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BID-lung deep breath, Las Vegas, TX (2026)

04/19/2023

Update to COPD Guidelines May Benefit You

What inhalation devices are right for you?
Dry powder inhalers (DPI)
These inhalers require powerful inhalation to get the medicine to your airways.
So, these should only be prescribed to people with COPD who can generate a “powerful inhalation.”
A good example of a DPI is the Advair Discus.

Metered dose inhaler (MD)
These require you to generate a slow and deep inhalation. MDIs also require you to coordinate the puff of the inhaler with your inhalation.
An MDI may be ideal if a doctor determines that you can do this. Examples of an MDI are Ventolin and Symbicort.

Slow mist inhaler
These are the newest inhalers on the market. They generate a slow mist to inhale.
Like MDIs, they require coordination and the ability to generate a slow and deep inhalation.
Examples here are Spiriva and Stiolto Respimat.

Nebulizers
These are ideal for anyone who has trouble with any of the above-mentioned inhalers.
A breathing treatment creates a mist that you inhale over a period of time.
So, inhaling the medicine does not require coordination, nor does it require a specific speed of inhalation.

What therapies help the quality of life?
Use of triple inhaler therapy
These include using a steroid, plus a LABA, plus a LAMA. These can all be given individually in a nebulizer.
Or they are all contained in inhalers such as Trelegy.

Smoking cessation
Quitting smoking, no matter when you quit is proven to help you live longer and have a better quality of life.

Long-Term Oxygen Therapy
If your oxygen levels drop below 88%, you qualify for home oxygen therapy.
Inhaling oxygen every day is shown to help you live longer.

BiPAP
This is a device that applies pressure to your airway.
It is applied to your face by a mask or nasal pillows and is usually only used while sleeping.
The pressures make it so you take ineffective breaths while you are sleeping.
It also helps ensure that your oxygen levels remain at safe levels while you are sleeping.

Computed Tomography (CT) may be used more often
The updates emphasize the use of CT, even in the early stages of COPD.
These scans can give a doctor a more detailed picture of what is happening inside your lungs than a regular X-ray.
They can aid a physician in determining if you have COPD. They can help a doctor determine the severity of our disease.

04/16/2023

Make Your Home COPD Friendly

Toss the bleach
The next thing we did was toss out all of the caustic cleaners.
I had those harsh chemicals in the bathrooms, the kitchen, and the utility room.
There are lovely safe alternatives and they are much easier on the lungs.

Air purifiers
Maintaining good indoor air quality can be an important variable in reducing COPD symptoms.
We have always been fairly good about changing the air filters in the house.
I never really thought about a purification system. Since being diagnosed with COPD,
it became apparent that adding a good air purifier would be the smart thing to do. After a great deal of research,
we found one that seems to really make a difference.

Wood, tile, or carpet
Carpet is not our friend. If you have the finances to eliminate it from your home, I suggest doing so. However,
if you have carpet and elect to keep it, have it thoroughly cleaned. Once you have a clean slate,
take your shoes off at the door and vacuum regularly.

Living clean
Our homes don’t have to be perfectly clean, but keeping the dust down and the floors clean will eliminate a lot of the pollutants that we breathe.
Using chemical-free cleaning supplies will protect your lungs. Also, on a monthly basis, change all of the filters in your house. Lastly,
I encourage you to ventilate your home and get fresh air when you can. It not only is great for breathing but can bring some peace and happiness to your day.
Your lungs will definitely thank you.

04/12/2023

Researchers Home in on Possible Cause of Emphysema

The human genome project was started in the early 1990s. About 20 years later,
researchers reported that they had identified every human gene.
They discovered that there are between 20,000 and 30,000 genes that make proteins.
It is breakdowns in these genes, they think, that is responsible for many of the diseases that plague mankind,
including emphysema.

Researchers have long been aware of an immune gene called FCHSD1.
It is a gene that makes a protein called FCHSD1.
Until recently researchers were uncertain what exactly this protein was responsible for.

However, after performing their study in Japan,
researchers now think this protein may be responsible for initiating the process I described above in my example.
They think this protein may be responsible for the early stages of emphysema.

To make this discovery, researchers in Japan performed experiments on mice.
They had two groups: one group was missing the FCHSD1 protein and the other group had “normal” levels of this protein.
In both groups, they injected elastase. This is the substance noted above that induces emphysema.
Then, over time, they compared the results in both groups.

Normal FCHSD1 protein levels. This group had elevated FCHSD1 protein levels.
They had evidence of lung cell death and lung tissue inflammation. This group developed emphysema.
Missing FCHSD1 protein. This group had no evidence of lung cell death and no lung tissue inflammation.
They did not develop emphysema.
The study results seem to indicate that the FCHSD1 protein causes lung cells to die and perhaps causes lung tissue inflammation.
This is what eventually leads to emphysema.

04/08/2023

COPD Choices

Respiratory rehabilitation
The best chance you have for better living with COPD is your work at respiratory rehab.
Rehab usually consists of two parts: exercise and education.
You will learn to control your breathing while building muscle mass to support your worn-out lungs.
The education portion will take you through mindfulness and help you to control anxiety and fear of constant shortness of breath.

Lung volume reduction surgery
LVRS is an invasive surgery that collapses diseased lung tissue and allows your lungs to fit better in the chest cavity.
The main goal of this surgery is to ease breathlessness. Recovery time can be 1 to 12 weeks.
It is a high-risk surgery so not everyone will qualify due to having compromised lungs.
Those who qualify will have severe emphysema mainly in the upper lungs.

Bronchoscopic lung volume reduction
(BLVR) are zephyr valves that are strategically placed to block the diseased part of the lung and help to deflate the lung and reduce hyperinflation.
This is less invasive than LVRS but it is not always a successful surgery. However, studies have shown improved shortness of breath,
greater exercise tolerance, and overall better quality of life. The valves are inserted via bronchoscope and the surgery takes about 60 minutes.

Lung transplant
This is major surgery, reserved for those that have tried other treatments and have not been successful.
The transplant procedure is becoming more common as the number of candidates rises and organs become available.
Most are hoping for a double transplant, but you can live nicely with just one new lung.

Cryotherapy
A brand new procedure for those with moderate COPD.
A spray of liquid nitrogen rapidly freezes airway walls to destroy mucus-producing cells while preserving healthy cells.

04/04/2023

If you have experienced a COPD exacerbation at one point during your health journey,
chances are, you are familiar with the drug prednisone.
The following article will outline the benefits and potential adverse effects of prednisone,
and provide tips on how you can minimize these side effects.

What is prednisone?
Prednisone is a widely used drug for its anti-inflammatory properties.
It is not solely used for the treatment of COPD: it can also be used for allergic reactions,
myasthenia gravis, bell palsy, gout, and several other conditions.

Side effects
For most people with COPD on a short course of therapy,
these side effects will most likely not be drastic and may not be experienced at all:

Heart: prednisone can increase blood pressure and fluid retention.
Brain: some people may experience depression, anxiety, poor sleep, and agitation.
Most cases of this happen within the first 5 days of use and are more likely to
happen in doses greater than 80 mg and in those with a history of psychiatric conditions.
Physical: steroids are associated with the classic “cushingoid appearance”,
in which people may retain fluid and fat in their face. This is more likely with long-term use.
Stomach: some people may be at risk of stomach ulcers with prednisone use;
people who use aspirin and/or drugs such as ibuprofen (Advil) are at a higher risk.
Bone: people who take the medication for several months are at a higher risk of fractures.
This is more likely in females who are over the age of 55 and are of low body weight.

While many of these side effects cannot be prevented, some of them can be alleviated:

Take prednisone right after meals to reduce the risk of stomach upset.
Your doctor may prescribe an antacid to reduce the risk of ulcers if you are at high risk of stomach bleeds.
Ensure that you follow your taper schedule, if prescribed, which can help reduce some withdrawal side effects.
Take your dose in the morning to avoid sleep disturbances.
Overall, prednisone can be an effective medication to treat COPD exacerbations.

Have you taken prednisone throughout the course of your COPD journey?
Share your experiences below, including any tips for reducing side effects.

04/01/2023

What sleep disorders are common in people with COPD?
Insomnia: A common sleep disorder that makes it hard to fall asleep and stay asleep
Obstructive sleep apnea (OSA): A sleep-related breathing disorder in which you repeatedly start and stop breathing as you sleep
Restless legs syndrome (RLS): This irresistible urge to move your legs often gets worse in the evenings and can keep you awake at night

How does COPD cause sleep disorders?

COPD comes with many symptoms that can disrupt your sleep. These include:
Difficulty breathing
Chest tightening
Coughing, wheezing, and breathlessness
Acid reflux
Anxiety/depression
Because our breathing slows at night, those with COPD can have lower levels of oxygen during the night.
Drops in oxygen levels can impact the quality of sleep and cause headaches and grogginess the next day.
Plus, lying flat on your back reduces lung capacity and makes breathing even harder for people with COPD.

Tips for better sleep

While there is no cure for COPD, it can be treated. In turn, treatment can help resolve some sleep issues.
Lifestyle habits that may help you get more restful shut-eye include:
Do not smoke. And if you do smoke, quit
Elevate your head at night so it is easier to breathe
If you get acid reflux at night, avoid alcohol, spicy foods, and heavy meals later in the day
Avoid naps during the day so you are tired at bedtime. If you do need a nap, keep it to under 30 minutes
Eat a healthy diet rich in vegetables and fruit in order to get the antioxidants, vitamins, and minerals you need
Keep a regular sleep-wake routine
Avoid using electronic devices about an hour before bedtime. The blue light from TVs, phones, and tablets can keep you awake
Exercise regularly.

03/28/2023

How to practice belly breathing

I practice this technique several times daily, especially when I am not exercising.
I do it while viewing the birds, watching TV, or listening to music,
and I can get myself into a meditative state or a feeling of wellness.
Once I have mastered this technique, I can get more mileage from my exercise routine without falling short of breath.
I must remember that when exercising, I am always exhaling upon exertion.

The importance of posture when breathing
I start with stretching exercises for my neck, remembering that posture is important. So, sitting up as straight as possible does help.
Taking a deep breath, I accept that breath to my belly and hold it for a few seconds while I turn my head to the left side.
Moving my head is the exertion part of the exercise, so I exhale as I move to the left.
Once there, I take another deep breath and move my head to the middle as I exhale. Taking a deep breath,
I turn my head to the right and exhale as I move it. I am turning only until I feel a pull, then I stop.

Take your time when doing breathing exercises
When exercising, we mustn’t hurt ourselves and defeat the purpose of the exercise.
Stretching should be mild and without pain.
You should be able to go slow enough to pay attention to your breath still.
We are not speed-exercising, especially as we begin.
If we go a little slower and pay attention, we should be able to do all stretching exercises,
neck, arms, and legs, without becoming short of breath.

Using belly breathing when using stairs
Stairs are the bane of my existence, but I can not avoid them. I live on a raised ranch,
so upon entering or exiting, I have seven steps.
In my quest to master these seven steps, I use them for exercise. I start at the bottom with a deep inhale of air into my lungs,
and as I lift my foot to go to the next step, I exhale.
Now, both feet are on the same stair. I repeat this seven times to get to the top of the stairs.
Then I lean on the railing until my breath returns to normal.
Going down the steps, I take the same care to go slow, exhale as I exert myself,
and use deep belly breathing.

So, do you think you could learn to do deep belly breathing?

03/25/2023

What are some known exacerbation triggers?

Heat.
Cold.
Humidity. Inside and out. I even found a home for my aquariums because
they put so much humidity in the air that they affected my breathing.
Dry air.
Dust, inside and out. Even when walking on dusty or dirty carpets
Unchanged furnace filters make it difficult for air to circulate
Cleaning products are used to clean houses, furniture, and even cars.
Air fresheners used in homes and cars
Candles. Those that are burning and those that aren't. Both ways, they carry a scent.
Musty-smelling books.
Mold.
Shopping. Yes, shopping! The laundry and cleaning aisles at stores. Cosmetics, perfume, candles,
and personal product aisles. As well as the gardening and animal products, the automotive department,
tire aisles, and individual items.
Public restrooms or those located in stores. The restrooms are often heavily scented with sprays.
Is there any wonder some of us don’t shop in actual stores?
Friend and relatives' homes. They may have plug-in air fresheners or carpet powder that gets vacuumed up.
Freshly mowed grass, swathed hay, sprayed or combined fields.
Even a skunk sprayed near a highway caused me to cough and cause breathing difficulty. Crazy, isn’t it?
Allergens. My doctors assumed that my allergies were my main triggers for COPD exacerbations.
Stress.
Pets can affect persons breathing, or they may even trigger an allergic reaction.
Birds have been known to affect those with COPD because of the preening of their feathers.
Many of these items affect me. Do they affect you?

Can you think of others?

03/21/2023

What having seasonal anxiety is like

Feeling depressed
If I allow depression to blanket my days, my breathing becomes a bit harder, my feet swell more,
and I seem to have an overall malady feeling. Less light so early in the afternoon fills me with a sense of dread for no particular reason.
These particular days even exercising seems like too much of an effort. I combat this depression by working hard to find gratitude and keeping a positive attitude.

High levels of anxiety
Adding to this time of year is the anxiety of the upcoming holidays and their financial and physical obligations.
It’s not easy to do what you always did when you are on a pension with limited funds. As tough as it is, expectations should be lowered.
Shopping in stores is almost impossible for me these days, and I still miss seeing the selection of items available.

Making myself happy
The bigger problem is spreading myself as thin as possible while making everyone, including me, happy.
It takes me a while to figure out what I want, what I need, and what my obligation to others means.
I must advocate for myself because I am my only priority. I make rules that guide me and intend to stick by them guilt-free.

Making my own holiday rules
I have a set of holiday rules that I have adopted over the years. These help me get through these long, dark months.

Do you experience seasonal anxiety? How do you get through it?

03/18/2023

“You are your own best advocate!” You hear this a lot in this community because it is true.
You ARE your best advocate unless you have someone to advocate for you. This is not an insult to doctors,
as there are many great doctors. Most great doctors have their patient’s best interests in hand.
That said, doctors are busy people. Like all of us, they are humans incapable of perfection.

Speak up for yourself
Tell your doctor how you are feeling! They cannot read your mind. They cannot know what you are thinking.
They cannot know, without you saying if you're feeling pain, shortness of breath, or any other symptom.

You live your life every day. You know what you are capable of doing. You know if you feel pain and symptoms and when and how often.
Such as fatigue, shortness of breath, coughing, chest congestion, etc. Your doctor cannot see all of your symptoms at all times.
So, if you do not share how you are doing, your doctor cannot possibly know.

03/14/2023

The do not's of COPD

Do not get upset about canceling plans
At some point, each of us will have to cancel a get-together. Do not let it upset you.

Do not feel alone
It’s important that you realize that you are not alone. You possibly have family and even friends.
They might understand what you are going through, or they might not.

Build memories.
Take and have others take photos. Many photos. Do not ever make excuses why you shouldn’t be in the photo.
These photos can be available for many generations.

There can be many things that might add stress, anxiety, and even sorrow to your life.
This can affect our bodies physically, emotionally, and maybe spiritually.

It’s up to each of us to find ways to cope. Remember, our bodies are our temples.
We need to take care of our temples. Do not ignore your body.

03/10/2023

Supplemental oxygen therapy is a mainstay of therapy for COPD and other chronic lung conditions.
As with all medical devices, oxygen concentrators intended for clinical use in the outpatient setting
must undergo a rigorous approval process to demonstrate both safety and efficacy before sales
and distribution are permitted. This assures that those who need supplemental oxygen therapy can
be confident that their needs will be met by their equipment.

Over-The-Counter Oxygen Concentrators
Recently, a number of lower-cost devices being marketed as oxygen concentrators
(as well as 'oxygen generators') have appeared on retail websites such as Amazon.com and eBay.com, and Facebook.
These devices are appealing to many, as they are readily accessible without a prescription and at a fraction of the retail
cost of approved devices. They are also often marketed with stock images of people using standard oxygen cannulas,
as well as stock images of people wearing clinical attire, implying these items are the equivalent of approved medical devices.
Comments and (potentially seller-generated) reviews in the retail listings often indicate these units are safe and effective
for patients requiring up to 7 liters per minute of flow, leading many to believe these units are appropriate for their needs.
However, the technical specifications (which are often obfuscated or difficult to find), reveal that the purity of the oxygen delivered
is as low as 30%, an unsafe level far below regulatory standards.

At this time the FDA has not approved the purchase of oxygen concentrators without a prescription.
We do not recommend the purchase or use of oxygen concentrators that are not approved for use as
Medical Devices for the treatment of COPD or other chronic lung conditions. We advocate for these unregulated
devices to be removed from the marketplace due to the high levels of risks they pose.

BID-lung deep breath

04/19/2023

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