When COPD Symptoms Worsen

Find out how to prevent a COPD exacerbation and what to do if you experience one.

Though patients with chronic obstructive pulmonary disease (COPD) can keep symptoms such as cough, shortness of breath, or sputum under control most of the time, they're susceptible to experience exacerbations, or severe worsening of those symptoms, at any time.

"An exacerbation is when a chronic disease gets worse for some reason. With COPD, this is usually because of infection,” explains Richard Castriotta, MD, professor at the University of Texas Medical School at Houston.

COPD exacerbations result in about 1.5 million emergency room visits every year in the United States, but a person's risk of an exacerbation varies depending on the severity of his or her condition. People with severe COPD have about 3.43 exacerbations a year compared with 2.68 on average for people with moderate COPD.

COPD Exacerbations: Signs and Causes
To recognize an exacerbation, look out for these COPD symptoms:
· Worsening cough
· Worsening feeling of being short of breath (dyspnea)
· Changes in sputum, such as changing color (clear to yellow, green, brown, or red) or quantity (either more or less than usual)

Many COPD exacerbations occur without any known cause. However, the most commonly understood causes of COPD exacerbations are respiratory infections such as colds or the flu.

If you have increased COPD symptoms such as a fever, chills, and "purulent" sputum (yellow in color), you should call your doctor immediately. You may need a prescription for antibiotics to help fight the infection.

COPD Exacerbations: How to Handle an Occurrence
How you handle a COPD exacerbation will depend on how controlled your symptoms are under normal circumstances and how severe the exacerbation is. If your symptoms are under control most of the time and your exacerbation is not severe, you should talk to your doctor about how to treat your symptoms at home. You may be able to use your bronchodilator or steroids to address some symptoms under a doctor's supervision.

If you have followed your doctor's instructions and your efforts to control symptoms at home have not worked, do not take more medication. Instead, call your doctor's office or go to the ER.

If you're having trouble breathing, you should go to the ER immediately. At the hospital, you may receive ventilator treatments or medication to help you breathe. In some instances, you may be hospitalized until you get better.

COPD Exacerbations: Prevention Strategies
There are several ways that you can prevent exacerbations or reduce their severity:
· Stop smoking. The more years you smoke, the worse your exacerbations are likely to be. Chronic and heavy smokers are at increased risk for severe exacerbations.

· Take antibiotics as prescribed. If your doctor gives you antibiotics to treat an infection that might lead to an exacerbation, make sure you take all the medication as your doctor instructs, even if you feel better before you have finished every dose.

· Get your flu shot. Get a flu vaccine every year when flu season begins and make sure that you are up-to-date with your pneumococcal vaccine.

· Find a primary care doctor you can see regularly. Data from a study of 388 COPD patients showed that those who did not have a regular doctor were more likely to need to go to the ER. The researchers estimate that 10 percent of hospital visits could be prevented if more people with COPD had regular doctors. You also can reduce the risk of having to return to the ER with a relapse if you have a doctor you can visit about a week after your initial exacerbation and hospital visit.

If you understand which COPD symptoms to watch out for, you will be able to respond to COPD exacerbations quickly and learn how to prevent them in the future.

Sometimes Will Power Just Isn't Enough~

By: Heidi Grant Halvorson, Ph.D.

Do you snack every night in front of the television? Do you drink a little too much when you are out with your friends? Do you ever find that you've smoked a whole pack of cigarettes, bitten off half your nails, or eaten an entire bag of Doritos without realizing you were doing it?

That's the real problem when it comes to ridding yourself of bad habits -- back in the beginning, when the behavior was new, it was something you did intentionally and probably consciously. But do anything enough times, and it becomes relatively automatic. In other words, you don't even need to know that you are doing it.

In fact, as new research shows, you don't even need to want to do it. If you develop the habit of snacking in front of your TV at night, how hungry you are or how tasty the snack is will no longer determine whether or how much you eat.

Many bad habits operate mindlessly, on autopilot. They are triggered by the context (e.g., watching TV, socializing, feeling stressed), rather than by any particular desire to engage in the behavior. So the key to stopping a bad habit isn't making a resolution -- it's figuring out how to turn off the autopilot. It's learning to disrupt the behavior, preferably before it starts.

Take for example a recent small study of movie theater popcorn-eating. Researchers invited about 100 people to watch 15 minutes of movie previews while seated in a real movie theater. They gave the participants free bags of popcorn and varied whether the popcorn was fresh or stale. (The stale popcorn was actually a week old. Yuck.) Then, they measured how much popcorn each person ate.

Not surprisingly, everyone who got the stale popcorn reported liking it less than those who got fresh. And people with a weak popcorn habit (e.g., those who didn't usually eat popcorn at the movies) ate significantly more fresh popcorn than stale. But here's the kicker -- for people with a strong popcorn habit (those who always ordered popcorn at the movies) it didn't matter how stale the popcorn was. They ate the same amount, whether it was an hour old or seven days old.

That's worth thinking about for a moment -- people with a strong habit were eating terrible popcorn, not because they didn't notice it was terrible, but because it didn't matter. The behavior was automatic, not intentional. So if tasting like Styrofoam won't keep you from eating something, what will?

The researchers found that there were, in fact, two effective ways to disrupt the automatic popcorn-eating.

First, you can disrupt the habit by changing the context. When they conducted the same study in the context of a conference room with 60 people, rather than at a movie theater, people with strong popcorn habits at the movie theater stopped eating the stale popcorn. The automatic popcorn-eating behavior wasn't activated, because the situational cues were changed.

If you have a habit you'd like to break, spend some time thinking about the situations in which it most often occurs. If you snack in front of the TV at night, consider doing something else in the evenings for a while -- reading a good book, spending time with friends or family, even surfing the web. Any alternative activity is less likely to trigger mindless eating. If you just can't give up your favorite shows, you might try rearranging the room or sitting in a different chair -- anything that alters the context can help.

Second, you can disrupt a habit by changing the method of performance. In another study, the researchers found that asking strong-habit popcorn eaters who were in a movie theater to eat with their non-dominant hand stopped them from eating the stale popcorn, too.



So if you can't change the situation, you can change the way the habit gets executed. If you mindlessly eat or smoke with your right hand, try only using your left. If you mindlessly drink from the glass that the bartender keeps refilling, try sitting at a table instead of the bar so you'll have to consciously get up and ask for a refill. Making the behavior a little more difficult or awkward to perform can be a great way to throw a wrench in the works.

Too often, we blame our failures on the wrong things. When it comes to ridding ourselves of bad habits, we usually chalk our difficulties up to a lack of commitment or willpower. But as I've argued in my new book "Succeed: How We Can Reach Our Goals," conquering your behavioral demons needs to start with understanding how they really work and applying the most effective strategy. In this case, success comes from not making it quite so easy for your autopilot to run the show.

Smoking Can Be Just Plain Goofy!

Quitting Even Tougher When Smokers Battle Other Addictions

FRIDAY, Aug. 26 (HealthDay News) — Four out of every 10 smokers is also burdened with alcohol or drug addictions, or mental health disorders, and getting them to quit cigarettes can be a big challenge.

But a new study finds that these patients are five times more likely to give up smoking if they receive smoking-cessation counseling from their primary care doctors.

Finding ways to help them kick the smoking habit not only boosts their health but also reduces tobacco-related health care costs, said study author Dr. Michael Ong, an assistant professor of general internal medicine and health services research and a researcher at Jonsson Comprehensive Cancer Center at the University of California, Los Angeles.

In the study, his team looked at success rates among almost 1,400 smokers who tried to quit. The rates were 6 percent for those with so-called "comorbid disorders" (for example, mental illness and/or substance abuse issues) who did not receive smoking cessation counseling from their family doctor, 10.5 percent for those without the comorbid disorders who did not receive counseling, about 31 percent for those with the comorbid disorders who did receive counseling, and nearly 35 percent for those without the disorders who received counseling.

Ong's group also found that smokers with alcohol, drug or mental health disorders were just as likely as those without the disorders to receive smoking cessation counseling from their family doctor — about 73 percent and 80 percent, respectively.

"It would be very effective for primary care physicians to provide help in quitting smoking to these patients," Ong concluded in a UCLA Health Sciences news release.

"However, in the context of everything these physicians are trying to do in a day, smoking cessation may fall by the wayside," he added. "It's also been thought that with this patient population, doctors should only take on one thing at a time, for example treating an opiate addiction and opting to deal with the smoking cessation later. But at the end of the day, we showed that smoking cessation counseling is effective in this patient population and should definitely be pursued."

The study was published Aug. 23 in the journal Nicotine & Tobacco Research.

Smoke Free in Memphis!

750 Smoke Free Days!!

Holy Smokes!

The two year anniversary passed with out much fan fare and now her I am over 750 Smoke Free Days!

Every so often it's fun to do the math ....

When I quit, I was smoking approximately a pack and half a day. I was going to the store and buying one 'premium' pack and one 'generic' (cheap-ass) pack and alternating the two. My surprise back then was that the cheap-ass smokes weren't really all that bad .......... back to the cost:

Every time I bought two packs of smokes it was costing me around eight bucks .... divide that out on a per cigarette basis and I was paying approximately twenty cents per smoke.

Twenty Cents for each cigarette and smoking thirty cigarettes a day I was spending right around $6.00 a day just for permanently damaging my lungs ... And that was two years ago ... prior to the Obama Tax Slap ....

Thirty Cigs a day multiplied by 750 days and that's 22,500 cigarettes I have NOT smoked! Let me spell that one out .... that is TWENTY-TWO THOUSAND, FIVE HUNDRED cancer sticks un-smoked by me! Now that's alata tobacco! At cost of twenty cents each or six dollars a day that's $4,500.00!

Four Thousand, Five Hundred Dollars! In my world that's a lot of cash .... and most of that doesn't even go to the evil tobacco companies ... it's taxes directly to the feds!

If you've quit smoking recently ... take the time to do the math ... it's fun and rewarding!

FJW

Two Years and Two Weeks!

The TWO YEAR ANNIVERSARY of my quit day has come and gone with little fan fare!
It would've been hard to believe two years ago that NOT smoking would be my norm and I would end up missing it very little!

That is not to say I NEVER miss it. But cravings are close to nil and the worst part of everything is smelling smokers and realizing I used to smell that way too! Yuk!

Two years later I still feel the effects of a lifetime of cigarettes though. When I do experience trouble in my breathing I can't help to (a) regret my decision to ever start smoke but more importantly (b) celebrate the fact that I was eventually able to free myself from the shackles of that addiction.

I can help to wonder what my life would be like if I continued down that path and I also wonder how much better off I am today because of my final, successful attempt two years ago this month.

A NSW Health Department fact sheet states that “The best thing a smoker can do for their health is to quit smoking. There are health benefits of quitting for all smokers, regardless of age, sex or length of time that they have been smoking. People who have already developed smoking-related health problems, like heart disease, can still benefit from quitting.”

There are many benefits to quitting and some of these even occur within hours of smoking your last cigarette. The changes that occur once you have quit highlight the amazing recovery, rejuvenation and regeneration your body is capable of even after years of smoking. Another plus to quitting is that people who quit smoking after having a heart attack reduce their chances of having another heart attack by 50 per cent.

Okay, so what are some of these benefits and what is the time frame?
I know I've listed some of these before but they are worth repeating
* Within 20 minutes of Quitting cigarettes your body begins a series of changes that continue for years. Your heart rate reduces.
* 12 hours from quitting the carbon monoxide level in your blood reduces dramatically.
* 2-12 weeks since quitting your heart attack risk begins to reduce, your circulation improves, your lung function improves and exercise becomes easier
* 1-9 months after quitting the coughing and shortness of breath decrease.
* 1 year on your risk of coronary heart disease is halved compared to a continuing smoker.
* 5 years later your risk of cancer of the mouth, throat and oesophagus decreases and your risk of stroke is dramatically reduced.
* 10 years of being a non-smoker and your risk of lung cancer falls to about half that of a smoker and your risk of cancers of the bladder, kidney and pancreas also decreases.
* 15 years of being a non-smoker and your risk of coronary heart disease and risk of death fall to about the same as someone who has never smoked.

Do you need more benefits?
** If you quit cigarettes before age 35, then your life expectancy is similar to someone who has never smoked.

** If you quit cigarettes in 60 minutes before age 50, then your risk of dying in the next 15 years is reduced by half when compared to people who continue to smoke.

** Best of all – quitting cigarettes in at any age doesn’t just increase life expectancy – it also improves quality of life!

As a non-smoker, you are also less likely to have:

•macular degeneration
•cataracts
•brittle bones
•wrinkles and look older faster
•yellow teeth and bad breath.
By quitting cigarettes in 60 minutes you will reduce your chances of:

•impotence
•having difficulty getting pregnant
•having premature births, babies with low birth weights, and miscarriage.
If you have children, your quitting cigarettes in 60 minutes can lower their risk of:

•Sudden Infant Death Syndrome (SIDS) – (cot death)
•being smokers themselves
•ear infections
•allergies
•asthma
•bronchitis and other lung problems.

By quitting you will reduce your chance of having:

•cancer of the lungs, throat, mouth, lips, gums, kidneys and bladder
•heart disease and hardening of the arteries
•a stroke
•emphysema and other lung diseases
•gangrene and other circulation problems.

All this while saving 'boat' loads of money!

5 Ways to Quit Smoking for Good This 4th of July ~

Do something special this Fourth of July -- make the decision to quit smoking for good! Here are five tips that will help you quit smoking for life.

1. Start With a Stop-Smoking Plan

* Pick a day to quit smoking. Having a specific day in mind will help you stick to your goal. One day next month would be best — that will give you enough time to plan for it, but not enough time to talk yourself out of it. Don't quit smoking during holiday periods or at a time when you can expect a lot of additional stress. Post the date on your calendar, and let family and close co-workers and friends know.

*Visit your doctor. Discuss your decision to quit smoking, and ask if nicotine replacement therapy or other medications might help you quit.

* Cut back now. In the days leading up to your quit-smoking day, begin cutting back on the number of cigarettes you smoke each day. Try to smoke just half a cigarette when you do light up.

*Get smart. Read about what you'll be going through, especially nicotine withdrawal and the stresses of quitting. Start paying attention to triggers that make you want to smoke. You'll need to avoid or deal with these triggers once you've quit smoking.

*Plan substitutes. Stock up on cigarette substitutes like carrot sticks, hard candy, straws, toothpicks, and sugarless gum.

2. Seek Help and Support to Stop Smoking

*Tell family and friends about your quit-smoking day, and ask for their support. Just having someone to talk with can help you during low moments.

* Ask those who still smoke not to smoke around you while you're trying to quit smoking.

*Find a support group or a smoking cessation program in your area. Many groups like the American Lung Association and the American Cancer Society offer programs through which smokers can receive help and advice while they're trying to quit smoking.

3. Make Your Quit-Smoking Day Special

* Don't smoke at all. Not one puff. This is it!

* Get rid of all of your smoking paraphernalia. Toss out your cigarettes, matches, lighters, and ashtrays.

*Plan to stay busy all day. Go for a walk or exercise. Go someplace where smoking isn't allowed, like the library or the movies. Eat foods you don't normally eat, and take routes you don't normally take. The idea is to avoid any association with your usual patterns of behavior.

*Begin using a nicotine replacement, if you've decided that will help you.

* Drink lots of water and juice. This will give you something to do and help flush the nicotine out of your body.

4. Be Prepared to Deal With Smoking Withdrawal Symptoms
As time passes, you’ll need to confront rationalizations. You will come up with reasons to smoke that wouldn't normally make any sense to you except at this point, when you're in the middle of a powerful craving. Thoughts like, "Just one to get me through this rough patch" and "I can't deal with this today, I'll quit tomorrow" will go through your mind. See these thoughts for what they are, and ignore them. Here’s how:

*Avoid situations that trigger the desire to smoke.

*Find ways to deal with cravings. Take slow, deep breaths until the craving passes. Drink some water slowly and hold it in your mouth. Munch on carrot sticks or suck some hard candy. Focus on a crossword puzzle. Play with a rubber band.

* If nothing else works, just tell yourself to hold off smoking for 10 minutes; often, that will get you past the craving.

5. Maintain Your Resolve, But Be Ready for a Slip
Whenever you feel your resolve weakening, remind yourself of all the benefits of not smoking:

* Count the money you're saving on cigarettes, consider how much better everything tastes and smells, and think about how your secondhand smoke is no longer affecting your family and friends.

*Avoid alcohol. Drinking makes it more likely you'll slide back into smoking.

*Eat right and exercise. A healthy diet and an exercise regimen can keep your mind off cravings and draw attention to how much better you feel now that you've quit smoking.

*Reward yourself. Buy something special with the money you've saved on cigarettes.

* Quickly regain control if you slip. Slipping is not the same as relapse — it's just a one-time mistake. You're still a non-smoker. Rededicate yourself, and use the slip as a learning opportunity by asking yourself what triggered your desire to smoke and what you can do to avoid it in the future.

Quitting smoking is difficult but not impossible. I did it, so can you! Just don’t give up!

The High Cost of Smoking Cigarettes ~

If you think your cigarettes are getting even more expensive, you're right. In the past 10 years, 47 states and the District of Columbia have implemented 105 cigarette tax rate increases. (In contrast, Missouri and North Dakota haven't raised cigarette taxes since 1993, while California last hiked them up in 1999.)

According to the Campaign for Tobacco-Free Kids, states currently charge an average of $1.47 in taxes on each pack of cigarettes. As a result, the average price for a pack of smokes in the United States is now $5.58, though the price fluctuates wildly by geography. In Missouri -- the state with the nation's cheapest retail price -- a pack costs $3.93, while in New York -- the most expensive state -- it's a whopping $9.11. And that's outside New York City. Here in the five boroughs, where there are additional city taxes, a pack can cost anywhere from $11 to $13.

The average smoker burns through 13 to 16 cigarettes a day, or four to six packs a week. That adds up. The average smoker forks over at least $1,500 a year, while here in New York City, it's closer to $3,300.

But because smoking, like takeout food and store-made coffee, hits our wallets in a series of small purchases, it can be easy to overlook how much you're spending. Still, it has a psychological impact: One of many reasons governments implement cigarette taxes is to reduce smoking among price-conscious consumers.

It works: Research shows that people smoke less as cigarettes get more expensive. As tobacco giant Philip Morris (PM) stated in its 10-Q for the Securities and Exchange Commission on Nov. 3, 2008, "Tax increases are expected to continue to have an adverse impact on sales of tobacco products by our tobacco subsidiaries, due to lower consumption levels."

Smokers will have a lot to ponder in coming months, as the Department of Health and Human Services implements its new packaging policy requiring warning labels that include graphic photos of the health damages caused by smoking. In the meantime, we wanted to know how sensitive smokers are to the price of their cigarettes, so we hit the streets of Manhattan during lunchtime to find out.

102 Weeks of Recovery ~

Recovery from nicatine addiction is a combination of carrots and sticks. There will be days when you feel great and love life. There will be days when everything seems like a challenge to your sanity; especially in the begining. That's perfectly normal. We're human!!

The key to living without our former crutch is to recognize that both days are good for our growth in recovery. And both days are potentially dangerous -- if we don't stay vigilant.

Remember, we're dealing with a foe that's cunning, baffling, powerful, persuasive, and extraordinarily patient. For me, nearly two years later it can feel as if I've got the tiger by the tail. But I can risk letting my guard down, even momentarily, or that tiger will pounce.

Happy occasions are just as likely to invite relapse as stressful situations. But as long as we keep your guard up and don't allow yourself to be seduced into thinking we're "cured" (we're not)... we'll all be fine.