Support Groups May Improve Disease Outcomes

Participation in social support groups may improve disease outcomes in elderly patients. That is according to a recent study published in The Journal of Aging and Health, “The Relation of Social Isolation, Loneliness, and Social Support to Disease Outcomes Among the Elderly.”

The study, which surveyed more than 750 New Mexico seniors, asked questions related to demographics, social isolation and loneliness, social support, and disease diagnosis including diabetes, hypertension, heart disease, liver disease, arthritis, emphysema, tuberculosis, kidney disease, cancer, asthma, and stroke. Correlational and logistical analyses were then applied to survey responses.

What researchers found was that belongingness support, often found in disease-related support groups, related most consistently to health outcomes, thus demonstrating the importance of social support in predicting disease outcomes.

For people living with emphysema or chronic obstructive pulmonary disease (COPD), support groups are often recommended as a part of a comprehensive treatment plan. That is because these groups bring together people in similar circumstances and offer individuals with emotional comfort, moral support and practical advice from others facing the same disease or illness.

According to The Mayo Clinic, support groups can also reduce feelings of loneliness, isolation, depression and anxiety, improve coping skills and insight feelings of empowerment and control over one’s disease.

For more information on support groups, including locating a group near you, contact your doctor or healthcare provider. Online support groups are also available via chat rooms, blogs and social networking sites.

Click Here to Access the Full Study from The Journal of Aging and Health.

Pneumonia

Pneumonia - Now that I have become a victim of this condition - here it goes:  Pneumonia is an inflammation of the lungs, usually caused by infection.  There are 84 known strains of pneumonia with 24 strains included in the pneumonia injection.  Pneumonia is of particular concern if you are older than 65 years, have a chronic illness, COPD, or impaired immune system.  However, it can occur in young, healthy individuals.  Pneumonia can range from mild to life-threatening.  Years ago people who contracted pneumonia usually died.

CAUSES:

Your body has ways to protect your lungs from infections.  You are frequently exposed to bacteria and viruses that can cause pneumonia, but your body uses a number of defenses such as cough and the normal microorganisms in your body.  More than 100 different microorganisms can cause pneumonia, so if your resistance is lowered it will allow the harmful organisms to get past your body’s defenses and into your lungs.  Once the invading organisms are in your lungs, white blood cells - a key part of your immune system - begin to attack them.  The accumulating invaders, white blood cells and immune system proteins cause the tiny air sacs in your lungs to become inflamed and filled with fluid, leading to the difficult breathing associated with pneumonia.

SYMPTOMS:

Pneumonia symptoms vary greatly and can be complicated with the flu.  Common signs and symptoms may include:

·        Fever - not always

·        Cough - usually dry

·        Shortness of breath

·        Sweating - if there is fever

·        Shaking chills

·        Chest discomfort

·        Headache

·        Muscle pain/weakness

·        Fatigue - extreme

Ironically, people in the high-risk groups such as older adults and people with chronic illnesses or weakened immune systems may have fewer or milder symptoms than less vulnerable people do.  Instead of a high temp, older adults may have lower than normal temps.

CLASSIFICATIONS: 

Community-acquired pneumonia

.  This refers to pneumonia you require in the course of your daily life.  The most common is bacterium streptococcus pneumonia.  Mycoplasma pneumonia produces milder signs and symptoms than other types of pneumonia.  Walking pneumonia is a term used to describe a pneumonia that isn’t severe enough to require bed rest and may result from mycoplasma pneumonia.

Hospital-acquired (nosocomial) pneumonia.

  If you are hospitalized, you are at a higher risk for pneumonia especially if you are breathing with the help of a mechanical ventilator, in an intensive care unit, or have a weakened immune system.  This type of pneumonia can be extremely serious for older adults, young children, COPDers and HIV/AIDS persons.  It usually develops 48 hours after being admitted to the hospital and includes post-op pneumonia.  A common predisposing factor for this type of pneumonia is GERD (gastro esophageal reflux disease.)

Aspiration pneumonia.

  This type of pneumonia occurs when you accidently inhale foreign matter into your lungs - most often phlegm, vomit, a pea or bean or any small food particle.  An inebriated person who passes out and then vomits is very likely to aspirate into the lungs causing aspiration pneumonia.

Opportunistic organism pneumonia.

  This type of pneumonia strikes people with weakened immune systems, such as those with AIDS or anyone who has had an organ transplant.  Medications that suppress your immune system such as chemotherapy or corticosteroids (solumedrol, prednisone) can put you at risk for opportunistic pneumonia.

Other pathogens.

  Outbreaks of the flu virus and severe acute respiratory syndrome (SARS) have caused serious, sometimes deadly, pneumonia infections in otherwise healthy people.  TB in the lung can also cause pneumonia.

RISK FACTORS:

·        Age:  65or older, especially if you have other health conditions.

·        Certain Diseases:  HIV/AIDS, chronic illnesses such as cardiovascular, diabetes, COPD.  Or if you are impaired by chemotherapy or immunosuppressant drugs.

·        Smoking or alcohol abuse.

·        Hospitalizations in an intensive care unit.

·        Surgery or traumatic injury.  People who are immobilized and unable to cough - to clear lungs - and are lying flat allowing mucus to collect in the lungs, providing a breeding ground for bacteria.

COMPLICATIONS:

·        Bacteria in your bloodstream.

·        Fluid accumulation and infection around your lungs.

·        Lung abscess.

·        Acute respiratory distress syndrome (ARDS)

TESTS AND DISGNOSIS:

·        Physical exam

·        Chest x-ray

·        Blood and mucus tests

TREATMENTS AND DRUGS:

·        Bacterial.  Bacterial pneumonia is treated with antibiotics.

·        Viral.  Antibiotics aren’t effective against most viral forms of pneumonia.  Some may respond to antiviral meds but generally rest and plenty of fluids is the treatment.

·        Mycoplasma.  This form is treated with antibiotics but recovery is slow.  Fatigue may continue long after the infection has cleared.

·        Fungal.  Fungal pneumonia is treated with antifungal meds.

DEALING WITH YOUR SYMPTOMS:

Over the counter meds are recommended to reduce fever, treat your aches, pains, and sooth the cough.  You don’t want to suppress the cough because coughing helps clear your lungs.

HOSPITALIZATIONS:

Sever pneumonia patients are hospitalized and treated with IV antibiotics and possibly oxygen.

FOLLOW-UP TREATMENT

Your doctor will most likely schedule a follow-up chest x-ray and an office visit after six weeks or when your infection clears.

PREVENTION:

·        Get vaccinated.  Both flu and pneumonia vaccine.

·        Wash your hands.  Wash hands for one minute and/or use an alcohol-based hand sanitizer.

·        Don’t smoke.  Smoking damages your lungs natural defenses against respiratory infections.

·        Take care of yourself.  Proper rest and a diet rich in fruits, vegetables and whole grains along with moderate exercise can help keep your immune system strong.

·        Get treatment for GERD.  Treat symptomatic GERD, and lose weight if you are overweight.

·        Protect others from infection.  If you have pneumonia, try to stay away from other people or wear a mask and always cough into a tissue that is disposed into your own bag.

Believe me!  You don’t want to get pneumonia!

Reprinted with the permission from the Cape Cod COPD Support Group Newsletter

Irish Study Reveals New Therapy for Hereditary Emphysema

Researchers from Ireland may have uncovered a new therapy for people who suffer from hereditary emphysema. That is according to a recent article published in the January 2014 issue of the journal of Science Translational Medicine, “The Circulating Proteinase Inhibitor α-1 Antitrypsin Regulates Neutrophil Degranulation and Autoimmunity.”

The study examined the ability of a serum α-1 antitrypsin (AAT) – a protein produced by the liver which, when released into the bloodstream, travels to the lungs to protect lung tissue from disease – to control tumor necrosis factor–α (TNF-α) – a contributor to many of the problems associated with autoimmune diseases. In addition, they assessed whether AAT deficiency (AATD), a hereditary disorder that leads to the most severe form of hereditary emphysema, is a TNF-α–related disease.

What they found is that AAT plays an important role in controlling inflammation from white blood cells.

"Our study is the first to reveal the mechanisms by which a lack of the Alpha-1 protein causes an increase in the release of white blood cell proteins into the blood stream,” said Professor Gerry McElvaney of the Royal College of Surgeons in Ireland. “This leads to an autoimmune process in the body that mistakenly recognizes these proteins as foreign and activates its own white blood cells to produce harmful oxidants."

These findings suggest that Alpha-1 is not purely a lung and liver disorder, but much more systemic, and treatments for Alpha-1 may also be used for other autoimmune disorders.

"This research gives new hope for a better quality of life for sufferers of this chronic condition and may also be applied to other autoimmune associated diseases such as rheumatoid arthritis," said McElvaney said. “[In addition], the data would suggest we can decrease the progression of emphysema by using this therapy.”

Researchers are now working on a new treatment for Alpha-1 which involves taking purified Alpha-1 protein from the bloodstream of a person without a deficiency in AAT and giving it intravenously to people with a deficiency. The result is a decrease in the abnormal protein release, which alleviates the disease-associated autoimmunity.

Click Here to Access the Full Story from the journal of Science Translational Medicine.

The Impact of Obesity on Respiratory Function

For chronic obstructive pulmonary disease (COPD) or emphysema patients, maintaining a healthy body weight is an important aspect of disease management. That is because obesity can often lead to a worsening of symptoms, as well as a decrease in both exercise tolerance and quality of life. In addition, obesity been recognized for having a significant effect on respiratory function in both healthy and diseased lungs.

This relationship was further explored by Dr. Stephen Littleton, attending physician in the division of Pulmonary, Critical Care, and Sleep Medicine at Cook County Hospital in Chicago and assistant professor of medicine at Rush University Medical Center, in the January 2012 issue of Respirology. The study, “Impact of obesity on respiratory function,” examined the respiratory function of both obese and average patients, making special note of breathing patterns, respiratory mechanisms, and lung volumes.

What Dr. Littleton found was that “obese patients tend to have higher respiratory rates and lower tidal volumes (the volume of gas inhaled and exhaled during one respiratory cycle),” wherein the respiratory rate increases to compensate for depressed tidal volumes. However, lung volume – particularly expiratory reserve volume (ERV), or the maximum volume of air that can be expelled from the lungs after normal expiration – is the most consistently affected respiratory function in these patients.

In addition, increased BMI has also been found to result in the reduction of pulmonary function in the following tests:

• ·         Forced expiratory volume in one second (FEV1)
• ·         Forced vital capacity (FVC)
• ·         Total lung capacity
• ·         Functional residual capacity
• ·         Expiratory reserve volume

Yet, weight loss can be an effective means to improving these symptoms.

“Perhaps one of the best ways of studying the effects of obesity on pulmonary function is to study the same group of patients before and after weight loss, [with]each patient acting as their own control,” said Dr. Littleton. “It seems that most of the changes associated with obesity are reversed after significant weight loss, and are therefore likely to be caused by obesity itself.”

Click Here to Access the full Study from Respirology.

Get Your Flu Shot!

Get Your Flu Shot!

It’s that time again. Where ever you get your flu vaccine – GO!  Flu seasons are unpredictable and the timing, severity, and length of the season varies from year to year.  It can begin in October and last through May, peaking in January and February.  Getting the flu vaccine will sustain you through the season.

            Most of the flu vaccine offered this season will be trivalent, meaning it will be made up of three viruses – the H1N1, the H3N2, and the B/Massachusetts/2/20012.  There is also a quadrivalent vaccine containing the above viruses plus B/Brisbane/60/2008 virus – a higher dose vaccine that is available for adults 65 and older.  The reason for the higher dose of vaccine is humane immune defenses become weaker with age, which places older people at greater risk of severe illness from the flu.  Also, aging decreases the body’s ability to have a good immune response after getting the flu vaccine.  The important thing is to get the flu vaccine.  Clinics, some doctor’s offices, health departments and pharmacies are available to get the vaccine.

            NEWS FLASH!!!  According to the June/July AARP Magazine, a potential perk of the flu shot is heart disease and stroke protection.  As reported: a new review of research finds that getting a flu shot could cut your risk of having a heart attack or stroke by 48 percent.  Study coauthor Jacob A. Udell, MD, of Women’s College Hospital in Toronto speculates that vaccinated “may block the inflammatory response our bodies mount to combat a flu infection, which protects arterial plaques from rupturing and causing a cardiac event.”  Another great reason to have a flu shot!

Reprinted with permission from the Cape Cod COPD Support Group Newsletter

Overcoming Anxiety and Depression

According to a review of current literature, “Anxiety and Depression in Patients with Chronic Obstructive Pulmonary Disease (COPD) — A Review,” roughly 50 percent of people living with COPD exhibit symptoms of anxiety and depression.

Symptoms of anxiety and depression include fatigue, loss of interest, persistent sad, anxious or “empty” mood, and various physical symptoms that do not respond to treatment and are often characterized by a person’s inability to work, sleep, study, eat, or enjoy once-pleasurable activities. However, for people living with COPD and other chronic lung conditions, such as emphysema and chronic bronchitis, these symptoms can have more serious effects.

“The social isolation that comes with anxiety and depression combined with the immobility that many patients experience often results in a loss of muscle bulk,” said Daniel Dilling, M.D., associate professor of medicine at Loyola University Chicago Stritch School of Medicine, medical director of the lung transplant program at Loyola School of Medicine, medical director of the medical intensive care unit, and medical director of respiratory care at RML Specialty Hospital in Hinsdale, Ill. “This leads people to be more deconditioned and more short of breath and, as a result, more isolated and more depressed.”

According to Dr. Dilling, this cycle is very common for people who have been diagnosed with chronic lung conditions and only becomes worse as the disease becomes more severe.

“All of these things feed on one another in very negative ways,” said Dr. Dilling. “If you become more depressed, you isolate yourself more and you become even more deconditioned and this makes you weaker and short of breath. It cycles the disease in a very negative way.”

However, treatment is available and has been proven to improve both the physical and psychological state of patients. These treatments include cognitive behavioral therapy, pharmacological treatments, relaxation therapy and pulmonary rehabilitation. 

“I think the most important, most beneficial and most underutilized treatment for COPD and emphysema—and specifically the depression and anxiety that goes along with it—is pulmonary rehabilitation,” said Dr. Dilling. “Pulmonary rehab has been shown in multiple studies to improve the depression and anxiety associated with emphysema, and I think it does more for those symptoms than any kind of medication we might try.”

A broad program that helps to improve the lifestyle and wellbeing of people living with chronic lung conditions, pulmonary rehabilitation can be used in conjunction with medical therapy and includes exercise training, nutritional counseling, education, and psychological counseling and/or group support.

“Pulmonary rehabilitation provides patients with a supervised exercise program that can be completed at an out-patient facility two to three days a week for up to three hours per day,” said Dr. Dilling. “During this time, they are monitored by a respiratory therapist, a physical therapist and an occupational therapist. This will often also include some group therapy, whether that be for learning mastery of the disease or for talking about some of the emotional and psychological aspects of the disease.” 

Dr. Dilling notes that medication directed at anxiety and depression may also be helpful and should be considered, with counsel from a physician, in addition to pulmonary rehabilitation.

“These kinds of medications can be useful. However, I try to use them sparingly,” said Dr. Dilling. “I think it’s the most common reaction to want to give someone a pill for a symptom or a disease, but I think especially in this case there might be other options to pursue first that might be more helpful and won’t include taking a medication.”

For more information on pulmonary rehabilitation and to find a program near you, visit the American Association or Cardiovascular and Pulmonary Rehabilitation website (www.aacvpr.org). Pulmonary rehabilitation benefits are available through most major insurance companies. 

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.