Friday’s Newsletter from COPD Support, Inc.

Volume 8,
Issue 45
edited by Joan Costello

HOW TO SAVE MONEY ON YOUR ALBUTEROL HFA INHALER
By Kathleen MacNaughton, R.N., About.com: The new HFA inhaler prescriptions are more expensive than their old CFC counterparts. This is especially true of the albuterol inhalers used as rescue medicine when asthma attacks begin. Unlike many of the current controller medicines, albuterol is a medicine that’s been available for many years, so there have been many inexpensive generic equivalents available until recently. The legislation banning CFC-type inhalers changed all that. Drug companies have had to develop new medicines with different kinds of propellants called HFAs and those are more expensive. In addition, there will not be generic equivalents on the market for several years until the patents on the new inhalers run out.

There is financial aid available to help people pay for their albuterol asthma inhalers. Following are some of the programs available for specific albuterol HFA inhalers.

ProAir HFA
http://www.proairhfa.com/PatientAssistance.aspx
Once you are approved for the program, you will be eligible to receive assistance for up to 6 months. Renewals will be handled on a per-patient basis. If you have any questions, you can call the Teva Assistance Program toll-free number: 1-877-254-1039.

Proventil
http://www.proventilhfa.com
Features: Offers savings cards for one free Proventil HFA inhaler and up to $15 off next two Proventil prescriptions. Call 1-800-656-9485 to see if you qualify for assistance

Xopenex HFA (Sepracor)
http://www.xopenex.com/patientAssistance/patient-assistance.html

Sepracor’s Patient Assistance Program is managed by RxHope and is designed to provide prescribed Sepracor medications at no cost to those eligible patients who lack prescription drug coverage and are unable to afford them. If you qualify for Sepracor’s Patient Assistance Program, you will receive a Patient Assistance Card that you can present with your Sepracor prescription to your local pharmacy. A pharmacist will dispense your medication at no cost.

Ventolin HFA
http://www.ashp.org
Physician or other health care professional acting as a patient advocate can obtain the application form at www.bridgestoaccess.com After application form is completed, physician or patient advocate must call the company to receive enrollment information or wait for approval. Immediate 60-day supply coupon given to patient after approval process is complete Coupon entitles patient to receive medication for $5-co-pay per fill

Here are some general programs that can also help, if you qualify:

Partnership for Prescription Assistance: https://www.pparx.org/Intro.php
RxAssist.org: http://www.rxassist.org/
RxHope.com: https://www.rxhope.com/home.aspx
TogetherRx: http://www.togetherrxaccess.com/Tx/jsp/home.jsp

See About.com’s web page for each brand’s complete requirements.
http://asthma.about.com/od/medicationfaqs/qt/saveonhfa.htm?nl=1

ALSO IN THIS ISSUE
-CLEVELAND CLINIC LIVE CHAT, LATEST ADVANCES IN LUNG DISEASE
-NEW NATIONAL GUIDELINES ON EMERGENCY OXYGEN USE, UK
-KEY COMPONENT OF COPD IDENTIFIED
-UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER GENETIC RESEARCH STUDY
-LETHAL MUTATIONS
-WHO CAUTIONS AGAINST CLAIMS MADE BY “ELECTRONIC CIGARETTE” MANUFACTURERS
-HUD SPONSORS HOUSING COUNSELING AGENCIES
-ENERGY DRINKS HAVE UNPREDICTABLE DOSES OF CAFFEINE
-MISCELLANEOUS

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SOURCES: News items summarized in The COPD-NEWS are taken from secondary sources believed to be reliable. However, the COPD Family of Services does not verify their accuracy.
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CLEVELAND CLINIC LIVE CHAT, LATEST ADVANCES IN LUNG DISEASE
October 16, 2008 at 12 noon (EST)
From Westley Stump: COPD Support Newsletter subscribers may be interested to know Cleveland Clinic will host an online health chat on Lung Surgery, Advances and Options. The chat will be held Thursday, October 16, 2008 at 12 noon (EST) and will be led by Dr. David Mason, a staff surgeon in the Cleveland Clinic Department of Thoracic and Cardiovascular Surgery. During this chat, Dr. David Mason will take questions on the latest advances in the treatment of lung disease. Some of the latest advances include improvement in diagnostic techniques, medical management and new surgical techniques, including minimally invasive surgery. Dr. Mason holds joint appointments as a staff surgeon in the Clinic’s Transplantation Center in the Division of Surgery and in the Cleveland Clinic Cancer Center. He specializes in general thoracic surgery, minimally invasive thoracoscopic and laparoscopic surgery, lung cancer, esophageal cancer, malignant mesothelioma and lung transplantation. Dr. Mason is board certified in general and thoracic surgery.

Lung disease can take the form of cancer, chronic breathing conditions and even lung failure. Determining the appropriate treatment options for the vast variety of lung diseases can be overwhelming to patients. Dr. Mason will join us on October 16th to take your questions on the latest advances have been made in the treatment of lung disease. These include improvement in diagnostic techniques, medical management and new surgical techniques, including minimally invasive surgery.

This Health Chat will open on October 15, 2008 to allow you to submit questions. We will try to answer as many questions as possible during the chat. Please create an account to attend the chat and submit your questions. Scroll down at:
http://www.clevelandclinic.org/health/ChatReg/mason.html

NEW NATIONAL GUIDELINES ON EMERGENCY OXYGEN USE, UK
The first national guideline for the emergency use of oxygen in adults has been published, with the aim of simplifying oxygen delivery and better protecting acutely ill patients. The guideline is published in the October 2008 issue of Thorax, the journal of the British Thoracic Society.

Until now, most healthcare professionals have followed their own institution’s customary practice when administering oxygen therapy…Oxygen is one of the most widely used drugs, and is used across the whole range of healthcare specialties. Oxygen is an extremely important drug because hypoxaemia can cause death during many medical emergencies and it is essential to protect patients from this risk by the rapid recognition of acute illness and hypoxaemia followed by the immediate provision of oxygen to hypoxaemic and critically ill patients.

The guideline recommends that oxygen is administered to patients whose oxygen saturation falls below the target saturation ranges (94-98% for most acutely ill patients and 88-92% for those at risk of type 2 respiratory failure with raised carbon dioxide level in the blood), and that those who administer oxygen therapy should monitor the patient and keep within those specified target saturation ranges.

Despite a widespread belief amongst medical staff, and patients, that oxygen relieves breathlessness, there is no evidence that oxygen has an effect on breathlessness if the blood oxygen level is normal. The guideline group advised that too much oxygen can prove harmful in patients with chronic lung diseases such as COPD and ‘blind’ oxygen therapy outside of critical illness might actually delay recognition of a patient’s deterioration by providing a false sense of reassurance based on high oximetry measurements.

The biggest changes that people will notice are as follows:
- Oxygen therapy will be adjusted to achieve target saturations rather than giving a fixed dose to all patients with the same disease.
- Nurses will make these adjustments without requiring a change to the prescription on each occasion.
- Most oxygen therapy will be from nasal cannulae rather than masks.
- Oxygen will not be given to patients who are not hypoxaemic (except during critical illness)
- Pulse oximetry must be available at all locations where emergency oxygen therapy is used.
- Oxygen will require a prescription in all situations except for the immediate management of critical illness.

More information and an abbreviated copy of the British Thoracic Society’s Guideline for Emergency Oxygen Use in Adult Patients for download are available on
http://www.brit-thoracic.org.uk.

The British Thoracic Society is the United Kingdom’s professional body of respiratory specialists
http://www.medicalnewstoday.com/articles/123424.php

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MEDICAL DECISIONS. Your physician should be consulted on all medical decisions. New procedures or drugs should not be started or stopped without such consultation. While we believe that our accumulated experience has value, and a unique perspective, you must accept it for what it is…the work of COPD patients. We vigorously encourage individuals with COPD to take an active part in the management of their disease. They do this through education and by sharing information and thoughts with their primary physician and pulmonologist. However, medical decisions are based on complex medical principles and should be left to the medical practitioner who has been trained to diagnose and advise.
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KEY COMPONENT OF COPD IDENTIFIED
Researchers have demonstrated a close correlation between the decline in a key component of the lung’s antioxidant defense system and the progression of COPD in humans. COPD is a degenerative condition that decreases the flow of air through the lungs as the lung’s air sacs are damaged. A study of lung tissue samples from COPD patients by scientists at the Johns Hopkins Bloomberg School of Public Health found that expression of the regulating gene NRF2 was significantly decreased in smokers with advanced COPD compared to smokers without COPD. The study is published in the September 15, 2008, edition of the American Journal of Respiratory and Critical Care Medicine.

“This work clearly demonstrates that decline in our antioxidant system is involved in progression of COPD, which could also be the case for other environmental diseases. There is no treatment of COPD, but NRF2 could be a novel target for the development of new drug therapies. As we learn how the protective actions of NRF2 are decreased in the course of a lifetime of exposure to cigarette smoke, it opens new venues for the development of novel drugs fitted for individual patients in specific stages of the disease.”
http://www.news-medical.net/?id=41425

UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER GENETIC RESEARCH STUDY
The UT Health Science Center San Antonio and the South Texas Veterans Health Care System seek to enroll 1,000 current and former smokers in a genetic epidemiology study of COPD. The institutions are part of the $35 million COPDGene™ research study funded by the National Heart, Lung, & Blood Institute. The study, which will enroll 10,500 Caucasians and African Americans at 12 sites nationwide, is designed to identify genetic abnormalities that predispose a person to COPD. The research will not focus on Hispanics, whose genes appear to protect them from the chronic disease.

Study participants will be between 45 and 80 years of age. “Anyone who has ever smoked would qualify; they don’t have to have lung disease,” said pulmonologist Antonio Anzueto, M.D., principal investigator of the San Antonio site and professor of medicine at the Health Science Center. “The rationale for this study is the fact that maybe something other than smoking can give you COPD.”

He said some people smoke very few packs yet develop very serious COPD, while others smoke a lot and develop very mild COPD. He also noted that the disease “appears to behave differently in African Americans,” who have a higher incidence of COPD that cannot be explained by health care disparities.
…individuals who suffer from a respiratory disorder other than COPD or have a close relative already in the study are not eligible.

The study will enroll 6,000 people with COPD and 4,500 current and former smokers who do not have it. Participants will make two visits to the study center; out-of-town participants may have both visits scheduled for the same day.

“We will send a copy of the breathing test and CT to the patient’s doctor, and if any abnormality is there, we will flag the doctor to do follow-up,” Dr. Anzueto said. “This is a very high-risk population, so it is a great way to screen for lung cancer or any abnormality in the lungs.”
Contact: Will Sansom, (210) 567-2579 or cell (210) 275-2160. Full article at: http://www.uthscsa.edu/hscnews/singleformat.asp?newID=2882

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COMMERCIAL FREE: We do not accept any paid advertising. Any corporations, products, medicines (prescription or non) mentioned in this newsletter are for informational purposes only and not to be construed as an endorsement or condemnation of same.
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LETHAL MUTATIONS
You’re hurting, frustrated irritated because you’ve seen numerous specialists regardless of how many tests are run, no one can give you a clear understanding of what is wrong with you. That’s the problem a woman named Mary Brown, a school teacher from Santa Barbara, California experienced for nearly two decades. “I believe my first symptom - a collapsed lung - showed up 19 years ago…In 1989 I experienced a severe cough and sinus infection. I thought my cough had caused pulled or sore muscles in my chest. I also thought it odd that a clicking sound came from my chest when I lay down. When I stood up I felt air bubbles running up my back. I now realize that this was a pneumothorax. “That pneumothorax apparently resolved by itself, and five years went by symptom-free.”

But the problems started coming back for Mary, more often and more severe… Mary was diagnosed a pneumothorax two more times before a pathologist at the National Jewish Hospital in Denver found out Mary had a rare lung disease called Lymphangioleiomyomatosis (lim-fan-gee-o-lyo-myo-ma-toe-sis) or LAM.
LAM is a progressive lung disease characterized by an unusual type of smooth muscle cell that grows uncontrollably and invades the tissues of the lungs, including the airways, and blood and lymph vessels. While there is currently no cure or effective treatment for lymphangioleiomyomatosis (LAM), the LAM Foundation scientists report some major breakthroughs in clinical trials that include identification of the genetic basis of the disease.
http://respiratory-care.advanceweb.com/Article/Lethal-Mutations.aspx

WHO CAUTIONS AGAINST CLAIMS MADE BY “ELECTRONIC CIGARETTE” MANUFACTURERS
The World Health Organization (WHO) has launched an attack on advertisers who are claiming that an electronic cigarette - a battery-powered product usually made of stainless steel and resembling a real cigarette - is a safe or legitimate nicotine replacement therapy for smokers trying to quit. The WHO says marketing which claims the product helps smokers break their addictions to tobacco, implying that WHO regards it as a legitimate nicotine replacement therapy like nicotine gum, lozenges and patches, is simply not the case.

Dr. Ala Alwan says the electronic cigarette is not a proven nicotine replacement therapy and there is no scientific evidence to confirm the product’s safety and efficacy. The WHO is calling for advertisers to immediately remove from their web sites and other informational materials any suggestion that WHO considers it to be a safe and effective smoking cessation aid. The electronic cigarette aims to convince smokers they are puffing on a real cigarette which needs no lighting and produces no smoke. The device instead has a chamber for storing liquid nicotine in various concentrations, which produces a fine, heated mist, which is absorbed into the lungs.

The electronic cigarette is sold in China, where it was developed in 2004, and in a number of other countries, including Brazil, Canada, Finland, Israel, Lebanon, the Netherlands, Sweden, Turkey and the United Kingdom.
http://www.news-medical.net/?id=41597

HUD SPONSORS HOUSING COUNSELING AGENCIES
Caught in a mortgage crunch in the current scene? HUD sponsors housing counseling agencies throughout the country that can provide advice on buying a home, renting, defaults, foreclosures, credit issues, and reverse mortgages. This page allows you to select a list of agencies for each state. Select a state from the list and click the “Go to this page” link, or select a state from the map.
http://www.hud.gov/offices/hsg/sfh/hcc/hcs.cfm

ENERGY DRINKS HAVE UNPREDICTABLE DOSES OF CAFFEINE
By Kristina Fiore. Energy drinks have unpredictable doses of caffeine that vary by six-fold, with no hint on their labels what kind of buzz is in store for consumers. The drinks carry between 79 mg and 500 mg of caffeine, Chad J. Reissig, Ph.D., of Johns Hopkins, and colleagues reported in a review in the September issue of Drug and Alcohol Dependence. The caffeine in a single energy drink can exceed that of two six-packs of Coke.

Although manufacturers of soft drinks, such as Coke and Pepsi, don’t disclose the caffeine dose on their labels, they are limited by the FDA to 71 mg of caffeine per 12 ounces of beverage, and the caffeine dose is less than half that much, said Dr. Reissig. By comparison, a six-ounce cup of regular coffee has 80 mg to 150 mg, according to the study.

Caffeine intoxication includes symptoms such as nervousness, anxiety, restlessness, insomnia, GI upset, tremors, tachycardia, and psychomotor agitation.
http://www.medpagetoday.com/PrimaryCare/DietNutrition/tb/11034

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The Newsletter, like all the other endeavors of the Family of COPD Support Programs, is provided to you by COPD-Support, Inc. a non-profit member organization with IRS designation 501(c)(3). If you would like to be involved and help us provide these programs to the individuals who benefit from them, please consider joining us as a member. Further information is available at:
http://copd-support.com/membership.html
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MISCELLANEOUS
Sudoku Portable is an addictive Sudoku puzzle game packaged as a portable app, so you can play on the go. You can place it on your USB flash drive, iPod, portable hard drive or a CD and use it on any computer, without leaving any personal information behind.
http://portableapps.com/apps/games/sudoku_portable

Another fly swatter game.
http://majman.net/fly_loader.html

Grandma’s Autumn Apple Cake
http://www.mamarocks.com/fall_cooking.htm

Until next Friday,

Joan Costello, Editor
Jadece@rcn.com

Web version of the News: http://copd-support.com/news.html

Archives at: http://home.ease.lsoft.com/archives/copd-news.html