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2013年9月26日星期四

What is chronic obstructive pulmonary disease (COPD)?



WELLNESS WEDNESDAY
November 28, 2013







What is chronic obstructive pulmonary disease (COPD)? COPD is a lung disease that makes it hard to breathe.  It is caused by damage to the lungs over many years, usually from smoking COPD is often a mix of two diseases; chronic bronchitis & Emphysema. According to Wikipedia, worldwide, COPD ranked as the sixth leading cause of death in 1990. COPD is the third leading cause of death in the U.S. and the economic burden of COPD in the U.S. in 2007 was $ 42.6 billion in health care costs and lost productivity. COPD gets worse over time. You can’t undo the damage to your lungs, but you can take steps to prevent more damage and feel better. I myself have battled with bronchitis for many years and find myself breathless sometimes when I take the stairs at work. Even though I have not been diagnosed with the disease, I feel that I have many of the systems. Anyone who has COPD understands the importance of listening to your body and to know your limits. Medline Plus suggests a few tips you can to make breathing easier:


·         Quitting smoking is the most important step you can take to prevent or slow damage to your lungs—it is never too late to stop smoking. 

·         Avoid conditions that may irritate your lungs, such as indoor and outdoor air pollution, smog, cold dry air, hot humid air, or high altitudes.

·         Take rest breaks. Schedule short rest breaks during household chores and other activities. An occupational or physical therapist can help you find ways to do everyday activities with less effort.

·         Stay as active as possible, and get regular exercise. Try to do activities and exercises that build muscle strength and help your cardiovascular systemif you get out of breath, wait until your breathing returns to normal before continuing.

·         Eat well

Eat Good nutrition is important to keep up your strength and health. Problems with muscle weakness and weight loss are common in people with severe COPD. People with COPD who are very underweight, especially those with emphysema, are at higher risk of early death than are people with COPD who have a normal weight.

·         Seek education and support Treating more than the disease and its symptoms is very important. You also need educating yourself and your family about COPD and your treatment program helps you and your family copes with your lung disease.

·         A support network of family, friends, and health professionals. Learning that you have a disease that may shorten your life can trigger depression or grieving. Anxiety can make your symptoms worse and can trigger flare-ups or make them last longer. Support from family and friends can reduce anxiety and stress and make it easier to live with COPD.

·         Take the medicines prescribed by your doctor. If you use a metered-dose inhaler (MDI), be sure you know how to use it properly. A self-reward system, such as a night out to eat after staying on your medicine and exercise schedule for a week, can help keep you motivated.

·         Your treatment plan. Following a treatment plan will make you feel better and less likely to become depressed.

·         Discuss pulmonary rehabilitation with your doctor.


Hearing you have COPD can be incredibly tough, but it’s far from a helpless situation. Starting today, you can learn ways to improve your breathing and slow the progression of the disease! Re-read this article and get started breathing better!


contact Nancy Larson at my.healthiswealth@comcast.net 

2013年9月21日星期六

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2013年9月11日星期三

Nebulizer Treatment for Chronic Sinusitis

Many people are already aware of nebulizer treatments to help with breathing during asthma attacks and other pulmonary conditions.


What many people may not be aware of is that such nebulizer treatments can also potentially be used for chronic sinus infections. One of the best known company offering such treatment is Sinus Dynamics.





Using one of several different nebulizers, compounded liquid medications (antibiotics and/or steroids) selected by the physician are nebulized/atomized which the patient than breathes into the nasal passages. The small size of the particles allow medication to theoretically move through the tiniest of sinus openings directly onto the infected tissue. Treatments are quick generally lasting 3 – 5 minutes (depending on medication and device). Here’s a video demonstrating how it is used.



Sinus Dynamicsâ„¢ specifically is contracted by over 14,000 insurance companies across the nation, which means that most patients are able to receive their treatment for little to no cost out of pocket.


Most ENT doctors are already familiar with this product.


Personally, I prescribe this mode of treatment for the particularly difficult sinus infection that has not responded to oral antibiotics and sinus surgery. The major advantage of such a device is not only the fact that it is topical, but much stronger antibiotics can be prescribed that otherwise would be toxic if given orally. Furthermore, more than one medication can be administered simultaneously (for example, a steroid, tetracycline antibiotic, and ceftazidime antibiotic).


Typically, I require a culture with sensitivities to determine what medication would be optimal for this mode of treatment. Another requirement is prior sinus surgery given studies showing greater effectiveness of the delivery system.


Once cultures are obtained and a determination of the optimal medication to treat, a prescription is faxed to the company who will than take care of the insurance coverage and than ship the device and medication(s) to you. The normal turn-around time is less than 1 week depending on the prescription.


An instructional video is included with the prescription as well as customer service representatives via phone to walk through the first treatment if needed.


Of course, sinus nebulizer treatment is not the only topical treatment than can be provided.


Other topical sinus treatments which may be just as effective if not more include saline flushes containing medications (which can be compounded by any willing pharmacy) as well as application of antibiotic ointments directly into the sinus cavity (which is performed by the ENT under endoscopic guidance).


It is up to your ENT physician to determine what is the best course of treatment based on your history, endoscopic sinus evaluation, culture results, CT scans, and response to prior medical regimens.



It should also be noted that there have been several studies performed suggesting such nebulizer treatment for sinus infections to be ineffective. However, it certainly is worth trying when all else has failed (or insurance has denied other treatment protocols).







References:
Nebulized antibiotics for the treatment of refractory bacterial chronic rhinosinusitis. Ann Pharmacother. 2011 Jun;45(6):798-802. Epub 2011 Jun 7.


Current concepts in topical therapy for chronic sinonasal disease. J Otolaryngol Head Neck Surg. 2010 Jun;39(3):217-31.


A prospective controlled trial of pulsed nasal nebulizer in maximally dissected cadavers. Am J Rhinol. 2008 Jul-Aug;22(4):390-4.


Nebulized bacitracin/colimycin: a treatment option in recalcitrant chronic rhinosinusitis with Staphylococcus aureus? A double-blind, randomized, placebo-controlled, cross-over pilot study. Rhinology. 2008 Jun;46(2):92-8.


Deposition of aerosolized particles in the maxillary sinuses before and after endoscopic sinus surgery. Am J Rhinol. 2007 Mar-Apr;21(2):196-7.


Comparison of topical medication delivery systems after sinus surgery. Laryngoscope. 2004 Feb;114(2):201-4.