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.

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!

On Promoting “4 Surgeries to Avoid,” According to AARP–Two Years Ago & Again Today

           I posted this op-ed two years ago at my website http://independent.academia.edu/JDMeyer and sent the op-ed hither and thither.  I’m trying again not only because my overall Twitter presence has improved, but since I’m a member of several health care social media (HCSM) member lists on Twitter, together with the mutual following of professionals in the health and medical field on Twitter.  This AARP article link still pops up in the margins of current articles, so it must be highly regarded.  Any contention for reducing the cost of an aspect of health care in the USA must be explored (Meyer, 2015).

http://www.aarp.org/health/conditions-treatments/info-05-2011/4-surgeries-to-avoid.1.html

“I’m promoting this AARP article about over-performed surgeries as something of a sequel to the Fareed Zakaria special on advice for President Obama’s second term. All of these surgeries are questionable in the long-term; some of these are “moneymakers for hospitals and doctors.” Thus, keeping control over Medicaid/Medicare expenses could start here. Here are the four debatable surgeries: (1) stents for stable angina, (2) complex spinal fusion for stenosis, (3) hysterectomy for uterine fibroids, and (4) knee arthroscopy for osteoarthritis.
Besides tweeting the article to my followers at @bohemiotx, I tweeted it to Fareed Zakaria & AARP with the hashtag #obamamemo. Afterwards, I posted it at the White House and Social Security websites. Then I posted “4 Surgeries to Avoid” at my Academia.edu, Facebook, Stumbleupon, and Linked-In sites. Then I emailed it to the county Democratic party and some members before tweeting the link to Reimagining Japan. My most recent cyberspace move is petitioning the President at his website; however, it failed to get hardly any endorsements.

Dr. Zakaria also stated, “U.S. spends $4 for every American over 65, compared with $1 for every American under 18 #obamamemo.” Dealing with an aging population that needs Medicare/Medicaid will be one of the biggest political issues that the U.S. (and Japan) will face in the near future. This could be the first step: eliminating unnecessary surgeries  (Meyer, 2013).”