Living With Emphysema

How-To Information:

Slowing the disease progression

People who have been diagnosed with emphysema can help to slow the progress of the disease by following these general health guidelines:

• Build your resistance to infections. Ask your doctor if you're a candidate for the influenza (flu) and pneumococcal pneumonia vaccines. Though not proven to specifically help those with emphysema, the general advice to all patients should be followed: Eat a diet high in vitamins, fiber, and other nutrients, and get enough sleep.

• Engage in a regular exercise program, which can help to build resistance to infections and improve your overall health. In general, if you can recover to normal within 5-10 minutes following exercise, you are not creating a strain on your body. Consult your doctor before starting any exercise program.

• Try to avoid exposure to other airborne irritants, such as smoke from fireplaces or wood-burning stoves.

• Contact your doctor if you feel a cold or respiratory infection coming on.

• Remember that air pollution may make emphysema symptoms worse. Weather reports on radio and television, and in local newspapers, provide information about air quality. It's usually safest to be active during early morning or late evening, when air pollution levels are lowest. If pollution levels climb, it's best to stay indoors and limit activity.

How-To Information:

Adjusting your daily routine

Emphysema is a chronic condition that forces most sufferers to limit their activities. Experts make these suggestions for adjusting to life with emphysema:

• Plan ahead and figure out the least strenuous way to get things done. Rearrange your home for maximum efficiency.

• Prioritize. Decide what must get done, then delay or ignore the rest.

• Schedule rest periods throughout the day.

• Consider using a small utility cart for doing chores and a remote control for the TV. Do as much as possible while seated.

Nice To Know:

What are some things I should think about before traveling?

Consult with your doctor if you plan to travel. If you'll be traveling outside of the U.S., consult a physician who specializes in travel medicine. He or she will be able to identify treatment concerns and provide information about levels of pollution in the areas you are visiting, weather conditions, and other pertinent factors.

• The International Society of Travel Medicine http://www.istm.org publishes a Clinic Directory designed to help health care providers, the travel industry, and the public find health-care professionals with an expertise in travel medicine. More than 500 travel medicine clinics representing more than 40 countries are included in this directory.

• AMTRAK http://www.amtrak.com provides train travelers with space for oxygen tanks. However, travelers dependent on supplemental oxygen must provide a battery-backup power source. Tell the reservation sales agent that you will be bringing an oxygen tank with you on your trip, so that appropriate arrangements can be made. As an additional safety precaution, you must advise the conductor that you are carrying oxygen when you board the train.

• Airplane travel requires a few more steps. Airlines require a prescription from a physician indicating diagnosis, liter flow, and the number of oxygen tanks the carrier needs to provide during the trip. Travelers must contact carriers at each destination to have their oxygen delivered to their home or to the plane. For a list of local carriers, ask your home care company or consult the Yellow Pages. Information also is available from the American Society for Respiratory Care. http://www.oxygen4travel.com

Airline charges for in-flight oxygen can vary widely, so it pays to shop around if you plan to fly. A recent survey of 33 international and domestic carriers found that charges for in-flight oxygen ranged from $64 to $1500. Airlines that provide in-flight oxygen usually require 48 to 72 hours notice, and liter flow options vary. You should pack any personal supplies you'll need, including extension tubing.

Unexpected layovers create problems for travelers dependent on supplemental oxygen. If you find yourself stranded without supplemental oxygen, contact the airport first-aid station or the airport fire station. Call 911 only if you are experiencing severe difficulty breathing, because ambulance crews are required to transport people they assist to a hospital.

How-To Information:

What impact can nutrition and diet have on emphysema?

Plenty. First of all, food is fuel. Emphysema sufferers use extra energy in the simple act of breathing, so their caloric requirements can be higher than those of healthy people. Food also provides vital vitamins and nutrients. Good nutritional support helps to maintain lung function, while improper nutrition can cause the diaphragm and other breathing muscles to weaken.

Here are eating tips for people with emphysema:

• Limit salt intake. Too much sodium can cause fluid retention that may interfere with breathing.

• Limit intake of caffeinated drinks, which may interfere with some medications and may also make some people feel nervous.

• Avoid foods that produce gas or make you feel bloated. The best process to use in eliminating foods from the diet is through trial and error.

• Choose foods that are easy to prepare so you don't waste energy in preparing a meal. Try to rest before and after eating.

• Avoid foods that have little or no nutritional value.

• Eat six small meals a day instead of three large ones. A stomach that is too full can cause shortness of breath.

• If you use supplemental oxygen, be sure to keep it on while eating, and after meals, too. Eating and digestion require energy, and causes the body to use more oxygen.