1 BCBSNEMEMWKBCD.XML VersionID: 1 Living with COPD Better Health Guide Becky Doe 1009 Main Street Anywhere, TN Southeast Eastgate Way, Suite 200 Bellevue, WA An Independent Licensee of the Blue Cross and Blue Shield Association
2 Checklist for better health Have regular lung tests. They can tell your doctor if your COPD is getting worse. A spirometry test measures how quickly your lungs can move the air in and out. A lung volume test measures how much air your lungs hold. Have these tests once a year, or as often as your doctor suggests. Don t smoke. If you smoke, quitting is the most important thing you can do. It is never too late to quit. No matter how long you have smoked or how serious your COPD is, quitting smoking can help stop damage to your lungs. Have an action plan. Work with your doctor so you know what to do right away if your symptoms change. This is called an action plan. Your plan will tell you how to handle any symptom flare-ups you may have. Get a flu shot. Having COPD makes it more likely you ll get the flu. The flu can make your COPD symptoms worse and can lead to pneumonia. Get a flu shot each year in the fall or at the beginning of each flu season. Get a pneumonia shot as advised by your doctor. Pneumonia can cause serious breathing problems, and you may need to stay in the hospital. Getting a pneumonia shot can help prevent pneumonia. Have a nutrition checkup. Losing too much weight or weighing too much can make it harder to manage your COPD. A dietitian can help you learn about healthier food choices and how to stay at a healthy weight. Be active. Physical activity can make your lungs stronger so you can do more. Talk to your doctor about what types of activity are right for you. Do pulmonary rehabilitation. A supervised program can help you with physical activity and breathing therapies Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Any references to commonly used brand-name medications or products are for example only and are not endorsements. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Printed in the United States of America Table of Contents Chapter 1 COPD basics...2 What is COPD?...2 What are the symptoms?...3 How well are you breathing?...3 Chapter 2 Treatment and medicines...4 COPD treatment...4 Medicines for COPD...4 Tips for using inhaled medicines...5 Drug interactions...6 Chapter 3 Help for depression...7 Depression and COPD...7 Chapter 4 Help for people who smoke...8 How does smoking cause COPD?...8 Steps to stop smoking...9 Chapter 5 Dealing with emergencies...10 If your symptoms suddenly get worse...10 How can you prevent flare-ups?...11 Your action plan...12 Tips for your home...12 Chapter 6 Self-care...13 Eating well...13 Staying strong...13 Pulmonary rehab programs...14 Home exercises...15 Chapter 7 COPD medicine appendix...18 Action plan form...20 Notes and contacts...21
3 2 Chapter 1 COPD basics COPD basics Chapter 1 3 Breathe easier when you have the facts You can make a difference in your health. Learning all you can about COPD will help you stay healthier. Use the information in this workbook to live better with COPD. What is COPD? COPD is chronic obstructive pulmonary disease. It is caused by damage to the lungs over many years, usually from exposure to tobacco smoke. Having COPD makes it very hard to breathe. COPD is often a mix of three diseases: Chronic bronchitis. In chronic bronchitis, the airways that carry air to the lungs your bronchial tubes get inflamed and make a lot of mucus. This can narrow or block your airways, making it hard to breathe. Emphysema. In a healthy person, the tiny air sacs in the lungs are like balloons. As you breathe in and out, these air sacs get bigger and smaller to move air through your lungs. But when you have emphysema, these air sacs are damaged and lose their stretch. Less air gets in and out of the lungs, which makes you feel short of breath. Chronic asthma. If you have had asthma for a long time, you also can develop COPD. This is especially true if your asthma is severe or has not been well controlled. You can develop COPD if your lungs have permanent damage from asthma attacks. Emphysema Normal airways and air sacs (alveoli) Emphysema Damaged air sacs Illustration copyright 2002 by Nucleus Communications, Inc. All rights reserved. Chronic bronchitis Trachea (windpipe) Normal bronchial tube Your Symptoms How well are you breathing? Grade What are the symptoms? The main symptoms of COPD are: A long-lasting (chronic) cough. Mucus when you cough. Shortness of breath that gets worse when you are active. As COPD gets worse, you may be short of breath even when you do simple things like get dressed or fix a meal. It s harder to eat or exercise, and breathing takes much more energy. You may lose weight and get weaker. Rank your shortness of breath during activity 1 You have trouble breathing with hard exercise. 2 You are short of breath when hurrying or walking up a slight hill. 3 You walk slower on level ground than people your age because you re out of breath, or you have to stop to catch your breath when you walk at your own pace. 4 You stop for breath after walking about 100 meters (a bit longer than a football field) or after a few minutes on level ground. 5 You are too short of breath to leave the house, or you are short of breath when dressing or undressing. Bronchial tubes Lungs Swelling and inflammation Mucus MRC scale adapted from: Fletcher CM, et al. (1959). The significance of respiratory symptoms and the diagnosis of chronic bronchitis in a working population. BMJ, 2: National Collaborating Centre for Chronic Conditions (2004). Chronic obstructive pulmonary disease. National clinical guideline on management of chronic obstructive pulmonary disease in adults in primary and secondary care. Thorax, 59 (Suppl. 1):
4 4 Chapter 2 Treatment and medicines Treatment and medicines Chapter 2 5 COPD treatment No treatment will cure COPD, but treatment can make you healthier and help control your symptoms. Having regular checkups and tests is important. Ask your doctor what you need and how often you need it. Ask him or her to write down a schedule for you, and check to see if someone will call to remind you. Put the dates on your calendar. Medicines for COPD Medicines can help you breathe easier. Most of them are inhaled so they go straight to your lungs. Some medicines are used every day to control your symptoms. Others are used only if you suddenly have severe shortness of breath and coughing. Medicines are called short-acting if they are used to relieve symptoms right away. They are called long-acting if they are used long-term to prevent breathing problems. To see more detailed information on COPD medicines, go to pages Reminders Flu Shot: Each fall or at the beginning of flu season Pneumonia shot: As your doctor advises Lung tests: Spirometry once a year, others as needed Short-acting medicines Your doctor may prescribe thesmedicines for symptoms that come and go. You may use them for milder symptoms or before exercise. Or you may use the short-acting medicines in emergencies for treating flareups of symptoms. They generally last for several hours and start working within a few minutes. These are short-acting medicines: Albuterol inhaler Ipratropium inhaler Long-acting medicines Your doctor may prescribe these medicines to control your symptoms. You also may use them to reduce the number of flare-ups you have. For these medicines to work, take them every day or as often as your doctor tells you to, even if you are feeling okay. These medicines are different than the short-acting medicines that you use only when you have symptoms. A few examples are: Tiotropium dry-powder inhaler Salmeterol inhaler (disk) Inhaled corticosteroids (Write other reminders as directed by your doctor) Tips for using inhaled medicines Using your inhaler Talk with your doctor to be sure you are using the inhaler the right way. Practicing in front of a mirror may help. Make sure you have the correct medicine. If you use several inhalers, put a label on each one so you know which one to use at the right time. Check the label to see how many puffs are in the inhaler. When you know how many puffs it holds, compare that number to how many you take each day so you can get a new inhaler before you run out. Ask your doctor or pharmacist to help you know how much medicine is left. Using a spacer Using a spacer with an inhaler is the best way to get the most medicine to your lungs. Here is the correct way to use a spacer: Shake the inhaler and remove the cap. Place the mouthpiece of the inhaler into the spacer. Remove the cap from the spacer. Hold the inhaler upright with the mouthpiece at the bottom. Tilt your head back slightly, and breathe out slowly and completely. Put the spacer s mouthpiece in your mouth. Press the inhaler to spray one puff of medicine into the Inhaler with spacer spacer, and start breathing in slowly. Try to hold your breath for 10 seconds. This will let the medicine settle in your lungs. If you need to take a second dose, wait at least 30 seconds to allow the inhaler valve to reset. Rinse your mouth out with water after use. Do not swallow the water. After each use, rinse the spacer, mouthpiece, cap, and case. Although using an inhaler with a spacer usually is recommended, you also can use an inhaler without a spacer. Your doctor can show you how to do this correctly. Ask your doctor whether this option is right for you. If your inhaler is a dry powder type, do not use a spacer.
5 6 Chapter 2 Treatment and medicines Help for depression Chapter 3 7 Oxygen therapy At some point you may need oxygen therapy. By boosting the oxygen in your blood, this treatment helps you breathe easier and gives you more energy. It also may help you live longer and stay out of the hospital. You can use oxygen while you move around and do daily tasks. You may breathe the oxygen through a flexible plastic tube in your nostrils, called a nasal cannula. Or you may use a face mask or a tube put into your windpipe. The oxygen can be supplied in several ways. You can get an oxygen gas tank, liquid oxygen that comes in a small container, or an oxygen concentrator (for home use). It is very important to use the oxygen just as your doctor tells you. Never increase or decrease the amount of oxygen you use unless your doctor tells you to. If you don t use it enough or for as long as needed, it may not help you feel better and live longer. Taking medicines safely You may have many different medicines to keep track of, especially if you have other health problems. Make a list of your medicines, and post it someplace where you will see it often. The list should include the name of each medicine, the dose, how often you take it and when, and any special instructions (such as whether you take it with meals or on an empty stomach). Include in your list any medicines you are allergic to. Try using a weekly medicine organizer. You can buy an inexpensive plastic pillbox with a space to hold each day s medicines. Be sure to keep at least one pill in each original bottle to help you identify the medicine. Label your inhalers if you use several different ones. Do NOT smoke or let anyone else smoke around oxygen. It could cause a fire. Drug interactions Be sure to tell your doctor about all prescription medicines, nonprescription medicines, vitamins, herbs, and supplements you take. Some of them may be harmful if they are used together. Bring all of your prescription and nonprescription medicines with you to each doctor s visit so your doctor can review them. Ask your doctor about any possible problems (called interactions) between some COPD medicines and other drugs. Susie s story After she found out she had COPD, Susie lacked hope. She was scared and depressed, especially after reading a lot about COPD. She was sure she would die shortly. But she found a Web site that said, COPD is not a death sentence. Those words motivated her to reach out to other people who have COPD. She found new friends in online support groups. They knew exactly how she was feeling. They taught her positive ways to cope with her COPD. She learned tips that made everyday chores easier. She got advice on how to eat. But most of all, her new friends gave her hope. That has allowed her to move forward, improve her health, and be active in her health care. Depression and COPD COPD is a chronic disease that does not go away with time. Depression is common in people with chronic diseases, but it often goes unnoticed. The link between depression and chronic disease is not well understood, but depression can be dangerous. Treatment can help you feel better and have better overall health. Are you depressed? You may think it s normal to feel down or depressed all the time because you have COPD. But it s not. You can get help to feel better. If you are depressed, you may: Feel sad, worried, or empty. Feel guilty or worthless. Not enjoy things you used to enjoy. Feel hopeless, as though life is not worth living. Have trouble thinking or remembering. Have low energy, or not eat or sleep well. Have trouble sleeping. Pull away from others. Think often about death or killing yourself. Call your doctor right away if you have at least three of these symptoms. Call if you have had one or two for more than 2 weeks. Or call if any of these symptoms make it hard for you to function normally. Counseling or medicine helps most people with depression. Often a combination of both works best. Counseling also can help you cope with having a long-term disease.
6 8 Chapter 4 Help for people who smoke Help for people who smoke Chapter 4 9 How does smoking cause COPD? Over time, breathing tobacco smoke irritates your airways and destroys the stretchy fibers in your lungs. If you smoke, you ve probably heard many times that you need to quit. No one knows more than you do how hard it is to stop. But quitting is the most important thing you can do. It s never too late to quit. No matter how long you have had COPD or how serious it is, quitting smoking will help slow the disease and improve your quality of life. Giving up smoking is much harder than just changing a habit. Your body has to stop craving the nicotine. Using treatment can double your chances of quitting. Duane s story Talk to your doctor about treatments to help you stop smoking. If you use medicines and get support, you increase the chances that you will quit for good. To learn more about how to quit, go to or call QUIT-NOW ( ). Duane smoked up to two packs a day, all his life. He tried to quit many times but couldn t. He was in his 60s when his lung collapsed. A surgeon removed part of his right lung, and from then on he needed oxygen to help him breathe. Although it was terrible to kick the habit, he weighed quitting cigarettes against not being able to breathe or having his other lung collapse. He quit overnight. Now, more than a decade later, he has to take it slow, but he walks as far and as often as he can. Exercise requires him to breathe deep and helps him get the congestion out of his lungs. He s taken up crocheting to give him something to do with his hands instead of using them to hold cigarettes. It keeps him from getting sidetracked, he says. Try these steps to stop smoking 1. Get ready. Choose a quit date that works for you. Do not try to quit during high-stress times. Get rid of your cigarettes, es, ashtrays, and lighters. Clean your house and clothes to get rid of the smoke smell. Ask others not to smoke around you and not to leave cigarettes where you can find them. 2. Make a plan for quitting. Decide what times are the hardest for you, such as when you are in a bad mood or are around others who smoke. Plan how you will handle your cravings during these times. Change your routine. Avoid those things that make you reach for a cigarette. Find ways to cope. For example, take a walk after dinner instead of having a cigarette. Find ways to cut down on stress in the first few weeks after you quit. 3. Get support. Ask for support and tips from loved ones or people who have quit. Get counseling. The more counseling you get, the better your chances of quitting. Join a support group for people p who are trying to quit. Find an Internet chat room for 24-hour support. 4. Use medicine and other products. Medicines and nicotine replacement products reduce your craving and withdrawal symptoms. Studies show they may double your chances of quitting. Talk to your doctor or a pharmacist about medicines and other products. Those usually tried first are: Nicotine replacement. You can buy nicotine gum, patches, and lozenges without a pes prescription. Or your doctor can prescribe a nicotine inhaler or nasal spray. Some states offer free nicotine replacement therapy. If you are pregnant and are trying to quit, your doctor may want you to try other ways of quitting before you try a nicotine patch or other nicotine products. Bupropion and varenicline. ne These prescription medicines have no nicotine. They help ease nicotine cravings and withdrawal symptoms. 5. Be prepared for relapse. Starting smoking again is called relapse. To avoid this: Stay close to your support system, such as your doctor, family, friends, and support group. Learn to recognize times when you might relapse. Plan ahead to cope with those times and events. Reward yourself. Quitting smoking is tough, and each small success deserves praise and some celebration. Do not smoke at all. Not even a puff! Do not give up, even if you do start to smoke again. Stop smoking again. Some people quit many times before they can do it for good.
7 10 Chapter 5 Dealing with emergencies Dealing with emergencies Chapter 5 11 If your symptoms suddenly get worse A sudden flare-up of your COPD symptoms can be serious. You also may hear your doctor call a flare-up an exacerbation (say egg-zas-ur- BAY-shun ). Ask your doctor to help you make a plan for what to do in case you have a flare-up. Pat s story Walking her dog one cold spring day, Pat was having more trouble breathing than usual. She worried she was having a heart attack. It felt like someone was sitting on her chest. After struggling to make it home, she thought she would get better. But she didn t. Two days later, she went to her doctor, who prescribed antibiotics and gave her a breathing treatment with a nebulizer. She realizes now that waiting could have been deadly, especially if her symptoms were a sign of a heart attack. Treatment made her feel a lot better REQUIRED BARCODE POSITION What causes flare-ups? A lung infection or air pollution can set off an exacerbation. Sometimes it can happen after a quick change in temperature or from being around chemicals. You may not always know the cause. Work with your doctor to learn what causes your flare-ups. If you know things that cause you to have a flare-up, you may be able to prevent it What are the warning signs? Your normal COPD symptoms suddenly get worse. You have more shortness of breath and wheezing. You have more coughing with or without mucus. You have a change in the color or amount of your mucus. You have a fever. You are not able to sleep, and you feel very tired. You are depressed or confused. What should you do? Follow the plan you and your doctor made for managing flareups. This set of directions is called an action plan (see next page). If you don t have a plan, call your doctor if you start having a flare-up. At your next visit, talk to your doctor about making an action plan. Call 911 if: You also are having chest pain. You feel like you can t breathe at all (are suffocating). Will you need treatment? Treatment depends on how serious your symptoms are. You may go to your doctor or a clinic for treatment. Or you may have to go to the hospital. You may need corticosteroid pills for a short time. If you have a lung infection, you also may get antibiotics. If you have to go to the hospital, you may need a machine called a ventilator to help you breathe for a short time. This is used only if medicine does not help. You may get oxygen treatment. Prevention How can you prevent flare-ups? Staying healthy and avoiding things that can set off flare-ups may help you prevent them. Stop smoking. Avoid colds and the flu. Get a flu shot each fall or at the beginning of flu season. Ask those you live or work with to do the same so they do not get the flu and infect you. If you must be around people with colds or the flu, wash your hands often. Avoid secondhand smoke, air pollution, cold or dry air, hot or humid air, and high altitudes. Stay at home with your windows closed when air pollution is bad. Avoid wood smoke, solvents and other chemicals, and pollen. Try to keep your home free of mold, dust mites and roaches, and pet hair. Avoid contact with a pet s skin or saliva.
8 12 Chapter 5 Dealing with emergencies Self-care Chapter 6 13 Your action plan Ask your doctor about making an action plan for managing flare-ups. Your plan will give you steps to follow if you have a flare-up. Do not panic if you start to have one. Quick treatment at home may help you prevent serious breathing problems. See page 20 for an action plan form to fill out with your doctor. Keep your action plan where it is easy to find. Include your doctor s daytime phone and emergency numbers. You also might include friends or family members numbers as well. Give copies of your action plan and doctor s numbers to neighbors, coworkers, or anyone else who might help you. Keep copies at home and in your purse or wallet. Be sure to update your plan each time you see your doctor and when your medicines change. Tips for your home Use an air conditioner so you do not have to open windows. Use an air conditioner or air purifier with a special air (HEPA) filter. Make sure fumes from wood-burning stoves and gas ranges are vented well and that they have tight-fitting doors. Check flues and chimneys for cracks that could allow fumes into your house. Install a carbon monoxide detector in your home. Carbon monoxide is odorless and colorless. If you see orange or sputtering flames in your gas furnace or stove, you may have a problem with carbon monoxide. Do not mix cleaning products. Consider using natural cleaners, like vinegar, lemon juice, boric acid, and baking soda. Do not keep items for recycling in your home. Newspapers, rags, cans, or bottles can give off fumes. Make sure outdoor fresh-air intake vents for your heater and air conditioner are located above the ground. Make sure they are not close to sources of air pollution, such as cars and trucks. Take good care of yourself Good self-care can help you stay healthy. For example, getting regular physical activity, using special breathing techniques, and taking rest breaks during the day may help you feel better from day to day. Staying as healthy as possible is one of the best ways to take care of yourself. Eating well As your COPD progresses, it may be harder to prepare and eat meals. Eating enough is important because: Food gives you energy, including the energy you need to breathe. You need more energy to breathe than a person who doesn t have COPD. Nutrients from food help strengthen your body s natural defense system, making it easier to avoid infections. Being underweight may increase your chance of getting infections. Here are some tips for making and eating meals: Make enough food so you can freeze some for future meals. Make food several hours before you eat. Then rest for an hour before eating. Eat 5 or 6 small meals instead of 2 or 3 large ones. Eat foods that are easy to digest and don t cause gas. Staying strong Being at a healthy weight will help you manage your COPD. If you are too heavy, your body has to work harder to breathe. If you are too thin, your body is not getting enough nutrients and calories to stay as healthy as possible. In this case, several things might be making it hard to stay at a healthy weight: Your body uses more energy and nutrients because you have to work hard to breathe. Your body needs more energy for physical activity. You may be less interested in food. This may be because you re depressed, or some of your medicines may reduce your appetite. You may be getting less oxygen into your blood. This can prevent your body from using food properly. Your full stomach can press on your diaphragm, a large sheet of muscle that helps draw air into your lungs. This makes it harder to breathe, so you may be eating less. You may be too tired to eat or prepare meals REQUIRED BARCODE POSITION
9 14 Chapter 6 Self-care Self-care Chapter 6 15 Pulmonary rehabilitation programs Has your doctor recommended a pulmonary rehabilitation program? With rehab, you can get help to stop smoking, try exercises to get your strength up, and learn tips for easier breathing. Pulmonary rehab can help you improve the quality of your life, reduce your symptoms, and be more active in your treatment. Many different people therapists, nurses, dietitians, and doctors may be involved in your program. When you ve learned the best exercises and therapies, you may be able to do many of them at home as part of your self-care. Breathing tips Because you have trouble breathing, you may take quick, short breaths. Breathing this One of the greatest way makes it harder to get benefits of a pulmonary rehab air into your lungs. Learning how to control your breathing program is meeting other may help. Use these breathing people who have COPD. You exercises whenever you are can exchange information and more short of breath than tips about how to live better usual. Also, use them if you re in a stressful situation, which with COPD. can make it hard to breathe. Pursed-lip breathing may help you breathe more air out so that your next breath can be deeper. Breathe in through your nose and out through your mouth while almost closing your lips. Breathe in for about 4 seconds, and breathe out for 6 to 8 seconds. Pursed-lip breathing helps with shortness of breath and makes it easier to exercise. Diaphragmatic (say dy-uh-frug-mat-ik ) breathing helps your lungs expand to take in more air. Lie on your back, or prop yourself up on several pillows. With one hand on your belly and the other on your chest, breathe in. Push your belly out as far as possible. You should feel the hand on your belly move out, while the hand on your chest should not move. When you breathe out, you should feel the hand on your belly move in. The goal is to practice this for 20minutes, 2 or 3 times a day. When you are able to do diaphragmatic breathing well while lying down, you can learn to do it while sitting or standing. Breathing while you bend forward at the waist can reduce shortness of breath while you are exercising or resting. Bending forward helps the diaphragm move more easily REQUIRED BARCODE POSITION Home exercises If you aren t in a pulmonary rehab program, talk to your doctor about these exercises to make sure they are right for you. Start these exercises slowly. Keep track of how long you can do them, or count the number of times you can do them before you are a little out of breath. Then rest and move on to the next exercise. Each week, increase the amount of time you do them or how many you do. Elbow circles Sit or stand with your feet slightly apart. Place your hands on your shoulders with your elbows at shoulder level and pointing out. Slowly make circles with your elbows. Breathe out as you start the circle, and breathe in as you complete the circle. Elbow breathing Sit with your feet slightly apart. Lift your elbows to shoulder level, and touch your fingertips in front of your chest. Breathe in as you pull your elbows back so that your fingertips separate. Breathe out as you return your elbows and fingertips to the starting position.
10 16 Chapter 6 Self-care Self-care Chapter 6 17 Knee extensions Sit in a chair with your feet slightly apart. Breathe out as you straighten your knee and raise your leg. Breathe in as you bend your knee and return your foot to the floor. Step-ups Start on a flight of stairs with a banister to hold. Breathe out as you take one step up. Breathe in as you step back down. Leg lifts Sit in a chair with your feet slightly apart. Breathe out as you lift one leg straight up so that the knee rises toward your shoulder. Breathe in as you return your foot to the floor REQUIRED BARCODE POSITION
11 18 Chapter 7 COPD medicine appendix COPD medicine appendix Chapter 7 19 Beta 2 -agonists These medicines open your airways to make it easier to breathe. You can use them for flare-ups, for milder symptoms, or before exercise. They usually are inhaled. The short-acting medicines last 4 to 6 hours, and they start working within 5 minutes. Examples include: Albuterol. Metaproterenol. Pirbuterol. Levalbuterol. The long-acting medicines work for at least 12 hours. Examples include: Formoterol. Salmeterol. Formoterol starts working within 5 minutes. Salmeterol takes about 30 minutes. Taking formoterol or salmeterol may increase your chance of having a fatal asthma attack. If your wheezing gets worse after you take these medicines, call your doctor right away. Anticholinergic medicines These medicines relax and enlarge the airways in your lungs. They also may reduce mucus. You take these every day for your ongoing symptoms. Ipratropium is a short-acting medicine that works for 6 to 9 hours. It comes in an inhaler or nebulizer. Tiotropium is a long-acting medicine that works for 24 hours or more. It may be more convenient, but it is more expensive. You inhale this medicine as a dry powder. Side effects include a mild cough, a dry mouth, and constipation. In rare cases, ipratropium has caused eye problems. Call your doctor right away if you have pain or redness in one or both eyes or if your vision is misty after you use the medicine. Stop taking the medicine. Methylxanthines You may take these medicines if other medicines haven t helped. You also may take them for flare-ups or trouble breathing at night. Examples include: Theophylline. Aminophylline. Theophylline may cause serious side effects. It may react with antibiotics, antacids, or other medicines. Some of the more common side effects of these medicines include: An upset stomach. Heartburn (which could cause more trouble with breathing). Trouble sleeping. A headache. Nervousness. Rapid breathing. You may be able to reduce these side effects by avoiding caffeine. More serious side effects can include: Nausea and vomiting. Seizures. Low blood sugar. Uneven heartbeat. If you take theophylline, you need to have regular blood tests. Steroid medicines Steroid medicines (also called corticosteroids) reduce swelling and mucus in your airways. You can inhale these medicines or take them as a pill or syrup. They are used to manage flare-ups and can be used if your symptoms are not controlled by other medicines. Oral steroids may be pills or syrups. They mostly are used during a flare-up, especially if you have a lot of mucus. They include: Prednisone. Methylprednisolone. Prednisolone. If you use oral steroids, you may have side effects such as: Weight gain and swelling from fluid buildup. Mood changes. Higher blood sugar. High 911 blood pressure. Call now if you take steroids and: You vomit blood or what looks like coffee grounds. You pass maroon or very bloody stools. Call your doctor if you take steroids and: Your ankles or feet swell. Your face gets puffy. You gain a lot of weight. You have a sore throat. You have a fever that will not go away. Your vision changes. Your mood is unusual and you are uncomfortable. Inhaled steroids are either a mist or dry powder. Examples include: Beclomethasone. Flunisolide. Budesonide. Fluticasone. Triamcinolone. Mometasone. Side effects include a sore mouth or sore throat, changes in your voice, and a mouth or throat infection called thrush. To help prevent thrush, rinse your mouth after you use the inhaler. Call your doctor if you have thick, white patches in your mouth or throat, or if you have pain when you eat or swallow.
12 20 Chapter 7 Action plan form Notes and contacts Chapter 7 21 My action plan form Treatment and medicines Notes and contacts Use this form to create your action plan. Give copies of it to neighbors, coworkers, or anyone else who might help you. Keep copies at home and in your purse or wallet. Update your plan each time you see your doctor and whenever your medicines change. My name, address, and phone: My doctor s name, address, and phone: Emergency contact name and phone: What to do if my symptoms get worse: I am allergic to these medicines: If I have these symptoms: I need this medicine (type and name): I take this much, up to this maximum dose: The information contained in this material is provided for educational purposes only, and shall not constitute medical advice. Please consult your doctor for specific medical advice before taking any medications and before beginning any lifestyle program. While we are providing you with this information, neither organization endorses the other or takes responsibility for the other s printed materials or products, and any references to commonly used brand-name medications or products are for example purposes only they should not be construed as endorsements.
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WHEN COPD* SYMPTOMS GET WORSE *Includes chronic bronchitis, emphysema, or both. Boehringer Ingelheim Pharmaceuticals, Inc. has no ownership interest in any other organization that advertises or markets
Understanding COPD An educational health series from Our Mission since 1899 is to heal, to discover, and to educate as a preeminent healthcare institution. We serve by providing the best integrated and
COMMUNITY HEALTH AND COUNSELING SERVICES Self Management for COPD Call Your Home Health Nurse and/or Physician Call 911 Sputum (phlegm) that increases in amount/color or becomes thicker than usual Unrelieved
The American College of Obstetricians and Gynecologists f AQ FREQUENTLY ASKED QUESTIONS FAQ065 WOMEN S HEALTH It s Time to Quit Smoking What are the dangers of smoking? How does smoking affect the body?
COPD Intervention 1. Primary disease education Member will have an increased understanding of chronic obstructive pulmonary disease, the causes, risks and complications. Explain COPD Explain how COPD is
Using an Inhaler Without a spacer Remove the cap Shake the inhaler for 3 4 seconds Place your middle finger on the sprayer Place your thumb on the bottom of the inhaler Stand up and tilt your head back
What is Asthma? Information for Behavioral Health Providers in Primary Care Asthma Asthma (AZ-ma) is a chronic (long-term) lung disease that inflames and narrows the airways. Asthma causes recurring periods
Your Go-to COPD Guide Learning how to live with chronic obstructive pulmonary disease (COPD) Inside, you ll learn: COPD facts COPD symptoms and triggers How to talk with your doctor Different treatment
DRUG INTERACTIONS: WHAT YOU SHOULD KNOW Council on Family Health Drug Interactions There are more opportunities today than ever before to learn about your health and to take better care of yourself. It
The Annual Direct Care of Asthma The annual direct health care cost of asthma in the United States is approximately $11.5 billion; indirect costs (e.g. lost productivity) add another $4.6 billion for a
Living With Congestive Heart Failure Information for patients and their families Patient information developed by EPICORE Centre, Division of Cardiology, University of Alberta The REACT study: supported
TAKING CARE OF YOUR ASTHMA WHAT IS ASTHMA? Asthma is a disease that affects the lungs. If you have asthma, you have it all the time, but will have an asthma attack only when something, known as a trigger,
Patient Education Your Lungs and COPD A guide to how your lungs work and how COPD affects your lungs Your lungs are organs that process every breath you take. They provide oxygen (O 2 ) to the blood and
Patient Information Once Weekly FOSAMAX (FOSS-ah-max) (alendronate sodium) Tablets and Oral Solution Read this information before you start taking FOSAMAX *. Also, read the leaflet each time you refill
Key #2 Stop Smoking There are many different poisons that can be found in cigarettes, such as carbon monoxide, tar, rat poison, paint thinner, and lighter fluid, just to name a few. Any of these toxins,
Smoking Cessation Program UHN Information for people who are ready to quit smoking Read this information to learn: why you should quit smoking how the Smoking Cessation Program works treatments to help
Emphysema Pronounced: em-fiss-see-mah by Debra Wood, RN En Español (Spanish Version) Definition Emphysema is a chronic obstructive disease of the lungs. The lungs contain millions of tiny air sacs called
II. ASTHMA BASICS Overview of Asthma Why do I need to know about asthma? In the United States, asthma is the most common chronic childhood illness. Asthma affects an estimated 4.8 million children nationally,
BOOKLET 8 TM A Guide To Remaining Smoke Life Without Cigarettes Contents Urges 2 Benefits of Quitting 4 But What About My Weight? 7 If You Do Smoke 9 In Closing 10 This is the eighth and last booklet in
Oxygen AND COPD This fact sheet talks about home oxygen, prescribed as a medicine for some people with COPD. For more information on COPD, phone 1-866-717-COPD (2673) or visit us online at www.lung.ca/copd
Medication Guide DULERA [dew-lair-ah] 100 mcg/5 mcg (mometasone furoate 100 mcg and formoterol fumarate dihydrate 5 mcg inhalation aerosol) DULERA 200 mcg/5 mcg (mometasone furoate 200 mcg and formoterol
Staying on Track with TB TUBERCULOSIS Medicine What s Inside: Read this brochure to learn about TB and what you can do to get healthy. Put it in a familiar place to pull out and read when you have questions.
Patient Information ASMANEX TWISTHALER 220 mcg (mometasone furoate inhalation powder) ASMANEX TWISTHALER 110 mcg (mometasone furoate inhalation powder) FOR ORAL INHALATION ONLY Please read this leaflet
Stop Now! The Bad News About Smoking Smoking harms nearly every organ of the body. Smoking causes cancer and coronary heart disease, the leading causes of death in the United States. Health effects from
Patient information How to Stop Smoking Before your Operation PIF 734 V5 Fag Ends can help you stop smoking before your operation. To contact Fag Ends for help to stop smoking please call Freephone: 0800
The Right Medicines Can Help You Get Control of Asthma BlueCare SM TennCareSelect WHEEZING. COUGHING. SHORTNESS OF BREATH. CHEST TIGHTNESS. If you or a family member has asthma, you know these symptoms
Alcohol and drug abuse This chapter explores how alcohol abuse affects our families, relationships, and communities, as well as the health risks associated with drug and alcohol abuse. 1. Alcohol abuse
Get the Facts About TB TUBERCULOSIS Disease What s Inside: 3 PAGE Get the facts, then get the cure 4 PAGE 9 PAGE 12 PAGE Learn how TB is spread Treatment for TB disease Talking to family and friends about
CHILDREN S NATIONAL MEDICAL CENTER The Diana L. and Stephen A. Goldberg Center for Community Pediatric Health Asthma A Guide for Patients and Families Kohl s is proud to partner with Children s National
Glossary 1. asthma: when the airways of the lungs narrow, making breathing difficult 2. bacteria: tiny living creatures that can only be seen with a microscope; some bacteria help the human body, and other
Inhaled and Oral Corticosteroids Corticosteroids (steroids) are medicines that are used to treat many chronic diseases. Corticosteroids are very good at reducing inflammation (swelling) and mucus production
Whooping Cough Introduction Whooping cough is a serious bacterial infection of the lungs and breathing tubes. It is also called pertussis. About 16 million cases of whooping cough happen worldwide each
Chemotherapy What It Is, How It Helps What s in this guide If your doctor has told you that you have cancer, you may have a lot of questions. Can I be cured? What kinds of treatment would be best for me?
New Beginnings: Managing the Emotional Impact of Diabetes Module 1 ALEXIS (AW): Welcome to New Beginnings: Managing the Emotional Impact of Diabetes. MICHELLE (MOG): And I m Dr. Michelle Owens-Gary. AW:
YOU CAN QUIT WE CAN HELP SO, you re thinking of quitting tobacco. Let s figure out where you are right now, and see how this book can guide you through the quit process. Which of these sounds most like
SUBSTANCE ABUSE You have to choose who you want to be in life. This happens by making lots of decisions every day. Using substances is a choice. This is a big choice, because substances have a very real
Functional rehab after breast reconstruction surgery UHN A guide for women who had DIEP, latissimus dorsi with a tissue expander or implant, or two-stage implant based breast reconstruction surgery Read
Help Yourself Breathe Tender Loving Care for Your Lungs PD 1359 (Rev 06-2009) File: peyles Department of Physiotherapy Why are you breathless? Chronic Airflow Limitation or Obstruction is a decrease in
Lung Disease page 1 Q: What is lung disease? A: Lung disease refers to disorders that affect the lungs, the organs that allow us to breathe. Breathing problems caused by lung disease may prevent the body
Natural Therapies for Emphysema By Robert J. Green Jr., N.D. CONTENTS Note to the Reader 00 Acknowledgments 00 About the Author 00 Preface 00 Introduction 00 1 Essential Respiratory Anatomy and Physiology
Smoking and your lungs Why it s never too late to give up Giving up smoking is never easy, but it s the most important thing you can do to look after your health. If you have a lung condition, you might
How to Stop Smoking In a Week Redding Hypnosis Roger Gray, CHT Call today for an appointment (0) - www.reddinghypnosis.com CONTENTS PREFACE THE RISKS OF SMOKING KNOW YOUR ENEMY HOW YOU CAN QUIT SMOKING
Cocaine Introduction Cocaine is a powerful drug that stimulates the brain. People who use it can form a strong addiction. Addiction is when a drug user can t stop taking a drug, even when he or she wants
MEDICATION GUIDE Xyrem (ZĪE-rem) (sodium oxybate) oral solution CIII Read this Medication Guide carefully before you start taking Xyrem and each time you get a refill. There may be new information. This
7 Asthma Asthma is a common disease in children and its incidence has been increasing in recent years. Between 10-15% of children have been diagnosed with asthma. It is therefore a condition that pharmacists
Steps to Help You Quit Smoking How Other Moms Have Quit Most Smokers Want to Quit If you are one of them, this workbook is for you. You may have good reasons to quit smoking and some concerns. This booklet
Oxford University Hospitals NHS Trust Physiotherapy department Stem cell transplant, you and your rehabilitation Information for patients and their carers Stem cell transplant exercise handout Thank you
Health Effects HEALTH EFFECTS Asbestos can kill you. You must take extra precautions when you work with asbestos. Just because you do not notice any problems while you are working with asbestos, it still
Lung Cancer Introduction Lung cancer is the number one cancer killer of men and women. Over 165,000 people die of lung cancer every year in the United States. Most cases of lung cancer are related to cigarette
Welcome to the MDwise Right Choices Program Helping you get the right care at the right time at the right place. MDwise Right Choices Program What is the Right Choices program? The Right Choices program
Dear Parent/Guardian, We all want our children with asthma to be healthy! Asthma can be a frightening experience for kids, as well as their parents. Let Darby BoIngg be your partner, along with your physician,
MEDICATION GUIDE VIVITROL (viv-i-trol) (naltrexone for extended-release injectable suspension) Read this Medication Guide before you start receiving VIVITROL injections and each time you receive an injection.
STAYING ASTHMA FREE All you need to know about preventers www.spacetobreathe.co.nz HELPING YOUR CHILD BREATHE MORE EASILY GETTING TO KNOW THE PREVENTER What is a preventer? When do you use it? How do they
TB Get the Facts About Tuberculosis Disease What s Inside: Read this brochure today to learn how to protect your family and friends from TB. Then share it with people in your life. 2 Contents Get the facts,
Asthma Ear Infections in childhood asthma in childhood Asthma in childhood is common and it can be serious. About one in six children (aged less than 15 years) in Western Australia are affected by asthma.
MEDICATION GUIDE WELLBUTRIN (WELL byu-trin) (bupropion hydrochloride) Tablets Read this Medication Guide carefully before you start using WELLBUTRIN and each time you get a refill. There may be new information.
GCE AS/A level 1661/01A APPLIED SCIENCE UNIT 1 Pre-release Article for Examination in January 2010 JD*(A09-1661-01A) 2 BLANK PAGE 3 Information for Teachers The attached article on asthma is based on some
Better Living with Obstructive Pulmonary Disease A Patient Guide Second Edition November 2012 Queensland Health The State of Queensland (Queensland Health) and The Australian Lung Foundation 2012 a Better
Seasonal Allergies Introduction Seasonal allergies are allergies that develop during certain times of the year. Seasonal allergies are usually a response to pollen from trees, grasses, and weeds. Constant
Colon Cancer Surgery and Recovery A Guide for Patients and Families This Booklet You are receiving this booklet because you will be having surgery shortly. This booklet tells you what to do before, during,
A ragweed pollen as a treatment for a ragweed allergy? It s called immunotherapy. RAGWITEK is a prescription medicine used for sublingual (under the tongue) immunotherapy to treat ragweed pollen allergies
Hemorrhagic Stroke GENERAL INFORMATION: What is a hemorrhagic stroke? A hemorrhagic stroke happens when a blood vessel in the brain bursts. This may happen if the blood vessel wall is weak, or sometimes
Help Yourself to a Healthy Home Asthma and Allergies SHOULD YOU BE CONCERNED? More than eight million children in the United States have a disease called asthma. Asthma is a leading reason that children