The Paper Pulmonary - Breathing Better, Living Well · Paper ThePulmonary May/June 2012 Find the Oxygen Delivery System That Is Right for You! DedicatedtoRespiratoryHealthCare •Volume23

PaperThePulmonary

May/June 2012

Find the OxygenDelivery SystemThat Is Rightfor You!

Dedicated to Respiratory Health Care www.pulmonarypaper.org • Volume 23, Number 3

My only daughter isgetting married

this June. The weddingdress on the left, worn in1974, is mine; the one onthe right, worn in 1950,is my Mother’s. Thedress in the middle,made with material fromthe other two, is whatAdrienne will wear ather wedding reception.

I see the past, presentand future when I lookat this picture, which Ireceived as a Mother’sDay present. The past

holds our memories, both good and bad. We control the decisions we makethis present day. If we are worrying about what happened in the past or whatwill be tomorrow, we haven’t appreciated the moments of today. Hope for thefuture is the most exciting to think about, as the possibilities are endless.

I hope you wake up each morning filled with hope of what can be!

contents

“Your past is important but it is not nearly as importantto your present as the way you see your future” – Tony Campolo

www.pulmonarypaper.org Volume 23, Number 3

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4

6

8

9

Sharing the Health

Get Up & Go2 CruisesTake a stress-free vacation

with the SeaPuffers!

Nutrition News

Respiratory News

1013

1416

SimplyGoLightweight and continuous flow!

How to Choose the POCThat Is Right for You!

Transtracheal Oxygen DeliveryAn alternative to a nasal cannula

Ask Mark …What is clubbing of digits?

Fibrosis FilePanther study is stopped

Dedicated to Respiratory Care

Volume 23, No. 3May/June 2012

On the cover:We may all be dealingwith chronic lung problems, but itunites us as a family to lean on eachother for advice and support!

The Pulmonary PaperPO Box 877Ormond Beach, FL 32175Phone: 800-950-3698Email: [email protected]

The Pulmonary Paper is a 501(c)(3)not-for-profit corporation supportedby individual gifts. Your donation istax deductible to the extent allowedby law.

All rights to The Pulmonary Paper(ISSN 1047-9708) are reserved andcontents are not to be reproducedwithout permission.

As we cannot assume responsibility,please contact your physician beforechanging your treatment schedule.

PaperThePulmonary

The Pulmonary Paper StaffEditorCeleste Belyea, RN, RRT, AE-CAssociate EditorDominic Coppolo, RRT, AE-CMedical DirectorMichael Bauer, MD

The Pulmonary Paper is a member-ship publication. It is published sixtimes a year for those with breathingproblems and health professionals.The editor encourages readers tosubmit information about programs,equipment, tips or services.

Phone: 800-950-3698Fax: 386-673-7501www.pulmonarypaper.org

May/June 2012 www.pulmonarypaper.org 3

In the January 2000 issue of Respiratory Care,Dr. Tom Petty stated that, “Practical portableconcentrators should weigh no more than 10 pounds,

produce 90% or more oxygen, and provide at least 2L ofoxygen for a minimum of 4 hours.” Within two years,the first modern portable oxygen concentrator (POC)appeared on the market, and by 2010 there were numerousPOCs available with varying abilities and features thatcould meet the needs of a range of long term oxygen users.Though the majority of these POCs provided significantfeatures and benefits to LTOT users, none of thesePOCs could claim to meet Dr. Petty’s definition of a“practical portable concentrator”.

The newly available SimplyGo from Respironics can beconsidered the POC closest to meeting Dr. Petty’s defini-tion. You will be able to compare its features in an updatedchart outlining the basic product specifica-tions of all of the currently availablePOCS on the market (see pages 4–5).I do hope that you find value in theinformation provided in these tablesshould you decide to buy or use aPOC. My most common recom-mendation when advising on thepurchase of a POC is to find one thatwill not only meet your oxygen needstoday, but in the future as well–POCs arenot inexpensive and you do not want to buya unit that will be obsolete to you should your oxygenneeds increase sooner than later.

With the SimplyGo, there is a trade-off in oxygenproduction in order to have a lower weight than otherContinuous Flow (CF) POCs. All other currently availableCF POCs weigh at least 17 pounds, but they all have theability to produce up to 3 LPM of oxygen. As with anyPOC, the SimplyGo does have intermittent flow (pulse)delivery capabilities.

Having a CF option available is an attractive choice forthose uncomfortable with using pulse delivery at night. Forthose who are able to sleep with a POC using pulsedelivery, the SimplyGo also has a second intermittent flowmode with increased triggering sensitivity called Sleepmode. Unlike the Pulse mode, Sleep mode dose volumeswill change based on your respiratory rate. Should the

SimplyGo not detect a breathfor a period of time, the unit willdefault to a CF setting.

Battery life is one of the mostimportant considerations instaying active with a POC.According to the SimplyGo specifi-cations, you can expect up to 3.5 hours ofuninterrupted operation if you have the device set at 2 inthe Pulse mode and are breathing at 20 BPM. Higher pulsesettings and/or breath rates will lower battery operatingtime, so you may need to experiment to find the operat-ing times that will match your typical usage. Operatingthe SimplyGo in Continuous Flow mode while on batterywill yield less run time than in Pulse mode, 2.3 hours whenset to 1 LPM and only about 40 minutes on 2 LPM.

Suffice it to say that if you want longer battery timeswhile out and about, it is in your best interest tooperate the POC in Pulse mode, provided you canstay oxygenated. I do not recommend sleeping withthe SimplyGo (or any POC) operating only frombattery power, though the unit will alarm when

battery power does get low.Charge time for one SimplyGo battery is

2 to 3 hours from a fully discharged state,though this may be longer if you are simulta-

neously using the device. Unlike the EverGo–Respironic’s first POC, the SimplyGo only has a slot

for one battery and you cannot use EverGo batteriesin the SimplyGo (and vice-versa). Should you be travel-ing a long distance with the SimplyGo, you shouldbring enough extra, fully-charged batteries to makethe trip.

At the time of this writing, the SimplyGo has not yetbeen approved as the applicationfor FAA acceptance is pending.The website www.faa.gov willhave all currently-approved POCslisted; just search for approvedportable concentrators.

Ryan Diesem is Research Manager atValley Inspired Products. Because ofspace constraints, this article is edited.Read Ryan’s entire review on the Sim-plyGo at www.pulmonarypaper.org.

Portable Oxygen Concentrator Update

Ryan Diesem

AirSep® AirSep® AirSep® Inogen Inova Labs Invacare®

Focus Freestyle™ Lifestyle™ One® G2 LifeChoice® XPO2™

2 Only

FixedDelivery:18 mL

18 mL

2 lbs.

Add 2–5 lbs.

1.5 hours

4 hours

12,000 ft.

1 to 3

FixedDelivery:9 mL persetting

27 mL

4 lbs.

Add 2–5 lbs.

2.5 hours

3.5 hours

12,000 ft.

1 to 5


45 mL

10 lbs.

Add 2–5 lbs.

50 minutes

2.5 hours

12,000 ft.

1 to 5

Minute Vol.Delivery:

Dose decreasesas rate rises

15 BPM: 60 mL

30 BPM: 30 mL

7 lbs.

Add 2–5 lbs.

3 hours

4 hours

10,000 ft.

1 to 3

Fixed Delivery:1) 15mL2) 25mL3) 35mL

35 mL

5 lbs.

Add 2–5 lbs.

2 hours

4 hours

10,000 ft.

1 to 5



15 BPM: 66 mL

30 BPM: 33 mL

6 lbs.

Add2–5 lbs.

2.5 hours

4 hours

10,000 ft.10,

AvailableSettings

Pulse Dose Type

Maximum Doseper Breath

Unit & Battery(Approximate)

Unit w/AccessoriesApproximate

(Approximate)Battery Time

at Pulse Setting 2

ApproximateBattery ChargeTime (Unit Off)

Maximum Altitude

Portable Oxygen ConcentratorsIntermittent Flow POCs (IF POCs)

Dose Volumes**2 LPM Continuous Flow Volume per breath: 15 BPM, 44 mL; 30 BPM, 22 mL4 LPM Continuous Flow Volume per breath: 15 BPM, 88 mL; 30 BPM, 44 mL

*** The Eclipse 3 also has pulse settings of 128, 160 and 192 mL, but has additional restrictions for use. See Eclipse 3 manual for more information.*** The SimplyGo has (2) IF delivery modes: Pulse Mode and Night Mode. Shown volumes are for Pulse Mode. Night Mode has minute volume delivery.*** Approximate Continuous Flow volumes at 2 LPM and 4 LPM are provided for comparison to maximum volumes delivered by selected POC.

All Units Approved for Flight by FAA (except Easy Pulse POC, pending)

Single Battery Operation Times

Weight

Flow Settings

4 www.pulmonarypaper.org Volume 23, Number 3

Precision RespironicsOxus EasyPulse EverGo

1 to 5


45 mL

10 lbs.

Add2–5 lbs.

3 hours

3 hours

000 ft.

1 to 5



15 BPM: 52 mL

30 BPM: 26 mL

7 lbs.

Add 2–5 lbs.

3 hours

Unknownat time of

publication

9,000 ft.

1 to 6

CombinationFixed/MinuteVol. Delivery

15 BPM: 72 mL

30 BPM: 36 mL

9 lbs.

Add 2–5 lbs.

4 hours

3 hours

8,000 ft.

Pulse 1 to 6

Continuous 1to 3 LPM

FixedDelivery:

16 mL persetting

99 mL

19 lbs.

Add 5–10 lbs.

4.5 hours

3 hours

13,123 ft.

Pulse 1 to 6

Continuous0.5 to 3 LPM



15 BPM: 133 mL

30 BPM: 66 mL

<20 lbs.

Add 5–10 lbs.

3.5 hours

5 hours

10,000 ft.

Pulse 1 to 6

Continuous1 to 3 LPM

FixedDelivery:

16 mL persetting

96 mL

18 lbs.

Add 5–10 lbs.

3 hours

4 hours

13,123 ft.

Pulse 1 to 6


CombinationFixed/Minute

Vol. Delivery**

15 BPM: 72 mL

30 BPM: 66 mL

10 lbs.

Add 2–5 lbs.

3.7 hours

3 hours

10,000 ft.

Pulse 1 to 6*


FixedDelivery:

16 mL persetting

96 mL*

18 lbs.

Add 5–10 lbs.

5 hours

3 hours

13,123 ft.

Note: Please consult with your doctor or therapist before deciding to use or purchase any of these devices.

DeVilbiss Invacare® OxLife Respironics SeQual®

iGo® Solo2 Independence SimplyGo Eclipse 3™

O2 Concepts

Continuous Flow POCs (CF POCs)

Flow Settings

Single Battery Operation Times

Weight

Dose Volumes**2 LPM CF Volume: 15 BPM, 44 mL; 30 BPM, 22 mL4 LPM CF Volume: 15 BPM, 88 mL; 30 BPM, 44 mL

All Units Approved for Flight by FAA (except SimplyGo, pending)



Transtracheal oxygen therapy (TTOT) deliversoxygen directly into the trachea via a small,flexible, plastic catheter. It is intended only for

people requiring long term, continuous oxygen therapyand is a scientifically validated alternative to oxygendelivered by nasal prongs.

Current estimates suggest between 600,000 and800,000 Americans use supplemental oxygen. The costof this therapy exceeds 2 to 3 billion dollars annually. Thevast majority of oxygen users use nasal prongs. Nasalprongs are inexpensive and simple to use, but compliancewith nasal prongs is sub-optimal for a variety of reasons.

Landmark studies such as the Nocturnal OxygenTherapy Trial done in the 1970s clearly showed peoplewere willing (or able) to wear the nasal prongs anaverage of only about 18 hours per day for bothvoluntary and involuntary reasons. They complained ofdiscomfort of the nose and ears and that the nasal prongsroutinely fell off during sleep. They did not want to goout in public wearing nasal prongs because of self-consciousness or embarrassment. The net result of thisnon-compliance is that most people are not getting thefull benefit of their oxygen therapy.

In 1982, Henry Heim-lich, M.D. created theconcept of deliveringoxygen directly into thetrachea via a small plastictube. A 16-gauge TeflonIV catheter was placedbetween the second andthird tracheal rings. Therewere few complications.Reductions in flowrequirements of oxygen ofapproximately 50% werenoted. There were reports of reduced shortness ofbreath and improvements in ambulation.

True 24-hour compliance, a more active lifestyle andconservation of oxygen resources are all feasible with thistechnology. The average TTOT patient has a 50% to

60% reduction in resting oxygen flow rate and a30% decrease with activity. TTOT can be used veryeffectively with Pulse or Dose type oxygen-conservingdevices – further reducing bulk oxygen consumption.The combined benefits result in an improved overallquality of life.

A small number of transtracheal catheters have beendeveloped and commercialized over the past 15 years, butthe SCOOP transtracheal oxygen program, has gainedthe most acceptance, and is by far the most widelyutilized transtracheal catheter in the United States andaround the world.

SCOOP is not just a procedure but a program of carethat requires a systematic, team approach to produce thebest results for the oxygen user. A knowledgeable teamconsists of a physician, office- or hospital-based respiratorytherapist or nurse, the oxygen user and their partner, andthe home care therapist or nurse. Together they providethe education, clinical support and supplies necessary tosupport transtracheal oxygen users during the fourphases of the program.

The SCOOP Program Has Four PhasesPhase 1

The goals of Phase 1 are orientation, evaluation,selection and preparation. These include:

• Oxygen user education,• Identification of indications and precautions,• Identification of good candidates and exclusion of

poor candidates,• Stabilization of the oxygen user before the procedure.

TransTracheal Oxygen Delivery Is an Alternative to a Nasal Cannula

Dr. Michael Bauer

Dr. Bauer will be back nextissue. If you have a question,you may write to him at ThePulmonary Paper, PO Box877, Ormond Beach, FL 32175or by email at [email protected].

Phase 1 may be the most important of the fourclinical phases. In Phase 1 potential transtrachealcandidates are oriented, evaluated, selected and preparedfor the procedure. Input may come from the patient’sphysician, family, other transtracheal users, or throughwritten or electronic media. Experience has shown thatideal transtracheal candidates:

• Are currently using 1 to 6 liters of oxygen/minute,• Have reasonable pulmonary function,• Have stable arterial blood gases,• Have dependable transportation and live less than one

hour from the follow up unit,

• Have a strong, competent, committed partner orfamily support,

• Spend less than 12 hours per day in bed,• Leave the house routinely for activities such as

shopping, socializing, etc.,• Are highly motivated to improve the quality of

their life.

TTOT achieves the best results when used early in theprogression of chronic respiratory disease. It is not meantfor every person on supplemental oxygen therapy but isan alternative and choice for you to consider.

In our next issue, we willdescribe the next three SCOOPphases in detail.

For additional information, visit www.tto2.com, call 1-800-527-2667, or writeTranstracheal Systems, Inc., 14 InvernessDrive, Suite H-100, Englewood, CO80112-5608.


John Goodman

Want to live longer? Look better?Breathe easier and improve your quality of life?

What are you waiting for?Talk to your doctor about thebenefits of SCOOPTranstrachealOxygenTherapy:

• Improved mobility• Greater exercise capacity• Reduced shortness of breath• Improved self-image• Longer lasting portable oxygen

sources• Eliminates discomfort of the nasal

cannula• Improved survival compared to the nasal cannula

Haven’t you suffered long enough?Ask your doctor about SCOOP

For more information call:800-527-2667 or email [email protected]

Melita (left) and Lyn know they made the right decision touse TransTracheal Oxygen!


Phillip H. asks Mark to explainwhat “clubbing” of the fingers andtoes mean.Mark explains, Digital clubbing is

a deformity of the fingers and fin-gernails and is a sign of underlyingheart and/or lung disease. Infectionhas nothing to do with the develop-ment of digital clubbing. The onlyhereditary condition in which club-bing is prominent is in those whohave Cystic Fibrosis.

Long term hypoxia (low bloodoxygen levels) is seen in congenitalcardiac defects and causes digitalclubbing. Folks who have pulmonaryfibrosis – most often idiopathic,meaning the cause of the fibrosis isnot known – develop digital clubbingin many instances. It is not a giventhat it will develop. If digital clubbingis observed or suspected, your physi-cian will try and determine the un-derlying cause.

Linda of New York has heard ofthermoplasty as a treatment for asth-ma and wonders if those withchronic lung disease could also ben-efit from it.Mark says, Thermoplasty destroys

bronchial smooth muscle throughthermal energy, preventing it from be-ing able to contract – a significantcause of acute asthma. This is not anobserved difficulty with COPD. InCOPD, many of the airways are al-ready destroyed and remaining onesdistorted, to further destroy or dis-tort their physiology would likely becounter-productive in reducing orcontrolling symptoms. It is strictly atreatment with application to asth-ma in which bronchospasm is a pri-mary symptom/cause.

Pat from Pennsylvania wonders ifAdvair, Spiriva or Xopenex couldcause hair loss.Mark notes that hair loss is not a

reported or expected action of thesemedications. The effect they have isnot of the nature that usually caus-es hair loss. Do you have patternbaldness in your family or other med-ical conditions that might be atfault? I’d certainly look at otherculprits long before suspecting themedications you mentioned.

Linder of North Carolina tellsMark her doctor has ordered aCT scan of the chest but the amountof radiation that is received duringthe test is a concern to her.Mark reports, Unless you have

worked in the medical field oraround nuclear materials where youhad a significant and long termexposure to gamma rays, yourconcern about the amount ofradiation you’d get with a CT scan

is completely unfounded.I have worked in the hospital

where I was exposed to muchradiation – numerous x-rays taken inmy proximity when on critical careunits for more than 20 years andwhen I was near cobalt therapywhen I worked with oncologypatients. We were assigned radiationcollection badges which we wore fortwo years before they were takenback because they didn’t collectenough radiation to make their useworth it. I was well within a safelimit for life time total exposure.I would ask your physician thepurpose of the test – getting a CTscan would not only be safe, but wiseand prudent.

Mark Mangus RRT, BSRC, is a member ofthe Medical Board of EFFORTS (the onlinesupport group, Emphysema Foundation ForOur Right To Survive, www.emphysema.net). He generously donates his time toanswer members’ questions.

Ask Mark …

Mark Mangus, RRTEFFORTS Board


Panther Study StoppedResearchers are reporting that a widely used

combination treatment for idiopathic pulmonaryfibrosis increased the risk of death among patients withmild-to-moderate lung impairment. In a randomizedtrial, the combination of prednisone, azathioprine, andN-acetylcysteine (or NAC) also increased the risk ofhospitalization compared with placebo, according toFernando Martinez, MD, of the University of MichiganHealth System in Ann Arbor, and colleagues. Because ofthat “compelling evidence,” the combination should nolonger be used. The data was presented at the annualmeeting of the American Thoracic Society and in the on-line publication of the New England Journal of Medicine.

A head-to-head trial of the two drugs versus threeshowed prednisone, azathioprine, and NAC did better atpreserving lung function, but there was no placebo group.To test the issue, they conducted the PANTHER-IPF tri-al – for Prednisone, Azathioprine and N-Acetylcysteine:A Study That Evaluates Response in Idiopathic PulmonaryFibrosis. The study was terminated due to the increasedrisk of death and hospitalization in those treated withcombination therapy compared with placebo. A place-bo is a known medically ineffective treatment, commonlythought of as a “sugar pill”. The participant does notknow whether they are receiving a medication or theplacebo.

I live with IdiopathicPulmonary Fibrosis. Afriend stitched my favoritesaying across the back of ashirt she made for me with myfavorite flowers, daisies, and bluebirds,because they seem so happy.For every door that has closed, many, many windows

have opened with breezes of hope and joy, I neverotherwise would have known. This has become mymotto as to how I look at my life, my disease, mychallenges past, present and to come. God Bless!

Trish Barron, McKean, PA

The Pulmonary Fibrosis Foundation (PFF) has creat-ed the Leanne Storch Support Group Fund to assist lead-ers in providing meaningful educational events throughawards of up to $500. Leanne Storch, the Foundation’sformer Executive Director, was diagnosed with pulmonaryfibrosis in 2003; the Fund honors her continued passionfor supporting those affected by the disease by promot-ing the efforts of support group leaders worldwide.Groups may apply for awards of up to $500 per awardyear, to be used towards meeting programming, educa-tional materials, or location requirements. Up to eightawards will be granted in 2012, and eight additionalawards will be granted in 2013. The application dead-line for 2012 awards is September 1, 2012.

To learn more, please contact the PFF’s SupportServices Coordinator, Courtney Firak at [email protected] or call 1-312-854-1940.

The Foundation also sponsors a new online supportcommunity for those with pulmonary fibrosis and theircare givers, a safe, secure place to connect with others,share information and find emotional support from oth-er members of the PFF community. To participate, visitwww.inspire.com/partners/pulmonary-fibrosis-foundation and follow the simple registration instructions.You will also have access to approximately 200 groupscovering a variety of health and wellness topics, in ad-dition to the PFF online community. Members also havethe opportunity to join Inspire’s Clinical Trial Programwhich provides up to date information on clinical trialsthat meet all of the requirements for the National Insti-tutes of Health database (www.clinicaltrials.gov) Regis-tered members can elect to receive messages from the Clin-ical Trial Program and complete a brief questionnaire todetermine potential eligibility.

Fibrosis File

There is an expression, “Life is not measured by thenumber of breaths we take, but by the moments that takeour breath away.” On my 77th birthday, my husbandand I took a plane ride in a Bi-Plane with an open cock-pit, an exact replica of the 1935 (my birth year)WACO. It truly was a breath taking experience!

Margaret Eaton, Palm Coast, FL

The National Council on Aging is sponsoring aworkshop from Stanford University to help you manageyour health. A free Better Choices, Better Health Work-shop® can help you get the support you need and findpractical ways to deal with pain, fatigue and stress. You’lldiscover better nutrition and exercise choices, understandnew treatment options and learn better ways to talk withyour doctor and family about your health. The no-costprogram is held entirely online.

You’ll join up to 25 others in an interactive workshopand participate in easy-to-follow online sessions, whichare posted each week for six weeks. Log on at your con-venience 2 to 3 times per week for a total of about 2 hoursper week. You’ll learn from trained volunteer leaders –many with health conditions themselves, set your owngoals and make a step-by-step plan to improve your healthand your life.

For more information and to sign up, visit http://tinyurl.com/cr4gtdh.

Thank you for publishing the recipe for making a cakein a coffee cup – it is the perfect size for me! I found an-other recipe for quiche that I would like to share withother single eaters – I use a 12-ouncecup for my meals.

Quiche for One, Please1 egg1-1/2 Tablespoon milkSalt, pepper1/4 of a bagel or similar amountof French bread2 Teaspoons cream cheese1/2 slice prosciutto or hamDijon mustardFresh thyme leaves or chopped chivesBeat egg and milk together with a fork in a coffee cup

with salt and pepper to taste. Tear bread into dime-sizepieces; stir into egg/milk mixture. Add cream cheese. Tearor cut prosciutto into small pieces and add to mixture.Sprinkle with thyme. Microwave 1 minute-10 seconds.Garnish with mustard and fresh thyme or chives.

Mimi Hollway, St. James City, FL

Five years ago, Lois Perelmanmade a video about howshe felt about needing to begin using supplementaloxygen. It has now been five years and she is still go-ing strong! To see Lois’s reaction, visithttp://tinyurl.com/4q5me67.

The modern vehicle ventilation system hasa control that allows a shutter to close toprevent outside air from entering. The airinside the vehicle cabin is recycled and we

can be spared from breathing in othervehicle exhaust, smoke, pollen and

similar irritants. On some vehicles, the shutter will returnto the open position if you change any other setting.Being aware of its position might allow you tobreathe easier.

Harold Hanson, Seaford, NY

Receive a Free One Year MembershipContribute a picture or tip on how you COPE with

COPD! Send to The Pulmonary Paper, PO Box 877,Ormond Beach, FL 32175. Include your name/address.


Sharing the Health


We Love the Name of This Backpack for OxygenUsers – Busy Breathers!

The oxygen carrying backpack was specifically madeto carry your oxygen tank or cylinder. It has a clear vinylwindow to view the tank gauge, a reinforced base tocarry the extra weight, extrapadded shoulder straps for extracomfort, and a metal grommetfor the nasal cannula. MichelleStaley designed the carrier forher baby who was born pre-maturely and needed supple-mental oxygen. The price of$49.99 includes UPS groundshipping.

Visit www.busybreathersllc.com to read more aboutthe Busy Breathers backpack. You will find anarticle about Tai Chi and Yoga Moves for oxygen userson the site that we found interesting. You may also call1-970-867-2235 for more information.

Anne from Wisconsin finds wearing loose fittingclothing and elasticized pants much easier to breathe inthan tighter fitting clothing. She finds it makes a bigdifference with pursed-lip breathing and trying toexpand her rib cage.

Now available: The COPD Foundation and the U.S.COPD Coalition are pleased to present select speakerpresentations from last December’s conferences in

audio and/or pdf format. Visit www.copdconferencesusa.org/Session-Recap.aspx.

Medicationdiscountcard.com (MDC) is now on-linewith its new Prescription Discount Card. MDC’s free -pharmacy card provides consumers deep discountsand rebates on a wide range of prescription medicationsand may offer lower out-of-pocket costs than even someinsurance plans. MDC’s prescription discount card is notinsurance. Consumers who have insurance may use thecard with their current prescription drug insurance. Inmany cases medications will cost less through the Pre-scription Discount Card than insurance co-pays. Go tohttp://tinyurl.com/d6dbv2a for more information.

Arizona has established internet and phone-basedapplications to help their residents stop smoking. The newCall It Quits quit-smoking iPhone app is the first of itskind, according to the Arizona Smokers’ Helpline(ASHLine, www.ashline.org). Thesmoking cessation tool is madeavailable free to Arizona smokers.

The app offers the recommendedcombination of tools to quit forgood – peer support, instant accessto a quit coach, and goal-setting. Ithas many benefits like goal track-ing and is the only app thatprovides the instant ‘call a coach’ feature. ASHLineoffers free telephone coaching at 1-800-556-6222.


Pulmonary Paper Readers you are cordially Invited to this exclusive Oxy-View Offer.

Oxy-View Oxygen Therapy Eyeglass Frames

Any frame just $179.95 plus Free Shipping (Free shipping in the contiguous United States via standard ground UPS

use offer code PP2012 when ordering)

Call Today Toll Free 877-699-8439 or Visit us at www.oxyview.com

2012 CruisesAugust 4–11Alaskan Explorer CruiseSee stunning, beautiful Alaskaon this 7-day cruise roundtripfrom Seattle, WA, on HollandAmerica’s Westerdam.

October 13–20Canada & New EnglandMarvel at Fall’s beauty onthis 7-day discovery cruisefrom Montreal, Canada,returning to Boston, MA, onHolland America’s Veendam.

2013 CruisesJanuary 19–February 2HawaiiFifteen-day vacation toHawaii on the SapphirePrincess, roundtrip Los Angeles

March 3–10Western CaribbeanSeven-day Western CaribbeanCruise on Holland America'sRyndam, roundtrip Tampa

May 13–24British IslesEleven-day British Isles holi-day on Celebrity’s Infinity,roundtrip Harwich.

July 20–27Alaska AdventureSeven-day Alaska Adventureon Holland America’sWesterdam, roundtrip Seattle

October 13–24Panama Canal VoyageEleven-day Panama CanalVoyage on the Coral Princess,roundtrip Fort Lauderdale

We Take the Worry Out ofTraveling with Oxygen!

Visit www.seapuffers.com for details!

FST: ST36334

Member

Join the Sea Puffers on one of our trips escorted byrespiratory therapists or call us at 1-866-673-3019

to arrange your cruise and oxygen and mobilityneeds for an individual vacation!

Join the Sea Puffers on one of our trips escorted byrespiratory therapists or call us at 1-866-673-3019

to arrange your cruise, and oxygen and mobilityneeds for an individual vacation!



Calorie-boosting Foods for Those with COPDKnowing that those with COPD require ten times as

many calories to breathe as those without lung problems,Fabiana Talbot of the COPD Foundation (www.COPDFoundation.org) recently discussed calorie-boosting foods for those with COPD on the Foundation’sblog site.

The key is to get those much-needed calories into yourdiet the healthy way. If you don’t know the caloriccontent of foods, consult the calorie counter at www.caloriecount.about.com or purchase one from thecheckout counter at your local grocery store.

Choosing high-calorie snacks will help you maintaina high energy level between meals. Try creamy, richpuddings, crackers with peanut butter, dried fruits andnuts. Spread honey, jam or peanut butter on dense, wholegrain breads, bagels or muffins or put peanut butter ona banana while washing it down with a tall glass of milk.Buy some trail mix in bulk and put it in your favoritecandy dish. Pop a potato in the oven or microwave andfill it with vegetables and a sprinkle of Parmesan cheese.

Drink milk shakes,regular milk and high-

calorie fruit juices for morecalories. Avoid coffee, teasand diet sodas. Try blendingyour own protein shakeswith protein powder andmixing it with fresh or frozenfruit and lots of ice.

Whole grains and cerealsare loaded with calories. Mix

oatmeal or cream of wheatwith milk instead of water and

slice up a fresh banana or stirsome tasty, sweet berries into it. Granola and muesliare excellent choices for cold cereal lovers. Avoid thincut, fluffy white breads. Choose dense whole grain,pumpernickel or oat bran instead.

Adding extra protein to food items isa great way to boost calories. TryCarnation Instant Breakfast orOvaltine in your milk. Stir somehearty wheat or oat bran intothose special casserole dishes.Add dry milk or soy protein powderto mashed potatoes, gravies, soups and hot cereal.Choose shellfish or salmon cooked in olive oil as opposedto fatty cuts of red meat.

Fruits that are high in calories include bananas, man-go, papaya, dates, dried apples or apricots instead ofapples, watermelon or honey dew melon.

Choose starchy vegetables like potatoes, beets, corn,peas, carrots or winter squash.

Fats are an essen-tial part of any diet –as long as you choosethe right ones. Drizzlesome olive oil onsome pasta and veg-etables for a greatdinner idea. Use flaxseed oil or canola oilinstead of shorteningor hard margarine.Grab a handful of nuts or seeds. Cut some avocados upon a salad. And don’t forget that peanut butter!

Robust soups or healthy salads are an excellent wayto supplement calories. Try hearty split pea, navy beanor lentil instead of broth or vegetable soups. Drench blackbean chili with a dollop of sour cream and an ounce

of cheese. Choose higher calorie dress-ings – but be mindful of the saturated

fat content. Try adding somecolorful, starchy vegetables tosalads for extra flavor and zest.

Information from www.about.com

Nutrition News


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Respiratory NewsIt was reported in the Archives of Internal Medicine,

the results of a small clinical trial by investigators fromJapan, showed acupuncture appears to be associated withimprovement of difficult breathing on exertion in patientswith COPD.

Another alternative for people with advanced COPDwho are not responding to other treatments is opioids,which provided relief and improved their quality of life,according to an article in the Canadian Medical Associ-ation Journal. However, physicians are reluctant toprescribe opioids for this condition, meaning many peo-ple will not benefit from this treatment.

New U.S. guidelines on the treatment of tuberculosisslashes the amount of time needed to treat the infectionfrom nine months to three months. The recommendations,released recently, are based on clinical trials showingthat once-weekly treatment with the anti-TB drugsrifapentine and isoniazid, taken under the supervisionof a health provider, work as well as nine months ofdaily treatment completed by patients on their own.

The supervised regimen, which ensures people take theirmedications faithfully, cuts the number of requireddoses from a total of 270 given once a day to 12 givenonce a week.

A new ranking for 2012 from the Asthma andAllergy Foundation of America lists which cities are theworst for people who have asthma, taking into accountissues like pollen counts, ozone days and air quality,the prevalence of asthma medicationuse and public smoking bans.

1. Memphis, TN2. New Haven, CT3. Knoxville, TN4. Pittsburgh, PA5. Chattanooga, TN6. Hartford, CT7. St. Louis, MO8. Oklahoma City, OK9. McAllen, TX

10. Allentown, PA

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The Paper Pulmonary - Breathing Better, Living Well · Paper ThePulmonary May/June 2012 Find the Oxygen Delivery System That Is Right for You! DedicatedtoRespiratoryHealthCare •Volume23