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Friday’s COPD Newsletter from COPD Support, Inc.

Posted Jan 28 2011 6:39pm

newspaper12
Volume 11, Issue 4
January 28, 2011
Richard D. Martin, Editor

We’re in the middle of winter, and more than a couple of us are probably wondering if we suffer from Seasonal Affective Disorder (SAD), sometimes called “winter blues”symptoms of depression thought by many to be due to decreased sunlight. As COPDers, many of us find winter especially difficult. To top it off, it is not uncommon for some of us with COPD to experience symptoms of depression regardless of season. When feeling especially depressed at this time of the year, we might wonder if we have SAD, and, if so, if we should pursue treatment. SAD is recognized as an illness in the mental health practitioner’s Bible, “The Diagnostic and Statistical Manual of Mental Disorders – IV.” In the manual, SAD is regarded as part of a broader depressive disorder; however, other descriptions of SAD seem to treat it as a very separate disorder. Although most professionals believe it exists, not all agree; there are all types of opinions and speculations about SAD. Nevertheless, here are some things the American Psychiatric Association says about SAD:

- symptoms can include: fatigue, lack of interest in normal activities, craving of carbohydrates, and social withdrawal (but you don’t have to have all of these symptoms)
- symptoms usually occur in the fall and winter months (but some have it in the summer instead)
- symptoms can come on gradually or suddenly
- symptoms can range from mild to severe
- symptoms subside when daylight increases

The above is from the American Psychiatric Association’s Healthy Minds – Healthy Lives website at http://tinyurl.com/4ayvhmr
and the British Journal of Psychiatry
http://tinyurl.com/4wbrdk5

Light and Seasonal Affective Disorder

Some theorists claim that slowing down (eating less and sleeping more) in the winter conserves energy and is a survival mechanism from earlier evolutionary times. A 2007 New York Times article, as well as other sources, points out that studies show SAD is more prevalent in northern areas due to decreased sunlight. Skeptics point out exceptions to this phenomena. In turn, their critics provide reasons for the exceptions. The New York Times article explains that light, or lack of it, affects our melatonin levels. Melatonin is a hormone. Changes in melatonin levels are also detected in animals with “seasonal behavior.” If the lack of light is the cause of SAD, it is believed by many that increasing the amount of light might reverse the symptoms of SAD. For more information, see The New York Times article at http://tinyurl.com/4zowrqd

Light Therapy Choices

The Mayo Clinic has some very good information on SAD, and they provide practical guidance on how to choose the best light treatment. They also point out there are other treatments besides light therapy, such as psychotherapy and antidepressant medications. Light therapy requires a special “light box,” and the Mayo Clinic says there are four things you should take into consideration in your choice: the intensity of the light, safety factors, cost, and style. Light boxes, they explain, should mimic outdoor light. Ordinary indoor lighting does not provide the type of light available in natural daylight. It is important to note that the FDA does not regulate the type of light box used for the treatment of SAD. The term “light box” is also used for a different type of light device used to treat skin conditions, and the FDA does get involved in regulating those. Be careful not to confuse the two. Incidentally, the FDA says that sun tanning lights don’t relieve symptoms of SAD. The Mayo website elaborates upon the following suggestions:

- Talk to your doctor, mental health professional, or pharmacist regarding a recommendation to use the light and any other guidance they might have.
- Be sure the light box is made for SAD.
- Choose the right intensity for your needs. The stronger the light, the less time you need to spend under it. The distance you are from the light also makes a difference.
- Be sure that the unit filters out ultraviolet light (UV), as it can cause eye and skin damage.
- Check out the advantages of the different types of lights used. Light boxes can use florescent lights, incandescent, or LED (light-emitting diodes).
- Find out if it emits blue light. Blue light might be more effective, but may also cause some damage (but studies are inconclusive).
- Be sure the style and planned distance from the light is appropriate to your needs.
- Does it simulate sunrise? Some studies show this might be preferable.
- Be aware that costs vary greatly, and the light box might not be covered by your insurance company.
- Pay attention to the light’s features, which can range from a simple on and off switch to elaborate timers, stands, carrying cases, etc.

For more information from the Mayo Clinic, see http://tinyurl.com/4mzyo38
The FDA publication (in PDF) regarding why tanning lights don’t work for SAD is available at http://tinyurl.com/4svjk28
Other recommended reading is the National Institute of Health’s MedlinePlus article at http://tinyurl.com/25dhud\

- ANTIBIOTICS AND BLOOD PRESSURE MEDS CAN BE RISKY MIX
- COPD DEATH RISKS HAVE CHANGED OVER TIME
- TSA OUTLINES REGULATIONS FOR TRAVEL WITH O2 AND OTHER EQUIPMENT
- FOLLOWING MEDICAL GUIDELINES LINKED TO PNEUMONIA DEATHS
- PROPER TECHNIQUES FOR INHALING MEDICATIONS IMPROVES HEALTH
- TINY ULTRASOUND DEVICES FOR DEADLY LUNG CLOTS
- EXPIRED DRUGS: ARE THEY SAFE AND EFFECTIVE?
- PROTEIN IN CYSTIC FIBROSIS ALSO PLAYS ROLL IN COPD
- MEMBER REVIEW OF VACUUM CLEANER

HIGH MERCURY LEVELS AGAIN FOUND IN FISH
CRANBERRY JUICE FOR UTI NO BETTER THAN PLACEBO
ENJOYING NATURE THROUGH SPECTACULAR PHOTOS
BING’S GAMES

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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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MedlinePlus, a service of the National Institutes of Health, reports that individuals taking blood pressure drugs in the category of calcium channel blockers could have a dangerous drop in blood pressure if they also take certain antibiotics. Taking the antibiotics erythromycin or clarithromycin along with calcium channel blockers can lead to dangerously low blood pressurelow enough to sometimes require hospitalization. The antibiotic azithromycin was not linked to the risk. Other classes of blood pressure medications such as ACE-inhibitors and beta-blockers do not appear to have this unsafe effect. If you are on a blood pressure medication, it pays to be aware of the class to which it belongs. More information is available at MedlinePlus at http://tinyurl.com/4wxf6ov

Researchers recently looked at individuals on long-term oxygen to see if there are any changes in the causes of death during the last 13 or 18 years (the number of years depending on particular aspects of the study). Their results appear in the American Journal of Respiratory and Critical Care Medicine. They find that over an 18-year period, the risk of succumbing to a respiratory illness decreased 3.8 percent, while other diseases playing an increased role. Also, the average age of starting oxygen therapy changed from 66 years old to 73 years old.

The current causes of death of individuals on long-term oxygen are:
- Respiratory disease 71 percent
- Circulatory disease 16 percent
- Cancer 7.6 percent
- Digestive organ failure 1.1percent
The study can be found at:
http://tinyurl.com/4erdsvr

WARNING: Be aware of misleading headlines and articles that twist the above findings to make it appear that long-term oxygen use is causing more heart disease, for example the headline: “COPD Therapy Boosts Heart Disease Risk.” That is not what the above study shows. As the percentage of deaths due to respiratory failure decrease, the percentage of other causes increase. Changes in the age of onset, advances and changes in treatment, etc. can all account for these trends.

The Transportation and Safety Administration’s (TSA’s) regulation for air travel with oxygen and other respiratory-related equipment is a must read for anyone considering air travel. It is important for travelers to know that neither the Americans with Disabilities Act nor the Air Carriers Access Act require airlines to provide oxygen service. Each airline has its own policy, so it is imperative to find out your airline’s particular policy and rules prior to making travel arrangements. The TSA regulations cover:

- Things you should know and do when making your reservations
- Types of inspections required in order to be allowed past screening points
- How you should handle screening if you cannot be disconnected from your O2
- The importance of making arrangements for layovers and/or for your arrival at your destination
- How to ensure your O2 provider or family members with O2 get past the inspection point and to you upon reaching your destination

The TSA regulations can be found at:
http://tinyurl.com/4o5b5r4

List of Airlines and What They Allow

The National Home Oxygen Patients Association’s list of airlines, their general policies, and links to the airlines, can be found at http://tinyurl.com/4688zoc

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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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Apparently, “Practice makes perfect.” Many of our medications require inhaling, and apparently, some of us get a little lax in our technique. However, our technique is related to proper dosing and therefore the overall effectiveness of our medications. This Japanese study published in the International Journal of Chronic Obstructive Pulmonary Disease demonstrates that proper adherence and repeated instructions on proper inhalation techniques improves our heath status. It might, therefore, be beneficial for us to periodically ask our healthcare providers to observe our technique and provide feedback.
The study’s abstract is at:
http://tinyurl.com/4ccg5cj
For information on proper techniques, see:
http://tinyurl.com/2fhwsbv

About 60,000 people in the U.S. die each year from blood clots in the lungs, called pulmonary embolism. These blockages can occur after extended plane rides or other forms of travel, surgery, extended bed rest, etc. Currently, clot-busting drugs are used to dissolve these clots, but tiny ultrasound devices show promise in treating this life-threatening condition. The results of a study of this new procedure were recently presented at the International Symposium on Endovascular Therapy’s annual conference. For more information, see http://tinyurl.com/4m8szbl

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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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This question comes up often, but the responses differ depending on the source of information. This Harvard Medical School Family Health Guide answers many of the questions http://tinyurl.com/bb5en

ScienceDaily reports that researchers from Johns Hopkins (Baltimore, Maryland) discovered that a protein involved in cystic fibrosis also appears to regulate both inflammation and cell death in COPD. In fact, it may be involved in other lung diseases. This research, published in December’s Journal of Immunology, helps explain the mechanisms of lung tissue destruction, and paves the way for more effective treatments for a host of lung diseases including COPD. From http://tinyurl.com/2ehdws5

Sharon, a member from Oklahoma, shares some helpful information about a vacuum she purchased a short time ago and now recommends. She recently moved to a two bedroom apartment with tile floors and area rugs. She bought a Bissell 3-in-1 vacuum, which the manufacturer bills as a “lightweight, all-in-one vacuum.” Sharon describes it as very light weight with an easy to empty cup container. She explains, “It has a floor attachment, crevice device, and can be used without the handle as a ‘dustbuster.’ It plugs in the wall, so no batteries or recharging needed.” She says she paid about $20 for it at Walmart, and along with her Swiffer products for furniture and floors, she no longer needs a housecleaner. She explains, “I use the Bissell on rugs. I take my time, rest, and do more. I live here so I can see the dirt and dust, and I’m in no hurry to get to my next job.” She adds, “I have no vested interest in Bissell, and the usual precautions apply.”

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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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HIGH MERCURY LEVELS AGAIN FOUND IN FISH
Deja vu anyone? A San Francisco group finds the mercury levels in locally sold fish are three times the established threshold. Will we see this concern spread…again? For more information, see http://tinyurl.com/4qpzvmz

CRANBERRY JUICE FOR UTI NO BETTER THAN PLACEBO
Wait until Ocean Spray hears about this! A University of Michigan study finds that cranberry juice is no better than a placebo for the treatment of urinary tract infections. There is no a response on Ocean Spray’s website (to date). Here’s the study http://tinyurl.com/4saaytu

ENJOYING NATURE THROUGH SPECTACULAR PHOTOS
Trapped indoors? Escape for a few minutes with these 15 breathtaking photos of nature. You will not want to miss them…really!
http://tinyurl.com/4uxmsyr

BING’S GAMES
Bing, Microsoft’s search engine, has a great website for games at http://tinyurl.com/4hy2o3t

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

Until next Friday,

Richard D. Martin, Editor


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