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Friday’s COPD Newsletter from COPD Support, Inc.

Posted Oct 22 2010 2:10pm

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Volume 10, Issue 46
October 22, 2010
Richard D. Martin, Editor

In a study of malnutrition in people with COPD, available on the Cambridge University Press website Journals Online, researchers point out there has always been some confusion about how many people with COPD suffer from malnutrition. They note that studies have shown between 10 and 45 percent of us with COPD are malnourished. This wide range, they explain, is because different measurements are used in different studies. This particular study uses the “Malnutrition Universal Screening Tool.” Their evaluation of 425 people with COPD finds that 21 percent of us are malnourished. They also conclude that the chance of being malnourished increases with the severity of the disease. The study can be read at http://tinyurl.com/28q2ysm

Nutritional Guidelines

The Cleveland Clinic has published nutritional guidelines for people with COPD. They explain the important role both O2 (oxygen) and CO2 (carbon dioxide) have in metabolism, and do so in simple terms that help the reader understand their guidelines. Although the article explains the benefits of proper nutrition for everyone with COPD, it also specifically addresses the needs of people looking for ways to increase their weight. They even have recipes for high calorie foods. Here are just some of the interesting things you will find in this article:

*Compared to normal people, those of us with COPD may require up to 10 times the number of calories to breathe
*Good nutrition helps fight infections
* 6-8, eight-ounce glasses of water a day helps keep mucus thin, however if you have a heart problem follow your doctor’s advice for water consumption
*Consume 25 to 30 grams of fiber a day
*Limit your salt intake
*Avoid carbonated beverages, greasy or spicy foods, as well as the short list of fruits and long list of vegetables identified in the article

The authors also address the common problem of being SOB (short of breath) while eating (or shortly after eating). One of their suggestions is to clear your airways one hour before meals. They also recommend, among other things, eating slowly and more often, drinking your liquids at the end of the meal, and sitting upright to ease pressure on your lungs.

The complete article, with something for everyone with COPD, can be read at http://tinyurl.com/16aj

Pulmocare Therapeutic Nutrition

One nutritional liquid supplement made especially for people with COPD is Pulmocare, by Abbott Nutrition. It is a high calorie, low carbohydrate drink designed to minimize CO2 production. There might be other brands and similar products available, but regardless of supplement chosen, it should only be used under a doctor’s supervision. The Abbott website for Pulmocare is at http://tinyurl.com/23tergu

Remember to talk to your doctor before starting any program or method to increase or reduce weight. Also get your doctor’s approval before taking any supplement in any form.

- REPNEU LUNG VOLUME REDUCTION COIL
- THE AMERICAN LUNG ASSOCIATION GIVES $5 MILLION FOR LUNG DISEASE RESEARCH
- COPD GREATLY INCREASES RISK OF CARDIOVASCULAR DISEASE
- THEOPHYLLINE FOR TREATMENT OF COPD
- NEW DRUG BLOCKS MORPHINE’S NEGATIVE EFFECT ON BREATHING BUT NOT PAIN
- NASAL CPAP CAUSES FACIAL CHANGES
- THE BENEFIT OF HAVING INDOOR PLANTS
- IS THE U. S. DEPARTMENT OF HEALTH AND HUMAN SERVICES’ “HOSPITAL COMPARE” WEBSITE INADEQUATE? MISLEADING?
- SCOTTISH MEDICINES CONSORTIUM SAYS NO TO ROFLUMILAST (DAXAS)
- MISCELLANEOUS
AUTUMN LEAVES
COLOR TEST
COUPONS, COUPONS, AND MORE COUPONS!
GAMES FOR YOUR BRAINS

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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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PneumRx, a medical device company in the United States, has developed a device, still under investigation, that is designed to improve lung functioning in people with COPD by reducing lung volume. This device, a coil, is implanted through a bronchoscope during a short, simple, and minimally invasive procedure. To date, their studies have shown that the benefits of the implant can be felt within hours, and patients can return home the next day. The trials are taking place in Europe and the device has received the “CE mark” approval. The CE mark certifies that the product has met the European Union’s safety, health and environmental requirements. For more information on this device, visit the manufacturer’s website at http://www.pneumrx.com/technology.aspx

The American Lung Association (ALA) announces it is providing $5 million to fund research into lung disease in 2010-2011. The grants support research into lung cancer, asthma and COPD. They support initiatives to promote smoke-free homes and research into how to stop airway wall thickening to improve the survival of people with COPD. For more information, see the article in RT Magazine at http://www.rtmagazine.com/news/2010-10-14_01.asp

People with COPD have 2 to 3 times the likelihood of having cardiovascular disease compared to people without COPD, according to research published in the International Journal of Chronic Obstructive Pulmonary Diseases. The researchers were able to show an increased risk across a spectrum of cardiovascular diseases, including, but not limited to: coronary heart disease, angina, stroke, congestive heart failure, etc. Please see the following website for the study http://tinyurl.com/2cnkzrj

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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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Theophylline has been used in the treatment of COPD for over 70 years. It is still widely prescribed throughout the world because it is inexpensive and works in more than one way. Because of potential problems with side effects, and because newer, more effective medications are available, it isn’t prescribed as frequently in some countries as it used to be. Nevertheless, it is still prescribed and some of us currently take theophylline. The U. S. National Library of Medicine, National Institutes of Health, lists 10 brand names of theophylline and another 22 medications that have theophylline in them. To see this long list of medications, as well as read about other important information concerning theophylline, see http://tinyurl.com/23zpspk

A 2005 article in the Proceedings of the American Thoracic Society also provides a thorough discussion of the use of theophylline. It is especially interesting in that it discusses the anti-inflammatory effects of the drug, and talks about how it interacts with corticosteroids such as prednisone. For the article, please visit http://tinyurl.com/2fvof6s

Morphine and other similar opiates have been used for pain relief for centuries. It is even used in a nebulized or other form for the treatment of severe shortness of breath. To find out more about morphine and breathing, see the article on the Quality of Care website at http://www.qualityoflifecare.com/?p=264

For a thorough review of morphine, its history and uses, see Wikipedia at http://en.wikipedia.org/wiki/Morphine

One of the big problems with using morphine for comfort care and pain relief is that it depresses breathing. Because of this, morphine may not be prescribed when we feel we need it most, or in the dosage we desire. However, good news might be around the corner. Medical News Today discusses a study (the study is unavailable to non-subscribers) in the International Anesthesia Research Society’s October journal that reports development of a drug that blocks morphine’s effect on breathing without blocking its pain-relieving properties. Although this Medical News Today article is comforting, note that was only recently approved for human trials. Please see http://tinyurl.com/279u59r

CHEST, the journal of the American College of Chest Physicians, reports that the use of nCPAP (nasal continuous positive airway pressure) machines result in craniofacial changes in adults with obstructive sleep apnea. They explain the structural changes as “reducing maxillary and mandibular prominence and/or by altering the relationship between the two dental arches.” You may want to quiz your dentist to see if he or she is familiar with the findings, which, incidentally, can be found at http://tinyurl.com/254h25m

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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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No, we’re not talking about covert operations and secret codes. We’re talking about those green things that take in CO2 and release O2 – the opposite of what we do. The following article from the Healthy Eating website suggests plants for both enhancing our environment and adding O2 to the air. They recommend the following plants:

*The ficus tree
*Pony tail palm
*Angle ivy topiary
*Chinese evergreen
*Moth orchid

You can read the whole article at http://tinyurl.com/234abz9

Kaiser Health News (not affiliated with the health insurance company Kaiser Permanente) explains the limitations of the HHS (U.S. Department of Health and Human Services) website that allows users to put in their zip codes and compare hospitals in their area. With the click of your mouse, you can find out such things as available services, treatment outcomes, and patient satisfaction ratings. However, Kaiser Health News points out that a recent article in the Archives of Surgery (subscription needed) claims that the HHS site really doesn’t help some Medicare beneficiaries in need of “high risk” surgery find better facilities. The Kaiser article also goes on to explain how some of the numbers used by HHS to evaluate hospitals are misleading. The complete article can be read at http://tinyurl.com/2c2dzll

The HHS Hospital Compare website is at http://tinyurl.com/25p49a2

Although approved by the European Union and elsewhere, the National Health Service for Scotland (NHS) has not approved the use of roflumilast (Daxas) in Scotland. Among their reasons for not approving the drug, they cite “some weakness in the clinical data,” weaknesses with the “comparators” (choice of drugs against which roflumilast was compared), and perhaps the most important reason, “the manufacturer did not present a sufficiently robust economic analysis” to gain acceptance by the SMC (Scottish Medicines Consortium). This can be interpreted as saying that the manufacturer didn’t show how it would help control treatment costs over the lifetime of individuals with COPD. Roflumilast is currently available in at Germany and in England (if a physician asks for it). It may also be available in other countries. It is awaiting approval in the United States. The SMC’s assessment can be viewed (in pdf) at http://tinyurl.com/234jfew
For availability in England, see http://tinyurl.com/28jgxxc

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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: http://copd-support.com/membership.html
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AUTUMN LEAVES
You’ll want to gaze out your window and sing along when you hear this. Heck you may even have an “exacerbation” of nostalgia! (Exacerbation: an increase in symptoms or severity).
http://tinyurl.com/2az8kal

COLOR TEST
John W. from Minneapolis sent this surprisingly “challenging” test. Be sure to read the instructions very carefully before you begin! Misunderstanding the instructions will not be accepted as an excuse for a pitiful initial score, which, you might find, you’ll probably want to keep secret!
http://tinyurl.com/528bn

COUPONS, COUPONS, AND MORE COUPONS!
You’ll find a wide variety of discount coupons and coupons for free items here http://www.shop4freebies.com/

GAMES FOR YOUR BRAINS
Lots of fun and interesting games without being bombarded with ads!
http://www.brain.com/

For comments and questions, or to contact Richard D. Martin, please send your email to: newsletter@COPD-Support.com

Proofreading provided by: Jennifer, B.C. Canada

Until next Friday,
Richard D. Martin, Editor


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