Understanding A COPD Diagnosis: Key Facts

If you or someone you know has recently been diagnosed with COPD, you may be wondering what exactly that means. COPD stands for Chronic Obstructive Respiratory Disease. COPD is composed of different respiratory diseases that cause troubled breathing.

The term COPD can be used to describe a singular respiratory disorder, or more than one. COPD encompasses chronic bronchitis, emphysema, asthma, and some forms of bronchiectasis, as well as any combination of the four. According to the American Lung Association, over 16 million Americans are diagnosed with COPD as of October 2020, but millions more suffer from it without being diagnosed.

The group of diseases in which COPD refers to cause airflow obstruction and trouble with breathing. COPD is chronic, meaning it is long-lasting and constantly present. Each individual case of COPD is different, and some cases are more severe than others. The most common cases of COPD include symptoms of both chronic bronchitis and emphysema.

COPD Explained

What is Happening in Your Body?

Your particular case of COPD will determine what is happening within your body. Cases that include chronic bronchitis will cause swelling and increased mucus production in the lung airways, or bronchial tubes. This causes breathing to become more difficult since your airways are inflamed and narrowed with mucus blocking them. Cases including emphysema cause destruction of the air sacs, or alveoli. The air sacs are responsible for oxygen exchange within the lungs, and they lose their elasticity by becoming destroyed. This causes breathing difficulty since the loss of elasticity leads to air being trapped inside the air sacs, making it harder to get oxygen in and carbon dioxide out.

Symptoms of COPD

Some of the most common symptoms include:

  • Increased shortness of breath
  • Frequent coughing (with or without mucus)
  • Wheezing
  • Tightness in the chest

Remember, not all cases of COPD will have the same symptoms. Other symptoms include frequent respiratory infections, lack of energy and unintended weight loss.

What Causes COPD?

COPD is mainly caused by inhaling lung irritants, and smoking is the #1 cause. People, however, do not realize that other potential lung irritants that can also cause COPD include exposure to air pollution, fumes, chemicals, secondhand smoke and dust particles. Oftentimes, inhaling these irritants can be work-related. Working in construction, mining or welding are examples of occupations that increase the risk of obtaining COPD due to increased exposure to lung irritants. A rare genetic factor called alpha-1 antitrypsin deficiency is also known to cause COPD and is passed from parents to their children.

Comorbid conditions seem to be more common in people with COPD than in people with other medical problems. These conditions may include:

  • High blood pressure
  • High cholesterol
  • Heart disease
  • Diabetes
  • Osteoporosis
  • Depression
  • Arthritis
  • Sleep Apnea
  • Cancer
  • Other medical problems

One reason for these additional problems may relate to the lung inflammation that occurs in people with COPD.

What is a Flare-Up?

A COPD flare-up, or exacerbation, is when your symptoms are considerably worse than usual. Some can be treated at home, but more severe flare-ups can require a visit to the hospital. Flare-ups are triggered by further lung inflammation. This can be from exposure to smoke, pollution or allergens as well as contracting the flu or pneumonia. Symptoms to look out for include:

  • Shortness of breath without physical activity
  • Increased mucus
  • Excessive coughing or wheezing
  • Lower blood  oxygen saturation level than normal

Those symptoms can usually be treated at home with antibiotics or inhalers, but the following list of symptoms require professional help.

  • Increased heart rate
  • Being unable to catch your breath
  • Lips or fingernails turn blue or gray
  • Treatments are not working

Does COPD Have a Cure?

COPD is a progressive disease, which means that it gets worse over time. Unfortunately, there is no cure, but luckily many treatment options are available to improve the quality of life. Bronchodilator and steroid medications are available through inhalers to relax the lungs, as well as oral anti-inflammatory medications. Oxygen therapy is also a popular treatment option to help patients achieve healthy blood oxygen levels, which is difficult to maintain when you have COPD. Oxygen therapy allows you to still be active and live a normal life while getting the oxygen into your body that you need, especially with the availability of portable oxygen concentrators. Pulmonary rehabilitation is another option for those with COPD. It helps patients adjust to and get educated about their conditions. Pulmonary rehabilitation programs often provide support and exercise training as well as breathing techniques that are personalized based on specific patient needs.

Living with COPD

Activities of daily living, such as completing chores or bathing, can be harder to accomplish due to shortness of breath. You may have to take constant breaks to catch your breath. Activities will take your energy to perform, so you will get physically exhausted more easily. Living with COPD means slowing down in order to control your breathing and to prevent tiring yourself too quickly. Living with COPD has its challenges, but modifying some activities of daily living can improve your quality of life and help you better manage your disease.

Takeaway

Although COPD is a life-long condition, you can still live a fulfilling life with the help of treatment options, although you may have to slow your pace. COPD takes a toll on your body, so taking care of yourself, monitoring your symptoms and following your doctor’s orders are top priorities.

Sources

https://www.cdc.gov/copd/features/copd-symptoms-diagnosis-treatment.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Ffeatures%2Fcopd-awareness-month%2Findex.html

https://www.copdfoundation.org/What-is-COPD/Understanding-COPD/What-is-COPD.aspx

https://www.hse.gov.uk/copd/causes.htm

https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/learn-about-copd#:~:text=With%20COPD%2C%20the%20airways%20in,the%20waste%20gas%20carbon%20dioxide.

https://medlineplus.gov/copd.html

https://www.nhlbi.nih.gov/health-topics/copd

https://www.nps.org.au/consumers/chronic-obstructive-pulmonary-disease-copd-explained

5 Tips to Reach Your Health Goals in the New Year

It is that time of the year where most people have intentions to set a couple of New Year’s Resolutions, and healthy eating and exercise typically make this list. As we head into the New Year, let us try setting goals that are realistic and achievable!

Achieve Your New Year’s Goals This Year!

It is important to set short-term and long-term goals for ourselves in order to stay on track and create the lifestyle changes we desire in each part of our lives. We hope this article will share some helpful tips on how to make more realistic goals for a healthier lifestyle change in the new year, especially with those facing health challenges.

When your New Year’s goal is big picture, it may be hard to determine the steps that need to be taken to accomplish it. Completing specific, smaller goals that lead to your overall goal is a smart approach to sticking with your resolutions. For example, rather than making “getting in shape” your goal, make it something more specific and tangible, such as walking for 20 minutes three times a week. Taking smaller steps like this to help you stay on track of your overall objective, with mini victories at each smaller action that is taken.

Make one change at a time.

Making changes to your routine that you want to avoid can be done simply by focusing on one particular action at a time. If you are trying to get out of a bad habit, this step will be helpful for you. Think about what you would like to change. If the change is eating healthier, get in the habit of replacing your late-night candy bar with a low glycemic fruit, such as a small portion of strawberries or blueberries. If you are trying to incorporate exercise, replace the time you would spend watching TV on the couch with some sort of movement, even if this means taking steps around the house or stretching exercises while you watch your favorite show. Everyone has a daily routine and changing it one step at a time will ease you into healthier habits that will stick.

Share your resolutions with others.

Sharing your goals for the year with friends or family will keep you on the right path since they will be able to hold you accountable. Having a support system can help remind you of why you are pushing yourself to make a change in the upcoming year. Support systems, online community forums, or groups can also help motivate you to reach your goals. For example, if you want to quit smoking, finding a support group with others experiencing the same feelings can be a helpful reminder that you are not alone. Receiving support will encourage you to stick with your short-term and long-term goals.

Remember that change is gradual.

Set yourself up for success knowing this is a marathon, not a sprint, and achieving your health goals in just a few days is unrealistic. Good and bad habits take time to develop, and changing a habit or making a new one is a process that is going to take time – be patient with yourself. Focus on the big picture, and remember the small changes you make on a daily basis are adding up to make the difference long term. If you happen to get off track, pick yourself right back up and start again.  Do not be discouraged if you are not seeing your goals come to fruition as quickly as you would like!

Reward yourself.

Each step taken in the direction of your goal is something worth celebrating. If cooking at home or choosing healthier options at restaurants is the objective, and you stuck with your healthy eating habit for 2 weeks straight, then by all means reward yourself! Not only will celebrating the little accomplishments help your goal seem more manageable, but it will help you feel motivated in moving towards your overall lifestyle change. Having little celebratory rewards will give you something to look forward to, and the biggest reward is reaching the milestones that lead to obtaining the overall objective you set for yourself.

Using these tips will help you stick with your short-term and long-term goals, and ultimately create a healthier lifestyle. We suggest keeping a journal to write in and keep track of reaching milestones, the pitfalls that will help you avoid them the next time, and how you celebrated the wins. The team at Belluscura wishes you the best of luck in achieving your health goals in 2021!

What to Know About Low Blood Oxygen Levels

Oxygen is a gas that is vital to human life. It is one of the gases that is found in the air we breathe. If you have a chronic lung disease limiting the effectiveness of your lungs, you may need supplemental oxygen for your organs to function normally.

When your oxygen level is low, the organs in your body are receiving less oxygen which can negatively impact their bodily function.

Low levels of oxygen in the blood are referred to as hypoxemia. Hypoxemia is a  below-normal level of oxygen in your blood, specifically in the arteries.

How is Hypoxemia Measured?

Hypoxemia is determined by measuring the oxygen level in a blood sample taken from an artery, called an arterial blood gas. It can also be estimated by measuring the oxygen saturation of your blood using a pulse oximeter. A pulse oximeter is a small device that can fit on your finger and measure your blood oxygen level.

What is the Normal Level?

There is no singular ‘normal’ oxygen level, as people have different needs based on their health conditions. If a person has no previous medical issues, a normal pulse oximeter reading usually ranges from 95 to 100 percent.

If you suffer from a respiratory or cardiac condition, your healthcare provider may recommend a lower acceptable range anywhere from 88 to 92 percent. Always clarify with your healthcare provider what blood oxygen level range they want you to stay within.

What Causes Hypoxemia?

Several factors can contribute to the low levels of oxygen in a person’s blood. Ideally, there should be enough oxygen in the air we breathe. Our lungs must be able to inhale oxygen-rich air and our bloodstream needs to be able to properly circulate our blood to our lungs so that it can take in oxygen and deliver it to our vital organs.

Common causes of hypoxemia include:

  • Anemia- a condition where your body lacks enough red blood cells to carry oxygen to your body’s tissues
  • Asthma- due to the narrowing and swelling of the airways in your lungs
  • Chronic obstructive pulmonary disease (COPD)- due to inflammation in the lungs
  • Pneumonia- due to the infection and the lungs filling with fluid
  • Pulmonary Fibrosis- due to the increased scarring of the lungs
  • Sleep apnea- when a person has a momentary pause in breathing, low oxygen levels can occur

There can be several other causes of hypoxemia. If you have a pulse oximeter and monitor your levels regularly, be sure to talk to your healthcare provider if you are experiencing low blood oxygen levels.

Symptoms of Hypoxemia

Just as the causes of hypoxemia vary, so do the symptoms. Depending on the severity of your condition, you may experience the following symptoms:

  • Shortness of breath- the hallmark symptom
  • Coughing
  • Headache
  • Confusion
  • Fast heart rate
  • Wheezing

Takeaway

Always contact your healthcare provider as soon as possible if you experience shortness of breath with slight exertion or even at rest. If your shortness of breath comes on suddenly and you are feeling your heart is beating fast and you cannot get enough air in, seek emergency care as this could be a life-threatening situation.

To maintain healthy oxygen levels, it is important to stop smoking if you are a current smoker, avoid secondhand smoke, and get regular exercise to strengthen your lungs.

 

Resource:

https://www.mayoclinic.org/symptoms/hypoxemia/basics/causes/sym-20050930

https://my.clevelandclinic.org/health/diseases/17727-hypoxemia

Asthma

5 Common Myths Associated with Asthma 

Asthma is a chronic condition that affects the airways in the lungs. Among children, asthma is a common condition however it affects people of all ages ranging from infants to the elderly.

While there are many things that can cause asthma such as genetics, environmental factors, and occupational exposures,  sometimes the exact cause cannot be determined. If you or someone you know has recently been diagnosed with asthma, it can be overwhelming.

Your healthcare provider can provide you with some great resources, and while the internet is a great source of information, take caution regarding some common myths associated with asthma. Read on to learn the truth to these common myths.

Myth #1: Asthmatics Should Avoid Exercise.

While many asthmatics experience exercise induced asthma, it does not mean that it should be avoided all together. This, in fact, is a myth. It is important to assess your individual risk factors and determine if your asthma is well controlled with an asthma-action plan. If your asthma is well controlled, you may enjoy activities such as a brisk walk, leisure biking, swimming, and hiking. Avoid exercising outdoors in colder weather months to avoid an asthma flare-up.

Myth #2: Asthmas Goes Away after Childhood.

While some children will experience asthma only in the early years of life, asthma does not just go away. A common misconception, but, in fact, a myth. A clear answer to this myth would be that, for some children, asthma can go into a hibernation state and never return. This is due to a person’s lungs growing and maturing and the lungs becoming less affected by triggers. Its important to know that while your asthma may not ever truly go away, your attacks can be well controlled if you are aware of your triggers.

Myth #3: No One Dies from Asthma.

This is alarmingly false. According to the World Health Organization (WHO), in 2016 there were 417,918 deaths globally due to asthma. Asthma is one of the major noncommunicable diseases, this means that asthma is not transmissible directly from one person to another. While asthma can be controlled with medication, it can cause deaths. It is important to seek treatment and not allow your symptoms to get worse. Ensure you continue your medications and asthma action plan set by your healthcare provider.

Myth #4 All You Need is Albuterol.

Albuterol sulfate is a common bronchodilator, which works by relaxing the muscles in the lungs, and makes it easier to breathe. The truth is albuterol is not the only medication available to treat asthma. Also, everyone with asthma does not take the same medication. Asthma can be treated with two types or medications: a quick-relief and long-term controller. A quick relief will control the symptoms of an asthma flare-up. A long-term medication will work by helping you have fewer and milder flare-ups.

Myth #5: Asthma is Easy to Diagnose and Treat.

The truth is asthma can be difficult to diagnose. The reason being that asthma mimics other diseases and often there are similar symptoms, making it difficult to make the diagnosis. Asthma is underdiagnosed and undertreated which creates a substantial health burden globally and to individuals and their families. If you suffer from asthma, and you have a long family history of asthma, it may be easier to diagnose. For some, a series of test may be needed to make the diagnosis.

Takeaway

Asthma is estimated to have affected more than 339 million people in 2016 according to WHO. It is a common condition, and it is important to have facts and understand the misconceptions and myths associated with it. Asthma can be treated and controlled so that a person can enjoy their day-to-day life!

Sources:

https://www.cdc.gov/asthma/faqs.htm

https://www.nhlbi.nih.gov/health-topics/asthma

https://www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653

https://www.who.int/news-room/fact-sheets/detail/asthma

thanksgiving

Family Health and Gatherings Amidst a Pandemic

‘Tis the season to gather, make memories with family & friends, and share great food. The rising cases of COVID-19 will make gatherings look a little different this year. It is important to take precautions and be safe while gathering this year. The Centers for Disease Control and Prevention (CDC) has a great resource available to help you with tips to stay safe this year. When we think of Thanksgiving, we think of turkey, cranberry sauce, and pies! Did you know that Thanksgiving is also National Family History Day? It is a great opportunity to learn more about your family’s health history. Read on to learn more about staying safe this holiday season and learn more about your family health history.

Learning About Your Family’s History

Family gatherings are a great way to learn more about your heritage, learn about your family history, and any health issues previous family members have struggled with. Even if you are social distancing this year, find creative ways to collect this information.

When talking to your family, write down the names of parents, siblings, grandparents, aunts, uncles, nieces, and nephews. Discuss any conditions they have had and what the diagnosis was. Sharing chronic health conditions can be difficult, be sensitive to this information and make your goal clear, to prevent any health conditions from developing if you can avoid it.

Ask Questions

To find out more about the chronic conditions in your family, it’s important to ask a few questions. Make a list ahead of time before gathering virtually or in-person this Thanksgiving and start with some examples such as:

  1. Do you have any chronic diseases, such as heart disease or diabetes?
  2. Has your healthcare provider been concerned you have high blood pressure or high cholesterol?
  3. Have you had any other serious diseases, such as cancer or stroke? What type of cancer?
  4. Approximately how old were you when these health conditions were diagnosed?
  5. What is your family’s ancestry? What countries or regions did your ancestors immigrate from?
  6. What were the causes and ages of death for relatives who have died?

Start with these questions and go from there. This is a great start to learning more about your family’s health history. Make sure to record this information, share it with your extended family, and update as you gain more information.

thanksgiving

Thanksgiving is also National Family History Day

Follow-up and Act

After learning about your family’s health history, then follow up with your healthcare provider. Talk to your healthcare provider about the next steps to take, future lab work, and what early screenings to consider. Time could be of the essence; some conditions will require specific screenings such as health histories that include:

  • Colon Cancer
  • Breast or Ovarian Cancer
  • Heart Disease
  • Chronic Blood Pressure Issues
  • Diabetes
  • Parkinson’s
  • Dementia
  • Osteoporosis

Staying Safe at Gatherings

According to the World Health Organization (WHO), as of November 23, 2020, there are approximately 58,425, 681 confirmed cases of COVID-19. As cases continue to increase rapidly across the world, the safest way to celebrate Thanksgiving is to celebrate virtually. If you gather, do so with people that live in your immediate household. Remember, you can collect your family’s health history virtually, stay safe, and still enjoy a nice feast! If you decide to host a gathering or attend a gathering elsewhere, keep the following tips in mind:

  • Host an outdoor meal, weather permitting, or make sure there is good ventilation in your gathering space
  • Limit the number of guests in your home, or ask how large the group will be
  • Set expectations with your guest as to the precautions you will be taking
  • Clean and disinfect high touch surfaces in your home
  • Limit the number of people preparing food, or pitch in and support a local restaurant and have your meal catered

Encourage your guest to wear a mask when the mealtime is over, hand washes, or use sanitizer often. Remember, it is better to be safe than sorry. Wearing a mask and social distancing can ensure everyone has a safe and happy Thanksgiving.

Takeaway

This Thanksgiving, remember to be grateful for your health and family. Take advantage of a ZOOM gathering to connect with relatives in other cities, states, and countries! Start the conversation early and make it a yearly tradition to discuss any new health conditions before having your annual celebration.

Fact Check Sources:

Coronavirus disease (COVID-19)

Gathering During the Holidays

Family Health History Resource

COPD Awareness: Understanding the Diagnosis and Stages

Awareness

Being told you have chronic obstructive pulmonary disease (COPD) can be overwhelming. COPD is a progressive disease that obstructs the airflow, making it difficult to breathe and get enough oxygen into your lungs. According to the Chest Foundation, COPD is the third leading cause of death in the US and impacts roughly 24 million Americans.

COPD is made up of two diseases; emphysema accounts for 33 percent, and chronic bronchitis accounts for the remaining 64 percent of diagnosed cases. Emphysema occurs due to the damage that happens to the air sacs in the lungs. These air sacs overfill with air and lose their elasticity which makes it hard to exhale the excess air. In chronic bronchitis, the airways become swollen and inflamed and produce large amounts of mucus. The increased production of mucus obstructs the airways, narrows them, and makes it hard to breathe.

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has classified four stages in which your healthcare provider will determine what stage of COPD you are in. This will help them determine the best treatment plan for you.

Symptoms

The first part of diagnosing your condition will consist of assessing symptoms. It will be important to provide your healthcare provider with the symptoms you have been having that have led you to seek medical attention. Common COPD symptoms include:

  • Shortness of breath
  • Chronic cough
  • New or increased wheezing
  • Coughing up phlegm or and increase in phlegm

Risk Factors

It will be important for your healthcare provider to know if you have had or are currently exposed to any risk factors. Risk factors could include things such as:

  • Genetic factors
  • Abnormalities from birth
  • Tobacco smoke
  • Smoke from cooking/heating fuels
  • Dust
  • Vapor
  • Fumes or other inhaled chemicals

Spirometry

Spirometry will play a large role in your COPD diagnosis. Once you have sought medical care for COPD related symptoms and you have discussed your risk factors, the next step will be for your healthcare provider to order spirometry.

Spirometry is a common breathing test used to see how well your lungs are working by taking a few test measurements while you breathe into a machine. Spirometry will measure the air you breathe in, the air you breathe out, and how quickly you breathe out.

One of the initial spirometry tests that will be performed is called the Forced Vital Capacity (FVC) measurement or the amount of forced air that you can exhale and inhale into the machine. An equally important measurement is the calculation based on the Forced Expiratory Volume in One Second (FEV1). This is the amount of air you can breathe out of the lungs in the first one second of forced expiration.

Your FEV1 is based on factors including your age, sex, height, and ethnicity.  Your healthcare provider will compare your results to a healthy individual and any deviations in measurements are what will lead to a sign of what might be causing your problems.

You will be given a breathing treatment with medication to help open your lungs such as a bronchodilator before you start the test. This is to ensure your lungs are performing at their best.

After your test is completed, your healthcare provider will review the measurements and see which of the four GOLD stages of COPD you fall into based on your results. This testing will serve as a follow-up assessment to determine what other therapies can work for you and to monitor you as the disease progresses.

Four Stages of GOLD

Your spirometry results, particularly your FEV1, will fall into one of the four GOLD classifications of severity which is how your COPD stage will be determined.

GOLD 1
  • Mild Stage, Stage I COPD
  • FEV1  greater than/or equal to 80% of predicted test results compared to a healthy individual
  • In this stage, you will likely experience very mild symptoms
GOLD 2
  • Moderate Stage, Stage II COPD
  • FEV1 between 50 – 79% of predicted test results compared to a healthy individual
  • Symptoms include shortness of breath with activity, cough, and sputum production
GOLD 3
  • Severe Stage, Stage III COPD
  • FEV1  between 30 – 49% of predicted test results compared to a healthy individual
  • In this stage, you may experience shortness of breath, fatigue, and a lower tolerance to physical as well as more frequent COPD exacerbations
GOLD 4
  • Very Severe, Stage III COPD sometimes referred to as End-Stage COPD
  • FEV1 less than 30 % of predicted test results compared to a healthy individual
  • In this stage, you may find that your quality of life is significantly decreased, and you may experience severe and life-threatening exacerbations

Takeaway

COPD is a chronic disease that cannot be cured and as time goes on, the disease progresses. Certain treatments and lifestyle changes can help you manage your symptoms and improve your quality of life. It is important to seek out a healthcare provider who will work with you to improve your breathing.

Sources:

https://foundation.chestnet.org/lung-health-a-z/chronic-obstructive-pulmonary-disease-copd/

https://www.who.int/respiratory/copd/burden/en/

https://goldcopd.org/

What Exactly is Respiratory Therapy?

Respiratory therapy involves caring for patients with chronic breathing problems and lung issues. Factors that cause respiratory problems such as lung cancer, pneumonia, and chronic obstructive pulmonary disease (COPD) are often treated by respiratory therapy interventions. The American Thoracic Society states that the most common diseases needing respiratory therapy include severe asthma, COPD, interstitial or fibrotic lung diseases, pneumonia, lung cancer, lung infections, and bronchiolitis.

Respiratory therapy can also help improve the breathing of premature babies. According to the March of Dimes, 1 in 10 babies born in the U.S. is born prematurely. Many of these premature babies will need assistance breathing well into the first months of life, and some will require respiratory therapy even after they leave the intensive care unit and go home.

Who performs Respiratory Therapy?

A respiratory therapist (RT) specializes in treating patients who require respiratory therapy. They work as part of a team to help diagnose lung and breathing problems and help people improve their respiratory health and day-to-day lung function. RTs’ must have a broad knowledge of how the body works, specifically the lungs, and are part of a medical team that diagnoses and treats patients.

Where do Respiratory Therapist Work?

They work in a variety of settings. They commonly work in hospital settings, including the emergency room, the intensive care unit, and the newborn or pediatric intensive care unit. Respiratory Therapists work with patients of all ages, ranging from premature infants with underdeveloped lungs to elderly patients with advanced heart and lung issues.

Outside of the hospital setting, respiratory therapists also work in pulmonary rehabilitation clinics and manage pulmonary rehabilitation centers. With the evolving pandemic and the rise in patients recovering from the Coronavirus, they may find themselves working in specialized clinics to treat Covid-19 ‘long haulers’. An RT can also work in doctors’ offices, sleep disorder clinics, and long-term care facilities. Careers in teaching, patient education, and roles within the medical devices industry are also new areas where respiratory therapists work.

What duties do Respiratory Therapist Perform?

Along with having extensive knowledge of the cardiopulmonary system, respiratory therapists must be experts in the machines and devices used to administer respiratory care treatments. This encompasses a variety of responsibilities.

Some responsibilities of respiratory therapists include:
  • Managing life support mechanical ventilation systems
  • Administering aerosol breathing treatments
  • Monitoring equipment related to cardiopulmonary therapy
  • Analyzing blood samples to determine levels of oxygen and other gases
  • Evaluating patients for the need for supplemental oxygen

Takeaway

During the last week of October, Respiratory Therapists are celebrated and acknowledged for their dedication to patient care, promoting respiratory health, and being a vital part of the healthcare community.

Face Masks and Your Oxygen Levels

Face Masks

As we approach the fall and winter months, it is imperative we continue the use of face masks to slow the spread of COVID-19 and follow the recommendations set by the Centers for Disease Control and Prevention (CDC). Misinformation about their effectiveness to slow the spread of COVID-19 as well as the misconception that their use deprives a wearer’s oxygen level will only lead to adverse impacts on individuals who follow inaccurate information.

An infodemic, that has recently accompanied the COVID-19 pandemic, is an overabundance of information, some information is accurate, and some is not. This makes it difficult for people to find trustworthy sources and reliable guidance when they need it the most.

Oxygen Levels

For most adults, wearing a face mask will not lead to the wearer developing hypoxemia. There are a few exceptions, including the use among very young children and people with certain pre-existing pulmonary or cardiac issues. Hypoxemia is a condition in which the supply of oxygen is inadequate for normal organ function and levels of oxygen are extremely low at the tissue level. Hypoxemia is determined by measuring the oxygen level in a blood sample, the artery, or it can be estimated by measuring the oxygen saturation of your blood by using a pulse oximeter.

Normal arterial oxygen is approximately 75 to 100 millimeters of mercury (mm Hg). For healthy individuals, a pulse oximeter reading of 95 to 100 percent is normal however for those with chronic respiratory conditions such as chronic obstructive pulmonary disease (COPD), an acceptable pulse oximeter reading is 88 to 92 percent. Pulse oximetry levels among COVID-19 patients vary as the condition evolves.

In a press release from earlier this year, CDC Director Dr. Robert R. Redfield shared, “Cloth face coverings are one of the most powerful weapons we have to slow and stop the spread of the virus, particularly when used universally within a community setting. All Americans have a responsibility to protect themselves, their families, and their communities.”

Stay safe and stay informed with good sources of information. Research shows masks are effective in spreading COVID-19 and they will not cause oxygen deprivation.

Read more about this topic at https://www.reuters.com/article/uk-factcheck-oxygen/fact-check-face-masks-do-not-cause-terrible-damage-to-the-brain-by-depriving-it-of-oxygen-idUSKBN2761ZW

Our fact-check sources:

The CDCs Recommendations

Questions and Answers regarding Face Coverings

True Hypoxia and Hypoxemia Facts

Frontline Workers & The Truth About Masks

Seven Steps to Help You Quit Smoking Cigarettes

Smoking is not only a physical addiction, but also a psychological habit. The temporary high that smokers get from tobacco is extremely addictive.

Smoking severely damages your lungs, specifically your alveoli which are tiny sacs found within the lungs. Smoking is the #1 cause of chronic obstructive pulmonary disease (COPD). According to American Lung Association, over 16.4 million people are diagnosed with COPD, yet millions more have COPD without being aware of it. Smokers also have a greater chance of getting cancer, especially in the lungs.

 

Based on information collected from the US Department of Health and Human Services, cigarette smoking is responsible for over 480,000 fatalities in the United States every year. Over 41,000 of these deaths are caused by exposure to secondhand smoke. To put these statistics in perspective, that is 1 in 5 deaths yearly, or 1,300 deaths per day. According to the New England Journal of Medicine, smokers’ lifespans are typically 10 years shorter than nonsmokers. Below are helpful steps to quit smoking.

Step 1: Realize Why You’re Quitting

This reason is usually health related, and quitting smoking will help you live a healthier and longer life. Another reason might be stopping for your loved ones. Living to see your kids or grandchildren grow up is a great motivator to extend your lifespan by quitting smoking. Whatever your reason may be, quitting will give you more time to do the things you love, and will eliminate the anxiety that comes with wondering when you will get to smoke next. You will look better, smell better, and most importantly feel better after quitting.

Step 2: Tell Others

Sharing that you are planning to quit smoking with your loved ones will give you the encouragement and support you need to stop. They will be able to hold you accountable for you dedication to quitting and can be constant reminders of your reason to quit.

Step 3: Get Rid of Cigarettes and Paraphernalia

Dispose of all cigarettes, ashtrays, lighters, or anything that reminds you of smoking. Not having easy access to cigarettes would cost you a trip to the store to buy another pack, and will remind you of your reason for quitting.

Step 4: Consider Alternatives

Nicotine replacement therapy (NRT) is a safe and efficient way to help smokers with nicotine withdrawal. NRT gives you the nicotine that your body is craving in a form other than a cigarette. Cigarettes contain thousands of chemicals when inhaled, including toxic ones found in rat poison and nail polish remover. Although nicotine is an addictive chemical, just taking in nicotine is much safer than smoking cigarettes. The more cigarettes you smoked per day, the higher dose of nicotine you will need starting out.

There are many options when it comes to NRT, and one of the most common is a nicotine patch. There are also other options such as gum, inhalers, nasal spray and lozenges. Some NRT is available over-the-counter, but others you need a prescription for. The goal of NRT is to gradually decrease your dose until you can get off nicotine altogether.

Other types of NRT can be prescribed in pill form as well. These do not contain any nicotine, but they work by cutting cravings and block nicotine receptors in your brain. Talk to your doctor to determine which quitting aid is best for you.

Joining a support group can be very helpful to connect with others that are struggling with the same problems. Support groups can either be online or in person.

Nicotine addiction rehabilitation centers are also available if you feel that you will not be able to quit on your own. These rehab centers offer full-time help along with other people who are going through the same thing as you. There are multiple options available, such as outpatient and residential programs.

Step 5: Keep Busy

You may be irritable, anxious and experience headaches for a few days after quitting suddenly, so keep this in mind if you are around others. Use this time to grow as a person by trying new things, picking up new hobbies and filling your time with activities. This will keep your mind occupied on things other than the need to smoke. Below is a list of ideas to keep yourself entertained.

  • Cook or bake
  • Shoot photography
  • Birdwatch
  • Exercise
  • Call a friend or family member
  • Adopt a pet
  • Try a new food or restaurant
  • Read a book, write or paint
  • Garden
  • Take a class to learn something new

Remember that half of quitting smoking is the psychological aspect.

Step 6: Know and Avoid Your Triggers

Realize what triggers you to smoke a cigarette. Triggers can range from smelling cigarette smoke to finishing a meal, but everyone has different triggers. Avoid the triggers when you can, but it’s a given that not all will be avoidable. For example, if your routine was to wake up and smoke with a morning cup of coffee, go to a coffee shop instead of making your own. This way you won’t be tempted because you can’t smoke inside.

What To Do if You’re Triggered

If you’re thinking about getting more cigarettes, go to a public indoor place such as the mall or a museum where smoking is prohibited instead. This will shift your focus off cigarettes for the time being.

If it’s the feel of the cigarette in your mouth that you are craving, have some gum or mints on hand to fight this urge and keep your mouth busy. Having a glass of water around at all times can be beneficial to drink since your body was used to the motion of moving your hand to your mouth and back.

Step 7: Reap the Benefits

By not smoking anymore, you are saving money which you can use to treat yourself for your hard work. You are also improving your quality of life by having more energy to perform your daily acts of living.

Quitting now will prevent any more damage from being done to your body. Even if you have been smoking for 40 years, you will be able to gain a great portion of your health back.

The American Cancer Society suggests that not smoking for just 12 hours will return your carbon monoxide levels to normal. Around 3 months after, circulation improves, and you will have better lung function. Anytime between 1 and 9 months after quitting, your shortness of breath will decrease along with your coughing. After a year, you will cut your risk of heart disease in half. The longer you go without smoking, the more benefits will come, such as lowering your risk of cancers and diseases.

We wish you the best of luck on your journey to quitting. It may not be easy, but quitting smoking is a great accomplishment and something to be extremely proud of. You are doing this to set yourself up for a healthier lifestyle, and taking this initiative shows how strong of a person you are.

 

Sources:

https://www.addictionsandrecovery.org/quit-smoking/how-to-quit-smoking-plan.htm

https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/learn-about-copd#:~:text=COPD%20is%20the%20third%20leading,disease%20without%20even%20knowing%20it.

https://www.cancer.org/healthy/stay-away-from-tobacco/benefits-of-quitting-smoking-over-time.html

https://www.ncbi.nlm.nih.gov/books/NBK179276/pdf/Bookshelf_NBK179276.pdf

https://www.nejm.org/doi/full/10.1056/NEJMsa1211128

https://www.rehabs.com/getting-help-for-nicotine-addiction/

 

 

Risk Factors of COPD Among Women

Historically, men have been perceived to have a higher prevalence of chronic obstructive pulmonary disease (COPD) as compared to women, however, studies now show that more women are diagnosed with COPD and their mortality rates are higher. There is evidence of susceptibility among women of the risk factors associated with COPD.

The World Health Organization (WHO) in conjunction with the Global Burden of Disease (GBD), reports a prevalence of 251 million cases of COPD as of 2016. In 2015, it was estimated that 3.17 million deaths, accounting for 5% of global deaths, were caused by COPD. This is something that WHO had not predicted to occur until the year 2030.

As we know, COPD is a progressive respiratory condition that causes various limitations for breathing.

  • Pathophysiological changes involve inflammation in the lungs, narrowing of the airways, and damage to the lung parenchyma
  • The most common risk factors associated with the development of COPD include smoking, exposure to secondhand smoke, air pollution as well as occupational dust and fumes that are inhaled
  • WHO estimates that 25% of deaths attributed to COPD involve low- and middle-income countries and correlate to the increased exposure of household air pollution
  • Women who are exposed to high levels of indoor smoke and are twice as likely to develop COPD as compared to women that use cleaner fuels and technologies

While the diagnosis and treatment of men or women with COPD are the same, the risk factors are not consistent among both sexes. The associated risk factors among women that will be discussed include smoking status, associated comorbidities, occupational exposure, as well as anatomical and biological differences.

Smoking Status

As we know, tobacco smoke is the main cause of COPD in the United States and smoking is the leading cause of preventable death. According to information available from the Centers for Disease Control (CDC) and the U.S. Department of Health and Human Services (HHS) cigarette smoke causes about one of every five deaths annually, or 1,300 deaths every day. Cigarette smoking is responsible for more than 480,000 deaths per year in the United States, of which 201,773 deaths are among women.

The use of tobacco among women has steadily increased over the years, with a dramatic increase in use since the 1950s. During this time, it was more socially acceptable for women to smoke, and the tobacco industry targeted women in their marketing campaigns by promoting sex appeal, independence, and style. Decades later, tobacco companies continued their strategies by marketing cigarettes with slogans that included phrases such as “It’s a woman thing” or “You’ve come a long way, baby.” Some companies even suggesting that reaching for a cigarette was better than reaching for food and over-indulging, aligning with their campaigns that smoking made you more appealing and stylish. The effects of advertising are attributed to the rise in smoking among women in that era and their shift in use explains why consumption levels remain higher in places such as France, as compared to other countries.

Associated Comorbidities

COPD is typically associated with accompanying comorbidities and includes more organ systems than just our lungs. A recent publication in the respiratory care journal shares data researchers gathered regarding comorbidities among COPD patients and their associated healthcare use. The study included a total of 70,274 COPD subjects, women made up 58.2% of the total COPD subjects. Fifteen comorbidities were identified and the most prevalent diagnosed were hypertension accounting for 47.6%, high cholesterol at 29%, and allergies accounting for 34.2%. Women were found to have at least one or more comorbidities, 51.2% of the subjects studied, and had three times as many diagnosed comorbidities than their male counterparts.

In a 2016 review, Barnes discusses sex differences in COPD and notes that women with severe COPD have a higher risk of hospitalization and death from respiratory failure and associated comorbidities. For those women that have developed COPD due to smoking, their risk of dying from coronary heart disease as compared to other middle-aged nonsmokers’ women is five times higher.

Often, comorbidities in COPD patients go undiagnosed and therefore lead to failure in treatment for their needs. More standardized protocols should be developed by organizations with a goal to provide useful management of patients with COPD and comorbidities so that those healthcare providers caring for these patients provide the right care.

Occupational Exposure

Occupational and biomass exposure is another common risk factor for COPD. Workplace exposures can include things such as dust, fumes, gases, and secondhand smoke. Presently, some three billion people use biomass or solid fuel as energy sources to heat and light their homes, and to cook. In developing countries, women often are exposed to these risks as they spend most of their time in the home and do most of the cooking leaving them disproportionately exposed to larger amounts of biomass irritants.

It has been studied that a lower a person’s socioeconomic status, the higher their risk of poor health. This statistic includes women and children who live in severely impoverished countries and have the greatest exposure to air pollutants. In a 2006 WHO review on energy and health, women who cook with solid fuels have an equivalence of smoking two packs of cigarettes a day. To put it in perspective, a 1-year old girl can accumulate a two-pack year smoking history without ever having been exposed to tobacco smoke.

Women now work in similar jobs as do men, taking on careers in factories and chemical plants, working as farmers, mechanic shops, and in the hospitality industry. All these job fields along with others risk their health through exposure to harmful toxins that can in time lead to the development of COPD.

Anatomical and Biological Differences

Recent studies have also discussed the anatomical differences among men and women and how that is factored into the development of COPD. Various authors have compared lung sizes via different radiological tests and proven that men’s lungs are bigger. According to Aryal et al.,  women are more susceptible to developing COPD due to the size difference of their airways. Their airways are relatively smaller than those of males in comparison to their respective lung volumes.  Therefore, the level of tobacco smoke may be increasingly concentrated per unit of small airway surface. However, no difference in size has been observed in the number of alveoli per unit area, the number of alveoli per unit area volume, individual lung units, and alveolar dimensions. Collectively, more studies should investigate the specific differences in lung size as it relates to tobacco particle disposition and inhaled irritants.

Tobacco smoke contains more than 4,000 chemicals, the smoke inhaled into the lungs is then absorbed and metabolized throughout the body. The process involves a multistep approach but what is important to note about it is that cytochromes p450 (CYP) are what differentiates COPD between men and women. CYP is important in the clearance and breakdown of various compounds, irritants from inhaled tobacco being one of them. In fact. According to a 2016 publication by Hardin, female smokers have increased lung expression of CYP enzymes compared with male smokers. This evidence explains why estrogen levels in women have also been linked to the development of COPD. Estrogen may regulate CYP expression, specifically the estrogen receptor Era, which is more prevalent in women. This information collectively suggests female hormones may hasten the metabolism of tobacco smoke, via the CYP pathways, and accelerate the metabolism of nicotine.

Closing Thoughts

While the number of COPD-related deaths has fallen over the years, the number of diagnosed cases is rising. In the UK, COPD cases continue to rise as the population ages. The long-term effects of smoking are also likely to increase the present burden of COPD on healthcare systems. This presents challenges for both patients and the healthcare systems, not just in the U.S. and UK, but worldwide. It is imperative that we understand the underlying differences between men and women as it relates to COPD.  We should continue to work towards improving the diagnosis, treatments, and monitoring of COPD in women. Reducing the stigma surrounding COPD, raising awareness about various risk factors, and tailoring smoking cessation programs to women can help flatten the curve of this incurable disease.

 

Resources:

Aryal, S., Diaz-Guzman, E., & Mannino, D. M. (2014). Influence of sex on chronic obstructive pulmonary disease risk and treatment outcomes. International journal of chronic obstructive pulmonary disease, 9, 1145–1154. https://doi.org/10.2147/COPD.S54476

CDC – Data and Statistics – Chronic Obstructive Pulmonary Disease (COPD). (2018, June 05). Retrieved September 22, 2020, from https://www.cdc.gov/copd/data.html

Barnes PJ. Sex Differences in Chronic Obstructive Pulmonary Disease Mechanisms. Am J Respir Crit Care Med. 2016 Apr 15;193(8):813-4. DOI: 10.1164/rccm.201512-2379ED. PMID: 27082528.

Han, MeiLan. (2020). Chronic Obstructive Pulmonary Disease in Women: A Biologically Focused Review with a Systematic Search Strategy. International Journal of Chronic Obstructive Pulmonary Disease. Volume 15. 711-721. 10.2147/COPD.S237228.

Hardin M, Foreman M, Dransfield MT, et al. Sex-specific features of emphysema among current and former smokers with COPD. Eur Respir J. 2016;47(1):104-112.

Quaderi, S. A., & Hurst, J. R. (2018). The unmet global burden of COPD. Global health, epidemiology, and genomics, 3, e4. https://doi.org/10.1017/gheg.2018.1

Soriano JB, Maier WC, Egger P, et al. Recent trends in physician-diagnosed COPD in women and men in the UKThorax 2000;55:789-794.

U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress. A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. Accessed September 22, 2020.

World Health Organization (WHO). Chronic obstructive pulmonary disease (COPD). http://www.who.int/respiratory/copd/en/. Accessed September 20, 2020