Living Well with COPDPage 1 of 10***Living Well with COPD (Part 1): Overview***NarratorCOPD, or chronic obstructive pulmonary disease, is a lung disease that makes it hard to breathe. Whenyou can’t breathe, you have more trouble doing everyday activities.Dr. Aris Iatridis, PulmonologistPeople find themselves more confined to the house they can't do as much, they can't be physically active.It's something which limits not only from the physical standpoint but it also diminishes your quality of lifeas far as social interactions if you don't take care of it properly.NarratorSheila Zambetti, who enjoys cooking, has been living with COPD for many years.Sheila Zambetti, PatientI always cooked big time and always set the table in the dining room, I loved that. I can't manage that, butthere are still things to do to make yourself happy.NarratorMore than 30 million people in the U.S. live with COPD. It’s the third leading cause of death, right behindheart disease and cancer. Smoking is the leading cause of COPD. That includes mainly cigarettes butalso cigars and pipes.Dr. Aris Iatridis, PulmonologistIt takes a number of years to develop COPD sometimes decades. It comes on very gradually so you don'treally even notice it initially. It's just kind of the shortness of breath just sneaks up on you as time goes on.NarratorCOPD can also result from long-term exposure to secondhand smoke that is, breathing other people’ssmoke. Air pollution or chemical fumes.Dr. Ngozika Orjioke, PulmonologistThey irritate the lungs. And so the way the lungs response to that irritation is by producing more mucuswith the coughing and if that goes on long-term it actually causes lung destruction.NarratorIn a healthy lung, the air you breathe travels down your trachea or windpipe. Then through tubes calledbronchi, smaller tubes called bronchioles and finally into tiny air sacs called alveoli. Normally these sacsare flexible and springy, so that when you inhale they inflate like a balloon and when you exhale, theydeflate.Dr. Ngozika Orjioke, PulmonologistThe alveoli are air sacs so air passes through the sacs into the bloodstream and then the bad gas,carbon dioxide, passes out.NarratorCOPD is a combination of two conditions: emphysema and chronic bronchitis. In emphysema, the airsacs lose their flexibility making it harder for them to expand and contract. In chronic bronchitis, the wallsof the airways swell, thicken, and make mucus.Page 2 of 10Dr. Ngozika Orjioke, PulmonologistThe lungs try to clear that by coughing. And the mucus also narrows the airway causing obstruction so it’sdifficult to breathe and if the mucus sits there long enough it will get infected and cause respiratoryinfections.NarratorCertain tests can help your doctor or respiratory therapist see how severe your COPD is. If you’ve beendiagnosed with COPD and you smoke, it’s very important to quit.Dr. Aris Iatridis, PulmonologistIf you can stop smoking you'll probably live longer and you'll feel a lot better with less shortness of breath.All these other inhalers we prescribe, they don't do nearly as much good as getting off the cigarettes.NarratorIf you’re overweight, shedding those extra pounds is also key.Dr. Aris Iatridis, PulmonologistWhen a person is overweight it makes you that much more short of breath.NarratorMedicines won’t cure COPD, but they will help you live better with the condition. Long-actingbronchodilators are maintenance drugs. That means they help you function better day to day. Youbreathe in the medicine through an inhaler or nebulizer. It keeps airways open and prevents shortness ofbreath.A metered dose inhaler delivers a set amount of medicine into your lungs. You can attach a device calleda spacer to help the medicine reach your lungs so it doesn’t wind up in your mouth.Short-acting bronchodilators work quickly. They’re sometimes called “rescue” medicines.Dr. Aris Iatridis, PulmonologistYou use a rescue inhaler whenever you feel like you're really badly short of breath.NarratorIf shortness of breath gets in the way of your daily activities, you may need to breathe in oxygen througha mask.Dr. Ngozika Orjioke, PulmonologistSo, you might be sitting down and not need oxygen but when you exercise or walk your body needs moregas and more fuel to work. And at that time you may need oxygen.NarratorYou can get oxygen in a few different ways. Cylinders called concentrators filter the air around you to pullin oxygen and then deliver it through prongs or a mask. But these big units aren’t very portable.Compressed oxygen and liquid oxygen come in smaller cylinders that are easier to take with you.Oxygen has helped David Carden be more active again.David Carden, PatientBefore I started using the oxygen on some days I couldn't hardly get from my bedroom to the living roomwithout just almost collapsing. And I started using the oxygen and it just made a tremendous difference.Page 3 of 10NarratorAnother way to feel healthier and live better is with pulmonary rehabilitation. This will teach you how tomanage your condition with exercise, nutrition, tips to conserve energy and breathing techniques.Dr. Aris Iatridis, PulmonologistPeople after pulmonary rehab almost always notice an improvement in their quality of life. They can justdo more and enjoy life more as a result.NarratorLiving with COPD can be emotionally draining, so you’ll also learn how to cope with the stress of yourillness.David Carden, PatientIf you feel overwhelmed talk to someone. Don't just keep it inside.NarratorIf treatments don’t work, your doctor might suggest lung surgery. Or if your COPD is very severe, a lungtransplant may be an option.Sheila Zambetti has seen improvement in her symptoms thanks to medicines, breathing techniques, andexercise.Sheila Zambetti, PatientHelping to get you through certain hardships, that's what they help you do.Dr. Aris Iatridis, PulmonologistIt doesn't matter how bad your COPD is but if you take care of yourself, take the proper medications, seeyour doctor on a regular basis, get your flare ups treated immediately you can have a good quality of lifeand enjoy your life for a long time.NarratorTo learn more, watch “Living Well with COPD: Living a Healthy Life.”***Living Well with COPD (Part 2): Living a Healthy Life***NarratorWhen Sheila Zambetti was first diagnosed with COPD, she feared that it would keep her from living anormal life. But by working with her health care team, she’s learned how to successfully manage hercondition.Sheila Zambetti, PatientI had physical for the exercises and the occupational therapist who came to the house here and sheshowed me different ways of doing things to make it easier on myself.NarratorTo keep your lungs as healthy as possible, remove yourself from the source of your COPD wheneverpossible. Tobacco smoke irritates your lungs and makes your cough and other symptoms worse.If you’ve had trouble quitting in the past, don’t give up. It can take an average of seven tries to finally kickthe habit, but you can do it: Ask your doctor about tools to help you quit, like nicotine replacement products. Write up a quit-smoking plan. Decide on which day you’ll quit.Page 4 of 10Dr. Aris Iatridis, PulmonologistYou want to throw away all the cigarettes that are in your home. You want to get the smell out of yourcurtains so you don't constantly smell it. If you crave it with your coffee in the morning maybe it's time tocome up with a different habit in the morning.NarratorWhen you do quit, you’ll see results quickly. In just 2 weeks, your lung function will start to improve.Within a month, your coughing and shortness of breath should also ease up.David Carden smoked for 35 years before he was able to quit.David Carden, PatientIt's been about 10 years since I quit and I saw a tremendous difference in my health, in what I could do,and especially in my breathing.NarratorMedicine is another important part of your treatment. If your doctor prescribed bronchodilators, steroids,or other drugs, take them, even if you feel well.Writing up a schedule can make it easier to remember which medicines to take and when to take them.Dr. Ngozika Orjioke, PulmonologistYou have to think of your medicines of the vitamins for your lungs. And so to keep your lungs open, theyreduce the mucus that it produces and help you breathe. So you need to make sure that you take themevery day as prescribed to be able to gain the benefit.NarratorA respiratory therapist can help you learn how to take your medicines the right way.Mike Lomboy, Respiratory TherapistThe best way to use an inhaler is to use a spacer which keeps the drugs in the chamber until it's ready togo into the lungs so that it doesn't go into the back of the throat. But if you don't have a spacer you cankeep it in front of your mouth and not touching your lips so that it works the same way.NarratorIf your medicines cause side effects, don’t just stop taking them. Talk to your doctor. You may need anadjustment.Keep up with all your doctor’s appointments. Then you can catch any problems early, before theybecome serious.Sometimes, COPD symptoms like coughing and shortness of breath get worse. These are calledexacerbations or flare-ups, and they could land you in the hospital.Dr. Aris Iatridis, PulmonologistIt's very important that when a person has a flare up of COPD if they got infection you’ve got to treat it.Because if you don't treat the infection and get rid of it you're not going to cure the flare up.NarratorTo stay healthy and avoid the germs that cause infections, get your flu shot every fall, before flu seasonstarts. Ask your doctor whether you also need other vaccines like pneumonia. Stay away from crowdsand from people whom you know are sick. Wash your hands during the day with soap and water. Andcarry around an alcohol-based hand sanitizer. Use it after you shake hands or touch items other peoplehave handled.Page 5 of 10Also, drink plenty of water to flush mucus out of your lungs.Exercise is another important part of staying healthy. It might seem impossible to work out when you can’tcatch your breath, but it’s one of the best things you can do.Dr. Aris Iatridis, PulmonologistIt's been shown without a shadow of a doubt that when you exercise on a regular basis you can do moreand have a better quality of life.NarratorAsk your doctor what kind of program is safe for you and whether you need to use oxygen while youexercise. Be sure to pace yourself.Dr. Ngozika Orjioke, PulmonologistI tell all my patients even if you can just walk for a few minutes, start there. Do that daily for five days andgradually increase by a few minutes every single day until you get to about 10 minutes, 20 minutes, 3 to 5times a week.NarratorPoor air quality can make it harder for you to breathe. Keep the air in your home clean. Turn on exhaustfans and use an air filtration system. When pollen and other allergens are in the air, close the windowsand turn on the air conditioner.Pollen can make your COPD symptoms worse. And smokers need to stay out.Dr. Ngozika Orjioke, PulmonologistAnyone who is smoking should not be smoking in your house or in your car. So, get them to smokeoutside or better still encourage them to quit smoking. If you have carpets, I encourage hardwood floorsas carpets can hold onto mold. With COPD and respiratory infections molds can make those conditionsworse.NarratorAvoid using strong-smelling cleaning products, paints, varnishes, and bug sprays indoors. If you have touse them, do it in an open area. Also avoid candles and air freshener sprays.COPD can tire you out so it’s important to pace yourself. Having a weekly schedule that tracks yourappointments and other activities can help.Focus on the most important tasks and break up big chores into small, manageable tasks. Rest when youneed to. And keep contact information handy for friends and family you can call for help.Sheila Zambetti, PatientMy son would go to the store after work and buy food and come here and cook it for us. On weekends hecooks an enormous amount of food so we have food for a few days.NarratorLiving with a chronic illness can feel overwhelming and it is understandable if you’re anxious or sad.Addressing these feelings is important. Talk with a therapist or counselor.You can also join a COPD support group, where you’ll learn tips to help you manage your condition andmeet other people who are going through the same experience.Page 6 of 10David Carden, PatientKnowing yourself, knowing what's going on with you and paying attention to what the doctors are askingyou to do that's very important.NarratorLearn more about managing your disease in Living Well with COPD: Recognizing and ManagingSymptoms.***Living Well with COPD (Part 3): Recognizing and Managing Symptoms***NarratorCOPD symptoms like coughing and shortness of breath can get in the way of your daily life.David Carden used to be very active outdoors until he was diagnosed with COPD.David Carden, PatientI used to do a lot of activities, fly fishing for trout. I was a hunter. I played softball. But since the COPD thatall went by the wayside. I just don't have the breathing for it.NarratorSymptoms of COPD include a persistent cough that produces phlegm and shortness of breath, especiallywhen you exercise or climb stairs.You may make a whistling sound called wheezing or feel tightness in your chest when you breathe.COPD also leaves you tired and drained of energy. And you may have signs of a cold, flu, or otherinfection.People with COPD often have triggers. The smell of varnish or a whiff of smoke can lead to a flare up,setting off your coughing or shortness of breath. Keep a journal to track your symptoms, when theyhappen, and what you were doing at the time. Then you can learn to avoid your triggers.One big trigger for many people, including Sheila Zambetti, is strongly scented products.Sheila Zambetti, PatientIn the supermarkets it’s the fragrances in the soap departments the soap powders. They’re suffocating.NarratorTry to avoid these products if possible. If you do have to use them, do so in a well-ventilated area.Pollution and pollen in the air can also set off your symptoms. When they get bad, stay indoors with thewindows closed and the air conditioning on. Most important, don’t smoke or let anyone around yousmoke.Dr. Ngozika Orjioke, PulmonologistAnyone who lives with a smoker, they should not be smoking in your house or in your car. And soencourage them to quit. And if they're struggling with that than have them do the smoking outside.NarratorNot taking your medicine can also set off your symptoms. If medicine side effects are a problem, ask yourdoctor about changing your drug or dose, but don’t stop taking it on your own.Infections like the flu, which affects the lungs and airways, can make coughing and shortness of breathworse. Avoid getting sick by washing your hands throughout the day with soap and water, or using analcohol-based hand sanitizer. Stay away from crowds and from anyone who looks sick. If you do get sick,see your doctor right away for treatment.Page 7 of 10Keep the humidity in your home at 40 percent. This will also discourage mold growth.If you have to go out on cold days, cover your nose and mouth with a scarf to prevent cold air from gettinginto your lungs. It’s also important to be careful in hot weather, when air pollution may be worse.David Carden, PatientI feel like I need to stay inside on hot summer days. The humidity and the heat, it really works on me.NarratorDiet and exercise are important, too. Drink lots of water and other fluids to flush mucus out of your lungs.Limit salt, which can cause your body to hold on to more fluid, make your feet and ankles swell, andworsen shortness of breath.Stay active. Exercising regularly will help your body use oxygen more effectively and improve yourbreathing so you won’t have as many flare-ups. If you have a flare-up, call your doctor.Dr. Aris Iatridis, PulmonologistIf you don't take care of a flare up right away it's going to get a lot worse and so you may end up in thehospital. Worse comes to worse you may end up in the ICU on a respirator.NarratorHere are some other signs you need to call your doctor: Difficulty catching your breath Trouble walking as far as you usually walk Feeling more tired than usual Having to use your medicines more often Coughing more than normal, and bringing up more mucus A change in mucus color or texture Fever, chills, weakness, or other signs of an infection. Confusion or forgetfulnessOther symptoms are serious enough to require calling 9-1-1, or going straight to the emergency room.These include: Breathing problems that are so severe you can’t talk in full sentences, and your medicine doesn’thelp Chest pain Blood in your mucus Swelling in your legs, feet, or ankles that doesn’t go away when you put up your feet Or quick weight gain, putting on 2 pounds in a day, or 5 pounds in a weekSince being diagnosed with COPD, Sheila Zambetti has learned how to deal with her symptoms.Sheila Zambetti, PatientEvery day you learn something else to do that makes you feel better.NarratorLearn more about managing your disease in living well with “COPD: Pulmonary Rehabilitation.”***Living Well with COPD: Pulmonary Rehabilitation (Part 4)***Page 8 of 10NarratorPulmonary rehabilitation, or rehab, is a program that helps you learn how to care for your COPD. Itcombines exercise, diet, breathing techniques, and emotional support. To find out if you’re a goodcandidate, your doctor will look at your lung function, overall health, and how well you can exercise.Albert Harrell, who used to enjoy an active outdoor lifestyle, has been living with COPD for many years.Albert Harrell, PatientOver the years it's been nothing but a slow decline in my breathing capabilities. And I look at therapy as anecessity to keep the decline of COPD from getting a head start on me.NarratorYou can have pulmonary rehab at a clinic, hospital, or sometimes in your own home. Before you start,ask the staff at the rehab center a few questions so you’ll know what to expect: Will my insurance cover the cost? What services does the program offer? Who will be on my rehab team? How often do I have to visit the center? How many weeks will the program last? And what will I accomplish by the end of the program?Mike Lomboy, Respiratory TherapistPulmonary rehab helps to keep the patients away from the hospital because they can stay on top of theirbreathing diseases and control it better.NarratorThat includes learning different types of breathing techniques.Mike Lomboy, Respiratory TherapistYou could do pursed lip breathing which is when you blow out slowly through your mouth like. Or youcould do diaphragmatic breathing which is when you get it from your abdomen breathing slow and thenout slow and deep.NarratorDuring the exercise part of the program, you’ll work with a therapist to build strength and endurance.Lifting weights will strengthen your arm and leg muscles. Walking on a treadmill, swimming, or riding astationary bike will improve your aerobic endurance.Dr. Aris Iatridis, PulmonologistExercise doesn't improve your lung disease but it improves everything else. It improves your muscle tone,level of fitness, cardiovascular tone. And so it improves your quality of life and that's why it's important forpeople with COPD to exercise regularly.NarratorWhile you exercise, your therapist will check that enough oxygen is getting into your blood.In the education part of the program, you’ll learn how to manage your COPD. You might take groupclasses, or work one-on-one with a health care provider.You’ll learn: When and how to take your medicines What triggers your symptoms and how to avoid those triggers How to use oxygen, if needed, to help you breathePage 9 of 10How to manage symptoms on your ownAnd when to call your doctor or 9-1-1 for helpYour team will help you write up a self-management plan to take home.Diet is another important part of your program. Shortness of breath can affect your appetite and make itharder to eat. A dietitian will help you design an eating plan you can manage and that gets you to ahealthy weight.Living with a chronic disease like COPD can make you feel sad or anxious. It is just as important toaddress your feelings, as it is to address your COPD.Dr. Aris Iatridis, PulmonologistCOPD can lead to depression because you're limited. You can't do it used to be able to do, you can't goout as much as you used to, you can't be around people as much as you used to. So it's important tomaintain your mental health. If you have issues with depression, or anxiety because of your shortness ofbreath, it's important to see your primary care who may refer you to a therapist.NarratorYou can also take part in support group sessions, where you’ll meet other people who’ve gone throughthe same problems and learn what they did to handle their COPD.Stick with your program. After 4 to 12 weeks in pulmonary rehab, your breathing should improve,Exercise will get easier, and you’ll start to feel better overall.Albert Harrell, PatientI'm staying ahead of my COPD. I don't want to it get the best of meNarratorTo learn more about COPD, watch “Living Well with COPD: An Overview.”Reviewed by Becky Anderson, RRT, Registered Respiratory Therapist, Manager of the DiseaseManagement and Respiratory Care Services at Sanford Medical Center, Fargo, ND© 2015 The Wellness Network, All Rights ReservedPage 10 of 10