Creating a Safer Living Environment

For people living with chronic obstructive pulmonary disease (COPD), the role of the home often changes; some areas take on new meaning as they find themselves spending more time inside while others present new challenges or dangers. Further, poor indoor air quality can exacerbate COPD symptoms and affect how a person with COPD feels in their home. Thus, it’s important for caregivers and their loved ones to work together to manage indoor irritants and pollutants, avoid second- and third-hand smoke and even test for radon.

To help those with COPD and their caregivers create a safer home, the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health (NIH), recently published the COPD Caregiver’s Toolkit to share tips for creating a safer home for those with COPD. In addition to patient stories, the toolkit is designed to help “develop a new eye for the home environment. It can also help you anticipate new difficulties that arise as people with COPD negotiate new limitations.”

Managing Indoor Triggers

Managing and reducing contact with indoor irritants and pollutants is vital for reducing the COPD flare-up they can lead to. Among the most common indoor triggers are tobacco smoke, pet dander, dust and mold, tree and plant pollen, and strong odors (e.g., household cleaning products, perfume, etc.).

To manage these indoor triggers, avoid using smoke-producing items such as fireplaces, wood-burning stoves, and candles, and any products with strong odors, such as bleach, cleaning products, air fresheners, perfumes, etc. Reduce mold by repairing any water leaks, reduce dust and dust mites by vacuuming and dusting frequently, and keep pets out of sleeping areas.

Windows should be kept closed on high allergen days – information you can track with your local news station. Air conditioning should be used whenever possible, and heating and cooling systems should be inspected yearly. Finally, if you live in an area where wildfires are common, speak with your healthcare provider about ways to protect your home and loved ones against wildfire smoke.

Maintain a Smoke-Free Home

When it comes to smoking, secondhand and thirdhand smoke – the residue of tobacco smoke that builds up on surfaces, fabrics, and people after someone smokes – the goal should be a smoke-free home. While smoking and breathing in secondhand smoke is harmful for everyone, it is far more dangerous for those with COPD.

To eliminate or drastically reduce exposure to smoke inside the home and other places, forbid smoking inside. By extension, don’t allow smoking in your vehicle and only visit smoke-free businesses and restaurants.

In terms of thirdhand smoke, the harmful chemicals in thirdhand smoke can remain in the home for years on walls and floors; carpets, rugs, and curtains; counters and appliances; and pillows, blankets, and bedding. It can also be found on a person’s skin, hair, and clothing; hotel room walls and bedding; and inside cars.

The solution, writes NHLBI, is to “create a smoke-free environment by saying no to smoking in and around the home. Of course, it is best that any smokers in your household quit smoking. Otherwise, maintain a smoke-free home by asking smokers to ‘take it outside’.”

Radon and its Health Effects

Radon is present in as many as 1 out of every 5 homes in the U.S. It is a gas that comes from uranium in the ground that cannot be seen, nor does it have a smell or taste.

Radon exposure – which most often happens by inhaling it – is the second leading cause of lung cancer in the U.S., behind only smoking. If you smoke and live in a home with high radon levels, you’re at an even higher risk for developing lung cancer.

Since people living with COPD already face an increased lung cancer risk, reducing radon is critical. It gets into the home through cracks in solid floors and walls; construction joints; gaps in suspended floors and around service pipes; spaces inside walls; and/or a groundwater supply.

Per NHLBI: “Testing your home for radon is the only way to determine if you and your family are at risk for radon exposure. Home radon tests are inexpensive and easy. It is important to test your home every two years. You can do it yourself by purchasing a radon test kit from your local hardware store. Or you can hire a licensed radon measurement professional.”

The full COPD Caregiver’s Toolkit can be accessed here.

COVID-19 Mitigation Efforts Linked to Reduction in Hospitalizations for COPD

Researchers at the University of Maryland School of Medicine found that public health measures designed to reduce the spread of COVID-19 may be linked to a reduction in hospital admissions for COPD. The study, accepted for publication in medRxiv, suggests the significant decline is due to a drop in circulating seasonal respiratory viruses such as influenza.

The pandemic led to widespread implementation of stay-at-home orders, social distancing, and masking mandates. Along with reducing the spread of COVID-19, these public health measures also reduced the transmission of common seasonal triggers of COPD exacerbations.

To determine if these measures impacted COPD-related hospital admissions, researchers conducted a retrospective analysis of data from a large, multicenter healthcare system. They compared season-matched weekly frequency of hospital admissions for COPD before and after implementation of public health measures for COVID-19. Community viral prevalence was estimated using regional Center for Disease Control and Prevention test positivity data and correlated to COPD admissions.

What they found was a 53% decline in COPD hospital admissions, which “was most pronounced in patients with fewer comorbidities and without recurrent admissions,” and led researchers to conclude that the “implementation of public health measures during the COVID-19 pandemic was associated with decreased COPD admissions. These changes are plausibly explained by reduced prevalence of seasonal respiratory viruses.”

Added Insights from Dr. Nair: Simple actions such as wearing masks and limiting exposure to others are helpful in controlling viruses like influenza. Those with emphysema typically maintain the practice of limiting contact to avoid getting sick, especially in the winter. Thus, use of masks is a cost effective, safety measure worth employing for some going forward. 

Read more on Newswise or the full study on medRxiv.

Targeted Lung Denervation Trials Hold Promise

With COPD poised to become the world’s third leading cause of death by 2030, there is a desperate need for new treatments. One clinical trial underway at Temple Health and other sites nationwide is offering hope and relief to participants by targeting the overactive nerves in the airways that contribute to COPD symptoms and flare-ups.

That promise is based on early outcomes of the AIRFLOW-3 Clinical Trials evaluating Targeted Lung Denervation (TLD), an investigational procedure designed to reduce airway nerve activity for patients who still experience flare-ups despite their medications. It involves a one-time, non-surgical outpatient procedure performed through a standard bronchoscope – a thin flexible tube that is inserted through the mouth into the lungs to put in place an investigational device called the Nuvaira Lung Denervation System. Once in place, the system delivers targeted radiofrequency (RF) energy to the nerves located on the outside of the airways.

Individuals participating at the Temple University trial site, which has so far treated the most patients in the U.S., report improved lung functions that have allowed them to return to their active lives with only their daily medications.

Added Insights from Dr. Nair: The therapy described here is more of a concern for those with asthma, where the main problem is airway narrowing from "bronchoconstriction" as opposed to emphysema, where this is only one of several factors causing breathing difficulty. However, shortness of breath and wheezing are two of the main symptoms that occur when the bronchial tubes constrict. Thus, short acting inhalers, such as Albuterol, are used effectively for these situations.

Read about Temple patient experiences at 6 ABC News and learn more on the AIRFLOW-3 Clinical Trial website.

Nine Gifts to Improve Comfort During Quarantine

Touch is essential, and a lack of it can have a negative impact on someone’s quality of life. It can also lead to or exacerbate mental health issues, especially for people suffering from chronic obstructive pulmonary disease (COPD) who need to continue quarantining until the COVID-19 pandemic comes to an end.

If you or someone you know is feeling lonely or isolated, here are nine gifts that can help cope with a lack of touch and human interaction.

1. Therapy balls — These are great alternatives for anyone longing for a massage. Placing these balls under different areas of the body can release tension and activate pressure points. Massage pillows are also available for people looking to restrict movement.
2. Weighted blanket — These blankets mimic deep pressure touch, which is a firm, hands-on touch that can help reduce stress and anxiety.
3. Bath and shower bombs — A warm bath or shower can be soothing for anyone suffering from touch-deprivation. Fizzy bath and shower bombs can take these activities to the next level by changing the color of the water and filling the shower or tub with pleasant scents.
4. A personal foot bath — Not only does this re-create the feeling of a foot massage, but by throwing in essential oils and wearing a clay mask, you can create your own little in-home spa day.
5. Stuffed animal/body pillow — Kids aren’t the only ones who can find solace in a stuffed animal. Limited research shows that touching an inanimate object, such as a teddy bear, can soothe anxiety and fear in adults. A large stuffed animal can also double as a comfortable — and comforting — body pillow.
6. Skin-care products — Self-touch while caring for your skin with oils, lotions or exfoliants can be very soothing. It can also help slow things down as you pay attention to the sensations you’re feeling.
7. A warm hug from your dryer — Warming up a bathrobe or neck wrap in a microwave or dryer and wrapping it around your body can be extremely soothing and cozy. Some wraps even offer aromatherapy and deep pressure touch when heated.
8. Cat robot — A great alternative for people who can’t take care of or who may be allergic to cats, these robots are incredibly lifelike — they heat up, imitate the rise and fall of a cat breathing, respond to touch and more.
9. Somatic therapy — This is a form of psychotherapy that utilizes self-touch to help explore any emotional issues you may be grappling with.

Read the whole story for more on coping with isolation and loneliness.

How Fruit Juice Leads to Healthy Lungs

Living a healthy lifestyle that includes regular exercise and abstinence from smoking is a great way to keep your lungs healthy. It is also important to have good dietary habits, and that includes eating or drinking fruits that contain antioxidants and vitamins.

Studies show people who consume large amounts of apples and tomatoes are less likely to have lung problems. According to Science Daily, this could be because of all the antioxidants in the peel of an apple and the color of a tomato. Consequently, keep the skin on whenever you are juicing them, or in the case of apples, blending them into a smoothie.

Fruit juices made from dark berries — raspberries, blackberries or blueberries — may help in preventing lung cancer because they contain antioxidants that protect cells from free radical damage. Berries also contain anthocyanins, which also lowers the risk of lung cancer.

Eating 1½ pieces of fruit and a large tablespoon of vegetables per day can reduce the risk of chronic obstructive pulmonary disease by protecting against emphysema or chronic bronchitis — two conditions that can cause COPD — according to Science Daily. And adding foods rich in omega-3 fatty acids such as nuts or flaxseeds can lower the risk of lung inflammation and ultimately, lung disease.

Read the full story for more information on the health benefits of fruit juices and vegetables.

Walking Is A Great Exercise for Hyperexpanded Lungs

Hyperexpanded lungs, which occur when air sacs break down and become enlarged, are commonly associated with diseases such as emphysema and chronic obstructive pulmonary disease (COPD) and can make breathing difficult. The good news is that doing some sort of cardiovascular exercise a few times a week can reduce the effects of hyperexpanded lungs.

Walking is a healthy, low-impact way to improve lung function. However, those suffering with hyperexpanded lungs should take things slowly at first and set modest goals. For example, start by walking for five minutes, or try making it to the end of the block and back.

The Cleveland Clinic recommends people count their steps when inhaling, and then exhale for twice as many steps. So, if you are inhaling for steps one, two or three, exhale for the next six steps. It’s a good idea to practice this formula whenever you are a walking, so it becomes a habit.

Once you begin walking regularly, increase the distance each time. But be smart — if breathing becomes difficult, stop and rest.

Read the whole story to learn about other cardiovascular and breathing exercises.

Don’t Forget Your Flu Shot

Flu season is upon us, and while it is advisable for everyone to receive a flu vaccination, doing so is extremely important for those living with chronic obstructive pulmonary disease (COPD).

COPD causes inflammation in the lungs and can flare up from the presence of a flu infection. But while getting a flu shot lowers the odds of hospitalization by 38%, just 66% of patients who participated in a study conducted by Dr. Sunita Mulpuru, an associate scientist at Ottawa Hospital in Canada, were vaccinated. Antiviral medications that lessen the severity of the flu, such as Tamiflu and Relenza, were used just 69% of time in hospitals and weren’t given until patients were headed into the intensive care unit. That’s too late, Mulpuru said.

Part of the reason so few COPD sufferers get vaccinated is because they never have been diagnosed with the flu, so they don’t think they’ll ever get it. In other instances, people believe the flu isn’t any worse than a bad cold and will go away after a couple of weeks, when in fact it can be fatal.

The whole story can be found here.

Managing Allergies and COPD

Allergies are no fun for anyone — but they can be especially bad for those suffering from chronic obstructive pulmonary disease (COPD). With COPD, any condition that makes breathing more difficult should be taken very seriously. According to a 2012 study conducted by the Johns Hopkins Allergy and Asthma Center, people with both COPD and seasonal allergies experienced more severe bouts of coughing and wheezing. They were also more likely to require medical attention to treat such symptoms.

However, there are several helpful resources to help COPD suffers manage their seasonal allergies. Services such as AccuWeather and The Weather Channel provide current pollen and mold levels in local areas, and AirNow offers information on air cleanliness and quality. The latter is particularly important to track because air pollution can wreak havoc on a respiratory system, so it is important for COPD and allergy sufferers to stay inside if the Air Quality Index goes above 100.

Installing a cabin air filter in your car can help keep allergens away when you’re traveling, and a good filtration system in the air conditioner can do the same for you when you’re at home.

Of course, there are always over-the-counter medications that can help relieve uncomfortable symptoms like congestion, itchy eyes or a runny nose — though patients should always speak with their doctor before taking anything. In some cases, doctors can prescribe allergy medications or suggest the use of an inhaler.

Read the full story to learn more about managing seasonal allergies when suffering from COPD.

COVID-19 and COPD: Some Surprising News

Despite its massive global impact, COVID-19 is still a relatively new virus that we know little about. We know it’s an upper-respiratory illness that spreads very easily—especially when people have no idea they have it. Some who are infected experience very minor symptoms while others become so severely ill they require hospitalization. For others, it is fatal.

One area of COVID-19 that has been surprising is its effect on those with underlying conditions such as chronic obstructive pulmonary disease (COPD) or asthma. According to said Dr. Tim Connolly, a pulmonologist at Houston Methodist, while COPD sufferers are still at risk because they have less respiratory reserve than those with healthier lungs, the impact of COVID-19 has been much higher on those with conditions such as obesity, diabetes or vascular disease.

“We still don't fully understand why people with preexisting lung conditions don't make up a larger majority of current COVID-19 cases as initially anticipated,” Connolly said. “Preliminary data suggest that people with asthma may make less of the receptor that the virus uses to invade the body, called ACE2, making it more difficult for the virus to gain entry into the host. In addition, ongoing maintenance therapy with inhaled steroids, such as budesonide, may also confer an advantage for people with chronic lung conditions.”

Read the complete story here.