I wanted to start out this week’s blog by thanking you all from the bottom of my heart for all your support of my blog. My readers rock my world with their kindness and thoughtful emails and it means so much to hear positive feedback from you all. I started this blog for YOU and I hope that in some small way, that I am making a difference. Please don’t be bashful in sending me ideas that you want me to write about. It was a tall order to think that I could come up with new topics from week to week, but I am up for it and your ideas will help keep the momentum going. Again, thank you so so much and please keep sharing my blog with friends in pulmonary rehab and others with lung conditions that could benefit from the information.
Now back to blogging…
So I have really been loving my “themed” blog posts but I don’t want to lose sight of the “basics” that I think everyone either needs to hear or be reminded of from time to time. We have been super busy seeing new patients in our pulmonary rehab center and it reminds me that no matter how long you have had your lung condition, sometimes we need to be reminded of the things we need to be doing to maintain our lung health from day to day. One of the things that I love the most about meeting new patients at our pulmonary rehab is seeing the “light bulb” moments when the idea of a new thought or process is presented to a person and they are like “YES!... I’m going to try that!” Unfortunately with blogging I don’t get to see that on your wonderful faces, but maybe after reading this blog a few of you might “light up” with an idea that could work for you. This week I am focusing on areas where you might be “going wrong” in managing your condition or your breathlessness. Read on and see if any of these apply to you and what you could do to improve.
5 Mistakes People with Lung Conditions Often Make
1. You aren’t taking your medications the right way or the right time of day. (Specifically your breathing medications, but not limited to.)
One of the common mistakes lung patients make is not taking their medications in the right order. There has been some talk in recent years on which medications you should take first. When I went to school for respiratory therapy (almost 17 years ago) the thought was when you woke up, the first thing that you would do is take a short acting bronchodilator first (like Albuterol) and then take your controllers. Now the thought process has changed a bit. What we recommend now is IF you wake up with NO shortness of breath… start out by taking your controllers first (i.e. Advair, Spiriva, Breo, etc.) and then take your short acting inhalers later. The reason for this is that many of the receptors that respond to the controllers can be filled by the short acting inhalers and therefore there aren’t as many receptors for your controller to “plug in.” Picture this… If your electrical outlet already has plugs in it… you have to move on until you find an available outlet. And if they are all occupied… there is no place to plug in.
However, IF you wake up with shortness of breath… the old method still applies. Take your short acting bronchodilator FIRST to open up your airways and then when you are breathing a bit more comfortably, take your controller medications.
The other common medicine related mistake is that many lung patients are waiting until the evening to take a “once a day” medication. Sure, these medications are designed to work for 24 hours, but to me it makes more sense to take these medications at the start of your day. The reason for this is that when you take your “once a day” medication, you have the most concentration of it in your system right after you take it (or shortly after). Why not reap its benefits throughout your day instead of while you are sleeping at night. This is a suggestion that you should try unless specifically instructed by your doctor or pharmacist to take them at night.
2. You don’t wear your oxygen as ordered.
I hear the following statement often… “I only wear my oxygen when I am feeling short of breath. Most of the time I’m fine without it.” Many times people who have a lung condition fall into the trap of thinking that if they feel fine, they are fine. Unfortunately this just doesn’t ring true. When you have lived with a chronic lung condition for years many times your idea of “normal” becomes skewed. If your doctor or respiratory therapist has performed a walking oximetry test and deemed it necessary that you need to wear oxygen with exertion then that entails everything but sitting still. Wear your oxygen when you get up to use the rest room, wear it when you get the mail, wear it when you are preparing a meal in the kitchen, and always wear it when you are bathing and grooming. Wearing your oxygen protects vital organs like your brain and heart. I know it can be cumbersome but it is for your own health and wellness you be as diligent about wearing it. For all my pulmonary rehab patients reading this, this also includes wearing your oxygen from your car into rehab! :)
3. You have been wearing your pulse oximeter as a piece of jewelry.
If you wear supplemental oxygen and have purchased a pulse oximeter to periodically check your oxygen saturations, you have a great way of getting a snapshot of your oxygen levels from time to time. Owning a pulse oximeter when you wear oxygen in many respects is just like owning a blood pressure cuff when you have high blood pressure (hypertension). Unfortunately often due to its small size, many people with lung conditions get fixated on the number and tend to carry it around and wear it like jewelry when we would never see anyone carrying a blood pressure cuff with them. Wearing it all the time can put you on the fast track to worrying about your oxygen levels too much. My recommendation is that you use it when exercising to monitor your oxygen saturation and heart rate and only pull it out occasionally throughout the day for a quick check. There are so many factors that can affect its accuracy like circulation, movement, and temperature that wearing it on your finger or around your neck will just giving you one more thing to worry about. Also remember when or if you do find that your pulse oximeter is indicating low oxygen saturations, to stop and rest or perhaps turn up your supplemental oxygen just until you have recovered. Don’t panic and let it cause you anxiety when you see low numbers. Remember to change the batteries out routinely in order for it to read accurately.
4. You rarely change or replace your oxygen, nebulizer, or CPAP equipment.
I understand that medical equipment can get pricey but your health is infinitely valuable. After each use, your nebulizer and mouthpiece should be rinsed out with warm water and dried. Remember after your last treatment of the day, that you should wash it out with warm soapy water using a mild detergent then dry it thoroughly. Every 3rd day, you should soak your nebulizer and mouthpiece in a one part vinegar/three parts water solution, rinse and dry. Replace your nebulizer, if you feel the output is diminishing and you aren’t getting a quality treatment.
I see many of my patients arrive to rehab with discolored or hardened nasal cannulas. Nasal cannulas can harbor bacteria and should be replaced routinely. Ask your oxygen supplier to order you a small stock that you can have available in your home. Always replace your cannula after a flare-up, cold, or sinus infection. Never let your nasal cannula get hard or discolored. If the material becomes hard it can develop tiny cracks in it that you might not notice until you recognize low oxygen levels. Always clean your nasal cannula if it falls and hits the ground.
If you wear a CPAP/BiPAP machine at night for obstructive sleep apnea, make sure you are cleaning the mask, tubing, and humidifier reservoir per the manufacturer’s recommendations. I often see patients who have been admitted to the hospital request to use their home unit and when we take a look at it... it is dingy and there is bacteria or mildew growing in the humidifier. Please be diligent about keeping this precious piece of equipment that allows you to breathe better while sleeping as clean as you possibly can. Replace/clean filters and other parts of your machine promptly.
5. You wait too long to see the doctor when you are sick
In the world of chronic lung disease many things can seem out of our control, but seeing a doctor quickly when you are sick can possibly slow the progression of your disease. Sure when you had healthy lungs you could wait to see if a cold progressed to anything worse, but now you must act as soon as you become ill.
Here is a list of reasons to call your physician and be seen:
· Increased shortness of breath, wheezing, or coughing
· Tightness in the chest that won’t go away
· Chest pain
· Mucus that has increased in amount, that has changed color, or is bloody
· Increased fatigue
· Increased swelling of the feet, ankles, or hands
· A fever, chills, or dizziness
· Friends are noticing that you are more forgetful, confused, or sleepy
· Are feeling more irritable or short tempered and/or noticing changes in your personality
· Sudden increase in weight of 2-3 lb. in a couple of days
***Keep in mind that the above list is NOT an “all inclusive” list as to when to see your doctor. I tell my patients all the time to trust their gut and if they are experiencing any symptoms that just don’t feel right or make them question if everything is okay… they should call their doctor and discuss their symptoms with them.***
Thanks for Reading!
Remember: We are in this TOGETHER!
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:) Christina
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