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Friday’s COPD Newsletter from COPD Support, Inc.

Posted Jul 23 2010 9:35am

Volume 10, Issue 34
July 23, 2010
Editors - Joan Costello
Richard D. Martin

There has been much lively discussion recently in the news and on our boards about vitamin D and its importance on our health (especially bone health). Because of the pervasiveness of vitamin D deficiency in the USA and other countries, and the many consequences of being vitamin D deficient, many of us are being tested and are being told we are deficient in this vitamin.

Many of Us Are Short on Vitamin D, Which Has Plenty of Health Benefits
By Kathleen M. Zelman, MPH, RD, LD

Scientists have known for some time about vitamin D’s role in helping the body absorb calcium, in maintaining bone density, and in preventing osteoporosis. But new research suggests it may also help protect against chronic diseases such as cancer, type 1 diabetes, rheumatoid arthritis, multiple sclerosis, and autoimmune diseases.

Yet many adults have low blood levels of vitamin D. Vitamin D is not abundant in our usual food choices, so we get most of the vitamin from sun exposure and multivitamins. The problem is that the sun is not a reliable source for everyone.

The season, time of day, geography, latitude, level of air pollution, color of your skin, and your age all affect your skin’s ability to produce vitamin D. Further, the form of Vitamin D found in most multivitamins is vitamin D2, which does not deliver the same amount of the vitamin to the body as the more desirable D3 form.

When you are deficient in calcium and vitamin D, your bones break down to supply calcium to the rest of your body. But being deficient in vitamin D can take a toll on more than just your skeleton. Low levels of vitamin D have also been linked with poor muscle strength and other chronic conditions, such as autoimmune disease and some forms of cancer.

D is also the only vitamin that does not need to be consumed in food or supplements because our bodies are efficient at making it when our skin is exposed to direct sunlight (not through a window). But not all sun exposure is the same, and many factors help determine how much we absorb. In general, the farther away you are from the equator, the less efficient the vitamin D production, but cloud cover and air pollution can hinder the sun’s ultraviolet (UV) rays. Along with geography, age and skin pigmentation are also factors.

The current recommended intake of vitamin D is 200 IU (international units) for those up to age 50; 400 IU for people 51-70; and 600 IU for those older than 70. Requirements increase with age because older skin produces less vitamin D.

But these recommendations date back to 1997. Evidence is mounting that we may need even more especially older, dark-skinned, or housebound people.

According to the IOM Dietary Reference Intakes, the safe upper limit for vitamin D is 2,000 IU for children, adults, and pregnant and lactating women. Some experts have suggested increasing the recommended amount to more than 2,000 IU daily. But since vitamin D is a fat-soluble vitamin that is stored in the body, there’s some concern it can be harmful in large doses.

You’re unlikely to get too much vitamin D in your diet unless you overdose on cod liver oil. Sunlight will only produce as much vitamin D as you need, so there is no fear of overdosing from the sun. Indeed, sunshine and supplements not food are the best sources of vitamin D, providing you choose a supplement with D3.

Chances are, you are not getting enough vitamin D for good health. So boost your D with safe sun exposure, or supplement your diet with 1,000 IU of vitamin D3 a day. And be sure to eat a variety of foods rich in vitamin D. Also, check with your dermatologist about guidelines for safe sun exposure.

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.



In August 2009, thieves stole a large amount of Advair Diskus (fluticasone propionate and salmeterol inhalation powder) from the manufacturer’s warehouse. The stolen goods have entered our supply chain and have started showing up in pharmacies. Because they were stolen, and because the FDA ca not assure they were stored properly, the pilfered medication with the following lot numbers is being recalled:

Lot 9ZP2255 - NDC 0173-0696-00, Advair Diskus 250/50, 60 Dose, Exp: Sep 2010 (14,400 inhalers)
Lot 9ZP3325 - NDC 0173-0697-00, Advair Diskus 500/50, 60 Dose, Exp: Sep 2010 (11,200 inhalers)
Patients who have products with these lot numbers should immediately stop using them, contact GlaxoSmithKline’s Customer Response Center at 888-825-5249, and follow-up with their physician or pharmacist to obtain a proper replacement.


By Menna Dohannrey, Health and Fitness Times

Quite a few homes have airborne dirt and dust, gases, bacteria’s, as well as other irritants which aggravate COPD symptoms.

Using tobacco creates a significant threat for the lungs of individuals having chronic obstructive pulmonary disease (COPD), with no question. Tobacco smoke includes a lot more than 4,000 chemical compounds, which includes forty three which are acknowledged to cause cancer. Outside atmosphere pollution is yet another major threat.

Countless homes hold airborne dirt and dust, gases, bacteria, and various irritants which aggravate COPD symptoms such as coughing, breathing problems, difficulty breathing, and also chest tightness. The potential risks are especially higher within the 20% of COPD patients which in addition have allergies. You may be shocked at many of the items throughout the house that may result in difficulty. For instance, a number of air filters which help clear away the dust in the air discharge small quantities of ozone, an air pollutant that’s a lung irritant.

“Ozone could possibly be problematic for those who have COPD,” states Byron Thomashow, MD, professor of medicine with Columbia University Medical Center, New York City as well as chairman of the COPD Foundation. “Which is the reason why I normally suggest HEPA filter systems,” that do not produce ozone. Listed here are 9 additional household dangers for those who have COPD:

1. Air Ductwork filled up with Dust

The forced air flow cooling and heating systems present in countless homes can easily blow dust and various irritants through the entire house. Cleaning the air ductwork regularly will help reduce this issue.

2. Carpets and Rugs Which Obtain Dust and Debris

Carpets and rugs are generally an additional significant source of dirt and dust.
Carpets trigger more problems as compared to rugs, simply because they usually are larger (and for that reason have much more irritants) and also tougher to completely clean than area rugs (which could merely be rolled away and taken to the cleaner). Brand new carpets could be particularly irritating, since they can “out-gas” formaldehyde along with other noxious organic and natural compounds for an lengthy stretch of time following installation.

3. Cleansing Products Which Produce Fumes

Stove cleaners, aerosol polish, along with other household cleansers, particularly those which contain bleach or ammonia, can be quite irritating. “Everything that gives off gases may cause difficulties, bathroom washing products, particularly,” Thomashow claims. Dr. Neil Schachter suggests exchanging fume-producing items with less-irritating “green” cleaning agents, or relying upon old fashioned cleansing agents such as water and soap, baking soda, and also vinegar.

4. Dry Cleaning Chemical substances

Many people having COPD tend to be sensitive to the smell of recently dry-cleaned clothes. To prevent difficulty, take the clothing from the plastic and allow them to air out prior to putting them inside your closet.

5. Fireplaces and also Wood Stoves

A roaring wood flame produces light as well as warmth, as well as various irritating gases and sooty air particle matter.

6. Moisture Which Breeds Bacteria and Mildew

Coming from shower stalls to basements to that particular sponge still left lying by the kitchen sink, moisture in your home could encourage the development of bacteria and also mold. Exactly what can you do to stymie these types of irritants? Seal all leaks. Wipe up spills immediately, and also get rid of water-damaged carpets. Make use of fans to improve air flow within bathrooms and kitchen areas. Exchange kitchen and bath sponges often. Get a humidity meter and make a plan to maintain indoor humidity under 40%, for instance, by running the dehumidifier or perhaps air conditioner.

7. Family pet Dander and Dirt

Dogs and cats fill your house with love, and also with aggravating dirt and dander (pieces of dry out hair and skin).

Not really desirous to bid au revoir to Rover? Have your pet cleaned and groomed two times a month. And also keep your pet out of the bedroom.

8. Showerheads Which Hold Mycobacteria

Current research has proven that showerheads could hold so-called “atypical mycobacteria.” These kinds of germs are usually safe to healthy individuals, yet capable of leading to a chronic, low-grade illness which brings hacking and coughing and also difficulty breathing in individuals with COPD. Mycobacteria may also be resistant to antibiotics, which make them difficult to eradicate. In order to avoid trouble, Schachter suggests getting showerheads cleaned out (or swapped out) twice annually.

9. Toiletries: Perfumed Soaps, Hair shampoos, Aerosols

Many people having COPD tend to be sensitive to perfumed soaps, hair shampoos, deodorants, hairsprays, and also cosmetics. In the event that describes somebody within your house, stick to fragrance-free personal products, and also avoid perfume and cologne.


The pharmaceutical company Merck announced that they received the FDA’s approval for a new medication named DULERA. It should hit the market this summer. Although it is indicated for the treatment of asthma at this time, it is similar to Advair, in that it is a combination of corticosteroid and a long-acting beta2 agonist.


A survey conducted by the AMA and 16 other medical groups found that recent changes to Medicare’s “Consultation Codes” used by specialty doctors (such as pulmonologists), has resulted in a reduction of services available to Medicare patients. Among other negative impacts, the study found that about 30% of doctors have reduced services or are contemplating reducing services to Medicare patients.


A portable heart/lung machine, used in Europe with “excellent results” since 2008, has recently been approved by the FDA. The Methodist Hospital in Huston is the first U.S. hospital to use this device. It is currently being put to work transporting critically ill patients to various areas of the hospital for tests and for transfers between medical centers for specialized treatment. This new machine, which weighs only 40 lbs, should reduce the number of situations when physicians have to conclude that, “The patient is too ill to move.”


On a State Level

To deal with state financial deficits, many states are cutting back on homecare services such as housekeeping, meals and other support services to older people and those who are disabled. Indeed, 25 states and D.C. have already curtailed some of their programs.

On a Federal Level

The Center for Medicare and Medicaid Services (CMS) has proposed cuts in home health care. The proposal, which they would like to enact in 2011, would amount to about a 4.75 decrease in Medicare payments to home healthcare providers.


Beginning January 1, 2011, Medicare is planning to implement its “competitive bidding process” which is anticipated to reduce payment to suppliers of home and portable oxygen equipment and supplies (and other durable medical equipment) by 29% in the following cities: Charlotte, Cincinnati, Cleveland, Dallas, Kansas City, Miami, Orlando, Pittsburgh, and Riverside. The competitive bidding process is a method to contain or reduce costs of services by awarding contracts to those vendors who bid the lowest.

In reaction to the competitive bidding plans, nearly 60 homecare and advocacy groups have joined to urge congress to repeal the program.


Many of us know from our own experience that COPD seldom exists alone. A recent study of 3,000 COPD patients found that more than half had between 6 to 10 other serious and independent health conditions and another 20% had even more than 10 conditions! Of course, it was no surprise that they also found 15% of us take more than 11 prescriptions. Show of hands please?


Dr. Rob provides us with highly sensitive insight into what it is like to treat individuals with chronic illnesses. He talks about his own fear of not having the answers expected of him, and what it is like on the other end of the stethoscope. He has many tips that will help you get the most from your relationship with your doctor, such as not coming on too strong, showing respect, not putting your eggs in too many baskets, etc.

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.

Ever wish you could send someone an email in a language other than English, or just want to insert a non-English word for phrase to make your point? How about a translation for something in a language you don’t understand? You can translate just about any language into any other language at Babelfish!

Like brainteasers? How about riddles, geometry games or just a simply puzzle? If not, play them anyway, they’re good for your brain!

Want to impress your grandchild by sending them a cool link? Or perhaps you are just a kid at heart yourself. PBS’s website for kids lives up to its expectations! If they tell you that you’re out of date, and they’ve looked at the site for years, ask them for their favorite sites. You can visit them when no one is looking and relearn the capitals of all the states and other things you’ve forgotten!

Until next Friday,
Richard D. Martin, Co-Editor

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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:

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