Cactus (Nopalitos): Why Fresh is Better than Pickled, by J.D. Meyer

I’ve been a major fan of sliced cactus (nopalitos) for many years.
I’d compare the flavor and texture to a cross between a bell pepper or
poblano pepper and okra. Admittedly, I’ve never bothered to buy the
whole pad from the vegetable section of the grocery store and carve
the quills out of them in my kitchen. However, usually I get the pickled
variety in a jar, and I save the jars for leftovers. Fresh bags of sliced
nopalitos in the vegetable section are confined to Mexican grocery
stores—such as La Michoacana. Cactus (Nopalitos) seems to find its
way to restaurants/taquerias either with beef fajitas or scrambled eggs
in a breakfast taco.

Finally, I read the nutritional information from two empty bags of
fresh nopalitos, and two jars from pickled nopalitos. The nutritional
data is staggering. Vinegar and salt deplete nutrients!
Let’s start by looking at that fresh bag of sliced cactus by Latin
Specialties. One cup contains the following: Calcium—39%,
Potassium—17%, Vitamin A—22%, Vitamin C—36%, Dietary
Fiber—20%, Iron–8%, Sodium—2%, Protein—6%, Carbohydrate—3% &
Fat—0%. The statistics for Ortega’s Nopalitos are virtually the same,
except the Potassium amount is unknown.

On the other hand, let’s look at the convenient pickled cactus in a
jar. Two tablespoons of Dona Maria Nopalitos has no Calcium, no
Potassium, Vitamin A—2%, no Vitamin C, no Dietary Fiber, no Iron,
Sodium—23%, No Protein, Carbohydrate nor Fat. Meanwhile, a half
cup of El Mexicano Nopalitos has the following: Calcium—5%, no
Potassium, no Vitamin A, no Vitamin C, no Dietary Fiber, Iron—6%,
Sodium—21%, Protein—2%, Carbohydrate—1% & Fat—0%.

Blood Cancer Research Annotated Link Page—Including Eastern & Natural Medicine By J.D. Meyer

1. http://www.hematology.org/Patients/Cancers/ Three Kinds of Blood Cancer: (1) Leukemia, (2) Lymphoma, and (3) Myeloma.

2. https://www.ncbi.nlm.nih.gov/pubmed/25136372 “Treatment of acute lymphoblastic leukemia from traditional Chinese medicine.” Highlights from Abstract: “Methotrexate (MTX) is a drug used in the treatment of various cancer and autoimmune diseases……Therefore, MTX can inhibit the synthesis of DNA. However, MTX has cytotoxicity and neurotoxin may cause multiple organ injury and is potentially lethal…..Our results show that the TCM compounds adenosine triphosphate, manninotriose, raffinose, and stachyose could have potential to improve the side effects of MTX for ALL treatment.”

3. https://en.wikipedia.org/wiki/Adenosine_triphosphate “ATP is a complex organic chemical that provides energy to drive many processes in living cells, e.g. muscle contraction, nerve impulse propagation, chemical synthesis. Found in all forms of life, ATP is often referred to as the “molecular unit of currency” of intracellular energy transfer.[1] When consumed in metabolic processes, it converts either to adenosine diphosphate (ADP) or to adenosine monophosphate (AMP). Other processes regenerate ATP so that the human body recycles its own body weight equivalent in ATP each day.[2] It is also a precursor to DNA and RNA, and is used as a coenzyme.”

4. http://www.itmonline.org/arts/leukemia.htm TREATMENT OF LEUKEMIA USING INTEGRATED CHINESE AND WESTERN MEDICINE, by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon. Highlight: “While specific nutritional approaches have not been developed for leukemia, certain general methods can be applied:
a. Make sure the individual is receiving adequate basic dietary nutrients, such as proteins, fats (preferably unsaturated), and carbohydrates. Monitor body weight and muscle strength, and take further action if there is not improvement, including recommending easy-to-use concentrated nutrition sources.
b. Provide additional nutrients and a high level of antioxidants using supplements (11). General anticancer substances may be tried, including flavonoids (quercetin, genestein, tea polyphenols), minerals (selenium), and vitamins (high dose vitamins A, C, and E). Even if these fail to produce a cancer-inhibiting action, they may provide other benefits for persons in the age group that suffers from chronic leukemia.
c. When possible, use Oriental dietary techniques to match the dietary components to the symptom/sign pattern (12). For example, use cooling foods for fevers, astringent foods for sweating, yin-nourishing foods for yin deficiency patterns, etc. Make sure the suggestions include using foods that can reasonably be obtained and prepared.”

5. https://blog.yinyanghouse.com/posts/one-more-reason-to-eat-your-veggies-significant-leukemia-risk-reduction Highlight: “Their analysis found that there was a significant decrease in leukemia risk as the vegetable intake was increased. Interestingly, they did not see a significant raised risk from red meat, poultry, fish, or fruits. The primary factors in elevating the risk were frequent intakes of “fat, deep-fried, and smoked” foods. They concluded that “diets rich in vegetables and adequate amount of milk reduce the risk of adult leukemia.

6. http://www.a-healthy-body.com/the-top-10-health-benefits-of-turmeric-plus-how-to-use-it-in-everything/#comment-92 “The Top 10 Health Benefits of Turmeric (Plus, How To Use It In Everything).” The most relevant benefits vs. cancer are probably #3 “Turmeric helps boost your immune system” & #5. “Turmeric can help treat and prevent cancer.”

FOOTNOTE (Initial Reaction): “I’m sorry to hear of your father’s illness. If my health research turns up anything, I’ll let you know. CoQ10 is great for cardiovascular diseases, and Dr. Peter Langsjoen of Tyler is one of the major authorities on CoQ10 in the world! But that may not apply for cancer.”

“Skillful Teaching through Facilitating Discussion—Teaching skills is an essential pillar of a competent CHW and CHWI,” a lecture by Dr. Shannon Cox-Kelley, summarized by J.D. Meyer

This was the first lecture at the 2018 Community Health Workers Conference for the NE TX CHW Coalition, July 13, 2018.

The NE TX CHW Coalition Conference featured two main lectures and three breakout sessions. The first main lecture was by Dr. Shannon Cox-Kelley –Dean of Health Science–who teaches in the Community & Public Health degree program at NE TX Community College. She received all of her degrees at Texas A&M at Commerce and is a noted online distance educator.

Dr. Cox-Kelly cited four occasions to use discussion: (1) Evaluate evidence. (2) Formulate application of principles. (3) Foster motivation for further learning. (4) Articulate what has been already learned—theory behind the discussion.

Memory is linked to how deeply we think about something. A research interest cited in Dr. Cox-Kelley’s biography really clicked with me: “the impact of educational attainment on health outcomes in diverse communities.” My disabling condition is COPD, but as a Master’s degree holder and former all-level teacher (mainly Developmental English/Writing: the Pre-College Composition course), I’ve learned to study my conditions. (Yes, I have other health issues). I write Word Press articles on health and make binders full of info on medicine, ER reports, and journal articles.

Returning to Dr. Cox-Kelley, she notes that relationships are key, and we have a need to know why and how information is needed. The CHW Instructor could start with controversy like a “devil’s advocate,” but one should announce it in advance to maintain trust. Uncertainty arouses curiosity; switch sides. Focus on solving problems rather than the solution.

Many students are passive and quiet since we’re taught to memorize in secondary education. An increasingly popular practice is to flip the class and have the lecture at night on You Tube or something like it. Then the classroom becomes a place for total discussion. This flip improved passing rates at Dr. Cox-Kelley’s junior college. Think, don’t memorize.

How to start with questions means to start with desired outcomes. Factual questions increase problem-solving. Application and interpretation questions find connections. Problem questions can induce critical thinking. Comparison questions can evaluate readings.

Dr. Cox-Kelley cites principles behind case studies: (1) Increase focus. (2) Break cases into sub-problems. (3) Socratic questioning, and (4) Lead students toward intended outcomes. Once again, passive students can be a possible barrier, as well as failure for students to see value.

Dr. Cox-Kelley cited Discussions as a Way of Teaching, by S.D. Brookfield and S. Breskill (1999) as a fine relevant book. Students can experience a fear of looking stupid and the inability to consider alternative sides because of emotional attachment. Are they trying to find a correct answer or explore? Helping emotional reactions includes asserting the value of discussion and keeping opinions and verbalization in perspective. To conclude, collaboration is better than competition.

“Skillful Teaching through Facilitating Discussion” lived up to its subtitle of teaching skills being an essential pillar of both the Community Health Worker (CHW) and CHW Instructor (CHWI). Furthermore, Dr. Cox-Kelley’s lecture reached out to teachers looking for a second career or a stimulating cause in retirement.

SOL18: Assisting a Local Journalist: Future Story About Coping with Obstacles to Success Faced by Locals

I received a Facebook message from our star local newspaper’s photojournalist that she was in the process of co-authoring an article about obstacles to success faced by locals: poverty, medical/mental disabilities, incarceration, and lack of housing. I was flattered that she wanted my input; she’s been a favorite acquaintance and neighbor for a few years. You’ll notice that I added “coping” to this article.

I’m a former teacher who is disabled with COPD and asthma. To get on SSDI, I went for tests at a local hospital–East Texas Medical Center. Later I got on Medicare and became connected with the East Texas Council for independent Living (ETCIL) and entered a nursing home for eight months. I got two overdue surgeries while I was there. However, I couldn’t get discharged until I got on Medicaid and was turned down the first time. So I went to the Records Department of ETMC and got a complete list of my Emergency Room visits for the previous four years. Most of y’all have probably heard that Texas is the largest state not to have Medicaid expansion. It’s so wonderful to have Cigna health care. I get maintenance medicine, have a pulmonologist and a G.P. that are really great and nice, and discovered what else was wrong with me health-wise. I study my Asthma-COPD Overlap Syndrome and have a binder and a couple of folders on the illness; some articles are by me on my Word Press.

I mentioned that I went to the City of Tyler Neighborhood Services to get an apartment rental discount through the Department of Housing and Urban Development (HUD). The local center for independent living relocation specialist facilitated the process. Later when I moved across town, I did it all myself. Before I got on Meals on Wheels and SNAP Food Stamps, I went to a couple of local food pantries once per month.

Besides specifically telling her to call Neighborhood Services and ETCIL, I told her about my main volunteer activity: East Texas Human Needs Network (ETHNN). We have five committees: Education, Employment, Healthcare, Housing, & Transportation. Transportation is my main focus because I ride the bus regularly, as I quit driving several years ago. I’ve arranged field trips with lunch for all five lines. We went to both shopping centers, two grocery stores, and Neighborhood Services. I also attend Education and Healthcare committee meetings.If more people rode the bus, we’d have less traffic, pollution, and more bus routes.

Just between us for now, I’ve really been trying to advertise the importance of finding a match between personality and college major choice/vocation. The local university wants to improve its graduation rate, so I sent my article on the topic to a couple of friends who work there. Furthermore, career counseling centers should advertise the free online Myers-Briggs Type Indicator (MBTI) instruments.

To conclude for now, I told the photojournalist that I may not make much money, but I don’t spend much either. Just because one may be a retired teacher (prematurely, in my case), a teacher never quits teaching.

Questions to Ask Someone with COPD (2nd Edition), by J.D. Meyer

1. What inhalers do you use? A rescue inhaler, like Pro-Air, was my first. Now, I usually take Combivent.

2. Do you use a nebulizer with albuterol or albuterol-ipratropium? Nebulizer fluid is an extra strength version of rescue inhalers with the same chemicals.

3. Do you use a twice daily inhaled corticosteroid, such as Advair or Symbicort?

4. Do you have a pulmonologist? I go to Pulmonary Specialists of Tyler on Fleishel, behind ETMC. Dr. Luis Destarac is my doctor. I get allergy shots there too. I’m allergic to Bermuda & Johnson grass.

5. Do you have lots of phlegm sometimes? Take Mucinex, and you can get the generic version at Family Dollar that’s cheaper.

6. Have you ever been to the ER for an exacerbation? Have you been there lately? More often or less often over the years?

7. Do you have sleep apnea? Do you have a C-PAP?

8. Do you have an oxygen machine with nasal canula?

9. Do you still smoke cigarettes? I quit a few years ago.

10. Have you ever had asthma? Child asthma can go away, & it’s more common. I developed asthma at age 28 & COPD at age 46. Asthma-COPD Overlap Syndrome (ACOS) is characterized by more dyspnea (breathlessness), more phlegm, but better response to inhaled corticosteroids (such as Advair). Some COPD inhalers, like Onoro, can be fatal to those with asthma also!!

http://www.healthcommunities.com/copd/early-stage-copd.shtml Early COPD.

https://bohemiotx.wordpress.com/2017/02/05/dealing-with-a-bad-copd-exacerbation-maybe-dodging-an-e-r-visit/ On reducing ER Trips.

Art of Peace Statement 2017, by J.D. Meyer

The Art of Peace implies a wide range of peace-making efforts. I’m going to analyze this issue according to four views: (1)my North Korea approach, (2) health, (3) apprenticeships, (4) the fiscally responsible approach to defending DACA and fighting The Wall. But first, I’d like to give an account of my spiritual experience some 30 years ago like a previous speaker. Self-confidence in one’s sincerity is the goal of the unity of knowledge and action (chih hsing ho-i). “Spontaneity as conforming to pattern-principle” (tzu-jan chi li) is another way to express having self-confidence in one’s sincerity.

I‘m a devout Twitter fan. I offered a different view of the North Korea crisis. “#NorthKorea wants praise for its nuclear weapons as a cash crop—their only crop! Make sure the bomb isn’t ticking #Diplomacy,”

I’m a member of COPD internet support groups and have written about health issues on my Word Press blog. Wear oxygen canula under your nebulizer mask to improve its efficiency. Also utilize your C-PAP while awake to end a bad exacerbation. I helped a depressed diabetic friend recently by telling her about the benefits of eating cactus (nopalitos). I buy my cactus already sliced, usually pickled in a jar. I don’t battle the quills.

How about more apprenticeships, as proposed by Tim Kaine and three other senators? The business would get a tax break, and the intern would make some money while they learned a valuable trade. People with a good job are more likely to be peaceful.

I’m a member of the local Indivisible group, a Fareed Zakaria Fan Club, and related closed Facebook groups. Let’s defend DACA and renounce Trump’s Wall through fiscal responsibility. It would take an average of $10.4K per person to expel a Dreamer. Moreover, we’ve heard many big business honchos, such as Mark Zuckerberg, protest against this proposal. Check out Congressman Henry Cuellar (D–Laredo, TX). 40% of agriculture workers overstay their visas. The Rio Grande is safer than the U.S. average. A wall is a “14th Century solution.” Texas Republican Senator, John Cornyn, prefers drones in environmentally-sensitive areas, such as the Santa Ana Refuge. The Wall would hurt ecotourism and reduce money coming into South Texas, among other atrocities. So when I say, let’s save focusing on humaneness concerns for a future generation, I sound like Booker T. Washington in a parallel universe!

So now we’ve examined a variety of ways to make peace. The possibilities are endless. To conclude, try to bring serious data to your argument in this hot-headed era. Strong self-respect is important; don’t let yourself get run over. For improving self-knowledge, check out a free online MBTI-style site, such as http://www.16personalities.com

Dealing with a Bad COPD Exacerbation & Maybe Dodging an E.R. Visit (4th 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 Combivent or Pro-Air. It’s like a “Bud Light” version of the nebulizer, as both use albuterol. Combivent is stronger, and it also has ipratropium. 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. Lately, I’ve switched back to the pipe-like breathing tube. Furthermore, I’ve started holding a lozenge in my mouth while I inhale my albuterol from the nebulizer. The lozenge is menthol and maybe eucalyptus too. That way, the cooling anti-inflammatory elements of the lozenge shoot directly to your lungs, as opposed to staying in your mouth and keeping you from coughing phlegm. My guess has been approved by real doctors!

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 I’m exploring fruit-flavored water to increase my likelihood of really hydrating. Furthermore, local water systems have been breaking down lately!

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. In the past, I added Mullein leaves (gordolobo), eucalyptus leaves to my morning coffee drip bin before I got health insurance but lived next door to a Mexican botanica. My goal is to reduce inflammation. Garlic pieces and ginger slices work too.

If you have severe or moderate COPD, take your Daliresp pill. I have allergies to Bermuda & Johnson Grass, so I have allergy pills to take–an OTC generic equivalent of Claritin called Loratadine, a non-drowsy tablet and now Montelukast, my newest prescription. Montelukast is actually the pill version of Singulair, and one of the cheaper lung-related prescriptions. I keep a daily pill reminder box by my bed, as I have a total of six per day–not all bad lungs related. 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.
Lately, I started taking Vitamin D and magnesium. I read a wonderful booklet about the benefits of magnesium for the lungs after my move of February 2018.

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? I wrote this article after coping with a severe attack lasted for 1 hour & 40 minutes; editing followed the intial blog!!
And when you quit choking, take those long-lasting spray/powders: Advair or Symbicort and Singulair or whatever.

Consider calling your G.P. M.D. later for an office visit. After this epic COPD attack, 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 (2nd Edition)

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 Later at the annual Northeast Texas Community Health Worker (CHW) Coalition conference in July 2019, we heard that grocery store tours–including how to shop at a dollar store–are available in some sectors. That lecture was “Meeting your clients where they are to promote healthy changes,” by Ardis Reed.

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 tried Shredded Velveeta at 10% saturated fat, and it tastes way better. Then I found delicious, generic shredded Mexican 4 Cheese Blend with a comparable low-level of saturated fat; the four cheeses are Monterrey Jack, cheddar, asadero,and queso quesadilla. But the winner of the low saturated fat award for cheese goes to Family Dollar’s Salsa con Queso with only 4% saturated fat in a 2 tablespoon serving. Plus it’s ready for dipping whether you heat it or not.

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 Developmental English and ESOL (mostly)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. Moreover, I no longer buy generic CoQ10 at the dollar store, but get the CVS Pharmacy choices– such as gummies and Qunol CoQ10. 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. Technically, most would consider a grocery store to be a far more valid dodge of food desert classification than a mere dollar store. But a dollar store is way better than nothing or mere snacks at a gas station.

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.

 

 

 

 

“Asthma-COPD Overlap Syndrome (ACOS),” Footnotes & a Commentary from a Patient (6th Edition), by J.D. Meyer

 

“Asthma-COPD Overlap Syndrome (ACOS): A diagnostic challenge,” was a Top 100 WebxMD article for 2015. http://onlinelibrary.wiley.com/doi/10.1111/resp.12653/full It caught my attention because I’ve had this condition for ten years; however, I never heard the two described as a unit in this manner! Three symptoms stood out on my first reading: increased sputum, more dyspnea (breathlessness), but better response to inhaled corticosteroids. At once, I told all my local health connections about ACOS. This article was written by three doctors in the Far East: Vietnam, Korea, and Japan. “Tho, N. V., Park, H. Y. and Nakano, Y. (2015), Asthma–COPD overlap syndrome (ACOS): A diagnostic challenge. Respirology. doi: 10.1111/resp.12653.”

Furthermore, a Google search for ACOS yielded nothing unless I entered the complete term. So the breakthroughs didn’t happen around here—adding to this disabled Developmental English/Writing—ESOL teacher’s sense of urgency!

Definition of Terms

I printed this article and started highlighting and making notes. Fortunately for me, many of these technical terms corresponded to familiar brand names for my many ACOS drugs. Symbicort is a Long-Acting Beta2-Agonist (LABA) and an Inhaled Corticosteroid (ICS). A LABA is a long-term brochodilator while an ICS decreases inflammation. Rinse your mouth with water after each use, and don’t swallow the water; spit it out. I was switched back to Advair (another LABA +ICS drug), which has bee my usual inhaled corticosteroid. Both drugs are used for asthma &COPD. A Muscarinic Antagonist is also a bronchodilator, such as tiotropium (Spiriva) and aclidinium.

Spiriva, an inhaled capsule, is used for COPD, including emphysema and chronic bronchitis. Later, I was switched to Montelukast, the pill version of Singulair.

There is only one PDE4 inhibitor—Daliresp (roflumilast), and it works against excess bronchitis and phlegm. Daliresp decreases the number of exacerbations in severe COPD, and it’s not a bronchodilator. Daliresp decreases lung inflammation and prevents COPD flare-ups. Don’t use Symbicort, Spiriva, or Daliresp for an acute attack.

For an acute attack, use your “inhaler,” such as ProAir and Proventil; they’re examples of Short-Acting Beta2-Agonists (SABA); both are albuterol. Proair will open the airways and prevent a bronchospasm. You could go for your nebulizer for an acute attack, especially a bad attack. Our albuterol vials for the nebulizer could be called an”extra-strength” SABA. Iprat-Albut (Albuterol & Ipratropium) are two bronchodilators for the COPD patients’ nebulizer. For two decades, I was on pure Albuterol for my nebulizer. Now my inhaler is Combivent–a stronger ipratropium-albuterol inhaler.

Atopic is an allergic reaction, often hereditary. Atopy is a feature of ACOS and associated with a higher prevalence of chronic cough and sputum production, according to Tho, Park, and Nakano. Eosinophilic airway inflammation means there’s a higher than average number of white blood cells. It can be detected in mucus if it’s tissue eosinophilia. Tho, Park, and Nakano note that ACOS patients have higher sputum eosinophil counts than those with COPD alone, but sputum count profiles may change over time. Blood eosinophilia is over 500 in a microliter of blood. I found these definitions at Medicine Net and the Mayo Clinic websites too.  Much of the drug definitions came from the pharmacy’s medicine sheets themselves.

Economic Burden & Disability

Tho, Park, & Nakano note that the percentage of ACOS patients visiting the ER or admitted to hospitals is significantly higher than COPD alone in South Korea. A United States Medicaid population reports that ACOS patients have a higher rate of utilizing any service versus asthma or COPD alone. Moreover, the average annual medical cost for an ACOS patient in the US is $14, 914–much higher than asthma, $2307 or COPD,  $4879. ACOS is common in the elderly. It features more dyspnea (breathlessness), wheezing, and more frequent exacerbations. The respiratory quality of life and amount of physical activity for those with COPD alone.

Addendum to Tho, Park, & Nakano

Using my peak flow meter to check my forced exhale volume (FEV) always has been one of my strong points in managing my ACOS. I check my peak flow meter before I go for a walk, and if I’m under my usual low moderate level of impairment, I head for the albuterol nebulizer. Check my article https://www.newscastic.com/news/forced-exhale-volume-fev-lung-disease-your-peak-flow-meter-1155949/ The “whole story” includes a link to an About.com article on Pulmonary Function tests, by Deborah Leader, RN, COPD Expert.

Returning to the Tho, Park, and Nakano article, we see that a staggering 49% of smokers develop chronic bronchitis and 24% get emphysema or COPD. “Smoker’s cough” is worst upon arising. Dyspnea increases as the disease worsens. Quit smoking or else!

Guaifenesin (Mucinex) has been one of my favorite OTC medicines for years because it’s an expectorant. You can find a cheaper generic version in the dollar store too. Warn the doctor if you smoke, or have asthma or emphysema. It thins the mucus, so it’s less sticky and easier to cough up, according to www.drugs.com/mucinex.html  Take guaifenesin when you have a cold, bronchitis, flu, or allergies–whatever got your chest full of phlegm. Still drink plenty of fluids. www.webmd.com/drugs/2/drug-63818/mucinex-oral/details I’ve been told by my doctor to take a larger than average dose of guaifenesin during an ACOS attack.

I also take an over-the-counter allergy pill, for I’m allergic to Bermuda and Johnson grass. My choice is non-drowsy Loratadine Tablets, an antihistamine that’s another find at Family Dollar. Loratadine is a generic form of Claritin.

Beware of drinks with carbon dioxide (CO2) also, such as beer and soda. http://respiratorytherapycave.blogspot.com/2008/06/asthmacopders-should-avoid-pop-beer.html The ability to exhale carbon dioxide is vastly impaired for the bad lung crowd. “The normal human body breathes to eliminate CO2, producing 200 cc./minute. However, one can of soda has up to 1000 cc. of dissolved CO2. Most is absorbed by into the blood stream by the intestines.” This can lead to more dyspnea (breathlessness) in those with lung disease. Furthermore, beer can cause dehydration too–another cause of dyspnea. Maybe gas pills help; time will tell.

On the other hand, if you like alcoholic drinks and wish to be more careful, then try red wine. First of all, you won’t have to worry about bubbles. Red wine increases antioxidant status and decreases oxidative stress in circulation, mainly because of glutathione (GSH). The “French Paradox” is explained by their love of red wine lessening coronary heart disease despite a fatty diet. https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-6-27

In closing, there’s a rich amount of literature on asthma, bronchitis, and COPD. Learn to manage your illness before you continue to deteriorate, and get a pulmonologist if you don’t have one already.