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The
PulmonaryPaperDedicated to Respiratory Health CareMay/June 2014 Vol. 25, No. 3
Inside:
What Portable Oxygen
Concentrator is right
for you?
DEOur annual POC review
is here along with articles to help you
make the right
choice!
Featuring 03 | Editor‘s Note
04 | Calling Dr. Bauer
16 | Ask Mark
18 | Fibrosis File
20 | Sharing the Health
30 | Respiratory News
Oxygen Things11 | Portable Oxygen Concentrator Chart and Checklist
15 | Fourth Annual POC Comparison
Your Health05 | Lung Force Unites Women in Fight Against Lung Cancer
10 | Write Your Congressman!
23 | Smoking Alarm
24 | Alpha-1 Antitrypsin Deficiency
26 | e-Smoking Gains Ground
For Fun28 | SeaPuffer Cruises Plan a vacation and leave your cares behind you!
Calling couples! Let us know how you cope with lung problems. Send us a photo!
www.pulmonarypaper.org Volume 25, Number 3
Table of Contents
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GiGi Bill
OxyView wearer GiGi and husband Bill Stoodley from California never let lung disease come between them!
We are hiding The Pulmonary Paper logo on our front covers. Can you find it?
May/June 2014 www.pulmonarypaper.org 3
Editor’s Note
D ecisions, Decisions, Decisions! How do you know you are making the right one? The only thing you can do is gather as much information and opinions as you can
about the subject. A member called one day and asked why you would choose one Portable Oxygen Concentrator (POC) over another. The answer is that only you can decide which one would best fit your needs and lifestyle! Do you travel away from home frequently? You may want one with one both continuous and pulse dose capabilities. Many times people purchase a POC based on size but, unfortunately, the smallest or lightest one may not be adequate for their oxygen needs.
If you are looking to purchase or rent a POC, we hope you will find this issue valuable to understand the differences of those on the market today. Please get involved in your care and don’t accept an oxygen concentrator that does not allow you to maintain your lifestyle.
We have had a tremendous response to our request to complete the survey we enclosed with our last issue – thank you so much for your support. We truly appreciate everyone taking the time to fill out the questionnaire to help determine how best we can serve your needs in the future. For those who would like to participate, the survey is available at www. pulmonarypaper.org/survey. The winner of an Apple iPad Air and Nonin oximeter will be announced in our next issue.
“In a moment of decision, the best thing you can do is the right thing to do. The worst thing you can do is nothing.”
Theodore Roosevelt
This is my husband Mark – one of the best decisions I have made in my life!
4 www.pulmonarypaper.org Volume 25, Number 3
Question for Dr. Bauer? You may write to him at The Pulmonary Paper, PO Box 877, Ormond Beach, FL 32175 or by email at [email protected].
Dr. Michael Bauer
Calling Dr. Bauer …
My patients often share with me their frustrations dealing with insurance companies and home care companies. I’d
like to share with you some of my frustrations, which, I suspect are quite the same.
In some ways, writing prescriptions has become a lot easier for me. I used to hand write 10 to 20 prescriptions every day. Now, almost all of this is done online using my hospital electronic record software. The hard part now is when I click “send”, I frequently get a message saying “this drug is not the preferred drug on the patient’s insurance plan”. This often means you, the patient, will have to pay more unless we all can agree on an alternative that “is covered”.
Albuterol is probably the most common inhaler I prescribe. Some of you like Proventil, some like Ventolin and some like ProAir. They are all albuterol, but some insurance carriers will only cover one or two of these brands. Cost is usually the deciding factor for insurance carriers. Multiply this by the scores of other types of inhalers out there, and it can be quite a challenge for all of us! Within reason, I try to help my patients get what they want. With the incredible high cost of many inhalers, sometimes we are left with little choice.
Certification and recertification for oxygen is the other high-volume paperwork chore doctors make sure we have completed for you. Regulations seem to keep changing regarding frequency of documentation and medical qualifying criteria. These are regulations that are driven by federal Medicare standards. Remember, an oxygen saturation of 88% or less is usually re-quired for you to continue to receive insurance coverage for your concentrator and portable systems.
CPAP users also know there is a “smart card” computer chip in their machine telling us exactly how often and how long the machines are being used. Medicare wants an average of at least 4 hours every night for a month-long time period.
Let’s keep trying to work together to keep our blood pressure and heartburn under control!
Do you have a
complaint or bad
experience with
changes in your
oxygen service and
equipment?
If you don’t voice
your concerns, the
people that will
be able to change
the situation will
never know.
Call the COPD
Information Line
at 1-866-316-
2673 for advice
on sharing your
concerns.
May/June 2014 www.pulmonarypaper.org 5
Pulmonary Paper subscribers get special pricing on the new 9590 Onyx Vantage! This pricing is only available over the phone.
Call 888.362.7123 today!aeroMEDIXRx carries only the highest quality, most reliable pulse oximeters. All of our products are made in the USA by Nonin Medical. Nonin has been making high quality fingertip pulse oximeters for over a decade with a track record of accuracy and durability. Don’t trust your life to cheap pulse oximeters, get a Nonin.
aeroMEDIXRx provides physician support for everything we sell. Get this prescription device from our physicians.
When American women were asked to
name a cancer that is top-of-mind, only one
percent named lung cancer. The truth is,
every eight minutes, lung cancer kills a
woman in our country. What are the lead-
ing causes of cancer death among women?
Number one is lung cancer at 38%, number
two is breast cancer at 22%.
The American Lung Association has
launched Lung Force to rally and unite wom-
en in the fight against lung cancer and for
lung health. Their partner, CVS Caremark
who made the bold move to remove tobacco
from their CVS/pharmacy stores, want this
new initiative to make lung cancer in women
a public health priority, drive policy change
and increase research funding.
Lung cancer is a disease that has per-
sonally affected actress Valerie Harper and
country music star, Kellie Pickler. Their
experiences motivated them to join LUNG
FORCE. In 2009, Harper was diagnosed
Lung Cancer is Number One Killer of Women
with non-small cell lung cancer. Her mother
died of lung cancer and like Valerie, never
smoked. When she was 15, Pickler lost her
grandmother to lung cancer just one day
after she was diagnosed. Picker shared, “Not
only was she a loving, strong and gracious
person, she was also the woman that I called
‘Mom.’ I support Lung Force in hopes that
others won’t have to lose such amazing
women in their lives.”
Visit LUNGFORCE.org to raise your
voice, share your story and take action.
Turquoise is the color to wear to support
the cause!
6 www.pulmonarypaper.org Volume 25, Number 3
Mark Mangus, RRTEFFORTS Board
Mark Mangus RRT, BSRC, is a member of the Medical Board of EFFORTS (the online support group, Emphysema Foundation For Our Right To Survive, www.emphysema. net). He generously donates his time to answer members’ questions.
Ask Mark …
Sharon from New Mexico was recently hospitalized with a pneumothorax and asks Mark to explain what caused it.Mark explains, A quick review of how the lungs work might help unde rstand how a pneumothorax may occur, as well as what must be done to correct it and reduce chances of its happening again.
The pleural space is a cavity between the lung’s outer surface and the inside of the chest wall – usually filled with about 5 ml of serous fluid that acts as a lubricant to let the lung and chest wall slideagainst each other without friction as you breathe. Thereare two pleural mem branes, the visceral pleura which covers and encloses the lung, and the parietal pleura, the membrane attached to the inside of the chest wall. If you’ve ever had pleurisy, you learned how important it is for there to be no friction between the two pleural membranes. Pleurisy is inflammation of those membranes and results in friction as the two membranes rub against each other with pain on every breath you take!
A pneumothorax is the collection of air or gas in the pleural space, sometimes caused by a hole that has developed in your lung. People with emphysema have weakened air sacs called blebs. In some cases, a collapsed lung occurs without any cause. This is called a spon-taneous pneumothorax.
The immediate treatment is to evacuate the air, usually done by inserting a chest tube or, in an emergency, placing a catheter or large needle into the space and pulling the air out with a large syringe. Once the air is evacuated, the lung re-expands under most circumstances. Suction put to the chest tube continues to evacuate air as it continues to leak into the pleural space through the hole in the lung. Given time for the hole to close and heal, the chest
Pleuralspace
May/June 2014 www.pulmonarypaper.org 7
tube keeps the lung expanded while that healing takes place. It can take as little as a day or two or even more than a week. If the pneumothorax does not resolve with simply waiting for healing and supporting with chest tube evacuation of the air, then another procedure may be considered.
For persistent leaks, a surgical procedure to close the leak once and for all and to sig nifi-cantly reduce the chances for recurrence is performed. That procedure is often done through the existing chest tube. It is called a pleurodesis which involves injection of a talc or the antibiotic tetracycline, into the pleural space. They are very caustic to the two pleural membranes, causing them to become inflamed and to ‘weep’ blood and fluids in response to the caustic attack. The two pleural layers then heal together, becoming one, effectively obliterating the pleural space. Once healed, even if other blebs might try to burst and leak air outside the lung, the pleural space is no longer able to be breached, or can only be breached for very small areas that are rarely clinically consequential. Pneumothorax in young folks is a surprisingly frequent occurrence, especially in tall, thin teen agers. They usually go on to lead normal lives without pulmonary consequences.
Subcutaneous emphysema is air that dis-sects its way between tissues and spreads
throughout the body, usually from areas closest to the lungs moving away from them. While a scary thing, most often it is a nuisance and cosmetic problem. The cause needs to be resolved and time will allow reabsorption of the free air. There is nothing one can do to prevent fu-ture recurrence of pneumothorax. If it is in the cards, it is in the cards. Having bullous emphy-sema sets one up for the possibility.
Healthy alveoli
Stretched anddamaged alveoli
8 www.pulmonarypaper.org Volume 25, Number 3
Fibrosis FilePeople suffering from idiopathic pulmo-
nary fibrosis (IPF) will soon have treat-
ment options! InterMune, Inc. has
initiated the Expand-
ed Access Program
(EAP) for the in-
vestigational drug,
pirfenidone. Pirfeni-
done is currently
under review by the FDA
to determine if it should
be approved in the United
States to treat IPF.
The EAP will be conducted under a
treatment protocol limited to enrollment of
IPF patients in the U.S. who meet specific
medical criteria and will be enrolled after
being assessed by a physician who specializes
in treating IPF and whose hospital or clinic
center is participating in the EAP, meeting
specific eli gibility requirements. This means
that not all physicians can provide access
to pirfenidone through the EAP and not all
patients who seek pirfenidone will be able
to get access to it through EAP.
InterMune decided to pursue this type
of EAP for pirfenidone now that their
Phase 3 clinical trials have been completed.
The duration of the program will be up
to 18 months from the initiation or until
InterMune has a decision from the FDA
regarding approval of pirfenidone.
As of May 2014, there are 15 sites
accepting patients for enrollment in the
pirfenidone EAP, 80 centers are expected by
September of this year. There is no cost to
you for the medication received through
the EAP. Costs for diagnostic tests to
determine eligibility or routine
medical treatment will need
to be covered by your
health insurer.
To learn if an
ap proved center is with -
in your reach, call InterMune
Medical Informa tion at 1-888-486-
6411. This number will be answered
24 hours a day. You will be given the
number of the nearest participating location,
and be told you are in the inclusion/exclu-
sion criteria to the study.
Information about other current studies
involving the drug that are currently
recruiting may be found at www.clinical
trials.gov and search ing for ‘pirfenidone’.
You may also visit the Coalition for
Pulmonary Fibrosis web site at www.
coalitionforpf.org for information.
InterMune has also launched two educa-
tional websites – www.KNOWIPFNOW.
com for patients and caregivers, and www.
IPFRALLY.com for health care providers.
Both offer pod casts and videos by several
interstitial lung disease experts. Sites include
downloadable materials to better understand
and live with IPF.
The good news continued when Boeh-
ringer Ingelheim announced the results of
its Phase 3 INPULSIS™ trials which showed
May/June 2014 www.pulmonarypaper.org 9
the oral medication, Nintedanib, slowed the
progression of IPF. The effect the drug had
on preventing exacerbations was less certain.
The results were published online in the New
England Journal of Medicine.
Over 1,000 people with IPF were involved
in the study and the scientists plan on further
studies to determine its effectiveness.
Unfortunately, the PANTHER-IPF
trial showed a third medication, N-acetyl-
cysteine used on its own, had no impact
on outcomes in idiopathic pulmonary
fibrosis.
PF Affects Horses, Dogs and CatsActress Anjelica Huston’s words greeted
researchers from around the globe when
they met recently to better understand
Pulmonary Fibrosis (PF). The lung disease
is killing horses, including thoroughbred
horses, and other domestic animals, just
as it is claiming an increasing number of
human lives. The scientists are hoping the
animals will hold a key to finding desper-
ately needed treatments faster for both.
The Fibrosis Across Species meeting, in
Louisville, KY, discussed comparative re-
search – or research that compares human
disease to similar diseases in animals. It
has been used successfully in the treatment
of bladder, prostate, bone and other forms
of cancer.
“We are concerned about the growing
incidence and prevalence of pulmonary
fibrosis and realize that research done the
customary way has limitations,” said Dr.
Jesse Roman, a human pulmonary fibrosis
researcher and chair of medicine at the
Uni versity of Louisville. “Studying animals,
in particular horses and dogs, may allow
us to better understand the underlying
causes of this lung disease and how to best
tackle finding life-saving treatments for all
affected species.” There is a comparative
research division at the National Cancer
Institute.
In addition to horses, the disease is also
known to affect cats and dogs, especially
terrier breeds of dog like the West High-
land White Terrier. As we know, there
are no approved drugs for this disease in
the U.S.
10 www.pulmonarypaper.org Volume 25, Number 3
Established by the Medicare Modernization Act of 2003 (P.L. 108-173), the Competitive Bidding
Program helps Medicare set payment rates for DMEPOS items and services. Studies from the
Department of Health and Human Services’ Office of the Inspector General and the Government
Accountability Office have shown Medicare’s current fee schedule payments were outdated and
too high. Unfortunately, taxpayers and Medicare beneficiaries bear the burden of paying these
inflated costs.
The Competitive Bidding Program replaces the current fee schedule amounts with competitively
bid prices. The first phase of the program was launched on January 1, 2011. In the nine areas where
competitive bidding was implemented, the program saved $202 million, a reduction of 42 percent
in costs. As the program expands, it could save an estimated $42.8 billion in taxpayer dollars.
As the Centers for Medicare and Medicaid Services continues forward with the Competitive
Bidding Program, we will continue to monitor the implementation of these programs and their
outcomes to ensure that beneficiaries have access to the medical supplies they need.
I wrote to my congressman about the
hardships people who use oxygen have
had to endure with competitive bidding and
asked for change. This is what I received:
I told him beneficiaries do not have access
to the medical supplies they need. A lady
in Minnesota was told she would have to
stay home more because her liquid oxygen
delivery was being reduced to once a month.
A man in North Carolina on high liter flows
was denied liquid oxygen all together. A lady
in Florida was told if she wanted portable
tanks, she would have to come to the office
to get them, even though she doesn’t drive.
A man in Colorado was told he could only
have eight tanks, even though he needed ten
to travel with. A national oxygen company
told a lady in California she would have to
pay triple the normal rate to rent a portable
oxygen concentrator because she was going
on a flight out of the country.
Please continue to contact your elected
officials. Mine obviously does not understand
the true situation. Many oxygen supply
companies that submitted low proposals
are finding out that it is hard to stay in busi-
ness. A lady who was expecting an oxygen
delivery was told that her new supplier did
not have enough tanks to go around!
Write your Congressman
May/June 2014 www.pulmonarypaper.org 11
This issue marks the fourth year
the Pulmonary Paper is publishing
its portable oxygen concentrator
(POC) chart. This year, we’re adding a
checklist of important questions to ask
before purchasing, renting or simply using
a POC.
POCs are seeing even wider acceptance
among oxygen users, home medical equip-
ment dealers and clinicians in the field.
Manufacturers have responded – POC avail-
ability is at an all-time high, with a majority
of current POC models being released within
the last five years. However, throughout
the home respiratory care spectrum there
remain many mis conceptions relating to
the performance capabilities and limitations
of POCs.
Perhaps the most important factor to
consider regarding POCs is that one size
does not fit all. Each POC has limited
oxygen production ability and, generally,
the smaller and lighter the POC is, the
smaller its production capacity is, meaning
it will meet fewer users’ needs than the
larger POCs. Since most oxygen users would
naturally prefer a smaller, lighter device,
manufacturers have made a con scious trade-
off in performance ability that allows for
the POC to be as little and lightweight as
possible while sacrificing oxy gen production
capacity, thereby limiting the total number
of users that could adequately oxygenate
on the device in some or all of their daily
activities.
The smallest available POC weighs
around 3 pounds and produces around
333 mL of oxygen per minute, or 0.33 LPM,
and can only deliver its oxygen in pulse
form while the user is inhaling. It features
no adjustable pulse flow settings, and as the
user breathes faster, the pulse flow volume
delivered actually decreases. Nevertheless,
since this POC is the smallest POC available,
it has clear appeal to a wide range of users,
even though some of them may not know
that the device may not be able to keep them
adequately oxygenated during some or all
of their daily activities.
At the other end of the spectrum, there
are several larger POCs available that can
produce 3000 mL of oxygen per minute, or
3.0 LPM. These units can provide oxygen
at both continuous flow settings and a wide
variety of pulse flow settings, making them
viable options for a wide range of oxygen
users. Yet these POCs can weigh anywhere
from 12 to 20 pounds, and this is before
Portable Oxygen Concentrators:
The Chart and the Checklist
Continued on page 12
12 www.pulmonarypaper.org Volume 25, Number 3
Want to live longer? Look better? Breathe easier and improve your quality of life?
What are you waiting for?
Talk to your doctor about the Benefits of Transtracheal Oxygen Therapy:
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 TTO2
For information call:
800-527-2667 or e-mail [email protected]
adding the weight of the various accessories
that come with the POC. To many users,
that is just too much size and weight to
routinely carry with them no matter how
well the POC can oxygenate them.
Unfortunately, despite the variety of
small- and large-form POCs available, POC
options for oxygen users with high flow
needs is still limited. Users with needs in
the 4 LPM to 6 LPM continuous flow range
may find they can oxygenate well in some
or all of their daily activities on some of
the larger POCs set to their higher pulse
Perhaps the most important
factor to consider
regarding POCs is that
one size does not fit all.
settings. However, those with needs greater
than 6 LPM may not be able to routinely use
any of the POCs currently available, though
there may be some select applications and
scenarios where one of these larger POCs
could be an option for use.
Following is a checklist of questions
anyone considering use of a POC should
take with them when deciding what POC
to buy or use. These questions cover what
we feel are some of the most important
factors to think about when determining
what POCs are options for the user, but this
is not meant to be an exhaustive list. The
more these questions are asked, the more
manufacturers and dealers will need to be
clear on the answers. For now, don’t expect
to get immediate answers to all of them, but
do try and find out as much information as
you can before making a decision.
Continued from page 11
May/June 2014 www.pulmonarypaper.org 13
Q What is the oxygen production capac
ity of the POC?
Oxygen production capacity tells you
how much oxygen the POC is capable
of producing per minute. Smaller POC
units tend to produce less oxygen per
minute than larger units, and will meet
a smaller range of user needs than their
larger counterparts.
Oxygen production is typically given
in milliliters (mL) per minute. 1000 mL/
min = 1 LPM.
Q Is the POC continuous flow capable?
Not all POCs can provide con-
tinuous flow oxygen. Many of the
smaller POCs are pulse-only devices,
meaning that all oxygen volumes are
delivered via pulses as the user breathes
in. Pulse delivery of oxygen has
fundamentally different characteristics
compared to con tinuous flow oxygen
deliv ery, so do not assume pulse settings
have liter flow equivalency (e.g., 2 pulse
setting ≠ 2 LPM). Use of a pulse-only
POC during sleep is not recommended
unless the user has completed an overnight
study with the device showing that
they stayed oxygenated throughout the
night.
Q What is the range of pulse settings
available – and continuous flow
settings if applicable, and what are the
associated pulse volumes at resting and
active breathing rates?
For example, a POC with settings of
1, 2, and 3 may deliver:
1 = 16 mL @ 15 BPM 8 mL @ 30 BPM
2 = 32 mL @ 15 BPM 16 mL @ 30 BPM
3 = 48 mL @ 15 BPM 24 mL @ 30 BPM
Pulse settings on POCs will vary from
device to device – one POC model set
to “2” pulse delivery will not be the
same on another POC model set to “2”.
Additionally, some POCs reduce the pulse
volume deliv ered at a setting as the user’s
breath rate goes up (aka, minute volume
delivery), whereas others keep the pulse
volume the same no matter the rate of
breathing (aka, fixed pulse delivery). Some
units combine both! Know that on minute
volume delivery POCs and some fixed
pulse POCs, you may need to increase
the pulse setting when you are active to
maintain adequate oxygenation.
Q What is the POC’s typical battery life
for each pulse setting at resting and
active breath rates? What are the battery
run times for continuous flow settings, if
available?
Battery life can be dependent on a
variety of factors. For example, a POC
with settings of 1, 2 or 3 may operate from
a full battery charge for:
1 = 4 hrs @ 15 BPM 3 hrs @ 30 BPM
2 = 3.5 hrs @ 15 BPM 2.5 hrs @ 30 BPM
3 = 2.5 hrs @ 15 BPM 1.5 hrs @ 30 BPM
Continuous flow opera tion, when
available, will go through battery power
much faster than a setting in pulse
operation. In pulse delivery, the setting
selection and the user’s breath rate are
significant factors in determining battery
life. Knowing how long each battery will
Continued on page 14
14 www.pulmonarypaper.org Volume 25, Number 3
last in the conditions it will be used in can
help to determine how long the user can
be away from a power source or will need
to swap in a freshly charged battery. Per
FAA regulations, traveling with a POC
requires bringing enough battery power
to last the user 1.5 times the duration of
the flight.
Q Is the device limited when being pow
ered by the DC power supply?
Some users find out too late that they
can’t use the device as they normally
would when using DC power. DC power
is provided through fixtures like car
adapters, and most POCs come with a
DC supply for travel purposes.
However, some POCs have limits on
their functionality when operating from
DC power. These limits may include non-
operation at higher flow and pulse settings
and/or the inability to charge the battery
while the device is in use.
Q How much does the POC unit weigh,
with and without all of the included
acces sories?
Manufacturers often will only report
what the unit plus one battery weighs,
which ignores the weight that is added
when toting a wheeled cart, AC/DC pow-
er supplies, extra batteries and other
accessories.
Carrying all of these addi tional pieces
can significantly add to the total weight
of the POC, which can make a difference
to those who may have trouble lifting and
maneuvering the equipment.
Q What is the manufacturer’s warranty
on the POC? If the POC needs repair
(under warranty or not under warranty),
will a substitute POC be supplied while it
is in for service?
If you are buying a POC new, be aware
that the warranty will typically cover the
unit, but not the battery, which will have
its own warranty terms. While the repair
cost may be covered, users who return a
POC for warranty service may be asked
to pay for shipping costs. Some, but not
all, dealers will provide a backup unit
while the defective POC is in for repair. If
a POC is bought used, the manufacturer’s
warranty may not be honored, so check
to see if the seller offers any warranty
guarantees.
The POC comparison chart compiles
information from manufacturer specifica-
tions, device manuals and manufacturer-
supplied material found in the American
Association of Home Respiratory Care’s
A Guide to Portable Oxygen Concen
trators, which can be downloaded for free
at https://www.aarc.org/resources/oxygen_
resources/portable_oxygen_concentrators_
guide.pdf. Please note that some POCs
previously included have been discontinued
and are no longer listed. Every effort has
been made to present the most accurate and
up-to-date infor mation in this comparison
chart – if you no-
tice an error please
contact Ryan
Diesem at rdiesem
@inspiredrc.com.
Continued from page 13
May/June 2014 www.pulmonarypaper.org 15
1,000 mL/min(1.0 LPM)
1 to 5
Minute Vol.Delivery: Dose
decreases as rate rises
15 BPM: 66 mL
30 BPM: 33 mL
6 lbs.
2.0 hours
12,000 ft.
333 mL/min(0.33 LPM)
NoneSelectable
Minute Vol.Delivery: Dose
decreases as rate rises
15 BPM: 22 mL
30 BPM: 11 mL
3 lbs.
1.5 hours
10,000 ft.
AirSep AirSep AirSep Inogen Focus™ FreeStyle™ 3 FreeStyle™ 5 One G2
PRODUCTION AND DELIVERY
Please consult with your doctor or therapist before deciding to use or purchase any of these devices.
2014 Portable Oxygen ConcentratorsINTERMITTENT FLOW (PULSE ONLY) POCS
Maximum Oxygen
Production (mL/min)
Available Settings
Pulse Delivery
Type
Maximum Delivered Pulse
Volume
Unit & Battery (Approx.)
Approx. Battery Time at Pulse
Setting 2
Max. Altitude
500 mL/min(0.5 LPM)
1 to 3
Minute Vol.Delivery: Dose
decreases as rate rises
15 BPM: 33 mL
30 BPM: 17 mL
4 lbs.
2.5 hours
12,000 ft.
1,260 mL/min(1.26 LPM)
1 to 6
Minute Vol.Delivery: Dose
decreases as rate rises
15 BPM: 60 mL
30 BPM: 30 mL
7 lbs.
4.0 hours(est.)
10,000 ft.
DOSE VOLUMES PER BREATH***2 LPM Continuous Flow: 15 BPM: 44mL 30 BPM: 22mL
4 LPM Continuous Flow: 15 BPM: 88mL 30 BPM: 44mL
6 LPM Continuous Flow: 15 BPM: 133mL 30 BPM: 66mL
WEIGHT (UNIT + STD. BATTERY); ADD UP TO 5LBS. FOR ACCESSORIES
STANDARD SINGLE BATTERY OPERATION TIMES
ALL UNITS APPROVED FOR FLIGHT BY FAA
High Flow
840 mL/min(0.84 LPM)
1 to 5
Minute Vol.Delivery: Dose
decreases as rate rises
15 BPM: 56 mL
30 BPM: 28 mL
6 lbs.
2.5 hours
10,000 ft.
16 www.pulmonarypaper.org Volume 25, Number 3
Inogen Inova Labs Invacare Oxus One G3 Activox™ XPO2 POC
PRODUCTION AND DELIVERY
INTERMITTENT FLOW (PULSE ONLY) POCS
450 mL/min(0.45 LPM)
1 to 3
Minute Vol.Delivery: Dose
decreases as rate rises
15 BPM: 30 mL
30 BPM: 15 mL
5 lbs.
4.0 hours
10,000 ft.
850 mL/min(0.85 LPM)
1 to 5
Fixed Delivery8.5 mL
per setting
43 mL
10 lbs.
3.0 hours
8,000 ft.
WEIGHT (UNIT + STD. BATTERY); ADD UP TO 5LBS. FOR ACCESSORIES
STANDARD SINGLE BATTERY OPERATION TIMES
ALL UNITS APPROVED FOR FLIGHT BY FAA
Maximum Oxygen
Production (mL/min)
Available Settings
Pulse Delivery
Type
Maximum Delivered Pulse
Volume
Unit & Battery (Approx.)
Approx. Battery Time at Pulse
Setting 2
Max. Altitude
Please consult with your doctor or therapist before deciding to use or purchase any of these devices.
2014 Portable Oxygen Concentrators
840 mL/min(0.84 LPM)
1 to 4
Minute Vol.Delivery: Dose
decreases as rate rises
15 BPM: 56 mL
30 BPM: 28 mL
5 lbs.
3.0 hours(est.)
10,000 ft.
****Approximate Continuous Flow volumes at 2, 4, and 6 LPM are provided for comparison to maximum volumes delivered by the selected POC.
DOSE VOLUMES PER BREATH***2 LPM Continuous Flow: 15 BPM: 44mL 30 BPM: 22mL
4 LPM Continuous Flow: 15 BPM: 88mL 30 BPM: 44mL
6 LPM Continuous Flow: 15 BPM: 133mL 30 BPM: 66mL
Precision DeVilbiss® Invacare EasyPulse iGo Solo2®
PRODUCTION AND DELIVERY
3,000 mL/min(3.0 LPM)
1 to 6Continuous 1 to 3 LPM
Fixed Delivery 14 mL
per setting
84 mL
19 lbs.
4.7 hours(20 BPM)
13,123 ft.
May/June 2014 www.pulmonarypaper.org 17
WEIGHT (UNIT + STD. BATTERY); ADD UP TO 5LBS. FOR ACCESSORIES
STANDARD SINGLE BATTERY OPERATION TIMES
ALL UNITS APPROVED FOR FLIGHT BY FAA
Maximum Oxygen
Production (mL/min)
Available Settings
Pulse Delivery
Type
Maximum Delivered Pulse
Volume
Unit & Battery (Approx.)
Approx. Battery Time at Pulse
Setting 2
Max. Altitude
Please consult with your doctor or therapist before deciding to use or purchase any of these devices.
2014 Portable Oxygen Concentrators
780 mL/min(0.78 LPM)
1 to 5
Minute Vol.Delivery: Dose
decreases as rate rises
15 BPM: 52 mL
30 BPM: 26 mL
7 lbs.
3.2 hours(est.)
9,000 ft.
3,000 mL/min(3.0 LPM)
1 to 6Continuous
0.5 to 3 LPM
Minute Vol.Delivery: Dose
decreases as rate rises
15 BPM: 133 mL
30 BPM: 66 mL
20 lbs.
3.5 hours
10,000 ft.
INTERMITTENT FLOW (PULSE ONLY) POCS CONTINUOUS FLOW POCS
O2 Concepts Respironics™ SeQual® SeQual® OxLife Independence SimplyGo Eclipse 3/5 eQuinox
PRODUCTION AND DELIVERY
2,000 mL/min(2.0 LPM)
Pulse 1 to 6Continuous
0.5 to 2 LPM
Combination Fixed/Minute
Vol. Delivery**
15 BPM: 72 mL
30 BPM: 66 mL
10 lbs.
3.0 hours(20 BPM)
10,000 ft.
3,000 mL/min(3.0 LPM)
Pulse 1 to 6*Continuous
0.5 to 3 LPM
Fixed Delivery16 mL
per setting
96 mL*
19 lbs.
5.1 hours(12 BPM)
13,123 ft.
18 www.pulmonarypaper.org Volume 25, Number 3
3,000 mL/min(3.0 LPM)
Pulse 1 to 6*Continuous
0.5 to 3 LPM
Fixed Delivery16 mL
per setting
96 mL*
14 lbs.
2.75 hours(12 BPM)
13,130 ft.
WEIGHT (UNIT + STD. BATTERY); ADD UP TO 10 LBS. FOR ACCESSORIES
STANDARD SINGLE BATTERY OPERATION TIMES
ALL UNITS APPROVED FOR FLIGHT BY FAA
Maximum Oxygen
Production (mL/min)
Available Settings
Pulse Delivery
Type
Maximum Delivered Pulse
Volume
Unit & Battery (Approx.)
Approx. Battery Time at Pulse
Setting 2
Max. Altitude
CONTINUOUS FLOW POCS
Please consult with your doctor or therapist before deciding to use or purchase any of these devices.
2014 Portable Oxygen Concentrators
3,000 mL/min(3.0 LPM)
Pulse 1 to 6Continuous 1 to 3 LPM
Fixed Delivery16 mL
per setting
96 mL
19 lbs.(w/2 batteries)
2.9 hours****(20 BPM)
13,123 ft.
****The Eclipse models also have pulse settings of 128, 160 and 192mL, but have additional breath rate restrictions for use. See Eclipse 3 manual for more information.
****The SimplyGo has two IF delivery modes: Pulse Mode and Night Mode. Shown volumes are for Pulse Mode. Night Mode has Minute Volume Delivery.
****The Independence is packaged with (2) batteries that can be used simultaneously, doubling the reported operating time.
May/June 2014 www.pulmonarypaper.org 19
Closer Look..Take a
Toll Free 877-699-8439
www.oxyview.com
Are you receiving
Your oxygen
Discretely?
20 www.pulmonarypaper.org Volume 25, Number 220 www.pulmonarypaper.org Volume 25, Number 3
Sharing the Health!My oxygen supplier no longer carries
these EZ-wrap ear protectors for me and I
relied on them to prevent sore ears. (They
slip over the cannula
tubing that goes around
my ears.) I found them
online at Amazon.com
from a company that
sells 50 pairs for $50,
that includes shipping. Maybe you can find
friends in your pulmonary rehab or Better
Breather support group to go in on them
with you!
Christie B., Colorado
Get friendly with your oxygen! A lady
from EFFORTS reports her husband has
named his “Jose” (hose-ay). They like to
try and find the humor in moments if they
can – it helps! He has two 25-foot lengths of
tubing with a connector between them that
rotates as he moves about. It really lessens
the tangling.
A Recipe for Joy
Put a smile
on your face.
A pedometer on
your waist.
Take a walk in
the mall
And stand tai chi tall!
Try a senior citizens’ center
for discussion groups.
Chair yoga to Zumba classes
Few fogies around!
A college, university or
other institute nearby?
Check it out!
Try a new fruit or veggie recipe lately?
Volunteer this year!
Judy Denkel, lucky to live in Reno, NV
The Proair (Al
buterol) inhaler
has a propellant
that may cause the
inhaler to become
plugged up if not
properly cleaned.
Visit www.proairhfa.com and click on
ProAir HFA Videos to learn proper clean-
ing techniques.
I clean my cannulas with hand sanitizer.
There is a new brand, Clean Smart, that does
not contain alcohol.
I hate the marks that the
cannula leaves on my cheeks.
Before bed, I move the sides
up level with my eyes. The
marks are barely visible when
I wake up. Hope these tips
help my fellow oxygen users!
Chris Gilfillan, Bloomington, MN
Sharon Miles of Loma Linda points out
that the word ‘Impossible’ becomes ‘I’m
Possible’ with a little rework!
March/April 2014 www.pulmonarypaper.org 21May/June 2014 www.pulmonarypaper.org 21
I think you will enjoy this! When I
went to church yesterday, a new priest
was standing at the door to introduce
himself and as he approached me, he
was really laughing. He said, “When I
saw you coming from the parking lot,
I saw you pulling this and all I could
think was why is this woman bringing
her vacuum cleaner to church? Now I
realize it is just your oxygen!”
So people who think the public is
staring at them because they wear
oxygen may have to clear up the
confusion!
I know he will always remember me,
so there is a plus!
Jeri M.
Minnesota
Ladies with emphysema often have
an increased chest diameter from hyper-
expanded lungs. This can make wearing a
bra very uncomfortable! Elaine from Canada
found extender hooks that can be purchased
in the notions de-
partment of fabric
stores. Some wom-
en have told us they
buy bras in a bigger
size than normal.
A camisole may be
your answer or if you need more support, a
sports bra may give you the support but be
flexible at the same time.
The Genie bra, available online at www.
geniebra.com, has been used by many ladies
with COPD. We have heard from some that
have deducted the purchase cost of having
to buy specials undergarments on their tax
return along with medical and therapy costs!
Russell from New Jersey loves his Vest®
Airway Clearance System! He has had
COPD for over ten years and was always
battling congestion, mucus and respiratory
infections that kept him on a lot of antibi-
otics and steroids and also in and out of the
hospital.
Since he has been using the Vest, his life
has improved tenfold! He is doing things
that he hasn’t done in years and is now able
to clear his secretions without medication.
For more information, visit the website,
www.thevest.com.
22 www.pulmonarypaper.org Volume 25, Number 3
Carmen Parent from Bangor, Maine was
annoyed with her cannula always getting in
her way. They now get along much better
since she slips it over her head and lets it
hang down her back while still resting on
her ears. Carmen also uses a small clothes
pin to attach it to her shirt!
I was annoyed with the “little
black bags” that I was given to
carry my oxygen canisters, so I
started making my own in colorful,
sometimes seasonal fabrics. I don’t
have a pattern, I just measure the
tanks. The bags are very sturdy be-
cause I use webbing for the handle
and it goes around the entire bag.
They have interfacing/interlining
in between the outer layer and the
lining and a pocket outside to carry
the tank key. I have dressy ones and
ones made from old jeans. They can
be made large enough to carry your
wallet, Kleenex, emergency inhaler
or whatever you want. It only takes
a quarter yard of fabric and 1-1/2
yards of webbing (or you can cut
up a garment you no longer want).
Appliqués can be ironed on or but-
tons added. If you don’t sew, get
with someone who does and ask
them to help you.
Hope Lee, Clinton, MD
Sharing the Health! continuedRose Sladek
who has been on
oxygen therapy for
two years writes us
with this tip. Every
once in a while, she
would get water
coming through the cannula and dripping
out her nose – very unpleasant! She talked
to her supplier and he gave her a water trap
that worked great. It fits between the tubing
and the end of her cannula so the excess
water drips into the trap.
She empties and washes it as needed. It
works in Florida where she spends the win-
ter and in northern Ohio where she spends
the summer.
Hope it helps others!
Beverly Campbell of Dillsboro, IN, agrees!
Being forced to change from her liquid ox-
ygen to a home fill concentrator was very
difficult. She found a problem with water in
her tubing, even when using the water trap
her supplier provided her. If she disconnects
the tubing and connects it to her nebulizer
for a few minutes, it quickly blows the
water out!
A respiratory therapist gave me advice
that made my morning routine much easi-
er. When I take a shower, it is okay to use
my oxygen – I just throw the tubing over
the shower rod to keep it out of the way.
She also told me to turn down the heat. I
had always liked taking hot showers, along
with leaving the bathroom door open, but
taking a cooler shower makes me less short
of breath! Vicky M., Ormond Beach, FL
May/June 2014 www.pulmonarypaper.org 23
Yes, I’m Airhead Dan, the O2 man,
wanting to help you make a stand
against the evils of smoking
to this end, I am not joking!
When you smoke,
your Lungs sound an alarm.
This warns you about all the harm.
Save me, Save me, they will say.
Somebody douse that butt,
Save the day!
Soon your lungs are turning black.
Then you get that nagging hack.
Very soon, no oxygen will flow.
Off to the coroner you will go.
He’ll wrap you up in a big white sheet
then put you under six feet deep.
So bury that cigarette instead
We don’t want you to end up dead!
Just say no!
Dan Lyle, the O2 Man
Smoking Alarm
A Great “Small” TownThe Villages in central Florida, is not
just a retirement community with approx-
i mately 50,000 homes, but was ranked
as the number one, fastest growing small
town in the United States in 2012 by Forbes
magazine. They have an active Better
Breath er group called the AirHeads that
meets twice a month.
Dan also wanted you to keep your
wits sharp by figuring out what these
abbre viated terms mean! (As an example,
“26 L of the A” would be “26 Letters of
the Alphabet”.) Answers next issue!
1) 88 P K 2) 7 W of the A W 3) 1001 A N 4) 12 S of the Z 5) 54 C in a D (with the J) 6) 9 P in the S S 7) 60 S in a M 8) 13 S on the A F 9) 32 D F at which W F 10) 18 H on a G C 11) 90 D in a R A 12) 200 D for P G in M 13) 8 S on a S S 14) 3 B M ( S H T R ) 15) 4 Q in a G 16) 24 H in a D 17) 5 D in a Z C 18) 1000 W that a P is W 19) 29 D in F in a L Y 20) 2 S Y O
“TransTrachealOxygenUser” Sally Dover and “NotUsingAnythingbutanECylinder” Dan Lyle
24 www.pulmonarypaper.org Volume 25, Number 3
It has been 50 years since the discovery
of the genetic abnormality of Alpha-1
Antitrypsin Deficiency, also known as
Alpha-1. It is a hereditary condition that is
passed on through generations that could
result in emphysema in adults and/or liv-
er disease in infants, children and adults.
A lack of a protein in the blood called
alpha-1 antitrypsin (AAT) that is mainly
produced by the liver is the problem. The
main function of AAT is to protect the lungs
from inflammation caused by infection and
inhaled irritants as tobacco smoke. When
AAT is missing and a person starts smoking,
they develop lung disease at a much earlier
age than cigarette smokers who have normal
levels of AAT.
Alpha-1 Education DayWe had the opportunity to attend a local
Alpha-1 Education Day sponsored by the
Alpha-1 Association and the Alpha-1 Foun-
dation. The event was a wealth of infor-
mation and support for those who have
been diagnosed with this genetic form of
emphysema. It is strongly recommended
that everyone who has been diagnosed with
COPD be tested for Alpha-1.
It is estimated that 3% of the people di-
agnosed with COPD, actually have AAT.
Testing is simple through a blood test or
mouth swab.
Free Testing Kits to Florida ResidentsThe Alpha-1 Foundation offers a free
Alpha-1 test kit for residents of the state
of Florida. You can get yours by calling
1-877-228-7321, extension 250. Call the ge-
netic counseling program at 1-800-785-3177
to find answers on testing results. Others
may receive an application for a free,
confidential test kit provided by the Alpha-1
Coded Testing Study – an Alpha-1 Founda-
tion-supported program run by the Medical
University of South Carolina. Contact the
MUSC at 1-877-886-2383 or email alpha
Listening to the participants, you could
hear “I am a MZ” or “I am a ZZ.” For each
trait a person has, as hair or eye color, there
are two genes – one from each parent. Nor-
mal alpha-1 genes are called M. The most
common types of abnormal alpha-1 genes
are S and Z. A person who does not have
Alpha-1 will be a MM.
The Z version of the gene produces very lit-
tle alpha-1 antitrypsin. Individuals with two
Z genes in each cell are likely to have Alpha-1
Antitrypsin Deficiency. If two parents have
the MZ combination of genes, with children
getting one version of the gene from each
parent, on average, one child in four children
will have Alpha-1 Antitrypsin Deficiency, and
three in four will have at least one Z version
of the gene.
Hereditary Condition Related to Emphysema
Alpha-1 Antitrypsin Deficiency
May/June 2014 www.pulmonarypaper.org 25
Treatment TherapiesAugmentation therapy is a treatment used
only for people who have AAT-related lung
diseases that involves getting infusions of the
AAT protein. The infusions raise the level of
the protein in your blood and lungs. Also
treatment with inhaled alpha-1 antitrypsin
is now being studied.
Patient Resources AboundThe Alpha-1 Foundation and Alpha-1
Association are merging into one organiza-
tion and a third called Alpha Net may soon
join the group. Call the Patient Information
Hotline at 1-800-245-6809 with any ques-
tions you may have.
The Peer Guide Program can give you
insight into what to expect as only one who
has personal experience can know. If you are
newly diagnosed and would like to speak to
someone who has been dealing with Alpha-1
symptoms and how it has affected their life,
call 1-877-346-3212.
You can access more than 200 past pre-
sentations given at all of the Education Days
and annual national conferences held for the
past eight years! Visit www.alpha1.org and
look for e-education under the education tab.
The Insurance and Reimbursement Referral
Hotline at 1-855-351-6610 is available to pro-
vide referral assistance with medical insurance
and reimbursement issues. The Associa tion’s
Private Health Insurance Toolkit can be found
under the Resources tab at www.alpha1.org.
The pharmaceutical companies that mar-
ket the medications also have education and
support programs for those diagnosed with
Alpha-1 Emphysema.
• www.aatmosphere.com (Baxter)
• www.cslcarez.com
• (Zemaira by CSL Behring)
• www.prolastin.com
• (Prolastin-C by Grifols)
Diet Choices Make a DifferenceAlina Zhukovskaya, a certified holistic
health coach, recently advised people with
Alpha-1 on food choices that may make them
feel better!
Alina warns burgers, fries and carbonated
beverages take a lot of energy to digest and
may cause inflammation. Choose foods that
are easy to digest and give your lungs energy
and support. You want to get the most nu-
trition out of the least volume of food. Fruits
and vegetables are a great choice. When you
juice your foods, you have a head start on
digestion and energy levels. The following
foods may benefit you:
• Avocados and sweet potatoes: Reduce
blood pressure and bloating.
• Cucumbers: Reduce bloating and hydrate
the body.
• Dark leafy greens: Purify blood and
strengthen the lungs.
• Radishes: Reduce mucus and relieve con-
gestion by clearing the sinuses.
• Tomatoes: Contain lycopene and support
heart health. Lycopene may block cancer
cell growth.
• Grapes: Help reduce mucus and bloating.
• Sesame seeds: High in calcium and support
strong bones.
26 www.pulmonarypaper.org Volume 25, Number 3
Ecigarettes were first developed in
China and introduced to the U.S.
market in 2007. When they appeared,
it was thought they could help people stop
smoking. Now we know it might not be
such a good idea! According to a study con-
ducted by the University of California, San
Diego, vapor from e-cigarettes makes the
untreatable MRSA superbug more poisonous
and weakens the body’s ability to fight the
multi-antibiotic resistant bug. E-cigarettes
strengthened the bacteria.
Vaporizing Nicotine ‘Solution’The Associated Press has presented a
series of excellent articles concerning the
dangers and potential regulation of e-
cigarettes. The battery-powered devices are
actually vaporizers, made of plastic or metal,
that heat a liquid nicotine solution creating
vapor that users inhale or “vape.” Some e-cigs
are disposable, while some are designed to
be reused with cartridges or tanks that fans
of the product call e-juice. Many come with
a tiny light on the tip that glows.
The ingredient in the liquid is nicotine, wa-
ter, glycerol, propylene glycol and flavorings.
Propylene glycol is a thick fluid some times
used in antifreeze but also used a food
ingredient.
Users say e-cigarettes address both the
addictive and behavioral aspects of smok-
ing. Smokers get their nicotine without the
thousands of chemicals found in regular
cigarettes while getting to puff and exhale
something that looks like smoke without the
ash, odor or tar.
Scientists’ research, as to their safety and
whether they help you quit smoking all
together, is inconclusive. The federal gov-
ernment is adding millions of dollars into
independent and company studies to deter-
mine the health risks.
Skyrocketing Usage since 2006The e-cigarette industry has skyrocketed
from thousands of users in 2006 to several
million worldwide. Sales have been estimated
at $2 billion last year. There are now more
than 200 brands. Many manufacturers are
staying with tobacco and menthol flavors
but others are selling candy-like flavors like
cherry and strawberry that could attract
children to the product. Because of this, our
FDA wants to ban sales to minors and require
approval for new prod-
ucts and health warning
labels on the products.
The FDA would like
to extend its authority
to regulate cigars, hoo-
kahs, nicotine gels, pipe
tobacco and dissolvable
tobacco products. The
E-Cigarette Use Gaining Ground
May/June 2014 www.pulmonarypaper.org 27
Information from the CDC (Centers for
Disease Control in Atlanta) told us on
May 2, 2014, the first U.S. case of Middle
East Respiratory Syndrome or MERS was
confirmed in a traveler from Saudi Arabia
to Indiana, via London and Chicago. The
patient is a healthcare worker who lives and
works in Saudi Arabia. He was isolated in a
hospital during the course of illness and later
discharged, having fully recovered. A second
U.S.-imported case of MERS was confirmed
in a traveler who also came to the U.S. from
Saudi Arabia. This patient is also a healthcare
worker who traveled from Saudi Arabia to
Orlando. The MERS situation in the U.S.
represents a very low risk to the general pub-
lic in this country. The CDC and other public
health partners continue to investigate and
respond to the changing situation to prevent
the spread of MERS.
FDA first announced its plans to regulate
e-cigarettes in April 2011 and many groups,
such as the Campaign for Tobacco-Free
Kids, are frustrated by the delay. A 2013
study published by the Centers for Disease
Control and Prevention, showed e-cigarette
use among American middle and high school
students doubled during 2011–2012. Gov-
ernment representatives worry if the regula-
tions are too strict, they will have the deadly
effect of causing people to turn to regular
cigarettes.
The first human lung transplant was
performed on June 11, 1963. The patient,
identified later as convicted murderer,
survived for 18 days after the single lung
was transplanted.
We have come a long way since then.
The world’s first living donor lung trans-
plant was successfully completed at Kyoto
University Hospital in Japan. The entire left
lung of a female patient with a diffuse lung
disease was removed, and replaced by the
lower lobe of her husband’s right lung. The
patient in her 40s had a type of idiopathic
interstitial pneumonitis, which causes respi-
ratory distress due to the hardening of lung
tissue as in Idiopathic Pulmonary Fibrosis.
The recipient is steadily recovering and her
husband has returned to work.
For further information on lung trans-
plantation you may visit the Second Wind
Lung Transplant Association, comprised
of people who have gathered information
to help those seeking a transplant and sup-
porting those that have had one. They may
be found on the Internet at www.2ndwind.
org or you may call their information help
line at 1-888-855-9463.
2014 CRUISES
28 www.pulmonarypaper.org Volume 25, Number 3
FST–
ST39
068 Member
PLAN YOUR WORRY-FREE VACATION.
CALL TODAY!
Our annual trip to Alaska is on the Grand Princess, sailing from Seattle on July 20–27, 2014.
ALASKAINNER PASSAGE
Experience Fall in style! Board RCI’s Jewel of the Seas, round trip from San Juan, Puerto Rico, sailing October 18–25, 2014.
SOUTHERN CARIBBEAN
Still time to
join us!
2015 CRUISES
OH, THE PLACES YOU’LL GO!
AND THE PEOPLE YOU’LL MEET!
Join the Sea Puffers on one of our group cruises escorted by respiratory
therapists!
Call 1-866-673-3019 to also arrange your own
cruise or tour!Visit www.seapuffers.com
for more information!
May/June 2014 www.pulmonarypaper.org 29
Enjoy 10 days of Spring on Holland America’s Noordam, leaving round trip from Fort Lauderdale on March 20–30, 2015.
Oxygen Guru Ryan Diesem will be our guest speaker!
SOUTHERN CARIBBEAN
Take an incredible 14day journey round trip from Amsterdam, leaving May 20–June 3, 2015. A once in a life time trip aboard Holland America’s small ship Prinsendam.
KIEL CANAL & BALTIC
Start the New Year right with a 7day cruise on the Grand Princess, round trip from Los Angeles January 17–24, 2015.
MEXICAN RIVIERA
30 www.pulmonarypaper.org Volume 25, Number 3
Respiratory NewsTo keep up on the latest pulmonary
news, click on the link on the home
page of www.pulmonarypaper.org.
A recent article in the respiratory therapy
journal, Respiratory Care, showed giving
the recommended dose of Guaifenesin had
no measurable effect on sputum volume or
properties and is unlikely to be help you
raise or thin secretions when used to treat
acute respiratory tract infections. Guaifene-
sin is sold under the trade names: Mucinex,
Robitussin, Liqufruta, QTussin, Guiatuss,
MucaPlex and Bronchoril.
Another reason to get moving! California
researchers found exercise might help reduce
the risk of hospital re-admission in people
with COPD.
Too many platelets in your blood is
known as thrombocytosis. It was found in
12% of COPD patients admitted for exac-
erbations and was associated with elevated
mortality rates.
The online journal, Thorax, reports low-
dose aspirin (80 to 100 mg/day) might be a
reasonable strategy during and after acute
exacerbations.
Sharpen those pencils for crossword puz-
zles or get out the Scrabble game! The online
journal, JAMA Neurology, reports seniors
with COPD have an increased risk of de-
veloping mental decline, especially thinking
problems, without apparent memory loss.
The study involved more than 1,400 adults.
An FDA advisory panel recommend-
ed Montelukast (Singulair) should not
be allowed as an over-the-counter help
for hay fever and other upper respiratory
allergy symptoms. Among the side effects
are agitation, aggressive behavior, anxiety,
depression, hallucinations, insomnia, irrita-
bility and suicidal thoughts. If people could
buy Singulair without a prescription, the
potential for inappropriate and potentially
dangerous use is high.
Canada has become the first country to
approve umeclidinium monotherapy (Incruse
Ellipta by GlaxoSmithKline) for COPD. In-
cruse Ellipta contains 62.5μg umeclidinium
delivered with the company’s Ellipta dry
powder inhaler. Used once daily, the drug is
indicated for long-term maintenance bron-
chodilator treatment of airflow obstruction.
Keep cool this summer! A study from
researchers at Johns Hopkins found COPD
patients who were exposed to warm tem-
pera tures had greater disease-related
morbidity, including an increase in symp-
toms, a rise in the use of rescue medications
and a decline in lung function.
A new study presented at the ATS Con-
ference has shown a direct link between
eating fish, fruit and dairy products and
improved lung function among those with
COPD. Conducted by researchers in the U.S.
and Europe, the study specifically looked
at lung function within 24 hours of eating
grapefruit, bananas, fish and cheese.
May/June 2014 www.pulmonarypaper.org
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The Pulmonary Paper is a 501 (c)(3) not-for-profit corporation and supported by individual contributions. Your donation is tax deduct ible to the extent allowed by law.
I I
The
PulmonaryPaperDedicated to Respiratory Health Care
Dedicated to Respiratory Care
Volume 25, No. 3
May/June 2014
The Pulmonary Paper PO Box 877Ormond Beach, FL 32175 Phone: 800-950-3698Email: [email protected]
The Pulmonary Paper is a 501(c)(3) not-for-profit corporation supported by individual gifts. Your donation is tax deduc tible to the extent allowed by law.
All rights to The Pulmonary Paper (ISSN 1047-9708) are reserved and contents are not to be reproduced without permission.
As we cannot assume responsibility, please contact your physician before changing your treat ment schedule.
The Pulmonary Paper StaffEditor . . . . Celeste Belyea, RN, RRT, AE-C, FAARC
Associate EditorDominic Coppolo, RRT, AE-C, FAARC
Design . . . . . . . . . . . . . . . . . . . . . Sabach Design
Medical Director . . . . . . . . . . Michael Bauer, MD
The Pulmonary Paper is a membership publica-tion. It is published six times a year for those with breathing problems and health profession-als. The editor encourages readers to submit information about programs, equipment, tips or services.
Phone: 800-950-3698 • Fax: 386-673-7501www.pulmonarypaper.org
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