Presenting OrganizationEvent NameEvent DatePresenter Name, Title

Minnesota COPD Coalition

The American Lung Association of MN has launched the Minnesota COPD Coalition.Our vision is to improve the health outcomes of patients with COPD by working with patients, caregivers, and the health care community to increase awareness, increase early diagnosis, and improve treatment and management.

The campaign is for men and women over age 45

Especially those who smoke or have smoked Those with risk associated with genetics or environmental exposuresPeople who have been diagnosed with COPD Health Care providers, particularly those in the primary care setting

Why should we learn more about COPD?

Scope of COPD in MinnesotaDid You Know?70,600 Minnesotans over the age of 45 have COPD = (1 out of 25)78% over 60 years old56% Female 44% Male

Emergency Room VisitsRelated to COPDMore than doubled (250%) between 1996 and 2005!

Hospital Charges for COPD

Average hospitalization charge per patient was $17,066 !!

Average length of hospital stay was 4.2 days

Todays Session Will CoverDefinition of COPDHow COPD affects breathingSymptoms of COPDHow you can find out if you are at riskTalking to your doctorGetting on the road to better lung healthResources

What is COPD?Chronic Obstructive Pulmonary DiseaseSerious lung disease that over time makes it hard to breatheEmphysemaChronic BronchitisBlocked (obstructed) airways make it hard to get air in and out

Did You Know?

4th leading cause of deathKills more than 120,000 people per year

2nd leading cause of disability

12 million+ have COPD

Another 12 million may have it but dont know it

How Does COPD Affect Breathing?

What Are the Symptoms?

Coughing - smokers coughShortness of breathExcess sputum or phlegmFeeling like you cant breatheCant take deep breathWheezing

Many people do not even know they have COPD

Many people attribute the changes or symptoms they are having to: aging being out of shapeTalk to your doctor about any questions you may have.

SymptomsWhen its hard to breathe, its hard to do anything

People with COPD:avoid activities that they used to do more easilylimit activity to accommodate shortness of breath and other symptoms. Some activities include:

Take elevator instead of stairs.Park close by instead of walking.Avoid shopping or other similar day-to-day tasks. Stay home rather than go out with friends.

Are You At Risk?

SmokingMost common cause, however, as many of 1 out of 6 people with COPD never smokedEnvironmental exposureChemicals, dusts, fumesSecondhand smoke, pollutantsGenetic FactorAlpha-1 antitrypsin (AAT) deficiency

Getting a Simple Breathing Test

Talk with your doctor!Simple breathing testSpirometryQuick, painless and noninvasiveCan tell if you have COPD and how severe it is

Treatments Can Help

Lifestyle changesQuit smoking. Its never too late. Freedom from Smoking (www.lungusa.org)www.smokefree.govMedicationsPulmonary rehabilitationSupport GroupsPhysical activity trainingOxygen treatmentSurgery

Start TodayTalk with doctor about your risks, such as smoking and other exposuresBe honest !Tell your doctor about any symptomsWrite down a list of questions before going to the doctors office

There Are Many Things You Can DoQuit smokingMany new options available from your doctorAvoid exposure to pollutants and secondhand smokeVisit your doctor regularlyFollow treatment adviceGet annual flu and pneumonia shots

Common MythsDont Believe ThemMy shortness of breath is just old age.

Theres nothing my doctor can do except tell me to quit smoking.

If I rest more, it will get better.

It All Begins With YouStart today

Be your own advocateask questions and seek information

ALAMN support groupsHuffers and Puffers - East side group- meets in St. Paul on Second Tues. of ea. month, 1-3 pm Respiratory Health Club - West side group- meets in Minneapolis on 3rd Thurs. of ea. Month 1-3 pmDuluth Better Breather Club- First Tues. of ea. monthVisit www.alamn.org for website listing of MN pulmonary rehab or pulmonary support groups Support Groups

Education and Reference resources available from the American Lung Association of MNPlease go to: http://www.alamn.org/copd/links.cfm

COPD Programs and Resources:List of MN resources and supports or people with COPD

COPD Information Sheets:Are you at Risk?Breathing Better with a COPD Diagnosis

More resources available @ http://www.alamn.org/copd/links.cfm

Scope of COPD in MNMN Healthplan Covered Services for COPDCOPD Fact SheetCOPD Around the ClockNon medical hints and suggestions to ease living with COPD

More resources available @ http://www.alamn.org/copd/links.cfmCommunication Tip SheetCOPD ProfilerHelps you make health decisionsOxygen Quick Glance GuideCOPD Guidelines Quick Glance GuideCOPD Action Plan

American Lung Association Cessation ResourcesBehavior Modification ProgramsFreedom From Smoking ClinicFreedom From Smoking Self Help ManualFreedom From Smoking Online www.lungusa.org click on the FFS icon

Lung HelpLine 800-LUNG-USAStaffed by Registered Nurses and Respiratory Therapists Cessation counseling Questions answered regarding COPD, asthma, allergies and other respiratory diseasesAir quality and environmental health concerns

Show your supportPrescribe an appropriate medicationHave your patient call 1-888-354-PLAN or Quitplan.com

Order Information:American Lung Association of Minnesota Our Mission: To prevent lung disease and promote lung health 490 Concordia Avenue St. Paul, MN 55103-2441 Phone: 651-227-8014 Fax: 651-227-5459 Email: info@alamn.org

Order Information Greater Minnesota:American Lung Association of MN Duluth 424 West Superior Street, Suite 202 Duluth, MN 55802 Phone: 218-726-4721 Fax: 218-726-4722 Email: info@alamn.org

Learn More Breathe Better

www.LearnAboutCOPD.orgorNHLBI Health Information CenterP.O. Box 30105Bethesda, MD 20824-0105Phone: 301-592-8573TTY: 240-629-3255Fax: 301-592-8563E-mail: NHLBIinfo@nhlbi.nih.govWeb site: www.nhlbi.nih.gov

Thank You

*Good (morning, afternoon, evening). My name is (name here). I am (title, organization, background).I am pleased to be here today to speak to you about a very serious disease that many of you have likely never heard of COPD. (Adapt for patient-only groups.)(Engage audience) By a show of hands, how many of you here today have heard of COPD?

*Today we have a lot of ground to cover. The topics well discuss are: (read slide)Definition of COPDHow COPD affects breathingSymptoms of COPDHow you can find out if you are at riskTalking to your doctorGetting on the road to better lung healthResources*So what is COPD? It stands for Chronic Obstructive Pulmonary Disease.

COPD is a serious lung disease that progresses slowly and over time, makes it very difficult to breathe. You may also have heard it called by other names. Emphysema and chronic bronchitis are forms of COPD. COPD is a general term that includes a spectrum of diseases. Very often a doctor may say you have emphysema when the person has elements of both emphysema and chronic bronchitis. In fact, it is common for people to have elements of both, which is why we prefer the term COPD. In people who have COPD, the airways, or tubes that carry air from the nose and mouth into the lungs, are partially blockedeither because of thickening and mucus, or because the airways are floppy and collapse, or both.

*COPD is the fourth leading cause of death in the United States. This applies to men and women. The disease kills more than 120,000 Americans each yearthats one death every 4 minutes. You may be curious what those other leading killers arethey are heart disease, cancer, and stroke. Among those diseases, COPD is the only one with the numbers of deaths increasing. The rates among women have increased dramatically in the last 50 years, such that in 2002, more women than men died of COPD.

COPD is also a leading cause of disability. When severe, it interferes with your ability to do everyday things like take a shower or tie your shoes. However, early on, the signs may be very subtle and many people might think they have gained weight, are out of shape, or are just getting older. They may make small changes in their lives to accommodate, like avoiding a hill, giving up a sport, or carrying less at one time.

More than 12 million people are currently diagnosed with COPD, and an additional 12 million likely have the disease and don't even know it. As I said, the symptoms early on can be very subtlenot enough to prompt people to seek medical attention and get a diagnosis. *Healthy airways and air sacs in the lungs are elasticthey try to bounce back to their original shape after being stretched or filled with air, the way a new rubber band or balloon does. This elastic quality helps retain the normal structure of the lung and helps move air quickly in and out.

In people with COPD, the air sacs no longer bounce back to their original shape. They become floppy and not as elastic. Picture a bag made of cellophane compared with a rubber balloon. The cellophane airwaysthose without support, collapse, blocking the air flow out of the lungs. The harder the person tries to breathe out, the more the airways collapse. The airways can also become swollen or thicker than normal, and lined with mucus.

Demonstration: Balloon vs. paper bag ---blow up a balloon and then let it deflatethe balloon recoils like healthy lungsif you blow up a paper bag and let it deflate---it does not recoillike the air sacs of a patient with COPD.

*So as we saw in the diagram, this blockage, or obstruction, caused by COPD can make breathing difficult. So what are the symptoms? Symptoms of COPD include (read list from slide).Coughingsmokers coughShortness of breath while doing activities you used to be able to doExcess sputum or phlegmFeeling like you cant breatheCant take a deep breathWheezing

For the millions of Americans with untreated COPD, shortness of breath and other symptoms can get in the way of even the most basic day-to-day tasksfrom doing housework, to taking a walk, or even bathing and getting dressed.

Its important to remember that COPD develops slowly, so if you recognize any of these symptoms, no matter how mild you think they are, talk with your doctor as soon as possible.

*COPD symptoms may be more subtle at first. Many people think they have just gained weight or are out of shape or are getting older. They may make small changes in their lives to accommodate.

Essentially, they begin to limit their level of activity to accommodate the disease, for example:Taking elevator instead of stairsGiving up a sportParking close by instead of walkingCarrying packages one at a timeAvoiding shopping or other similar day-to-day tasks Staying home rather than going out with friends

If you are beginning to experience shortness of breath you may avoid climbing stairs, or taking long walks. You may find you have to stop mowing your own lawn or other daily activities.

(Engage Audience) Is this the case with anyone here? Are there any other examples youd like to share? *As we mentioned earlier in the presentation, many people who are at risk for getting COPD have never even heard of it. Thats why it is so important to be aware of some of the things that put you at risk for COPD.

These risk factors include:SmokingCOPD most often occurs in people over age 40 with a history of smoking. That being said, it is also important to note that as many as one out of six people with COPD never smoked. Environmental ExposureCOPD also occurs in people who have had long-term or heavy exposure to things that can irritate your lungs like chemicals, dusts, and fumes.In some people, COPD is caused by a genetic condition known as alpha-1 antitrypsin, or AAT, deficiency. People with AAT deficiency can get COPD even if they have never smoked or had long-term exposure to harmful pollutants. So youre thinking maybe you may fall into one of these risk categories or you recognize one or more of the symptoms we discussed. What do you do?*First and foremost, talk with your doctor about getting a simple breathing test, or lung function testcalled spirometry.

Spirometry can detect COPD before symptoms become severe. It is a simple test that measures the amount of air you can blow out of the lungs and how fast you can blow it out. Its fast, noninvasive, and doesnt require any special preparation. Based on this test, your doctor can tell if you have COPD, and if so, how severe it is.

So, lets say youve had the spirometry test and youve been diagnosed with COPD. Now, what do you do?

Again, first and foremost, talk with your doctor. There are many things that you and your doctor can do together to slow the progress of the disease, manage symptoms, and improve your quality of life. *

Your doctor might recommend any one or a combination of treatments including: (read from slide)Lifestyle changesQuit smoking. If you smoke, NOW is the time to stop. It is never too late to stop smoking. While your lungs will not re-grow, you can prevent further damage. In the past, smoking was considered just a bad habit. But today, doctors have a much better understanding of nicotine addiction and what is needed to deal with it. Medicationsto help open the airwaysPulmonary rehabilitation a program that teaches you how to manage your disease, how to go about regular activities a little more easily and how to get into good condition.Physical activity trainingeveryone should be getting physical activity.Oxygen treatmentin severe cases, oxygen may make the person feel better and live longer.Surgerymay be indicted in certain people who meet very specific criteria.

Every patient is differentwork with your doctor to determine what works best for you.

*Start today!Talk with your doctor about your risks, such as smoking and other exposures.Tell your doctor about any symptoms.Make a list of breathing symptoms and think about any activities that you can no longer do, or do as easily because of shortness of breath.*There are many things you can do to breathe better:Quit smokingMany new options available from your doctor.Avoid exposure to pollutants and secondhand smoke.Visit your doctor regularly.Follow treatment advice.Get annual flu shots and check whether you should have pneumonia shots.*You might be thinking that the things Ive mentioned may not necessarily apply to you. Many people ignore their symptoms or avoid talking to their doctors because they dont think theres anything that will work for them. This is simply not true.

As you can see on this slide, there are a number of myths about COPD, such as: (read slide)My shortness of breath is just old age.Theres nothing my doctor can do except tell me to quit smoking.If I rest more, it will get better.

Many people may dismiss their shortness of breath as old age or believe that nothing can be done about a smokers cough, but this is simply not the case. For example, there are many treatments and options for smoking cessation that have become available just over the last few years. *Remember, it all begins with you!Start todayBe your own advocate ask questions and seek information

Our website lists local support groups and pulmonary rehab programs. If you have a program you would like to list just click on the bottom of the page to enter your program information.This is the screen that will allow you to enter your program information. Both providers and public have access to this information to help you build your program.**In closing, let me leave you with thisIf you think you might be at risk for COPD, get a simple breathing test. If you have COPD, talk with your doctor. Together, you can take steps to make breathing easier and live a longer and more active life. If you would like more information, please visit the NHLBI COPD Awareness and Education Campaign Web site or contact the NHLBI Health Information Center directly. Thank you very much for your time and attention. If anyone has any questions, Ill be happy to take them at this time.