Sleep Apnea? Just Didgeridoo It!

Before you run out for didgeridoo lessons to fix your sleep apnea, read here to learn why you might hear mention of this ancient musical instrument as an alternative treatment for obstructive sleep apnea.

The didgeridoo is a very long cylindrical musical instrument belonging to the “wind family”. It was invented over 1,500 years ago, by Indigenous Australians. Didgeridoos are very long, from 3 to 10 feet, and are sometimes called wooden trumpets or drone pipes.

In 2009, the results of a Brazilian research study revealed that people who learned to play the didgeridoo had some mild improvement in their sleep apnea (a decrease in their apnea-hypopnea index). This is thought to be related to the “circular breathing” required to play this instrument, which allows the player to create continuous sound without interruption. This technique entails breathing in through the nose, while at the same time, blowing out through the mouth into the instrument, using air that has been stored in the cheeks. Breathing this way is thought to strengthen the muscles in the upper airway, making them less likely to collapse during sleep.

There have been other similar small research studies, also pointing to the possibility that strengthening the muscles of the upper airway may provide some help with sleep apnea and snoring. In fact, the specialty field of Orofacial Myofunctional Therapy focuses on retraining the muscles of the lips, tongue, cheeks and face. During myofunctional therapy, therapists can use different techniques to strengthen the tongue muscle, stabilize the jaw and improve the “oral resting posture” during sleep.  Oral resting posture refers how the tongue, teeth, and lips rest during sleep.

Myofunctional therapy for obstructive sleep apnea involves exercises and behavioral changes that can improve nose breathing and airflow during sleep. It is also a common treatment for children who have difficulty chewing, swallowing, speaking and breathing. While not a cure or first line treatment for sleep apnea, myofunctional therapy is used by some people along with other sleep apnea treatments to help them breathe better. After a consult and evaluation, a therapist will develop an individualized treatment plan, including daily exercises to be done at home. As with any exercise, a commitment to time will improve results.

Although CPAP is considered the most effective treatment for moderate to severe sleep apnea, more people are looking for alternative and holistic treatments to add to their current plans. If you are considering trying something new, it is important to first discuss with your doctor.

 

 

Tips for Cleaning with Chronic Lung Disease

I wish I could say that having a chronic lung disease makes you exempt from cleaning your house, but alas, it does not. However, here are some tips that can help you prepare and maybe make it easier to accomplish.

  • Use your controlling bronchodilator before you start. If you take it only once a day in the evening and you think you’ll get winded in the morning or afternoon while you clean, take two puffs of your rescue medication before you begin to clean.
  • Put all your cleaning products in one place such as a pail that you can easily carry from room to room.
  • Don’t overdo it. Clean whatever you can and rest when you need to. The rest of the stuff will still be there tomorrow.
  • Keep your windows open for ventilation while cleaning.
  • Use non-toxic cleaners that don’t have a strong scent. Mom used this back in the day for everything-it works!
    • 1 tsp. liquid soap
    • 1 tsp. baking soda
    • 1 quart warm water
  • Still washing walls? Use a mop to reach for those high areas.
  • Use a damp cloth for dusting and spray water on the bottom of a broom to prevent dust and animal hairs from filling the air you’re breathing.
  • Check for water leaks that can cause bacterial and mold growth such as in your shower area or basement.
  • Use long-handled dustpans to avoid bending over after you sweep.
  • Use a lightweight vacuum and make sure it has a clean filter.
  • Have a professional clean your air ducts.
  • If you choose to hire a cleaning service, make sure to ask what type of cleaning products they use. A service might save you time, but the products they use could cost you a trip to the ER.

For a list of cleaning products deemed safer by the EPA visit www.epa.gov/saferchoice/products.

If you take proper precautions before cleaning, you can tackle your tasks in a safe way. Grab those buckets!

 

It’s Raining, It’s Pouring, the Old Man is…Having an Asthma Attack?

Can a thunderstorm cause an asthma attack? Seems like a silly concept, but some research claims that changes in airflow patterns during a storm can increase the chances for an attack. Downdrafts of cold air create thunderstorm outflows. These drafts take concentrated levels of mold spores and pollen high into the clouds moisture where they are broken down into very small particles and are released by the rain. Due to the high concentration of these particles in the air, people who are sensitive to these allergens can have severe asthma attacks called “Thunderstorm Asthma.”

Though attacks are not likely to occur every time there is a storm, certain factors such as wind patterns, temperature changes and humidity do play a role in making the “perfect storm.”  Asthma symptoms can appear right before and up to 24 hours after a thunderstorm occurs so it is important to take the proper steps to protecting yourself from the high concentrations of pollen.

First, always make sure asthma is well controlled, this will help prevent an attack from occurring. It is also very important that your asthma treatment plan is up to date and albuterol rescue inhaler is available. Talk to your doctor about use of a regular allergy nasal spray, which will help block inhaled allergens. Try to avoid being outside on high pollen days, especially if the wind picks up and a thunderstorm occurs. Keeping windows closed and staying indoors before and during the storm will help reduce the amount of pollen inhaled.

Though “Thunderstorm Asthma” is uncommon, we have to remember that it could happen. If you are a part of this sensitive population, it is important to keep yourself safe. Take the steps to keep asthma under control so the next time decide to dance in the rain, it doesn’t turn into an asthma attack.

Do I Have COPD or Emphysema?

There is so much confusion when it comes to defining COPD, so let’s try to clear it up for you. According to the World Health Organization, Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by chronic obstruction of lung airflow that interferes with normal breathing and is not fully reversible. The more familiar terms “chronic bronchitis” and “emphysema” are no longer used, but are now included within the COPD diagnosis. Other diseases that fall under the COPD “umbrella” are bronchiectasis and refractory asthma (chronic, difficult to control).

Let’s break them down:

Chronic Bronchitis causes the following changes to occur in the airways: increased mucus production, swelling and constriction of the smooth muscle that surrounds the airways.

https://www.physio-pedia.com/Chronic_Bronchitis

Emphysema is a lung condition that causes the air sacs in the lungs (alveoli) to become damaged. Over time, the inner walls of the air sacs weaken and rupture — creating larger air spaces instead of many small ones. This reduces the surface area of the lungs and, in turn, the amount of oxygen that reaches your bloodstream.

When you exhale, the damaged alveoli don’t work properly and old air becomes trapped, leaving no room for fresh, oxygen-rich air to enter.

https://www.drugs.com/health-guide/emphysema.html

Most people with emphysema also have chronic bronchitis.

Bronchiectasis(brong-ke-EK-ta-sis) is a condition in which damage to the airways causes them to widen and become flabby and scarred. It is usually the result of an infection or other condition that injures the walls of your airways or prevents the airways from clearing mucus. Your airways slowly lose their ability to clear out mucus, which then builds up and creates an environment in where bacteria can grow. This leads to repeated, serious lung infections. Each infection causes more damage to your airways. Over time, the airways lose their ability to move air in and out. This can prevent enough oxygen from reaching your vital organs.

http://www.cumc.columbia.edu/pulmonary/clinical-centers/bronchiectasis


Chronic or Refractory Asthma
Another frequent component of a COPD definition is refractory asthma, meaning asthma that is nonreversible, which differs from most forms of asthma. Some forms of asthma can be nonreversible and mimic emphysema. The following chart shows the differences between asthma and COPD but it is important to note that long-untreated asthma can become a chronic condition that has caused irreversible lung damage.

Global Initiative for Chronic Obstructive Lung Disease

This was meant to be a brief overview of chronic lung diseases only. If you are unsure of your diagnosis or need more information, please contact your physician.

 

 

How to Gain Weight If You Have COPD

When you have COPD, your body burns many more calories due to increased work of breathing. While much is made of the need to lose weight, we forget about those who are losing too much weight, muscle mass and strength. About 1 in 4 people with COPD are underweight, and this makes it more likely that their immune system won’t work properly. Eating more protein and getting more calories from nutrient-rich foods are good ways to prevent excessive weight loss. Here are some tips:

  1. Eat healthy fats. Because of the way fats are digested, they don’t tax the respiratory system like other foods can. Toss a salad in olive oil instead of having plain steamed veggies.
  2. Eggs and lean meats are full of protein. Eggs are easy to cook, which is a big benefit for those who find that cooking takes too much energy. Marinate a lean cut of meat in a vinaigrette and make a stir fry cooking with oil.
  3. Dairy can add calories and calcium to your diet. Add a slice of cheese to pastas, casseroles and sandwiches or add mixed powdered milk into recipes. Don’t go overboard.
  4. Nuts are a concentrated source of healthy fats. They add calories and have antioxidants (to fight inflammation). Toss into salads or make your own favorite snack by adding some dried fruit to a handful.
  5. Dessert? You Bet! Enjoy eating, even if it is a struggle at times, by allowing yourself to indulge in sweets you love. Cakes and ice cream are usually made with eggs and/or milk so you’ll be getting added protein and fats. Make sure to balance these treats with more healthful food, though.
  6. Milkshakes and smoothies can be a good choice as a supplement to your meals, but make sure they have protein, fiber and fat. You can find these already prepared and canned for a quick snack during the day. Look here for recipes- http://theindianspot.com/healthy-weight-gain/

Tips for Choosing a Portable Oxygen Concentrator

Many of you who are using oxygen are finding it more and more difficult to get out while using it, mostly because the tanks don’t last you long enough to make even short trips to the store, let alone take in a movie. For some of you a portable oxygen concentrator, which takes air from the room around you and converts it into a concentrated source of oxygen may be an answer. Before you actually buy one, here are some things to consider:

  • Check with your insurance to see if it is a covered item.
  • Talk with your physician to determine whether you can use a pulse dose (intermittent flow-IF) or will need continuous flow (CF).
  • Call your durable medical equipment company to see if they have one for you to try before you buy one or if they can rent one to you. All companies are different and have different portable concentrators that they use and supply. They should be able to help you find the most appropriate device for your circumstances.
  • Check the specifications- How much does it weigh? How much does it weigh with the battery? Is there a battery included? How long will the battery last? How much will a spare battery cost? Will it provide continuous flow (CF) or only intermittent flow (IF)?
  • If you are set on purchasing one on your own, do your homework. It is best to call the manufacturer directly to eliminate the possibility of getting one that isn’t appropriate for you or one that may have been used and refurbished. This is not to say that there aren’t companies out there that have a variety to choose from, provide decent service and sell both new and used, but if you want to be sure, buy directly from those making the concentrator or your DME company.
  • Come to our “Breathing In The ‘Burgh” boat ride on the Gateway Clipper on Friday, June 15. Our keynote speaker will be talking about this topic and can answer your questions to prevent you from making a purchase that does not suit your needs. Call 724-772-1750 or register online.

To Itemize or Not to Itemize: Deducting Medical Expenses on Your Tax Returns

With another tax season behind us, it’s not a bad idea to think about how you’re going to handle medical expenses on next year’s returns. The federal tax law has a 7.5% threshold for medical expenses for taxes filed in 2018 and 2019 (for 2017 and 2018 tax years). This means that you can deduct medical expenses that are higher than 7.5% of your adjusted gross income (AGI). For example, if your income is $30,000—7.5% of your income is $2,250. If your medical expenses add up to $4,000, you can then claim $1,750 ($4,000 – $2,250) on your tax return for medical expenses.

Keep in mind that it will only make sense to itemize your deductions if the total of the deductions is more than what you’d get by filing with the “standard” deduction. Taking the standard deduction is much easier so if there is only a slight difference between the two totals, the standard would be the way to go.

Starting with the 2019 tax year, the standard deduction is going to go way up, almost double what it is now. If you’ve spent a large amount on medical bills over the last year, this would be a good time to look at the numbers. This deduction is particularly important to Medicare beneficiaries who spend on average $5,680 each year on health expenses that Medicare does not cover, says the AARP.

For a complete list of medical expenses you can deduct, go to www.IRS.gov/forms and see IRS Publication 502. Here is a short list of some expenses that are included aside from the typical such as physician, dental and X-rays:

  • Inpatient hospital care or residential nursing home care
  • Acupuncture or inpatient alcohol or drug addiction centers
  • Weight-loss program for a specific disease
  • Insulin and drugs that require a prescription
  • Admission and transportation to a medical conference relating to a chronic disease that you, your spouse or dependents have if necessary for medical care
  • False teeth, reading or prescription glasses, hearing aids, crutches, wheelchairs
  • A guide dog or other service animal to assist a visually impaired or hearing impaired person
  • Electricity costs for using an oxygen concentrator (you will need a formula for this calculation)

There are many more deductions available and you will need to check for specifics, but this should at least get you thinking whether itemizing might be for you. Good luck!

Ref: The Pulmonary Paper, January/February 2018 Vol. 29, No.1
The COPD Store
www.IRS.gov
www.aarp.org

Exercising With Asthma

Exercise benefits our bodies by controlling weight, it helps us to fight certain health conditions and diseases, and it improves our energy and mood.  But when you have asthma, exercise may seem impossible because while exercise is very beneficial to us, asthma that is out of control will make it more difficult to workout.  It is very important to work with your doctor to control your asthma before you decide to begin an exercise regimen.

With asthma, my choice of exercise is running.  I know when and how fast I can run, and when I need to pre-medicate.  I do more of my road work in the fall and spring, while spending my hot summer days and cold winter days in a controlled inside environment on a treadmill.

Asthma does not have to keep you out of the game, though.  There are exercises that are best if you have controlled asthma that will benefit you.  It is very important to offer your body a 5-10-minute warm-up and cool down, no matter what form of exercise you choose.

Some of the following exercises could work for you:

  1. Walking- studies have shown that 30-60 minutes of walking at a moderate pace is one of the best cardio exercises we can do, with or without asthma. Walking 3 times a week for 12 weeks can help better control asthma and increase your exercise abilities.
  2. Yoga- while offering you core strengthening, yoga is great for asthma because it teaches the individual controlled breathing. One study focused on people, who after doing yoga 2.5 hours a week for 10 weeks, were able to decrease their asthma medication.
  3. Swimming- Allergists have said that swimming is ideal for people with asthma because you’re breathing in air that is highly humidified and often warm, and staying horizontal can sometimes help loosen mucus in the lower parts of the lungs. Don’t think you have to swim laps either—just moving around in the pool can be beneficial. However, note that chlorine used in pools can trigger asthma, so use precaution at pools with a strong chlorine smell.

In addition to these exercises, Health.com also suggests baseball, softball, volleyball, and football as good sports for asthma because of the quick bursts of play coupled with rest.

Whether you pick swimming, football or walking, working out with asthma is very important for the health of your body. So, let’s get up and get moving!

Lice Treatments Could Trigger Your Child’s Asthma

Recently I received a dreaded call—the lice call. My first-grader with beautiful, flowing, long hair was possibly exposed to someone with lice! I wasn’t sure what to do, so I headed to the local pharmacy to pick up a lice kit. I wanted to arm myself against any new little friends setting up house in my little girl’s head. After speaking with the pharmacist, I purchased the Nix, Lice treatment Creme Rinse kit.

It is extremely important to read every label of the products we use. On the side of the Nix box there is a warning stating; “Ask a doctor before use if you are allergic to ragweed. May cause breathing difficulty or an asthmatic episode.”

As someone with asthma and a ragweed allergy, I wanted a better understanding of the active ingredients in this product. So what is in Nix Crème Rinse that causes this reaction? I contacted the  Nix consumer group and regulatory department and learned that the active ingredient in the product is Permethrin, a synthetic version of pyrethrin. Pyrethrin is derived from chrysanthemums, which is a direct relative to ragweed. Though it is uncommon for this synthetic version to cause an asthmatic episode, it can happen.

A study on Permethrin Crème Rinse was done by using products containing this synthetic pyrtherin.  The study’s results found that 1.0-3.5 adverse events per 1,000 patients proved that this reaction is uncommon, but it is still important to watch the use of this product in someone with a ragweed allergy.

Nix consumer group actually suggested NOT using this product if an allergy exists and utilize Nix Ultra with active ingredients of Dimethicone (silicone-based polymer) and mineral oil.

After this scare, I have spoken to numerous parents regarding their treatment options, and one mother turned to the Nuvo method, which is a non-toxic option that uses Cetaphil to suffocate the lice and eggs.

Another method recommend for asthmatics is repeated wet combing with the use of a lice comb.

Lice cause a real itchy situation in homes, but it is important that during the anxiety of treatment and cleaning, you don’t forget about other underlying issues such as asthma.  Whatever method you use, always be careful using products on children—especially ones with asthma and allergies. Please read your labels and don’t be afraid to ask questions.

About World TB Day

Tuberculosis is a global epidemic, but it is preventable and curable.  In 2016, 10.4 million people were sickened with tuberculosis and there were 1.7 million TB-related deaths throughout the world.  In the United States, there were 9, 272 cases of TB in 2016. According to the CDC, TB was reported in all 50 states with 174 of those cases in Pennsylvania.

March 24 is annual World TB day.  It marks the date in 1882 that Dr. Robert Koch announced the discovery of “Mycobacterium tuberculosis”, the bacteria that causes tuberculosis (TB).  In Dr. Koch’s time, TB killed 1 out of every 7 people in the United States and Europe. Today, one-fourth of the world’s population is still infected with TB.  100 years later, March 24 was designated as a day to educate the public about the impact that TB is still having around the world.

Even though the number of people with active TB disease is declining in the United States, there are still millions that have latent TB infection (LTBI).  Someone with latent tuberculosis lives with tuberculosis bacteria in their body, but is not sick and cannot transmit the disease.  Sometimes, the bacteria can become active.  When this happens, a person will change from having latent disease to being sick with active disease.  People with active TB are contagious and can spread the infection. There are certain people who are at increased risk of converting from LTBI to active TB, and for this reason, should be treated preventatively. Treatment for LTBI has been challenging, and many people do not comply with the often lengthy regimens.

For over 100 years, Breathe Pennsylvania has been involved in the fight against tuberculosis in western Pennsylvania.  In honor of World TB day, we will be offering our 5th Annual Tuberculosis Education Conference on March 22.  This event is an opportunity for health care professionals involved with tuberculosis to learn from experts in the field.

For more information about this year’s conference, visit our event page: http://breathepa.org/programs/tuberculosis-educationoutreach/tuberculosis-education-conference