Previous studies have suggested that using inhaled corticosteroids (ICS) increases the risk of pneumonia in people with COPD.  It has not been clear, however, if ICS increases the risk of death from pneumonia.

In a retrospective cohort study published in the American Journal of Respiratory and Critical Care Medicine, researchers examined data collected from 15,768 patients . Each had an underlying diagnosis of COPD and were hospitalized with pneumonia. They were also treated with one or more appropriate respiratory medications.

Results of the study concluded that in COPD patients, prior use of ICS was associated with a decreased risk of death (at 30 and 90 days) following hospitalization from pneumonia and a decreased risk of being placed on mechanical ventilation.

GOLD Guidelines don't advocate the use of inhaled corticosteroids until the disease has advanced to at least Stage III COPD, and only under certain conditions. If you are using any form of steroids, talk to your doctor about the benefits and risks associated with their use.

Are you using steroids in your current COPD treatment plan? If so, what stage COPD are you in? What side effects have you experienced? How long have you been on them? Share your comments below.

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I received this email from a former COPD Forum member who asked that I post it for the benefit of anyone who wants to attend:

"The Iowa Respiratory Rally will be held May 25, 2011 at the W. Des Moines Marriott from 9:00 am to 3:00 pm.  We have several great speakers, including Mike McBride, who completed the Boston Marathon in 2009.  Lt. Governor Kim Reynolds is planning to stop by and show her support as well. Iowa patients and caregivers are urged to attend, as well as professionals.

http://www.lungusa.org/associations/states/iowa/events-programs/respiratory-rally/respiratory-rally-pdf-1.pdf

Please join us for a really fun and informative day!"

The respiratory rally is open to all individuals affected by lung disease and cancer. Whether you are a patient, family member, caregiver, health care professional or anyone wanting to learn more about lung disease, the day will be packed with education, networking, exhibits, and will  even include a healthy lunch.  As an added bonus, liquid oxygen refills will be free of charge, with a valid prescription.

Will you be attending this rally? If so, please share your comments below.

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The most difficult -- and often frightening -- aspect of COPD is its associated dyspnea. For years, doctors have frowned upon using opioid pain relievers to treat dyspnea related to COPD because they can compromise an already weakened respiratory system, resulting in dangerously low breathing rates and/or breathing cessation. A recent study suggests differently.

A total of eighty three people participated in a dose increment and pharmacovigilance study. Of these, fifty three were male with an average age of 75 years and 54% had a diagnosis of COPD.  Subjects received ten milligrams (mg) of sustained-release morphine tablets once a day. Those who did not respond well to the lower dose received an increase of 10 mg a day each week, to a maximum of 30 mg per day.

Results concluded that 52 of the participants (62%) experienced a significant reduction in dyspnea from baseline, but increased constipation despite using laxatives. Additionally, there were no reports of respiratory depression or hospitalizations during the study.

The Global Initiative for Obstructive Lung Disease (GOLD) does not include morphine in their COPD treatment guidelines, but does mention that oral and intravenous morphine is effective in treating dyspnea associated with advanced disease. According to GOLD, because studies suggest that using morphine may result in serious adverse events, its benefit in COPD treatment may be limited to a select group of patients.

Are you currently taking morphine or other opioids for dyspnea related to COPD? Share your experience in the comment section.

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_Source:

_{Currow DC, McDonald C, Oaten S, Kenny B, Allcroft P, Frith P, Briffa M, Johnson MJ, Abernethy AP. Once-Daily Opioids for Chronic Dyspnea: A Dose Increment and Pharmacovigilance Study. J Pain Symptom Manage. 2011 Mar 30. [Epub ahead of print.]}

Last week, I received a comment from a new COPD Forum member who was concerned -- in fact the word he used was embarrassed -- about wearing his oxygen in public. From what I have learned from my readers, this is a normal reaction to oxygen therapy and most people say that in time, feelings such as these go away, especially because they realize that oxygen helps them maintain a relatively active lifestyle. But, what about those people who continue to have feelings of shame no matter how long they've used oxygen and even refuse to leave home because of it? For these people, I have but one word -- Oxyview!

Oxyview Oxygen Therapy Glasses provide a superior alternative to the traditional (and highly visible) nasal cannula oxygen delivery system. In fact, they deliver oxygen in such a way that others will barely notice. While they are not cheap by any means, they are well worth the cost and saving a few dollars to buy a pair. And, everyone I know who uses them loves them.

So, why bother with supplemental oxygen in the first place? The air we breathe contains 21% oxygen. For most people, this is sufficient, but, for those whose lung function is impaired due to poor health, it is simply not enough. That's where oxygen therapy comes in.

Still not convinced? Take a look at some of oxygen's excellent benefits:

• increases survival in some patients who use it at least 15 hours a day
• improves sleep (a big concern for people with COPD)
• improves mood
• increases stamina
• increases mental alertness
• allows you to carry out day-to-day activities

If you are someone who feels uncomfortable in public because of carting around your oxygen tank, read my full review of the Oxyview eyeglasses to see if they might be right for you.

Have you ever been embarrassed by wearing your oxygen in public? How did you get through it? Share your comments below.

Get answers to FAQ about oxygen therapy in the COPD Forum.

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