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Childbirth
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Advice from the Maternity Clinic
Advice from the Maternity Clinic (Part 2)
Alcohol in Pregnancy
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Full Listing with story descriptions
Introduction
Managing Your Pain
Movement Matters
Moving Forward
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Returning to Work
Understanding and Goal Setting
When Pain Doesn't End
Dental Health
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Baby Bottle Tooth Decay
Baby Teeth
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Smiling through the Senior Years
Teeth for Life
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Tobacco Risks to Oral Health
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Wisdom Teeth
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DIABETES
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10,000 Steps
A1C Test
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Alchohol and Diabetes
A Diabetes Success Story
ABCs of Diabetes Management
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Benefits of Insulin
Benefits of Breakfast
Blood Glucose Medications
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Blood Sugar Lows
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Canada Food Guide Revisited
Carbohydrate Counting
Catastrophic Drug Plan
CDA Guidelines for Diabetes
Celiac Disease and Diabetes
Celebrating Health
Childhood Diagnosis of Diabetes
Children and Type 2 Diabetes
Cholesterol-lowering Medications
Colds and Diabetes
Constipation
Continuous Blood Glucose Monitoring
Cutting Edge
Dangers of Uncontrolled High Blood Pressure
Debunking Diabetes Myths
Driving and Diabetes
Diabetes and Menopause
Diabetes and OTC Medications
Diabetes Care Team
Diabetes and Celiac
Diabetes and Depression
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Diabetes Distress
Diabetes Eating on a Shoestring Budget
Diabetes Etiquette
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Diabetes in Cats
Diabetes in Dogs
Diabetes Management ABCs
Diabetes Meter Technicians
Diabetes Myths
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Diabetic Retinopathy
Diet Tips for South Asians
Dining Out
Drinking and Diabetes
The Discovery of Insulin
Eating Disorders
Easing the Strain of Stress
Eating to Protect Your Kidneys
Eating Well During Shift Work
Eggs in a Diabetic Diet
Emotional Eating
Emotions of Diabetes Diagnosis
Erectile Dysfunction
Exercise Excuses
Why Fad Diets Fail
Fats
Fibre
Fill Your Day with Energy
Financial Support for Diabetes
Food Temptation
Foot Care
Footwear and Foot Health
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Gastroparesis
Gestational Diabetes
Get Active
Get Physical
Gift Ideas
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The Glycemic Index
Going Green in the Kitchen
Grocery Shopping Tips
Guidelines for Diabetes Management
Holiday Party Survival Guide
Health Information on the 'Net
Healthy Happy Holidays
Healthy Beverage Choices
Health Benefits of Soy
Healthy Restaurant Meals
High Blood Pressure and Diabetes
High Blood Pressure
HbA1c Test
Healthy Eating for Active People
High Blood Lipids
Home from the Hospital
Home Alone and Sick
Hypoglycemic Unawareness
Impaired Glucose Tolerance
Immunization & Diabetes
Incretins-a Hormone Treatment
Injecting Insulin
Insulin Discovery-The Story
Insulin
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Insulin - the Key to Energy Management
Insulin Pumps
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Insulin Pump Infusion Sets
Insulin Pump Therapy
Immunization and Diabetes
Internet Health Sites
Islet Cell Transplantation
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Ketones
Kidney Disease - Reducing the Risk
Living with Diagnosis of Diabetes
Living Powerfully with Diabetes
Low Blood Glucose
Managing Diabetes
Managing Blood Glucose
Metformin
Nutrition Food Labels
Meal Planning
Your Medication Expert
Medication Research Studies
Metabolic Syndrome
Microalbuminuria
New Diabetes Technologies
Natural Medicines and Diabetes
No Need for Insulin?
Not Snoozing
Over-the-Counter Medications
Oral Health and Diabetes
Osteoporosis and Diabetes
Diabetes and OTC Medications
Pedicure Precautions
Peripheral Arterial Disease
Pet Diabetes
Planning for Pregnancy
Prebiotics and Probiotics
Preparing for Activity
Putting off Insulin
Reducing Stress of Surgery
Safe and Successful Travel
Schizophrenia and Diabetes
Sensible Snacking
Setting Health Goals
Setting Goals for Physical Activity
Sharps Disposal
Shorter Insulin Needles
Sleep - a Missing Link
Smart Snacking
Smart Summer Nutrition
Snack Bars
Snacking with Diabetes
Sodium
Social Media & Diabetes
Solving the Insurance Puzzle
Stress and Diabetes
Success in School
Supplements
Supporting Spouse with Diabetes
Sweeteners
Sugar, Carbs and Blood Glucose Control
Think Positive with Diabetes
Tiny Bites Equal Big Calories
Travelling with Diabetes
Tips for a Better You
Tobacco Use and Diabetes
Top 10 Reasons to Exercise
Treating Low Blood Glucose
Treating Hypoglycemia - Role of Glucagon
Tune up Your Diet
Type 1.5 Diabetes
Type 2 Diabetes
Understanding Diabetes
Understanding Diabetes Medications
Understanding Ketones
Used Sharps
Urinary Incontinence
Vacationing with Diabetes
Vegetarian Eating for Diabetes
Vitamin D
Walking
Wise Choices About Natural Medicines
Wonderful Water
Natural Medicines & Diabetes
World Diabetes Day
Your Medicine Cupboard
Zimbabwe Hand Jive
Family Medicine
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ADHD in Children
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Antibiotic Use
Arthritis
Aspirin Every Day?
Asthma
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Back Pain Myths
Back Pain - Lower
Birth Control
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Doctor Visit
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Get Active!
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Stroke
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Win by Losing
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Full Listing with story descriptions
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First Aid Travel Kit
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Get Active!
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Modern Living
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Abuse
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Bisphenol A
Canada's New Blood System
Caring for a Loved One Dying at Home
Carpal Tunnel Syndrome
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Diabetes Epidemic
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Melamine in Food
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Mom Time
Money Matters
Outdoor Workers and Sun Safety
Patient Safety in the Hospital
Pets and Health Benefits
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Physiotherapy Visit
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Schizophrenia
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Sexually Transmitted Diseases
Soy
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5 Tips to Manage Weight
10 Ways to Cut Down on Fat
Battle the Bulge
Boost Your Bone Strength
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Breakfast is Important
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Building Your Bones
Celiac Disease
Challenging the Milk Myth
Diet Reality Check
Drink Up!
Eating Smarter & Cheaper
Energy Drinks
Food Allergies
Food for Active Kids
Fast Food
Food Labels
Giving Up Gluten
Healthy Diet, Healthy Smile
Healthy Eating for Boomers and Zoomers
Healthy Eating for Seniors
Healthy Eating on Business Travel
Healthy Ethnic Meals
Fad Diets
Fruits & Veggies - 5-10 a Day
Fats
Fat Phobias
Fats & Cholesterol
Feeding Your Kids
Fibre
Food Chemistry 101
Food and Mood
Getting Kids to MOVE
Healthy Eating for Teens
Healthy Habits
Herbal Medicine and Nutrition
New Ingredients for Your Shopping Cart
Iron
Kid's Food
Liquid Candy
Meal Planning with Planned Overs
Mercury Levels in Fish
Night Snacking
Night Shift Eating
Nutrition on the Net
Nutrition Myths Busted
Nutrition Questions Top 5
Nutrition for Menopause
Essential Omega-3
Preventing Cancer Through Nutrition
Picky Eaters
Power of Fruits & Veggies
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After a Heart Attack
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Inhaled Asthma medications
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Changing Role of the Pharmacist
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Diuretics and Potassium Supplements
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Expanding Role of Pharmacies
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Generic or Name Brand?
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Antibiotic Resistance
Backpack Pain
Bacteria Fight Back
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Caffeine
Cell Phones and Driving
Childhood Obesity
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Farm Safety for City Kids
Foodborne Illness
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The Flu and You
Heading Home for a Visit
Health Tips for Snowbirds
Hearing Loss and Music Players
H1N1 Virus - Plan Ahead
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Live Actively!
Insect Repellant
Keys to Preventing Cancer
Kids' Mental Health
Live Actively!
Low Birth Weight
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Are Pesticides Safe?
Preventing Burns and Scalds
Preventing Cancer through Nutrition
Quit Smoking 101
Respiratory Infections
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Should You Immunize?
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15 Great Reasons to Breastfeed
Anemia
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Breast Cancer Screening Guidelines Changes
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Estrogen's Effect on the Brain
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Hirsutism - Unwanted Hair
Hormone Replacement Therapy
The IUD
Menopause - What Men Should Know
Menstrual Bleeding - Abnormal
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Third Generation Birth Control Pills
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Family Health Online / Pharmacy at Safeway
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Family Health Magazine - FAMILY MEDICINE

Chronic Obstructive Pulmonary Disease (COPD)
When breathing becomes a chore

Most people never think about breathing. For those who suffer from Chronic Obstructive Pulmonary Disease (COPD), breathing can be all they think about. COPD affects the airways, or the tubes that take air to the lungs, and the air sacs in the lungs. COPD is different from asthma. While asthma symptoms can be reversed, COPD is permanent, and we cannot make it go away. However, there are things people with COPD can do to improve their breathing and reduce the effects of COPD on their daily lives. Since COPD is almost always the direct result of a person smoking, it is very important that someone with COPD quit smoking as soon as possible. Not everyone who smokes will develop COPD. A very small number of people who have never smoked will get this disease.

For people with COPD, symptoms may include shortness of breath, cough with or without sputum (saliva and mucus spit out), some chest pain or heaviness, and wheezing. To determine if someone has COPD, a doctor will ask about symptoms, family history and smoking, and will test the person's lung function. The doctor may also do a chest x-ray or some blood tests. The lung function test is important, as it shows how long it takes the person to blow out all of his or her air. Someone with COPD takes much longer than a healthy person to blow out all of the air, because the airways are obstructed and the air gets trapped.

COPD is often divided into two types: chronic bronchitis and emphysema. Too much mucus in the airways causes chronic bronchitis. Mucus can clog the airways, making it difficult for air to pass to the lungs. Two things indicate chronic bronchitis - blocked airways, tested with a lung function test, and more than three months of cough and sputum for at least two years in a row. Emphysema results from the air sacs in the lungs being damaged and becoming larger. As a result, the airways around the air sacs collapse. People with emphysema suffer from shortness of breath, especially with activity, and they sometimes have a cough and sputum.

Using an Inhaler

  • Remove the cap and shake the inhaler well.
  • Breathe in and out away from the inhaler.
  • Place the mouthpiece of the inhaler in your mouth, between your teeth. Try to keep your tongue flat as this will keep it out of the way of the medication.
  • Start to inhale and press the canister, continuing to inhale.
  • Remove the inhaler from your mouth and hold your breath for 10 seconds if possible.
  • If taking two puffs, wait about a minute in between.

If possible, it is best to use an inhaler with a spacer. A spacer helps to trap the medication so that you do not have to co-ordinate inhaling with pressing on the canister. This makes it easier to get more of the medication into the airways, and reduces the chances of side effects.

Using the Turbuhaler™

  • Remove the cap.
  • Holding the Turbuhaler™ with the mouthpiece pointing up, twist the base all the way to the right, and then back all the way to the left, until you hear a click.
  • Breathe in and out away from the Turbuhaler™.
  • Place the mouthpiece of the Turbuhaler™ in your mouth, between your teeth. Try to keep your tongue flat as this will keep it out of the way of the medication.
  • Take a deep breath in.
  • Remove the Turbuhaler™ from your mouth and hold your breath for 10 seconds if possible.

Using the Diskus™

  • Slide open the Diskus™.
  • Holding the Diskus™ flat, press the lever all the way to the right until you hear a click.
  • Breathe in and out away from the Diskus™.
  • Place the mouthpiece of the Diskus™ in your mouth between your teeth. Try to keep your tongue flat, as this will keep it out of the way of the medication.
  • Take a deep breath in.
  • Remove the Diskus™ from your mouth and hold your breath for 10 seconds if possible.

Once a person has been diagnosed with COPD, the doctor recommends treatment. The first step in managing COPD is to stop smoking. Since smoking can worsen COPD symptoms and increase the chances of getting infections, quitting is an essential step towards lung health. Smoking is an irritant and affects the body's natural ability to clean the airways, making infection more likely. As people with COPD get infections more easily, it is often recommended that they receive the pneumococcal vaccination (only needed once) and influenza vaccination (every fall).

People with COPD must also carefully consider their surroundings and reduce their exposure to known irritants. Irritants include second-hand smoke (being around other people while they are smoking), pollution, strong smells such as perfumes and chemical smells, and changes in the weather. The best strategy for managing these irritants is to avoid them. Stay away from smoke and fumes, and reduce exposure to extreme weather changes by wearing a scarf or even staying indoors during very cold weather.

Going to pulmonary rehabilitation classes may also help. People with COPD learn appropriate exercise and breathing techniques to achieve their best physical potential. The extercises are particularly good for those who, even with medication, are limited in their activities. One breathing technique commonly taught is pursed-lip breathing. This is done by breathing in slowly through the nose, and exhaling slowly through pursed-lips as if whistling. This type of breathing can be helpful when experiencing shortness of breath. The classes may also teach conditioning exercises, and strategies which save energy, reduce effort, and improve respiratory muscles.

Some prescription medications can help reduce the symptoms of COPD, but they cannot reverse the damage in the airways. Bronchodilators relax the muscles around the airways, making it easier to breathe. Short-acting bronchodilators are usually taken as needed every four to six hours. Long-acting bronchodilators are taken twice daily and relieve symptoms throughout the day.

Theophyllines are bronchodilators that are taken orally once or twice a day. They are usually not the first choice of medications to treat COPD. With these drugs, side effects such as nausea, stomach cramping, diarrhea and headache can occur. It is also important to regularly monitor the amount of theophylline in the blood to make sure the right dose is being given.

Anticholinergic drugs decrease the mucus in the airways, and help to reduce the tightening in the airways. They are most commonly taken up to four times a day.

About 10 to 20 per cent of people with COPD benefit from inhaled or oral steroids. These reduce inflammation inside the airways. They do not work quickly and must be used regularly to be effective. It can not be predicted who will benefit from these medications. They must be tried for a few weeks to see if they help. People taking inhaled steroids should rinse their mouth after each use to reduce the chance of side effects such as a mouth or throat infection.

When the amount of oxygen in the blood falls below certain levels it becomes difficult to continue everyday activities. Low oxygen can affect the way you think, cause heart problems and even death. People with COPD who suffer from low oxygen are given oxygen therapy through a face mask or tube (nasal cannula) under the nose. Oxygen therapy helps to prolong the life of people with COPD who have low oxygen in their blood. Oxygen also improves their quality of life, as portable oxygen makes possible daily activities such as walking and grocery shopping. A doctor prescribes oxygen based on the person's needs and condition. It is generally given for at least 15 hours per day, and the amount of oxygen is carefully monitored. Respiratory home care providers visit those who need oxygen to assist the family in using the equipment and ensure that the needs of the person on oxygen are being met. It is essential that homes where oxygen is used are non-smoking, due to the potential fire risk.

With proper medical care, lung rehabilitation, medication, and dedication, people with COPD are able to achieve a good quality of life. In most cases COPD can be prevented. By stopping smoking and encouraging young people not to start, you can help reduce the burden of COPD in Canada.

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FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
FAMILY HEALTH is written
with the assistance of
The College of Family Physicans of Canada
Alberta College of Family Physicians
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