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Friday’s COPD Newsletter from COPD Support, Inc.

Posted Aug 13 2010 12:36pm

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Volume 10, Issue 37
August 13, 2010
Richard D. Martin, Co-Editor

A single drop of blood can contain millions of red blood cells. Red blood cells contain hemoglobin, and hemoglobin is the means by which oxygen (O2) and carbon dioxide (CO2) are transported throughout the body. There has been some recent discussion about how COPD might affect one’s red blood cell count.

What seems to be a paradox is that COPD can (but certainly not always) cause us to produce an abnormally high red blood cell count, called polycythemia, as well as an abnormally low red blood cell count, which we know as anemia. This apparent paradox is not really a paradox at all once we understand a bit about both polycythemia and anemia.

Overview of Polycythemia

First, there are two types of polycythemia (also called “thick blood”). One type, primary polycythemia (also known as polycythemia vera) is the result of a bone marrow abnormality. Although there is no guarantee that someone with COPD can’t also have primary polycythemia as a separate illness, the type of polycythemia more common in the COPD community is secondary polycythemia. It is called secondary polycythemia because the abnormally high red blood cell count is due to other primary health factors, of which COPD is one. There are other causes of secondary polycythemia besides COPD; they include cardiac problems, inflammatory diseases, acclimation to high altitude, etc. There are also other types of polycythemia beyond those mentioned. You’ll find a good overview of polycythemia at http://www.medicinenet.com/polycythemia_high_red_blood_cell_count/article.htm

Secondary Polycythemia

Many of us have heard that (secondary) polycythemia is common in people with COPD. Given this, Chest, the journal of the American College of Chest Physicians, decided to determine how frequently this condition actually occurs in people with COPD. They collected data on 677 people with COPD in 2005 and found that polycythemia occurred in only 5.3% of those individuals studied. Because secondary polycythemia can occur when the body compensates for decreased blood oxygen level, the researches didn’t speculate on how home and portable oxygen may have decreased the frequency of occurrence of polycythemia since oxygen therapy became available and widely used. To read an abstract of the study in Chest, please visit http://tinyurl.com/2eoezxz

Symptoms of Polycythemia

The Mayo clinic provides the following symptoms of polycythemia: “headache, dizziness, itchiness after a bath, redness of skin, shortness of breath, breathing difficulty when you lie down, numbness, tingling, burning, or weakness in hands, feet, arms and legs, chest pain, a feeling of fullness or bloating due to an enlarged spleen, and fatigue.” Because polycythemia can also lead to a stroke, the symptoms might also be similar to those of a stroke. For more details and information, see http://www.mayoclinic.com/health/polycythemia-vera/DS00919/DSECTION=symptoms

Anemia

Yes, Chest, the journal of the American College of Chest Physicians, looked at this too! They point out that anemia is common in a number of chronic diseases and that anemia is also associated with poor survival. They reviewed 1185 clinic records and found that 19% of individuals with COPD were anemic. To read the abstract, please see http://tinyurl.com/2cfm5gz

Chest also points out that anemia is common in other diseases including inflammatory diseases, of which they consider COPD to be one. They state, “Anemia in chronic illness is characterized by weakness, fatigue, cachexia (weight loss syndrome), nutritional state, and impaired mood, cognitive functions, and quality of life.” For more information, see http://chestjournal.chestpubs.org/content/127/3/825.full

Following Up with Your Doctor

A Complete Blood Count (CBC) can determine your red blood count as well as other important red blood cell
factors (and white cells also). Those of us with COPD should discuss regular testing with our doctors. If the results are abnormal, we should find out how to address this abnormality and determine when follow-up tests should be scheduled. Although pulmonologists might be more aware that COPD can cause anemia than primary care providers, many pulmonologists defer blood testing to primary care physicians.

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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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- GLAXOSMITHKLINE FINDS COMPOUND THAT COULD HELP FIGHT SUPERBUGS
- FDA SEEKS INJUNCTION AGAINST COLORADO MANUFACTURER OF CULTURED CELL PRODUCT
- CMS FINALIZES POLICY AND PAYMENT RATE CHANGES FOR INPATIENT STAYS IN ACUTE LONG
TERM CARE AND CERTAIN EXCLUDED HOSPITALS IN FISCAL YEAR 2011
- MEDICARE CUTS MIGHT AFFECT MEDICARE ADVANTAGE PLANS
- CONSUMER MEDICATION INSTRUCTION (CMI) LACKING IN MANY PHARMACIES
- SETTING EXPECTATIONS FOR REDUCING ASTHMA TRIGGERS
- COMPARISON OF WEIGHT LOSS AT 2 YEARS ON LOW-CARB VS. LOW FAT DIET
- SINGING AS THERAPY FOR RESPIRATORY DISEASE
- COMPRESSION CPR INSTRUCTIONS
- MISCELLANEOUS

The drug manufacturer GlaxoSmithKline has announced the discovery of a compound that can kill drug- resistant bacteria. Their discovery holds the promise of helping the development of new antibiotics to fight resistant strains of bacteria which has been called, “one of the world most pressing health problems.”
http://tinyurl.com/23tkjf2

The FDA announces that it is seeking an injunction in federal court against Regenerative Sciences, LLC for selling adulterated and misbranded products. The company claims to use an individual’s own stem cells for treatment of medical conditions.
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm221656.htm

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COMMERCIAL FREE:
We do not accept any paid advertising. Any corporations, products, medicines
(prescription or over the counter) 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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The Centers for Medicare and Medicare Services (CMS) issued their final rates for inpatient services at acute care and long term hospitals for fiscal years 2011. The overall effect is to decrease payments, and most hospitals, understandably, are not pleased. This decrease in payments is arrived by a formula that defies any attempt to simplify or summarize it. For the highly adventurous, an explanation of the new payment rate is available at: http://www.medicalnewstoday.com/articles/196580.php

As part of the healthcare reform act, Medicare will be implementing a number of cost-saving measures. Part of the $575 billion in planned savings is made up by reducing the payments to Medicare Advantage plans. These are the plans that provide Medicare coverage through private insurance plans. We’ll have to wait and see how these plans are actually affected, and how they will react, but it is anticipated that a number of people in the Advantage programs will opt for traditional Medicare once costs rise or benefits such as dental coverage or coverage for eyeglasses are decreased. For complete information, please see http://tinyurl.com/2eqjos9

It appears that we need to go out of our way to insure we understand the proper use of the medications we are on. A study published in the current Archives of Internal Medicine finds that, “Private sector initiatives to provide useful CMI have failed.” For the abstract, go to http://archinte.ama-assn.org/cgi/content/short/170/15/1317

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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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Because many if not most of us have asthma or an asthmatic component to our COPD, the following article in Advance for Respiratory Care and Sleep Medicine, provides a good review and valuable tips http://tinyurl.com/26cbole

Researchers from Temple University found no differences in weight loss between those on a low- carbohydrate diet compared to those on a low-fat diet. They did find, however, that those on a low- carbohydrate diet had fewer cardiovascular risk factors at the end of 2 years. For more information, put that donut down and visit http://www.annals.org/content/153/3/I-35.full

A study in the BioMed Central Journal, published in the UK, reports that although singing in a group might not result in increased breathing capacity or endurance, the activity resulted in participants reporting benefits, mainly in decreasing anxiety and improving their quality of life. The study can be found at http://www.biomedcentral.com/1471-2466/10/41/abstract

As a follow-up to last week’s news that chest compression CPR is better than mouth-to-mouth CPR for those in cardiac distress, members of the SmokeNoMore group want to share the following instructional video http://tinyurl.com/2fx8r59

If you are unable to watch a video, you will find written instructions at http://firstaid.about.com/od/cpr/ht/06_cpr.htm

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JOIN US? Subscription to this Newsletter is free and we hope that it serves your needs. For more Newsletter information, go to: http://copd-support.com/signup-news.html

The Newsletter, like all the other endeavors of the Family of COPD Support Programs , is provided to you by COPD-Support, Inc . a non-profit member organization with IRS designation 501(c)(3). If you would like to be involved and help us provide these programs to the individuals who benefit from them, please consider joining us as a member. Further information is available at: http://copd-support.com/membership.html
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Here’s a good website that provides specialized legal information pertinent to older people.
http://www.elderlawanswers.com/

If you have high speed Internet, these videos will keep you entertained long past your bedtime!
http://www.flixxy.com

Have you considered creating your own word search puzzle? If you choose your words carefully, you can
make an amusing gift, highly individualized gift, or, pray tell, a gag gift!
http://puzzlemaker.discoveryeducation.com/WordSearchSetupForm.asp

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


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