COPD Links to Malnutrition and Economic Burden

December 19th, 2014 | Author: Aleena Gardezi

A recent study around the global economic burden of malnutrition tied to chronic illness found that patients with COPD experience the highest rates of malnourishment. Although close to 60 percent of patients suffering from chronic illness are never screened for malnutrition, disease-associated malnutrition imposes an economic burden on society of about $157 billion per year, according to research published in a supplemental issue of the Journal of Parenteral and Enteral Nutrition (JPEN).

nutritionThe study explains that when malnutrition goes undiagnosed, particularly in seniors, it can lead to an increase in health complications, hospital readmissions rates, and overall health care costs, which also increases health care costs. In the eight specific diseases that were evaluated by direct medical costs, the years of quality life lost, and mortality to determine the total economic burden, more than 80 percent of the total cost came from cases of depression, chronic obstructive pulmonary disease (COPD), coronary heart disease, and dementia. Patients with COPD had the highest malnutrition rate at 11 percent.

Because patients with COPD require up to 10 times the calories needed by a patient without COPD, it is important for patients to make sure they are getting the nutrients and energy their body requires. Proper eating habits can help fight body infections and help produce the energy required to function normally. Malnutrition can be treated if the patient is screened and offered nutritional support when they are at risk.  Dieticians can guide patients by working out a diet plan that recommends high calorie foods that are easy to prepare. The COPD Foundation also offers information regarding proper diet and nutrition in its Big Fat Reference Guide.

Please contact our C.O.P.D. Information Line at 1-866-316-2673 for further information and support.

If you would like to share your thoughts and experience with COPD, check out COPD360Social, a “one-stop-shop” for members of the COPD community.

Read the full Journal of Parenteral and Enteral Nutrition (JPEN) report here.

Have Trouble Eating with COPD? You’re Not Alone

December 5th, 2014 | Author: COPD Coach

Dear COPD Coach,

I have stage 4 emphysema. It is impossible to eat without immediately feeling chest tightness or bloated like I am about to explode. I read about how the diaphragm gets pushed by the stomach and how it changes shape as COPD worsens. Does this mean that eventually I won’t be able to eat?

Thank you,
-Worried

Dear Worried,

Thanks for writing. As a patient myself at stage 4, I also experience this. The mechanism you described is exactly correct! To answer your question, you will always be able to eat, however you are going to have to eat a little differently. As you lungs deteriorate, they become larger which then pushes against your stomach. When you eat large meals, your stomach pushes against your lungs and diaphragm which restricts your breathing. The key here is not to eat large meals or large portions, but instead eat smaller meals throughout the day. Also do not eat foods that

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can cause bloating or gas. Drinking plenty of water during the meals will also help ease the bloating. If you use supplemental oxygen, make sure you use it while you eat.

When my wife and I go out to dinner, I tend to eat too much and have a difficult time returning to the car. I have since learned to order smaller portions, especially if I have to walk a long distance after the meal. I also make sure to eat throughout the day, several times a day, even if it is just a light snack. When I do this, I feel far less bloated.

For information on what is best to eat, go to the COPD Foundation’s Big Fat Reference Guide webpage. It is a free download and contains lots of information written for the patient. There you will find a list of the best foods along with lots of other useful lifestyle tips.

It is important to remember that when you eat large meals, you burn lots of calories in order to digest. You also burn calories just trying to breathe! So, the foods you eat must contain not only enough calories to augment what you are using up. In other words, learn to eat smart!

While you are on our website, you might want to check out our new social network called COPD360social. It is a site where you can meet others with COPD and see what works for them! Just click on community and registration is quick and simple!

Hope this helps,
-The COPD Coach

Ask the Expert is aimed at providing information for individuals with COPD to take to your doctor, and is not in any way intended to be medical advice.

If you would like to submit a question to the Coaches Corner email us at coachescorner@copdfoundation.org. We would love to hear your questions and comments. You can address your emails to any of the following: COPD Coach, Caregiver Coach, COPD Doctor or COPD RT.

The COPD Foundation Thanks You

November 27th, 2014 | Author: Fabiana Beltran

This Thanksgiving, the COPD Foundation would like to express its gratitude to you, our advocates, for all of your time and effort on spreading awareness of COPD. Your passion and dedication is inspiring and we appreciate all of your hard work over the years.

As 2014 comes to a close, we look forward to the latter part of our 10th Anniversary. We began our journey in May pinwheel thanks2004, with a small team of individuals who were committed to bringing effective change to a widely misunderstood, ignored, and stigmatized disease-state. We formed the Foundation with the goal of preventing and curing chronic obstructive pulmonary disease, and to improve the lives of all people affected by this devastating disease.

2014 was a transformational year for the COPD Foundation and a time of many firsts for the international COPD community.

We look forward to seeing these research, educational, and advocacy opportunities grow and thrive to ultimately form a COPD movement that will bring our silent epidemic to the forefront.

Happy Thanksgiving!

Alpha-1 Awareness: #AreYou1?

November 24th, 2014 | Author: Fabiana Beltran

At least 100,000 Americans live with Alpha-1 Antitrypsin Deficiency (Alpha-1), but fewer than 10% have been diagnosed. Alpha-1 is the most common known genetic risk factor for emphysema. Are you 1? That is the question the Alpha-1 Foundation is asking YOU for COPD/Alpha-1 Awareness Month.

Take part in the  Alpha-1 activities happening this month!

  • As part of the “I am 1. Are you?” awareness campaign, the Alpha-1 Foundation wants you to record a video of yourself or a loved one and post it on Facebook and/or other social media sites. Make sure to use the hashtag #AreYou1 and include a link to alpha-1foundation.org/awareness.

  • Participate in the Alpha-1 Art Auction! In November 2013, NASCAR drivers showed their artistic side for Alpha-1 Awareness when they created art alongside children living with Alpha-1. Now you have a chance to bid on their creations! Proceeds will benefit the Alpha-1 Foundation’s research programs.

Take a look at the artwork and participate in the auction here.

Spread the word about Alpha-1 by downloading the fact sheets below and sharing with friends and family. Don’t  forget to ask - #AreYou1?

Fact Sheets:

The Portable Oxygen Concentrator Dilemma

November 21st, 2014 | Author: Fabiana Beltran

This opinion piece was written and submitted by COPD community member, Tony St. Amant of Chico, California.

The other day I received an email announcing a portable oxygen concentrator (POC) weighing less than two pounds with a battery life of three hours, and even longer with supplemental batteries. Wow! A two pound oxygen source that could operate for three hours or more! Absolutely dazzling to anyone who has been tethered by supplemental oxygen for any length of time–except, the devil is in the details.

I scanned the manufacturer’s product webpage to find out how much oxygen this little dynamo can provide, but it’s not there. There is only an indirect reference to a “2 pulse setting.” What in heaven’s name does that mean? Is it a shadowy implication that this little baby can output 2 liters per minute (LPM)? If not, what does the “2” mean? I need to know, so I start digging through the support literature. The cut sheet is no help. It contains substantially the same info as the web page.

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Finally, I find the Patient Manual—you know, the document you normally read after the unit is bought, paid for, and delivered. And there it is, on page 30 of the 40 page manual, almost an answer. Each pulse delivers 17.25 milliliters (ml) ± 10%. But, unlike most pulse dose specifications I’ve seen over the years, this one doesn’t specify a respiration rate. Will it deliver that pulse dose at 10 breaths a minute, 15, 20, more? There can be a world of difference in the unit’s therapeutic value.

So let’s take a look at what I will call best case oxygen output. Let’s assume the machine is operating at the upper boundary of output: 17.25ml + 10%. That would be 18.975ml per pulse. If it will provide that output at a fairly normal resting rate of 15 breaths per minute, its total output would be about 285ml per minute or about .3 liters per minute. If it will provide that output at a somewhat elevated respiration rate of 20 breaths per minute, its total output would be about 380ml per minute or about .38 liters per minute. But who knows? That information is not disclosed. And what’s the real value of a two-pound $2,000+ POC that might be insufficient under mild exertion?

Of course, it’s not as simple as that. A person who has a prescription for 2 LPM continuous doesn’t actually inhale two liters of output from any oxygen source. The actual amount inhaled is dependent on respiration rate and other factors. But there is no industry or government standard for comparing pulse to continuous flows. Additionally, a POC that delivers a nominal continuous flow of 2 LPM doesn’t actually deliver 2 LPM of oxygen. For POCs, oxygen is normally somewhere between 87 and 95 percent of the flow. Therefore, the oxygen delivered at 2 LPM continuous flow is typically between 1.74 and 1.9 LPM.

So if you have an oxygen prescription for as little as 2 LPM, will this hyped up pulse-flow mini-POC meet that requirement? It’s not clear at all that it will, nor is the real pulse flow equivalency clear for any other POC. And even if the POC will deliver 2 LPM of oxygen at rest, will it deliver it at an elevated respiration rate during physical activity? The only information available to the potential POC buyer is that published by each manufacturer, with no assurance that the basis for the information is consistent between manufacturers.

If “buyer beware” ever applied to any market, it applies to the POC market. If you’re shopping for a POC, good luck. Please hope with me that the U.S. Food and Drug Administration or the industry will come up with standards that will help individuals with COPD accurately match their needs with POC oxygen output.

-Tony St. Amant
Chico, CA