthma in children are also involved with how well your lungs function in adulthood, is what spurred investigators to being this study.

Dr. Juan C. Celedon, associate professor of medicine at Brigham and Women’s Hospital and Harvard Medical School, and his colleagues studied seven different groups of people, in all 8,300 children and adults. Their findings, published in the New England Journal of Medicine, shed light on the association the variant of MMP12 has to better lung function in children with asthma, adult smokers, and the connection between asthma and COPD.

"There is certainly overlapping in that how you get asthma and how you get COPD is related and probably very closely related," said Jeffrey Cirillo, professor of microbial and molecular pathogenesis at Texas A&M Health Science Center College of Medicine in College Station."That's exciting because it suggests that if we can decrease or increase expression of genes that are common to both, we could potentially affect both. It's nice to have one treatment."

By understanding more about MMP12, researchers are hopeful that they will be able to come up with new therapeutic approaches including ways to induce or oppress the protein expression in the lungs and treat COPD and asthma.  Click here to read the full story on MedicineNet.

Even Mild COPD May Limit Heart Function

Researchers have long known that severe cases of chronic obstructive pulmonary disease (COPD) have diminished the heart’s ability to pump blood effectively. However, a new study funded by the National Heart, Lung and Blood Institute (NHLBI) of the National Institutes of Health suggests that there are strong links between heart function and mild COPD.

The study, published in the Jan. 21 issue of the New England Journal of Medicine, is the first research to show that COPD diminishes the heart’s ability to pump effectively even when the disease has mild or no symptoms. This suggests that the changes in the heart occur much earlier than previously believed – even before symptoms appear.

Researchers measured the heart and lung structure and function in 2,816 generally healthy adults who were part of the Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study, an extension of a large, NHLBI-supported study focused on finding early signs of heart, lung and blood diseases before symptoms appear.

Using sensitive magnetic resonance imaging (MRI) and computed tomography (CT) scans, researchers uncovered mild abnormalities in heart and lung function in many participants with the link between the two strongest in current smokers who are at risk for both diseases, especially those with emphysema. The findings also appeared, to a lesser extent, in people with mild COPD who had never smoked.

"These results raise the intriguing possibility that treating lung disease may, in the future, improve heart function," said Graham Barr, M.D., Dr. P.H., assistant professor of medicine and epidemiology at Columbia University Medical Center in New York City, principal investigator of the MESA Lung Study, and lead author of the paper. "Further research is needed to prove whether treating mild COPD will help the heart work better." Click here to access the full story on NIH News

Asthma, Emphysema Patients May Be Misusing Inhalers

Many people with asthma or emphysema may be taking their inhaled medications incorrectly, according to a recent study published in the Journal of General Internal Medicine.

The study, which observed 100 adults hospitalized for asthma or other lung diseases while using their inhalers, found that patients misused metered-dose inhalers nine out of 10 times and Diskus inhalers seven out of 10 times. The patients included in the study were admitted to one of two hospitals in the Chicago area because of serious asthma or a worsening of their COPD, with some patients hospitalized due to near-fatal complications.

For people who use both metered-dose and Diskus inhalers, which researchers note is quite common, learning to use both types of inhalers can be tricky. That is because while both inhalers deliver medication to the lungs, they work by different mechanisms and require different steps to deliver medication. Used mainly as a controller medication, Diskus inhalers require a sharp inhalation for maximum effectiveness. Conversely, metered-dose inhalers, which can be used as both controller and rescue medication, must be inhaled slowly.

Researchers note that one of the biggest problems found in the use of inhalers was that patients failed to breathe out fully before placing the inhaler in their mouth. Another obstacle appeared to be vision problems, which researchers believe may impact patients’ ability to read the inhaler’s instructions and properly use them.

On a positive note, researchers found that it did not take much instruction to improve people’s inhaler use. Of the 100 study participants, 42 were given one or two lessons on how to use the devices and all were able to master the techniques for both inhalers.

For people with asthma or COPD, trouble controlling symptoms may be a sign that the inhaler isn’t being used correctly. That is why it is important for people using inhalers for lung disease treatment to bring them to their doctors’ appointments and demonstrate how they use the devices at home. Doctors will then be able to correct poor practices and ensure that patients are receiving the correct dose of medication to their lungs.

Click Here to Access the Full Story From the Journal of General Internal Medicine

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