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| Volume 9, No. 31 |
Provided To You By COPD-Support, Inc. | July 03, 2009 |
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DRUG ABUSE, COENABLERS, AND LUNG DISEASE IN MICHAEL JACKSON By Nancy Reyes. The public is rarely surprised when another Hollywood celebrity dies of what is suspected to be an overdose or reaction to drug abuse. When it comes to prescription drugs, some people get addicted after taking narcotics for a valid reason, such as Jackson did after suffering burns making a commercial. But most people–including those who take narcotics for long term pain– can sustain pain relief on stable doses. The problem is when they find taking a higher dose lets them feel good. Ironically, one of the drugs mentioned in the Jackson stories is Oxycontin, which is notorious for it’s abuse and causing deaths. Yet for those in chronic pain, oxycontin is a blessing: those with cancer for example can take it according to a schedule (and not wait for the pain to return before the next dose). If the medicine is adjusted correctly, the patient is pain free, and not sedated or euphoric. The usual cause of death from narcotic or multidrug overdose is respiratory depression (you don’t breath enough). Yet this can be reversed by an anecdote, Narcan. In the elderly or with those with respiratory problems such as COPD or emphysema, giving ordinary doses of narcotics or sedatives can slip them into such a coma. I accidentally had this happen to one of my emphysema patients after her leg was amputated, and she came back to the nursing home. Luckily, the nurses noticed the problem, and the problem was easily reversed, and we readjusted her medicines so that it wouldn’t happen again. Why did it happen? Well, in some people with lung disease, they may breathe enough to keep their oxygen level high enough, but if you decrease their breathing just a little bit, they don’t breathe enough to get rid of all their "bad air" (carbon dioxide) and this retention of Carbon dioxide can put them into a coma and even kill them if it’s not noticed. Which brings us to another story: The British Tabloid, the Daily Mail, has an article that says Mr. Jackson had emphysema from alpha-1 antitrypsin deficiency. This is a rare disease that we look for if we get a young child showing signs of liver disease, or a younger non smoker who has signs of chronic lung problems. Most people who have it probably never get enough symptoms to get diagnosed, and for those who do end up with lung problems, there is now a way to get injections of the enzyme to stop the disease from getting worse. But if there is too much damage, the treatment is a lung transplant. So is the tabloid article right, and did Jackson die because of an inadvertent overdose? Or did he die from a seizure, which is a rare complication of Demerol? Or did he have other health problems related to his lifestyle...Some reports were that he was malnourished, either from the drugs or from anorexia/bulemia. Did this cause a nutritional cardiomyopathy leading to sudden death, or an electrolyte imbalance that caused an irregular heartbeat? http://www.bloggernews.net/121396
COPING WITH COPD Dear Senior Fitness Examiner: I was a smoker for many years - even though I quit a long time ago - and I have now developed COPD. I'm finding myself more and more unable to do anything except sit around like a lump on a log because I can't breathe, and I am tired all the time. I'm using a little inhaler now which helps a little when I'm short of breath, and my doctor says I will probably have to go on oxygen eventually. Is there ANYTHING I can do? Breathless Dear Breathless: My dad would have known exactly how you feel. You see, he, too, was a heavy smoker and quit more than 40 years before developed COPD. He finally expired in June 2008 after a battle of several years with the disease. He had difficulty breathing and was constantly tired from the lack of oxygen, but he exercised up until the day he died which greatly enhanced his quality of life until the end. I asked him once why he started smoking in the first place, and he said that, during the war (WWII), they gave everyone five packs of cigarettes a day and three cigarettes with every meal in place of dessert and, since no one thought they would be coming back anyway, everyone started smoking. Unfortunately, there is no known cure for COPD, but there ARE certain things that you can do to better manage your disease and maintain your quality of life. Believe it or not, exercise is one of the most important components for managing COPD. Now, I'm not going to tell you that you are going to FEEL like exercising because it is probably the last thing in the world that you feel like doing when you are fighting for every breath, but it can make a difference in your ability to live with this insidious disease. Of course, before you embark on any exercise program you should consult with your physician who may have some recommendations with regard to specific exercises or, perhaps, can refer you to a physical therapist or personal trainer for consultation. Learning to breathe properly is critical in your day-to-day living with COPD, but it is even more important when exercising - and there IS a difference. Normal breathing is through the nose - not the mouth - so that the nose can "filter" the air and prevent the tissues in the mouth and throat from drying out and becoming irritated. Learn to control your breathing to avoid panicking when you experience a shortness of breath, and breathe slowly and deeply using your diaphragm - not your chest - to take in as much oxygen as you can with each breath. Yoga is an excellent way to learn how to relax and control your breathing. Endurance and resistance training exercises usually require more oxygen, and since most people cannot typically take in enough oxygen through the nose while exercising without the danger of hyperventilating, you should breathe through your mouth. However, you should purse your lips and draw the air in slowly through your mouth - pretend that you are blowing up a balloon - until you have reach your capacity, then slowly exhale. It takes some practice, but eventually you will get the hang of it. Walking is one of the best forms of endurance exercises - you just put one foot in front of the other and start walking. Set your own pace - how fast you walk is irrelevant - and gradually try to increase your distance a little bit at a time. Move your arms in cadence with your legs to establish a rhythm. Weight training or resistance training is important to maintain your strength, muscle mass, and muscular endurance, and it can greatly enhance your breathing capacity. I would recommend exercises such as bent-arm pullovers, lat pulldowns, bench or cable flyes, and other movements that will encourage chest and lung activity. A competent personal trainer can show you the proper form on these and other exercises. My dad installed a bar across the top of his bed so that he could do "pull-ups" with his upper body every morning from a reclining position. Proper nutrition is important too so that you do not gain weight (which can make breathing even more difficult) or, conversely, lose weight (unless you are already overweight) by allowing your body to waste away. Stay properly hydrated, and eat smaller, more frequent meals to maintain your optimum weight. Medication is also an important factor in managing COPD whether it be in the form of bronchodilators, anti-inflammatories, oxygen, antibiotics, expectorants, or any combination prescribed by your physician. Listen to your doctor, but take charge of your disease and don't let it control you. Your quality of life depends on it. http://www.examiner.com/x-14968-Senior-Fitness-Examiner~y2009m6d28-Coping-with-COPD TELEPHONE RESEARCH STUDY We are currently conducting a search study for people residing in the United States who are between 41-70 years old, current or ex-smokers that are suffering from COPD, Emphysema or Chronic Bronchitis and currently on an inhaler, to participate in a 20 minutes telephone interview on July 8th or the 9th for their opinion. Each person will receive $50 as a token of appreciation for their valuable opinions and for helping us with this important research study. All opinions will be kept strictly confidential, non-published in any way. Anyone interested in participating please call Lotus Winnie Lee at toll free # (877) 361-2517 ext 209 or call Tina Blafford at ext 252. Lotus Winnie Lee, Project Manager 718.222.5600 x 209 Fax 718.222.5680 winnie.lee@recruitingresourcesllc.com Note: Recruiting Resources Unlimited has been locating qualified research participants for over 30 years. Our focus groups and interviews are broad in scope, yet small and informal, making it easy for respondents to express ideas and opinions. Your participation in our research is invaluable and your input will be used for market research purposes only; your opinions are strictly confidential; and there will be absolutely no attempt to sell anything. If you would like to find out more about our company please visit our Web site at http://www.recruitingresourcesllc.com. VOLUNTEERS NEEDED FOR LUNG DISEASE TRIALS-UK Sarah Brealey: Norfolk scientists want volunteers to help test the benefits of a new herbal medicine on lung conditions such as asthma, bronchitis and emphysema. There are 5.4m people in the UK receiving treatment for asthma, while three million suffer from COPD. The new treatment, called AKL1, is a mixture of gingko biloba, ginger and katuka, also known as picrorhiza kurroa, a herb widely used in Ayurvedic medicine. All are available individually as health supplements. Researchers at UEA hope this new combination of botanical nutrients may also help patients with COPD. Patients have reported reduced symptoms of coughing and breathlessness, as well as fewer attacks. Study leader Andrew Wilson, from UEA's School of Medicine, said: "We want to investigate the effects of AKL1 further and hope this novel treatment may have huge benefits to patients with asthma or COPD. "We know many people use herbal treatments for conditions, including asthma, but we don't yet have conclusive evidence of their clinical effectiveness. If the benefits of AKL1 were confirmed, it could provide a new treatment option for both asthma and COPD." The research team is looking for 164 volunteers, aged 18-80, who have asthma or COPD and experience coughing or breathlessness. They will need to attend the Clinical Research and Trials Unit at UEA four times over a period of 10 weeks. They will receive either the AKL1 or a placebo, which they will be asked to take twice a day. At each visit, patients will have a series of breathing, walking and blood tests and will be asked to fill in questionnaires. For more information or to volunteer call 01603 289876, or email a.m.wilson@uea.ac.uk http://tinyurl.com/kk8xou
...featuring comedian and actor Robert Klein. The campaign, dubbed RethinkCOPD, is aimed at getting sufferers to consider their options with respect to diet, exercise and, of course, medication. "For a lot of these patients, it's really about getting through their day," said senior brand communications manager Dana Settembrino. "It's a struggle to get out of bed in the morning, it's a struggle to brush their teeth, and they want to be independent. It's all about getting them to talk to their doctor and start to think differently about this condition. There's not a lot known about it, and there's a stigma associated with it because most people have gotten it from smoking." Klein, a 67-year-old Bronx-born performer whose career has spanned Broadway roles and HBO comedy specials, features on the campaign's website (www.RethinkCOPD.com), where he'll discuss his diagnosis and the steps he's taken to keep his COPD in check. The campaign also features 15-second broadcast PSAs aimed at driving traffic to the Website. http://www.mmm-online.com/AstraZeneca-unbranded-effort-urges-sufferers-to-Rethink-COPD/article/139249/ SOY IN THE DIET MAY PROTECT LUNG FUNCTION Consuming lots of soy foods such as tofu and soy milk may improve lung function and lower the chances of developing COPD, new research suggests. Researchers asked 300 COPD patients in Japan and 340 age-matched healthy people about their soy intake. The results, published online in the journal Respiratory Research, indicate that consumption of soy products is associated with better lung function and reduced risk of COPD. "It has been suggested that flavonoids from soy foods act as an anti-inflammatory agent in the lung, and can protect against tobacco carcinogens for smokers. However, further research is needed to understand the underlying biological mechanism," study author Fumi Hirayama said in a news release. http://health.usnews.com/articles/health/healthday/2009/06/26/soy-in-the-diet-may-protect-lung-function.html Editor's note: The Soy study has been all over the web and other media this week. The "structured questionnaire" part bothers me. The abstract of the study says: A total of 278 eligible patients (244 men and 34 women), aged 50-75 years with COPD diagnosed within the past four years, were referred by respiratory physicians, while 340 controls (272 men and 68 women) were recruited from the community. All participants underwent spirometric measurements of respiratory function. Information on demographics, lifestyle characteristics and habitual food consumption was obtained using a structured questionnaire. FURTHER: High fruit intake is inversely related to the COPD risk and respiratory symptoms. A cohort study of 49,140 Singaporean men observed that non-citrus fruits (apples, pears and grapes) were independently associated with reduced cough with phlegm. Similarly, a cross-sectional study among 13,651 adults aged 20-59 years in The Netherlands reported that solid fruits (apples and pears) were inversely associated with the prevalence of COPD symptoms such as chronic cough and breathlessness. The same authors also noted the favourable effect of fruits (180 gm.day) in lowering the prevalence of these respiratory symptoms. Increased vegetable consumption is likely to reduce the risk of COPD. However, two large studies conducted in The Netherlands and Singapore observed no relationship between vegetable intake and the prevalence of respiratory symptoms. One cross-sectional study from Norway involving 4,300 subjects found fish intake beneficial against developing a night cough but not other symptoms. On the other hand, epidemiological evidence from several prospective studies indicated that red meat or cured meat consumption had detrimental effects on the risk of COPD. In particular, preserved red meat was positively associated with respiratory symptoms and could lead to a decline in lung function . Little is known in relation to soy foods, apart from one cohort study in Singapore which suggested that soy foods may reduce the development of chronic productive cough , and conclusions cannot be drawn because of the limited evidence. Soybean products, a primary source of isoflavones, are consumed worldwide. The aim of this study was to investigate the relationship between soy consumption and the risk of COPD and respiratory symptoms. Conclusions Smoking is acknowledged as the major cause of COPD, but the present case-control study has suggested an inverse association between soy products and COPD risk for Japanese adults. More research and/or replications are required to ascertain whether the observed findings can be generalized to other populations, before incorporating these foods into dietary guidelines so as to encourage consumption. Besides experimental studies, long-term prospective cohort studies collecting detailed dietary exposure information are recommended to provide epidemiological evidence on both morbidity and mortality due to COPD. http://respiratory-research.com/imedia/9838383512484121_article.pdf?random=614384
COPD-SUPPORT GROUPS Last week we lifted a thread from our Caregivers List on Dysphagia. I inadvertently (does anyone ever omit something advertently?) left off a link to our COPD Support page that tells you where and how to join our Caregivers if you are so inclined: http://copd-support.com/caregivers.html You can find a list of all our groups on the left side of the page at: http://copd-support.com/ SENIOR HEALTH COPD AND OTHER VIDEOS A big bunch of brief videos on a bevy of health problems. http://nihseniorhealth.gov/videolist.html#copd COPING WITH PULMONARY DISEASE By Susan Akers: When John May was a child he contracted pneumonia. He recovered and went on to live a normal life -- he learned to play trombone, ran on the track team, served in the Army, worked his way up to vice president in the banking business and enjoyed tending to a large garden at home. When he turned 61, his life changed dramatically. John was diagnosed with COPD. His physician thought it was probably a childhood bout with pneumonia that contributed to John's chronic illness. Though he still works full time, John, 71, knows his physical limitations and has made many adjustments to his lifestyle. "At first I was embarrassed to go out with the oxygen tank," John said. "But now it doesn't bother me." John..is an early riser often starting his day at 4:30 a.m. He uses an exercise bike and then puts on a vest that loosens phlegm and helps clear his airway system. He is on two medications and uses a nebulizer to jump start his breathing every morning and a separate piece of equipment at night. "Those with COPD will never get completely well, but there are exercises and things you can do to help develop the muscles around the lungs," he said. http://www.theheraldbulletin.com/peopleandplaces/local_story_174074629.html?keyword=secondarystory
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MISCELLANEOUS Brain Fitness Games Memory, attention to detail, and recall. Everyday you encounter the need for these mental skills, whether you're at the office, grocery store, or just hanging out with friends. These games are are designed to keep your brain fit. An American in Paris (memory) This game provides a splendid tour through eight of the greatest cities on earth, including Paris, Rome and London. You will need to memorize the names of some of the most famous monuments in your favorite city, together with their locations on a grid. Secret files (attention) This game requires you to catch words before they fall to the ground and file them in the correct secret drawer. Split Words (language) You're searching for the name of a flower. It's on the tip of your tongue. You know it starts with "am..." What is it? As quickly as possible, form complete words by combining syllables from the game table. Happy-Neuron.com , has created scientifically-proven, entertaining games to keep your brain fit. For more about these games, and their comprehensive brain fitness program, visit www.happy-neuron.com. http://health.discovery.com/centers/brain-health/memory/brain-fitness/brain-games.html Math with Ma & Pa Kettle An oldie, but good. After watching this I hope I maintain whatever fragile grasp I have on numbers. <g> http://www.youtube.com/watch?v=cydcnQf0usg&NR=1 Forth of July Trivia Quiz I thought I always knew this stuff, but I got three WRONG. Good thing I'm a citizen and don't have to take any tests. http://puzzles.about.com/od/trivia/l/bl_july4quiz.htm Fourth of July by Dave Fisher Note: This puzzle contains two diagonal entries running from top and bottom left which spell out two timely phrases. Print and solve. http://puzzles.about.com/od/holidaycrosswords/l/qpr0704.htm Fourth of July jigsaw puzzle. http://puzzles.about.com/library/jigsaws/bljuly4jigsaw.htm This page will be next updated on July 10, 2009 |
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