Dealing with a Bad COPD Exacerbation & Maybe Dodging an E.R. Visit (2nd Edition)

By J.D. (“Joffre”) Meyer
Those of us with COPD (Chronic Obstructive Pulmonary Disorder) live with the strong risk of an exacerbation that is severe enough to go to the Emergency Room by way of ambulance. I developed asthma 18 years before COPD too. We face a mix of lung spasms, excess chest phlegm, and a low FEV (Forced Exhale Volume). Asthma-COPD Overlap Syndrome (ACOS) is known for increased breathlessness and sputum–but a better response to inhaled corticosteroids.

It’s typical for me to have some coughing and wheezing when I awake, and sometimes after a walk. Choice #1 is using an asthma rescue inhaler, such as Pro-Air. It’s like a “Bud Light” version of the nebulizer, as both use albuterol. But the likelihood of its effectiveness goes downhill if our attack is more than simply mild. Rule #2 is not to take the long-term inhalers during an acute attack, such as Advair or Symbicort, and Singulair.

So we go for our dear friend, the nebulizer, and pour a vial of albuterol or albuterol-ipratropium in the receptacle. We get “Albut-Iprat” when our condition becomes worse. I just started getting Combivent, the stronger “Albut-Iprat” inhaler. Our next choice is mask or “pipe.” Most say the pipe-like hose is better because we get more of the medicine. So here’s my first original suggestion. If you wear the mask, put your oxygen canula up your nose (assuming you own one). Really tired COPD sufferers may have difficulties with the pipe.

Speaking of phlegm, keep a plastic can with a lid handy, such as my old Folger’s coffee can, the regular 10.3 oz. size. Don’t even consider swallowing that phlegm. I’m not trying to be funny because it’s not. Don’t expect to be able to run to spit in the nearest toilet or sink either. Make sure you drink enough water too–a likely weak area for most people. 1.5 liters daily should be enough since other fluids are okay; vegetables and fruits are full of water too. I use an attractive purple jug for my water, so I’ll notice it better! I can keep the squirt cap on when I take my many morning pills. Then I remove the cap for water guzzling!

Now let’s look at the OTC (over-the-counter) medicines. For your chest congestion, take some guaifenesin; that is, Mucinex or a generic version. COPD is a mix of emphysema and bronchitis. Bronchitis is like having a perpetual chest cold while emphysema is a destruction of the lung sacs and a lack of elasticity in the lungs.

What if you have nasal congestion? A saline nasal spray will open a constricted nose. Later I submitted this article to COPD Breathing Buddies of Facebook, and I was warned about Sudafed. This drug may reduce nasal congestion, but Sudafed can raise your blood pressure, which may happen anyway during a COPD attack. Lately, I’ve been adding ginger root slices, eucalyptus leaves, and even garlic cloves to my morning coffee drip bin. My goal is to reduce inflammation.

If you have severe or moderate COPD, take your Daliresp pill. By the way, since you’re taking all these pills have a water bottle next to your bed. The more water you drink, the more the mucus will be thinned.
Here’s my second original tip. If you have a C-PAP machine for sleep apnea, you can use it when you’re wide awake to force air into your inelastic, sagging emphysema-ridden lungs! Don’t overuse your nebulizer; try a wide range of strategies to stop the COPD attack.

Please check out my methods for battling severe COPD exacerbations! Maybe I have a higher tolerance for pain than many, or a fear of walking home from the E.R. before sunrise? My latest severe attack lasted for 1 hour & 40 minutes!!
And when you quit choking, take your Symbicort and Singulair or whatever.

Consider calling your G.P. M.D. later for an office visit. Last week I got a shot of Salumedrol, a steroid, at her office. Then I got prescriptions for prednisone pills and a Z-Pac antibiotic.

SOL Tuesday: Shopping at Family Dollar for a Low-Fat/Low-Sodium Cardiac Diet

I spent a half week at the East Texas Medical Center (ETMC) Cardiac floor for COPD & hypertension. I’m on disability for COPD and asthma. Usually, my blood pressure isn’t bad, but in it was in mid-September 2016. It was my first overnight stay in a hospital in five years. Previously, I’d assumed my diet was okay because I eat a balanced diet. I’m no carnivore, for I like grain, vegetables/fruits, and dairy. My diet is if I see food, I eat it. Recently, I’d become aware of anti-inflammatory foods to cope with my Asthma-COPD Overlap Syndrome (ACOS). http://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation Foods that Fight Inflammation

So I’ve been shopping with memories of the Cardiac Diet in my mind. Now, I check all foods for saturated fat, cholesterol, and sodium. I made sure I bought Mrs. Dash, the salt substitute, for starters. Texas Pete, a Louisiana type hot sauce, makes the cut with only 3% sodium per tsp. Texas Pete is the hot sauce for Church’s Chicken too.

Cheese was on the not-there list at the hospital. So I surveyed all the cheese at Family Dollar. Much to my amusement, the lowest fat/lowest sodium cheese is the cheapest generic cheese in Family Dollar! It’s simply called, Singles, an “imitation pasteurized process cheese food.” Saturated fat is 5% and sodium is 9% per slice, and the package has 16 slices for a mere $1.25! However, it didn’t melt well, so I’ve switched to Shredded Velveeta at 10% saturated fat, and it tastes way better.

Unfortunately, that delicious slab of generic dark chocolate is off-the-scale for saturated fat at 41%! Hershey’s with Almonds has a staggering 71% saturated fat for the day. But all is not lost, Family Dollar chocolate syrup has no saturated fat! Here’s a pleasant surprise. Snack-Pack Chocolate Caramel Pudding has only 8% saturated fat and 5% sodium per cup. Furthermore, a four cup package only costs $1 at Family Dollar.

My beloved Family Dollar Sweet & Salty Peanut Granola Bars are OK at 10% saturated fat and 7% sodium per bar. Those peanut granola bars are so good with beer! Another generic granola bar favorite is Dark Chocolate-Peanut Butter Protein Chewy Bars. They’re a bit high in fat at 15% saturated fat, together with 7% sodium per bar. Snicker’s Ice Cream has only 15% saturated fat and 3% sodium for a half-cup–another mega-relief! I had to indulge myself on Halloween but within reason. So I bought a package of 6 “Fun-Size” Snickers bars. Two bars have 15% saturated fat and 3% sodium

Margaret Holmes Seasoned Collard Greens have 16% sodium per half cup, but a staggering 130% of your daily Vitamin A, and of course, no saturated fat. Family Dollar Diced Tomatoes have no fat and 8% sodium per half cup. Both are considered anti-inflammatory foods.

Dean’s Zesty Guacamole Dip from Brookshire’s–Tyler, Texas’s major grocery store– has 15% saturated fat and 8% sodium per 2 tbsp serving. Speaking of other favorite grocery stores, Granvita Ganola from La Michoacana only has 4% saturated fat and 1% sodium per serving. I also mix horchata (cinnamon rice milk powder) with low-fat milk from Meals-on-Wheels. Horchata only contains 3% saturated fat per 4 ounces, and I only need a tablespoon, as I mix the half-pint of milk with a half-pint of water. La Michoacana is the leading chain Mexican grocery store in Texas. Hey, sometimes I catch the bus instead of walking a block.

Sardines–my favorite seafood in a can–tomato, mustard, plain; which is the healthiest choice? Pampa Sardines in Tomato Sauce wins with 5% saturated fat, 11% sodium, and 15% cholesterol. Furthermore, a serving has 20% of daily Vitamin A. A 15 ounce sardines-&-tomatoes can has seven servings, and it’s only $1.75! Our sardines are a product of China that’s distributed by a Miami company. I love globalization. Alas, sardines in mustard sauce–my former favorite–finishes last in my health measures with 15% saturated fat, 17% sodium, and 20% cholesterol.

Peanut butter is a mandatory fixture in my pantry, so let’s check it out. Value Time Creamy Peanut Butter (a generic) has 15% sat. fat & 6% sodium in a 2 tbsp serving size. Total fat is far higher at 25%, not a common large gap between total fat and saturated fat. Gold Emblem Crunchy Peanut Butter has 12% sat. fat & 6% sodium per 2 tbsp serving size with 23% total fat. I bought my crunchy peanut butter at CVS Pharmacy. Did you hear CVS bought out Medicine Chest? Peanuts show a range of saturated fat/sodium, depending on the seasonings. Japanese peanuts win with only 11% saturated fat & 9% sodium. Honey peanuts contain 17% saturated fat and 5% sodium. Meanwhile, the two spicy peanuts clock in at 20% saturated fat & 15% sodium and 17% saturated fat and 14% sodium.

CONCLUSION: Hopefully, you liked my analysis of some key favorite foods–mostly from Family Dollar. I’m no health professional, just a disabled teacher. However, I’m certainly going to research what I eat from now on, and I seem to be improving. Furthermore, I can guarantee another revision with a sat.fat/sodium analysis of more food. I was glad to pass this article to a Family Dollar employee, who had some heart issues about a month before I got sick. Don’t you feel sorry for those who live in food deserts? Some apartment complexes in town aren’t close to any stores–let alone hospitals, pharmacy, and a pulmonology clinic. We’re really happy to have a dollar store–Family Dollar–in this neighborhood: Midtown (aka. Hospital District), Tyler, Texas.

Memories of My Three Walking Pneumonia Attacks, by J.D. Meyer

Watching Hillary Clinton cough during a speech and later stumble as she was leaving a 9-11 memorial service brought back memories of my three walking pneumonia attacks. I describe walking pneumonia as the “silent killer,” because you don’t know that you have it until it has gotten pretty bad and you end up in the E.R. of the hospital. Pneumonia is way different from noisy lung ailments such as asthma, bronchitis, emphysema, and COPD.

The first attack was in 1995 when I was an Adjunct Instructor of Developmental Writing at Mountain View Community College in northwest Oak Cliff. Some of my students noticed I’d been looking bad before I ended up getting my folks to take me to the E.R. of Baylor Hospital, which was near my centrally-located apartment in Old East Dallas.  I’d developed asthma eight years earlier, but only needed a rescue inhaler at the time. My other part-time job was as a construction assistant/groundskeeper for Medical Center of Mesquite. Plus, I played half-court basketball every weekend with my mentor prof friend, the late Lew Sayers, and his friends.  Immediately, I quit cigarettes for five years.

The second attack occurred in late 2005 when I was a full-time Instructor of Developmental English at Texas College, an HBCU in north Tyler. Strangely, I’d delivered a sermon entitled, “Best Practices and Biggest Challenges of Unitarian-Universalists,” and spoke way too fast that time. A few days later, I went to the doctor and discovered I not only had walking pneumonia but emphysema! By that time, I’d been using an albuterol nebulizer for eight years and Advair sporadically for a year or two.

The third attack was in 2011, and the worst of all of them as I was kept in the hospital for a few days after the all-too-frequent ER visit. By this time, I was on disability and waiting for Medicare to start. Fortunately, there was a computer for the patients to use. That’s where I met a middle school science teacher, who was there to visit an older relative. I ended up interviewing him about the Urban Gardens movement, and he knew plenty of websites. Later, I’d research the work of Detroit mayor and former NBA star, Dave Bing, for more information. There were some sites on urban vegetable farms from progressive Austin too. I ended up publishing an article on the topic, despite having an IV in my left arm while taking my first batch of notes! Now it’s on my website at https://www.academia.edu/1084754/Urban_Gardens

In conclusion, give Hillary Clinton a break. Walking pneumonia is sneaky, and it may not seem bad at first –even if you knew about it like her, unlike me. The important thing is making it to the doctor or hospital somewhat soon–instead of late. This article was delayed because of my hospitalization for COPD & hypertension, but no pneumonia!

2016 Northeast Texas Community Health Worker (CHW) Coalition Conference

The Northeast Texas Community Health Worker (CHW) Coalition held its second conference at Tyler Junior College West on Friday June 15, 2016. The Keynote Speakers were David L. Lakey, M.D.; Paul McGaha, M.D.; and Ardis Green, MPH. To begin the conference, Dr. Lakey presented, “Improving Health in Northeast Texas.” After lunch, we heard Dr. McGaha speak about the “Zika Virus: Implications for East Texas and CHWs.” The final talk was by Ms. Green, and it was entitled, “The New Diabetes Educator Paraprofessional Competencies.”

We chose three Breakout Sessions from a choice of eight. My choices were “Hypertension,” by Debbie Warren–a CHW Instructor; “It Takes a Village–The importance of Partnerships,” by Lori Arteaga, M.Ed.; and “Helping Clients Self-Manage Chronic Disease,” by Marcus Wade, LMSW & CHW Instructor.

The other Breakout Sessions were “Suicide Prevention in Youth: Part 1 & 2,” by Carolyn Harvey, Ph.D.; “Preconception, Pregnancy, and Tobacco,” by Jeanie Gallegly, MS & CHW Instructor; “Compliance: Confidentiality/HIPAA/PHI,” by Christie M. Cofer, BS & CHW Instructor; and “Chosen–The True Story of America’s Trafficked Teens,” by LaJuan Scott, MPA and Dreka Strickland, BS & CHW.

My choice of Breakout Sessions reflect that I have a chronic disease-Asthma and COPD-that got me on SSDI, and Medicaid/Medicare; furthermore, sometimes I get hypertension. As you can surmise, I see plenty of medical personnel and volunteer, so I know the importance of partnerships.

Improving Health in Northeast Texas

This presentation by Dr. Lakey was the ideal opener because of its broad focus and a call for action because our area’s health fairs poorly. Like all the other talks, we saw a Power Point and received a handout of those Power Points. Dr. Lakey defined Population Health as examining the overall health of an area–together with groups based on gender,age, and ethnicity. The Triple Aim is to improve the individual experience of care (quality and personal satisfaction), improve the health of the populations, and reduce the per capita cost of health care.

Despite spending more money on heath care than any country in the world, the U.S. only ranks #34 in Life Expectancy and #42 in Infant Mortality. Coincidentally, Texas ranks #34 among the states. Lack of health insurance is the major problem. Senior health for Texas is just #41. Moreover, Northeast Texas health is clearly among the worst in the state. So it keeps getting worse as you narrow the territory from nation to state to region.