Friday’s Newsletter from COPD Support, Inc.

Volume 9, Issue 9
January 30, 2009
Joan Costello, Editor

POWER OUTAGE CAN BE FATAL FOR THOSE ON HOME MEDICAL EQUIPMENT
By Lauran Neergaard, AP - For many of the growing millions who depend on home medical equipment, a power outage goes way beyond inconvenience…It could be deadly. It’s an issue that snuck up on emergency officials as better medical treatments over the past decade have helped more critically ill people not only survive but move out of nursing homes. The Associated Press found emergency planners around the country struggling to find new ways to identify people at risk before the lights go out, to ensure they will have the aid they need to survive small outages or big ones.

Utilities in every state operate “medical priority lists” designed to track who depends on power for life. But an AP survey found huge state-to-state variations that suggest only a fraction of patients know they could sign up. Illinois’ biggest utilities together report 10,000 patients on critical-care lists, for example. Neighboring Indiana’s biggest list carries just 2,000 names. Even if patients did sign up, in large outages companies don’t have the ability to restore power to one home before another down the street. The lists may offer false hope.

Roughly 2 million people use home oxygen machines, mostly “concentrators” that make oxygen on the spot as long as electricity flows. Just a few years ago, oxygen-gas tanks that don’t require home electricity were the norm. At least another 10,000 people breathe with home ventilators, and thousands more have implanted heart pumps called VADs, or ventricular assist devices.There even are a few remaining users of those body-encasing iron lungs infamous from the polio era. Millions more use other at-home equipment: dialysis machines, nebulizers, IV and nutrition pumps, CPAP breathing masks. But power failures bring the most immediate risk for users of ventilators, heart pumps and oxygen. Ventilators and heart pumps have internal batteries that last 45 minutes to a few hours, time to put on longer-lasting batteries or get to help. Some portable oxygen concentrators can run on batteries for three hours or four hours or be plugged into a car adapter, but patients typically depend on oxygen suppliers to deliver old-fashioned tanks of the gas for emergency use.

When it comes to oxygen, many home health-care companies “bend over backward” to race tanks to customers during power outages…after Hurricane Katrina, the American Association for Home Care asked the government to designate oxygen providers as “first responders” for easier movement in disaster zones. But if roads are impassable or the disaster’s too big, home oxygen may not be delivered. Yet there are no overarching recommendations on how many back-up tanks patients should keep on hand. Nor is there agreement about home generators, which have their own risk — deadly carbon monoxide poisoning if operated wrong — and can’t always adequately power energy-hogging medical equipment. But the AP survey found utilities frequently advise generators, such as Wisconsin utility We Energies, which also doesn’t keep a list of power-dependent customers. “There’s a danger to keep the list and give a false hope you might be able to turn that power on sooner,” said company spokesman Brian Manthey. “We feel more comfortable telling people you need to have a back-up plan,” including generators or batteries..
http://www.madison.com/wsj/home/local/432273

ALSO IN THIS ISSUE
-WHAT IS A COPD EXACERBATION?
-AVOID AIRWAY IRRITANTS
-NEW COPD CHANNEL ON MEDICAL NEWS TODAY
-FREE-EXPERT’S GUIDE TO BETTER BREATHING
-COLD AND FLU VIRUSES TRAVEL A TRICKY ROUTE
-IF SMOKING IS SO BAD FOR YOU, WHO STILL DOES IT?
-EXPIRATION DATES:
-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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WHAT IS A COPD EXACERBATION?
By Deborah Trendel, RN, About.com: COPD Exacerbation: Defined: In its simplest terms, an exacerbation is a worsening of symptoms. In more in-depth terms, a COPD exacerbation can be defined as “an event in the natural course of the disease characterized by a change in the patient’s baseline dyspnea, cough, and/or sputum, that is beyond normal day-to-day variations, is acute in onset and may warrant a change in medication in a patient with underlying COPD.”

Causes of COPD Exacerbation: The top two causes of an exacerbation are infection of the airways or lungs and air pollution. In one-third of all COPD exacerbation cases, however, the cause cannot be identified.

Signs and Symptoms of a COPD Exacerbation: The main symptom of an acute exacerbation of COPD is increased breathlessness which is often accompanied by the following:

-Increased cough and sputum production
-Change in the color and/or thickness of the sputum
-Wheezing
-Chest tightness
-Fever
http://copd.about.com/od/copd/a/copdexac.htm?nl=1

AVOID AIRWAY IRRITANTS
Exposure to irritants is known to be the main cause of many lung diseases including COPD, emphysema, chronic bronchitis, and asthma. The cause of most COPD is chronic exposure to cigarette smoke. Unfortunately you cannot turn back the clock and remove years of breathing irritants, but you can protect yourself from irritants now to improve your breathing.

Indoor Pollution – There are a number of indoor irritants that can make your breathing worse. One of the worst for your breathing is tobacco smoke. If you are a smoker, you need to quit.

Other indoor air pollution may include anything with a strong odor or fumes including household cleaners, perfumes, air fresheners, paints, pet odors, and even cooking odors. In general, it is better to avoid as many aerosol sprays and heavy perfumes as possible. Look for options to aerosols such as using roll-on antiperspirant rather than a spray. If a particular irritant can’t be eliminated, look for a way to increase ventilation to decrease it.

Outdoor Pollution – Although outdoor pollution is typically less of a problem, outdoor air quality can be an issue in some areas. If you live in a metropolitan area, smog can be a problem for you. In the country, living near a livestock confinement may cause you problems. Before going outside, check the Air Quality Index or AQI for your area. This color-coded index was created by the Environmental Protection Agency and is calculated from levels of five pollutants including ground-level ozone, particulate matter, carbon monoxide, sulfur dioxide and nitrogen dioxide. The Weather Channel provides regular reports on air quality, allergies, pollen, and even cold and flu outbreaks. Their information is also available at http:// www.weather.com, by clicking on their ‘Stay Healthy’ menu tab.

Weather – Exposure to very cold air causes breathing to worsen. Likewise, exposure to hot and humid air can also cause breathing difficulties in others. If you have these problems, try to plan your outings at a time of day that is more comfortable for you. Also, covering your mouth with a scarf or mask may help heat cold air before it hits your airway.

Emotions – Even strong emotions can affect breathing. Crying or laughing can dry and irritate during quick, deep breaths. Anxiety during difficult breathing can also make shortness of breath worse. When experiencing these problems, do your best to relax and take a few slow, deep breaths.

Lots more at:
http://www.rotech.com/respiratory/forms_docs/vol19_4.pdf

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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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NEW COPD CHANNEL ON MEDICAL NEWS TODAY
Medical News Today announced the launch of a new COPD channel. The section will include news on chronic bronchitis (inflammation in the larger airways) and emphysema (damage to the lung tissue).

COPD is also referred to as chronic airflow limitation (CAL), chronic obstructive airway disease (COAD), chronic obstructive lung disease or chronic obstructive respiratory disease (CORD).
http://www.medicalnewstoday.com/articles/136532.php

FREE-EXPERT’S GUIDE TO BETTER BREATHING

• Quit Smoking — Avoid tobacco smoke. The only way to slow the progression of COPD is to stop smoking. You should also avoid secondhand smoke.

• Exercise — Helps strengthen your body. When your body is in better shape, you may be more active with less shortness of breath.

• Nutrition — Eating healthy foods may help you stay strong. Being overweight can put a strain on your heart and lungs, making it harder for you to breathe. If you are underweight, you may have less energy and your body may be less capable of fighting off infection.

• Avoid Triggers — When possible, avoid conditions that make your breathing difficult. Some people find hot, humid air makes it harder to breathe, while others have a hard time with the cold.
http://www.copdguide.com/

COLD AND FLU VIRUSES TRAVEL A TRICKY ROUTE
Avoiding colds and flu is hit-and-miss, and transmission isn’t as clear-cut as it seems. But the classic preventive measures still seem to be the best. Get that flu vaccine…but don’t count on it to keep you healthy this winter. Sure, it can immunize you against scientists’ best guess at this year’s bug, but it’s no guarantee you won’t be confined to bed for a couple of days in the event of an outbreak. And of course, there’s no vaccine for colds. Even isolating yourself — from family, friends, coworkers, acquaintances and strangers — might not be enough to protect you from illness.

Scientists now know…how long cold viruses can survive on telephones and money and how much flu virus emanates from a sick person’s breath. What they don’t agree on is exactly how colds or flu pass from one person to the next. In addition, cold and flu viruses are different enough that you can’t generalize about prevention. This state of cold and flu knowledge makes science-based recommendations for staying healthy difficult.

A 2007 study showed that sick people leave cold viruses on the things they touch, such as door handles, pens and light switches. In a second phase of the study, those same subjects (now immune to that cold virus) were told to use the light switches and the telephone, upon which researchers had swabbed rhinovirus either an hour earlier or 18 hours earlier. Virus was found on their fingers after two-thirds of contacts with the one-hour-old virus and after a third of contacts with the 18-hour-old virus…a Swiss study showed that influenza virus not only can remain on paper money for up to 17 days, but also that it can be alive and ready to infect.

The likelihood of transmission via air is fuzzier. Many scientists believe that viruses may float in the air on tiny droplets or dust and be inhaled, thus bringing the germs into contact with the mucous membranes or lungs.

Research has shown that alcohol-based hand sanitizers can reduce the viability of cold and flu viruses on your hands, but washing your hands in a sink physically removes them. The effectiveness of face masks is less clear. Until researchers sort this all out, the best preventive strategies are the same ones you grew up with. Avoid coughing, sneezing people. Wash your hands regularly. Get a flu vaccine. Disinfect surfaces in your kitchen, bathroom and office. Ultimately, the only sure-fire way to avoid a cold or flu might be not to touch anything. Ever.
http://www.latimes.com/features/health/la-he-coldflu12-2009jan12,0,6246701.story

Josephine,/Swiss Jura: By the way…blue face masks are another life-saver of mine. I don’t care if folks on trains and in the street give me peculiar looks and back off (it guarantees plenty of room around me on the train). If I can, I remove the mask briefly and explain, in a friendly way, that I do NOT have any contagious (disease)and my mask is because of bronchitis/asthma. And then they looked relieved

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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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IF SMOKING IS SO BAD FOR YOU, WHO STILL DOES IT?
…So, who exactly — in the face of all the mounting scientific evidence, social stigma and legal bans — still lights up? According to the CDC, about 43.4 million Americans (19.8 percent of the population) smoke. Look around you. If you are in Kentucky, the state with the highest smoking rate, more than one out of every four people (28.3 percent) smokes. On the other end of the spectrum is Utah, with just over one person in 10 (11.7 percent) a smoker.

“Smoking prevalence in the entire country has gone under 20 percent for first time in over 50 years,” said Dr. Richard Hurt, director of the Nicotine Dependence Center at the Mayo Clinic. “For women, it’s 18 percent in most places, and for men it’s hovering at about 20 percent. We have gone from one in two men smoking to one in five — a very dramatic change — and one in three women to one in five.”
http://www.cnn.com/2009/HEALTH/01/09/who.still.smokes/

EXPIRATION DATES:
Pharmacist: One of the questions I get a lot from my customers is, “How long are my medicines really effective? Are those expiration dates for real?” The answer is yes– the expiration date ensures that the medicine meets applicable standards of strength, quality, and purity at the time of use. And that expiration date is only good if you kept your medicine in the original unopened container, stored exactly as the manufacturer specified. Heat, cold and moisture can all affect the medicines’ potency. Light can too, which is why most prescriptions come in amber bottles. So those expiration dates are there to insure that you get the relief you paid for. And incidentally, if your over-the-counter medicine has just a month and a year listed, it is good until the end of the month.
http://healthcorner.walgreens.com/display/669.htm

Pharmacist: I don’t recommend purchasing quantities of medication greater than a 90 day supply. Your doctor may change the prescription before you have an opportunity to use it all. Or the drug product may expire.
http://healthcorner.walgreens.com/display/1398.htm

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MISCELLANEOUS
America Movie Channel TV Games
http://www.amctv.com/games/

The Olympics
http://unix.rulez.org/~calver/funny/swf/olympics.swf

With apologies to Patsy Cline
http://www.youtube.com/watch?v=bT0-WFsP0sM

Cold & Flu season crossword puzzle
http://respiratory-care-manager.advanceweb.com/Article/Games-Crossword-Cold-and-Flu.aspx

Will It Never End?
If cold is a preservative most of us in the frozen parts of the globe, will look pretty good come the Spring Thaw.

Until next Friday,
Joan Costello, Editor