Staying Healthy. Living Well. Outlook Breathing Easy Summer 2013 S How to Stay Hydrated ummer’s getting underway, which means things are heating up outside. And that means you’re going to be sweating. Generally speaking, the higher the temperature, the more you sweat—and the greater your fluid loss. So when it’s hot, experts recommend taking extra precautions to stay hydrated. Here are a few simple ideas to help you make sure you’re getting enough hydration: > Carry a reusable water bottle and refill it often. > Resist the temptation to drink coffee and other caffeinated drinks. They have a diuretic effect, which means they increase urination. > Eat high water content fruits, such as watermelon and cantaloupe. > Carry fluids with you. Invest in a small cooler or insulated bag where you can stash water and cool drinks. > Drink sparkling water as an alternative to plain water. > Stay inside an air-conditioned area, especially during the hottest part of the day. ( ) Good Question Good Health Guidelines For people with COPD, it’s important to make sure the following tests and vaccines are kept current:  Flu vaccine  Pneumonia vaccine  Spirometry—breathing test to check how your lungs function Be sure to talk with your health care provider about these topics:  Writing an Action Plan  Getting a nutritional assessment  Reviewing your exercise routine  Taking part in a pulmonary education program  Quitting smoking A Closer Look According to the most recent data from the Centers for Disease Control and Prevention, more than 6 percent of the adult population in the United States has COPD. That’s about 15 million people—and many more may have it but not yet know it. The states with the highest reported rates of COPD in 2011 included Oklahoma, Indiana, West Virginia, Kentucky, Tennessee, Mississippi and Alabama. Cigarette smoking is the largest contributing factor, but environmental factors also play a role. And the American Thoracic Society notes that it’s possible that genetics also may be a factor in who develops COPD. 2 Breathing Easy Outlook | Summer 2013 Know the Symptoms of Chronic Obstructive Pulmonary Disease (COPD) The term COPD is used to describe a group of lung conditions that makes it hard for someone to empty the air out of their lungs. A person with COPD may have chronic bronchitis or emphysema, or a combination of the two, according to the American Thoracic Society. Some people’s COPD may lean more toward emphysema, while others struggle more with chronic bronchitis. COPD may resemble chronic asthma, too. Do you have a friend or family member who’s showing some of the common signs of COPD, including chronic cough, chronic mucus production, wheezing, not being able to take a deep breath and/or shortness of breath during daily activities? If you do and they haven’t been diagnosed yet, encourage them to see their health care provider for an evaluation. This may include getting a lung function test. The information in this publication is not intended to be a substitute for medical care or advice provided by a health care provider. Always consult your provider for appropriate examinations, treatment and care recommendations. If you have any questions about this information, you should call your provider. Specific treatments and therapies may not be covered by your health plan. For questions about your benefits, please consult your health plan. Any reference in this material to other organizations or companies, including their Internet sites, is not an endorsement or warranty of the services, information or products provided by those organizations or companies. All models are used for illustrative purposes only. © 2013 Healthways, Inc. Images: thinkstock How many people in the United States have COPD? Lifestyle Oxygen Therapy Travel Tips Being on supplemental oxygen therapy doesn’t mean you can’t travel. Here are some pointers to help you when traveling with a portable oxygen system. If you’re flying: 1. It’s a good idea to alert the airline long before leaving home. Traveling With COPD Experts suggest that people with COPD prepare carefully before traveling, so they have plenty of time to get and pack all the necessary supplies. The Cleveland Clinic suggests doing the following before you leave home: 1. 2. Tell your health care provider that you’re planning to travel. Ask for copies of any paperwork you might need, including prescriptions that you take. If you use oxygen, check with the airline, train, bus or cruise ship company for their policies. And carry an extra copy of your oxygen prescription to show to travel and security personnel. 3. 4. 5. 6. Put together a list of names and phone numbers of your physicians, your respiratory therapist, your oxygen supplier and other important people. Wear an emergency medical identification bracelet or necklace. Keep an emergency medical identification card in your wallet, too. If you have portable oxygen, make sure you know how to use the system—and how long the oxygen will last. If you need oxygen refills, be sure to have them ready, too. Take extra medication, and pack all medications and supplies in your carry-on bags. Never pack these items in your checked luggage. 2. When flying, you won’t be able to use your own oxygen on the plane. Call the airline to arrange for oxygen delivery and supply. Be sure to ask about the fees, too. 3. Make arrangements to leave your portable oxygen tank at the gate prior to boarding. You may need to call your oxygen supplier for pickup, or leave it with a family member. 4. Make arrangements for oxygen to use during layovers and upon arrival. If you’re traveling by bus or train: 1. Call the bus or train company in advance and request to sit in a non-smoking area. 2. Plan to bring along your portable oxygen system. Make sure you have enough oxygen refills. If you’re taking a cruise: 1. Call the cruise line at least a month before you plan to leave and ask about the paperwork you will need to file. The cruise line probably will request a letter from your health care provider, along with a copy of your current oxygen prescription. 2. Make arrangements to have oxygen units delivered to the ship. Verify this was done and that your oxygen is available to you prior to departure. Summer 2013 | Breathing Easy Outlook 3 Special Report How to Motivate Yourself What You Should Know About Ozone Are you a little hazy about how ozone levels affect your health? Ozone causes irritation and inflammation of the airways and the lungs. High ozone levels can be tough for people in these five groups: children and teens; adults over 65; people who spend a lot of time outdoors; people with lung disease; and people who, for unknown reasons, react strongly to ozone. According to the American Lung Association’s most recent “State of the Air” report, “Many areas in the United States produce enough ground-level ozone during the summer months to cause health problems that can be felt right away.” What exactly is ozone? Ozone is a molecule formed by three oxygen atoms. It can be very harmful to your lungs because it reacts chemically with those tissues. Ozone is created when two other gases—nitrogen oxide (NOx) and hydrocarbons [or volatile organic compounds (VOCs)]—react with heat and sunlight. The result of the mixture is ozone smog. What are the signs of ozone exposure? It’s important to be able to recognize the signs of health problems that are a result of ozone exposure, so you can handle them right away. Watch out for: 4 Breathing Easy Outlook | Summer 2013 • shortness of breath • wheezing and coughing • pain in your chest when you inhale • asthma attacks Since these symptoms also may indicate other potential health problems, such as infection, always discuss these symptoms with your health care provider. Exposure to high ozone levels also makes you more prone to respiratory infections and pulmonary inflammation. And people with lung diseases, including both COPD and asthma, may need medical treatment or even a visit to the hospital as a result. What should you do? Since ozone is the main ingredient in smog pollution, it’s a good idea to stay inside on days when smog pollution levels are high. If you have errands to run, wait until after sundown when ozone levels typically drop. To Live a Healthier Lifestyle There’s no time like the present to commit to being more actively involved in planning your life and making the best possible decisions about your health care. Take this chance to set some healthy lifestyle goals—and find creative ways to motivate yourself. A 2012 study in the Journal of General Internal Medicine found that people with chronic diseases have more success in managing their conditions when they break their larger goals down into smaller goals that are easier to manage. How to achieve this: Make a list of any overall goals that you have. Then break those down into smaller, specific steps toward achieving those goals. Use these step-by-step mile markers to keep you moving forward. Social Support Another strategy to try: Figure out what motivates you to get on track and stay there. We all want to live longer and be healthier, but is there something personal that drives you? It could be that you want to be more active so you can spend more time playing with your children or grandchildren. Perhaps you want to eat more vegetables and whole grains so you can lose weight and fit back into a favorite outfit. Or maybe you plan to reward yourself for meeting certain goals with a treat— a new book, a trip or some new shoes. How to achieve this: After you decide what motivates you, write it down or find a picture of it. Put the reminder in an easy-to-see spot so you remember why you’re making the effort. Try putting the reminder on your bathroom mirror, refrigerator or even the sun visor in your car. Don’t Be Afraid to Ask for Help A t some point, you may realize that you could use a helping hand. Maybe you need a little extra help with housekeeping, other chores and errands, or transportation. You can call on your friends or family members for help, but there are other options for getting the support you need. For example, the American Lung Association (ALA) operates a service called Lotsa Helping Hands that allows you to create an online community where loved ones can access a calendar and sign up to help you with certain tasks or personal needs. It also allows you to post important medical and legal info to share with certain friends or relatives. It takes only about a minute to create your own community, and you can even choose friends or family members to become coordinators so they can help with the site. Or maybe you just want to reach out to others who understand what it’s like to have COPD. Lotsa Helping Hands has online message boards where you can have a virtual conversation with other people who have COPD. You can even share photos or send messages to fellow members and their families. For more support and education about COPD and related health topics, try a local chapter of the Better Breathers Club, another program of the ALA. The Better Breathers Clubs are in all 50 states, and they often have guest speakers and presentations on topics ranging from supplemental oxygen and home health care to air pollution and medical tests. Another way to learn more about your options is to ask your health care provider for recommendations about other local support groups or clubs in your area. Summer 2013 | Breathing Easy Outlook 5 Nutrition How to Get More in Your Diet It’s well worth making the effort to add more whole grains to your diet. According to the Harvard School of Public Health, there are many benefits to eating whole grains, notably the effect they have on lowering your total cholesterol, your LDL (or bad) cholesterol and your triglycerides. Studies such as the Nurses’ Health Study at Harvard University have shown that switching from refined flours to whole grains will help reduce the risk for developing cardiovascular disease. 6 Breathing Easy Outlook | Summer 2013 Making the switch also can lower your chances of developing Type 2 diabetes: The Nurses’ Health Study and other research have found that replacing white rice with brown rice or another whole grain could reduce your diabetes risk by as much as 36 percent. Also, whole grains are good for you because they contain vitamins B and E, and fiber. The U.S.D.A. suggests whole grains should make up at least half of the grain products you eat every day—more than half is even better. (Baked Salmon Dijon) Here are a few ways to get more whole grains into your diet: > Use whole grain pasta instead of regular pasta. > Add a handful of barley to your vegetable soup. > Switch to whole grain cereals and breads. > Try whole grain macaroni and cheese. > Use rolled oats or crushed whole grain crackers as a breading for chicken or fish. > Make a whole grain pilaf with brown rice, wild rice and barley, along with a little broth and your favorite spices. > Use whole-wheat flour in recipes like pancakes, muffins and waffles. (The U.S.D.A. notes that you may need to add a little extra leavening.) It’s important to note that just because something is brown, that doesn’t mean it’s whole grain. Read food labels closely to make sure you’re actually getting whole grains. The U.S.D.A. says products labeled “multi-grain,” “100% wheat” or “cracked wheat” usually are not whole grains. They recommend using the nutrition facts label on the package to help you choose whole grain products with a higher daily value percentage of fiber. Watch out for added sugars, too. INGREDIENTS 1 cup fat-free sour cream 2 teaspoons dried dill 3 tablespoons scallions, finely chopped 2 tablespoons Dijon mustard 2 tablespoons lemon juice 1½ lbs. salmon filets with skin, cut in center ½ teaspoon garlic powder ½ teaspoon black pepper Fat-free cooking spray 1. W hisk sour cream, dill, onion, mustard and lemon juice in small bowl to blend. Preheat oven to 400 degrees F. Lightly oil baking sheet with cooking spray. 2. Place salmon, skin side down, on prepared sheet. Sprinkle with garlic powder and pepper. Spread with the sauce. 3. Bake salmon until just opaque in center, about 20 minutes. YIELD: 6 one-piece (4 oz.) servings NUTRITION: Per serving: 196 calories; 7 g total fat; 229 mg sodium; less than 1 g total fiber; 27 g protein; 5 g carbohydrates Summer 2013 | Breathing Easy Outlook 7 Health or wellness or prevention information Staying Healthy. Living Well. HW Summer 2013 A More Natural Clean Ever wonder about that long list of difficult-to-pronounce ingredients on the label of your cleaning products? The Environmental Working Group suggests that you skip using products like commercial oven cleaner and air fresheners altogether. If you would like to switch to something that’s a little more natural, try making your own cleaning concoction of water, vinegar, baking soda and lemon juice. In fact, a simple mix of baking soda and water is very effective as a cleanser for areas like the oven and the toilet.