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LIVING WELL WITH A LUNG CONDITION 2001 news February LungNet • • • • A fresh look at coping with Lung Disease here is so much that can be written about better ways of coping with your lung disease, but at the end of the day coping is a very individual thing, and what works for you may not work for the next person. We all have different ways of coping. T With the New Year in full swing we thought it was time to refresh your memory on different approaches to coping. 1) Keeping your stress levels down Letting your stress levels rise too much may lead to breathlessness and even panic. To avoid this, you could learn new ways of keeping your stress levels down. There are 3 main tasks to your “action plan” for reducing stress: a) Learn what stresses you Over the next few days take a closer look at the stressful activities in your life. Keep track of the reactions you have to stress (e.g. becoming breathless) and what has caused this (e.g. trying to do too much at once, getting frustrated with yourself for not being able to do something as quickly as you used to). b) Learn what helps you reduce the stress How did you deal with the last thing that made you feel stressed? Did you take time out to think and relax, or just get angrier and angrier? Are there things you could have done to better manage or even eliminate the stressful situation? Here are some simple stress reducers: ❚ ❚ ❚ ❚ Try not to do too much at once Slow down when you talk, walk, drive and eat Let go of non-essential tasks and worries Off-load unnecessary anger towards others - tolerance and acceptance are good for your health c) Set a goal to put your stress management technique into action If you are more aware of what causes you stress and how you can cope with it better, you should be able to mobilise your stress management plan when you next need it. 2) Think about the value of SUPPORT you’re not alone A frustrating thing about living with lung disease is that no one really understands what you’re going through. As LungNet friend Irene Asquith says “the only way, in my view, for a person who has healthy lungs to begin to comprehend how we FEEL is to tape up their mouth and block one nostril for 24 hours...then ask them to take a shower, dry themselves, experience the puffing and panting, sit on their bed until they recover then to make their bed and bend over to tie their shoelaces”. The LungNet is an initiative of THE AUSTRALIAN Irene says support groups give support in a very personal way. “We support each other by our personal concern for each other, by listening and talking. We inspire each other by our presence at our meetings. Yes we do. Having a chronic illness is frightening but it is not all doom and gloom. It is how we cope with it that is important, and when you look at some of the members attending our meetings, in the same or worse condition than we are, and you see them coping in a positive, cheerful way by adding to the warmth which reaches out to each corner of the room. That is inspiring. “It’s inspiring because it gives us hope, it prompts the thought ‘What they can do, I can do’. I believe being part of a good support group is more beneficial than all the medical papers I have ever read. Papers do not inspire me or give me hope. They inform me. They do not provide me with living proof, as our support group does, that this life we lead is better than the alternative.” 3) A good night’s sleep Quality sleep is important to everyone. If it is shortened or disrupted too often, it will make you feel tired and irritable and decrease your ability to cope with what the next day has in store. There are things you can do to give yourself a good chance of getting quality sleep. Do Don’t ❚ Exercise, eat well and stay active. ❚ Relax before going to bed (try relaxation techniques) ❚ Take a warm bath or drink a cup of warm milk ❚ Listen to music to help you drift off ❚ Eat a big meal before bed time ❚ Drink coffee, tea, cola drinks or eat chocolate ❚ Have stressful conversations before bedtime ❚ Watch emotional movies that might upset you 4) Laughter - the medicine with great sideeffects! Laughter releases endorphins (the bodies natural painkillers) so our mind and body can start to relax! The whole body benefits from a good laugh, including your lungs. The psychological benefits of laughing are enormous, so go looking for things to laugh about. Watch a funny TV show, ring a friend who makes you laugh, or remember something funny from your past. Humour very quickly and effectively breaks the negative thought patterns so have a good laugh! Laugh for yourself. Laugh at yourself. A fake laugh can be beneficial too - the brain doesn’t know the difference! (Remember our Have a Laugh column on page 2 too). ■ LUNG FOUNDATION proudly Supported by 1 Have a place the odd joke here and there. I don’t want you getting overly excited. At least check with your doctor before you read my column... Laugh THE LIGHTER SIDE WITH DAVID EMDUR Hi Folks! I’m never quite sure whether I should write about my crazy adventures, as many people seem to ask me if these things really happened! It was only this morning an attractive blonde asked me this very question. This took me completely by surprise, as she’s been married to me for over 35 years! So to my latest adventure, back up in my little fishing spot on the Hawkesbury River. I was sitting on one of those lightweight folding chairs and chatting with a friend (my very own witness), when my line screamed off, catching me off balance and near toppling me off the chair. Luckily after a minute or two the fish gave me the slip - thank goodness. I sat there wondering why do I do this to myself maybe I should take up reading as a safer hobby! I had a restless night after that incident, and thought I must have pulled a muscle during the excitement. However, I was down there again the very next day and actually caught myself a nice fish. Just to top it off, I had another lousy night’s sleep. A day or two later, after much discomfort, it was time to call my doctor. Would you believe, that damned fish had broken my rib and the catch the following day had made it worse. I know you think I’m kidding, so I quote the letter accompanying the Xray, “a fracture to the anterior end of the 10th rib”. Beat that! Enough of me. Let me tell you a little about a good buddy named Rod. First off, he has Interstitial Lung Disease. Basically that’s not an airways problem, however his lungs, due to tissue damage, prevent any fast movement and limit his exercise. He is able to walk about 300 metres, with several stops, on a good day. He has to rest after walking up as little as 3 stairs. Rod has a Concentrator at home for use during physical effort. Why tell us all of this, you ask? Well Rod and I were having a quiet coffee one day when he suddenly piped up and said he was bored and that he was going to put his car on the train to Alice Springs and drive back! “You’re WHAT??” I exclaimed. 2 LungNet - Toll Free 1800 654 301 Before you could catch your breath (so to speak), Rod was sitting on the Ghan with his vehicle in tow on the way to “Alice” via Adelaide. He took 5 tanks of oxygen with him just in case. Rod managed to collapse on the train platform at Adelaide after running out of oxygen. The railway staff were great and helped him get more oxygen so he could continue his trip. After a few days in Alice, Rod took a little drive to Uluru, 460 km south of Alice. Later, he took off to Tennant Creek, just 508 km away! Next stop, Mt Isa, a mere 650 km! Fair dinkum! Wouldn’t you think he’d had enough by now? Not quite. Off now to Longreach, just another 740 km. Then Blackwater (485 km), then Munduberra via Rockhampton, (try 800 km!!) Next day he took it easy, driving only 300 km to Caloundra. Then 560 km to St George in far western Queensland. Down to Bourke, (560 km), then Dubbo (370 km) and finally back to Bondi (410 km)!! Hey, forgot to mention, Rod managed to drop an oxygen tank onto the connecting tubing and destroyed it. He was not able to replace it until he reached Rocky! A happy ending, Rod actually arrived back in good old Sydney Town 20 days later. I just can’t wait to see what he’s going to tackle when he has GOOD health!! I really enjoyed our annual LungNet meet last November and it was great to meet up with some old friends. I was expecting a kick in the butt for putting a Viagra joke in my last column, but no, all commented that they had a good laugh. Be assured I will take care if I I am pleased to report I have found out that one of our readers uses Viagra, not to improve his love life but merely to stop himself rolling out of bed. As chief test pilot for all new ideas submitted to this publication, I can assure you that this DOES NOT WORK. I had the misfortune of falling out of bed onto my head and severely concussing myself on my nebuliser. I’ll see you next column, if I recover from all the damage I do to myself. Have a great 2001! ■ Christmas Seal Appeal 2000 The ALF extends its grateful thanks to everyone who donated to this year’s Christmas Seal Appeal. Once again, we received many encouraging comments, Densey Clyne’s lovely butterflies were very much appreciated. Thank you to all who took the time to express their appreciation and encouragement. Donations resulting from the campaign to date have reached $33,000, a wonderful response from you, the ALF’s loyal supporters. Thank you also to those of you who passed on the lung health message with the “Send Seals to a Friend” option. We hope your family and friends enjoyed the Seals. A very special thank you to our volunteers from the TLC Support Group, who played a major role in this year’s campaign. Your help is greatly appreciated, as always! We wish you all a happy and prosperous 2001. ■ About the LungNet News Publication dates: February, May, September and December. The LungNet National News is distributed free of charge to all members of patient support groups affiliated with the LungNet, and healthcare professionals. The LungNetTM is an initiative of Editor Lara Thompson Phone 07 3832 2245 Fax 07 3832 1451 Email [email protected] Editorial contributions from patient support groups are welcome. They should be directed to the Editor, c/- The Australian Lung Foundation, Publisher Level 3, 454 Upper Edward St, The Australian Lung Foundation Spring Hill, Qld, 4000 When you can’t breathe, nothing else mattersTM HelpingHands In our last issue we talked about why it’s important to improve your ‘aerobic capacity’ through aerobic exercise such as walking, cycling, dancing and swimming. Your exercise routine should also include some exercises to keep your muscles strong. It is very common for people with lung problems to avoid exercise because they are frightened of becoming breathless. Lack of exercise may in fact make you feel more breathless. It could also lead to your muscles becoming weak and de-conditioned. By keeping your muscles strong you will maintain the strength you need to carry out those everyday tasks, like hanging out the washing, cooking a meal and carrying the shopping in from the car. Exercising muscles in the upper body can also help your breathing power. Muscles in the shoulder and upper chest, lower ribs and upper abdomen are all important ‘breathing muscles’. So to keep your muscles strong you need to ‘train’ two different muscle groups: 1) The Upper Limbs - strength and endurance in your arms and shoulders will help with everyday tasks and breathing. 2) The Lower Limbs - it is important to maintain strength and endurance in your leg muscles. An example of an upper limb exercise is the Arm Curl. Stand with your elbows tucked into your sides. Straighten your arm down and then bend up until your fingers touch your shoulders. Start by doing this 5 or 6 times with each arm and build up the number of repetitions each time you do the exercises, until you can do 3 sets of 10 lifts. You can then advance to using a light weight for this exercise. Start with something light like a packet of biscuits, and as you get stronger, build up to a tin of baked beans! An example of a lower limb exercise is the Knee Bend and Straighten. Sit on the edge of the bed or on a chair, with a small rolled towel under your knee. Bend your knee back as far as you can. Then fully straighten it and hold for 5 seconds. Continue to bend straighten and do the exercise 8-10 times on each side. Build up to 3 sets of 10 on each leg. ▼ These are just two examples of many upper and lower limb exercises that you can do. Most exercises are safe to do in your own time at home. For more help with upper limb and lower limb exercises talk to a doctor or physiotherapist who can help you develop a program. ■ Oxygen The simple facts Happy New Year to all LungNet News readers and your families. Oxygen conservation and reducing the cost of oxygen is an ongoing concern. For many, a trip outside the home for more than a few hours means multiple cylinders and often seems more hassle than what it’s worth. The CR50 oxygen conserver from the oxyCare range is a compact regulator and conserving system in one. Using an oxygen conserver is a great way to enjoy a day’s outing without having to worry about taking extra oxygen cylinders with you. It can reduce the amount of portable cylinders around the house as well as the constant change over of cylinders. The CR50 oxygen conserver is a demand device that delivers oxygen at the set flow rate. Oxygen flow only occurs during inhalation, regardless of inhalation length. The CR50 will reduce the amount of oxygen wasted in between breaths, saving you very valuable oxygen and money. The oxygen conserver is easily set with one simple, easy-to-understand control, delivering up to 6 lpm. With the CR50 oxygen conserver you can rest assured that each time you breathe, the delivered oxygen volume equals or exceeds the amount received with continuous flow. In the case of mechanical failure, the oxygen conserver will automatically switch over to continuous flow, providing optimum protection. The lightweight design, yet highly durable CR50 oxygen conserver is great for portability. The combined conserver and regulator only weighs 500 grams and can provide oxygen savings of between 52% and 65% for most patients. For further information on suitable oxygen equipment for your lifestyle, contact the BOC oxyCare team toll-free on 1800 050 999. ■ Exercise Tip: If the thought of 30 minutes of exercise per day is too daunting to face, remember that the time can accumulate throughout the day. Try 15 minutes of walking in the morning and 15 minutes of gardening in the afternoon. Or do your exercise for 10 minutes three times a day. By splitting up and varying your activity time, you’ll hardly notice you’re exercising at all! LungNet - Toll Free 1800 654 301 3 for Medicinal Purposes... Steroids in Lung Disease - Part 1 Inhaled Steroids Many people have concerns about taking corticosteroid (“steroid”) medications. This two part series will inform you about steroids, including their benefits and risks. In this issue, we will talk about inhaled steroids. Medically prescribed corticosteroids are not ‘anabolic’ steroids which build muscle tissue in athletes. Corticosteroids are used to control inflammation in several areas of the body including: ❚ Bowels (colitis) ❚ Joints (arthritis) ❚ Skin (dermatitis) ❚ Respiratory Tract (Asthma, sinusitis, alveolitis, bronchitis, bronchiolitis) Corticosteroids are related to cortisol, a ‘natural steroid’ produced by adrenal glands, which is essential for health and well-being. During stress our bodies produce extra cortisol to keep us from becoming seriously ill. Inhaled steroids are commonly used in the treatment of asthma, and are delivered using an inhaler or dry powder device. They are prescribed as preventive medication, usually taken on a daily basis whether you have symptoms or not. Inhaled steroids have been proven to achieve the following results for asthma: ❚ Reduced symptoms (breathlessness, wheeze, cough) ❚ Reduced time in hospital ❚ Improved quality of life ❚ Reduced need for other medication ❚ Reduced further loss of lung function Inhaled Steroids are sometimes used in the treatment of chronic bronchitis and emphysema. Research is still being conducted to determine the benefits, which may include: ❚ Increased speed of recovery from acute illness ❚ Reduced number of acute episodes of illness ❚ Improved quality of life ❚ Reduced further loss of lung function Inhaled Steroids can also be used to treat other respiratory diseases such as sarcoidosis, bronchiectasis and interstitial lung diseases (e.g. pulmonary fibrosis). Steroids show a good response in some patients with these conditions, so are often considered by doctors as “worth a try”. Side effects from inhaled steroids are relatively minor when they are used at the recommended doses and can be minimised with simple precautions. The most common side effects are dry mouth, sore throat or gums, a husky voice, and yeast infections of the mouth or throat (thrush). To minimise these side effects it is important to: ❚ Wash your mouth and spit out after each dose (some people also find it helpful to gargle and brush their teeth) ❚ Use a Spacer device (such as a Volumatic or Nebuhaler) ❚ Anti-fungal drops or lozenges can help prevent thrush. Side effects can be more severe if you are using a high dose of inhaled steroids for a long period of time. Some people bruise more easily than normal after long periods of treatment. If you are also taking a bronchodilator medicine, you should take your steroid medication 10 minutes after the bronchodilator puffers as this allows the airways to open before you inhale the steroids. As with any medicine, unexpected individual reactions to steroids may occur, and should be reported to your doctor immediately. Many readers of LungNet News are concerned about the side effects of long term steroid use, particularly oral (tablet) steroids, which we will talk about in the next issue. ■ OutandAbout The Happy Caboolture Airways Support Group getting ready to party... 4 LungNet - Toll Free 1800 654 301 ▼ Heather and Roma from Huff and Puff at Moe Community Health Service, Victoria Don’t forget... Have you cleaned and serviced your nebulizer lately? Its important to clean your nebulizer, it’s bowl, mask and tubing regularly using “Nebulizer Clean” (from your pharmacy) or Pinoclean. Don’t forget, the bowl needs to be replaced every 3 months, and the mask and tubing should be replaced once per year. Talk to your pharmacist if you’re not sure what to do. Lung Support Setting the Cat among the Pigeons Around Australia he Cat certainly was let out of the bag on Thursday December 21st when both it and the Pigeons were launched from Port Melbourne in the innovative fundraising event masterminded by ALF’s Tasmanian branch and its hardworking committee led by Dr James Markos. T The Pigeons were released from the DevilCat at 8.45am. The Cat won by just over 2 hours, arriving in George Town at 3.05pm. The first bird touched down in Ulverstone at 5.15pm. The pigeons were delayed by an easterly wind which pushed them westward, plus the very warm weather and the fact they were racing out-of-season added to their difficulties. All 5 raffle prizes were won in Tasmania. Winners were: 1st E J Smith of Hobart, 2nd C Wickham of Launceston, 3rd T. Round of Coles Bay, 4th R W Robinson of Launceston, and the Race Promotion prize by W Harris of Hobart. 23,000 out of 50,000 tickets were sold, plus a $2000 donation, raising $23,000 for medical research into lung disorders. A huge thank you to the event organizers, committee members and volunteers, sponsors, prize donors and raffle ticket sellers in Tasmania and Victoria, and of course the Tasmanian Homing Pigeon Federation and TT-Line! ■ Who Set the Cat Among the Pigeons? These people did– Con Eliades (Ship’s Captain), Simone Ferrier (TT-Line), James Markos (ALF Tas Chairman), Geoffrey Matthews (Tas Homing Pigeon Federation) and John Bruce (ALF Tas) So many groups and so little space to publish everyone’s news has forced us to reassess our “Around Australia” column. We will now be concentrating on New Groups, New Rehabilitation Programs and Special Events. New Groups Forster/Tuncurry (NSW) - Bob Jones and Karyn Jarvie have set up a new group to cover the Forster/Tuncurry area in NSW. They plan to hold their meetings on the second Monday of the month at 2pm, at the Community Health Centre, Breeze Pde, Forster. Karyn hopes to set up a group in Gloucester next, so if you know of anyone in that area who may be interested, please let Karyn know on 0414 473 630. Bundaberg (Qld) - Not strictly a “new” group, but close - Bundaberg & District Lung Support Group Inc celebrated their first birthday in January. They meet at the Cross Waves Club at 11am on the 3rd Monday of each month. Contact Ross Robson on (07) 4155 3858. Bowral (NSW) - The first meeting will be on 8/03/01 at the Old Bowral Hospital meeting room, at 2pm. All welcome! Interested patients/carers who are not able to attend meetings are still welcome to join the Group and receive support through telephone and mail. Enquiries from the public and health professionals are encouraged. Please contact Greg or Christine Segal for more information on (02) 4869 4389. LAM Lunch Melbourne: LAM (lymphangioleiomyomatisos) is a rare, terminal (and unpronounceable!) lung disease which almost exclusively attacks the respiratory system of women of child-bearing age. The 4th annual LAM Lunch is planned for 24th March 2001 in Melbourne. More information about the Lunch (or the disease) can be obtained from Virginia Northwood, phone (02) 9810 4828. ■ Sutherland Shire (NSW) - Beginning in April 2001, the Group will be coordinated by a Physiotherapist, and will meet at the Sutherland District Trade Union Club, 57 Manchester Road, Gymea, 10.45am - 12noon (lunch included) on the 1st Wednesday of the month. Contact Michelle Duvall on (02) 9540 7540. ■ Oxycare and LungNet cheering on the wonderful participants of the Sydney Paralympics OutandAbout Taking a break at the NSW LungNet Seminar 2000 Margaret, Joyce and Joan LungNet - Toll Free 1800 654 301 5 Understanding Breathing, Swallowing and Speaking-Part II Dr. Lynette Hodgson - Speech Pathologist Breathing: When feeling tight in the throat, and breathless always push air out (on a long whhhh... through pursed lips). This causes air pressure to fall in the larynx, so that the vocal folds open, the lungs and surrounding muscles automatically work like bellows, and air is sucked back in. Struggling to take “a big breath in” can work against you, by tightening the throat and upper chest so that breathing is tense and shallow. Remember: PUSH AIR OUT TO ESTABLISH BREATH CONTROL. Talking: The biggest strains on the voice are talking loudly, talking for a long time, and using extremes of pitch. Minimise strain by avoiding these behaviours. You can use gentle voice sounds like “mmmm” to listen to your own voice and think to yourself “I need to keep my voice relaxed and calm like this” and “I should talk on a nice relaxed low tone like this.” Another trick is to imagine you are having a relaxed quiet laugh, or to talk to people with “a smile in the voice”- this tends to relax the laryngeal muscles. Establish good breath support for speech by focusing on pushing the lower chest (or tummy) area in as you say: Hi! Hey! Make sure there is no tightening occurring in the throat. It must stay relaxed! Swallowing problems are frequently reported to me. People may have the sensation of having “a lump in the throat ”when they swallow, with the commonest causes of this being (i) reflux and (ii) chronic extra tightness or constriction in the larynx. The other difficulty may be coordinating eating with breathing. Studies done by speech pathologists of people with chronic 6 LungNet - Toll Free 1800 654 301 Eating & Swallowing: Make time for stopping and taking a few breaths in and out during meals. Sometimes, you might have to stop during chewing. Just hold the food in the mouth, and take a few breaths in and out through the nose. During the actual act of swallowing, the breath actually has to be held. To make the swallow easier and more effective, tuck your chin down slightly (this puts the base of the tongue in the swallow “starting position”), hold the breath and squeeze hard as you swallow. If chewing your way through a big meal takes a lot of energy, it is helpful to convert some of the foods to smooth, soft foods, thick liquids, or moist, well-cooked foods that have been well cut up or minced. Some people cough or splutter when drinking fluids. There are several types of fluid thickener available to help with this (for example Quik-Thik, Resource Thicken-up and Nutilis). Remember water can always be converted in to soft gels or icy poles. Keeping hydrated is really important. The people with the best looking larynxes have those famous 8 glasses of waterbased fluid per day! In conclusion, take time to coordinate swallowing, breathing and eating. Try to eat meals where it is quiet, free of distractions and pressure. Remember also to take your time and treat yourself to a bit of a rest and relax straight after a meal. ■ ▼ I respiratory conditions show that compared with the general population, they are more likely to have difficulties chewing and swallowing food, or clearing food and fluid from the throat. Special Challenges - C aring for a loved one with a chronic disease poses some difficult challenges for carers. Caring is a tough enough job when you live in the city close to services and help. C Imagine the challenges for carers who live in rural and remote areas. Their job of caring is made more difficult by the isolation, a lack of services available and the costs and time associated with travelling to reach the services. Support networks can also be difficult to build in country areas where family, neighbours and community health care workers can be great distances away. Here’s a few helpful tips for readers who are caring in rural and remote areas: 1) Be informed Being aware of resources that are available in your particular area is important. Every area is different, but services like those available in metropolitan areas may be accessible, although they may work differently because of your location. Services to assist Carers which are often available in cities include hospital services such as home nursing and outreach services, Home Help, Meals on Wheels, Respite Centres and transport services. You may not think that any of these services exist near you, but you never know unless you pick up the phone to find out! Countrylink and Health Department Rural Services are places where you can start your investigations. Take the positive step of finding assistance before emergencies arise. The first point of contact should be your local Carer Resource Centre. Diet/Nutrition Tip: When you’re not up to preparing a full meal, try something quick and easy to prepare like: ❚ boiled or scrambled egg, toast, tomato, lettuce & carrot ❚ sweet corn on toast with a side salad of tomato, lettuce, grated carrot & cheese ❚ jaffle or electric sandwich maker, filled with leftovers, chicken, baked beans and cheese, cooked meat or canned meat such as Irish stew ❚ a frozen meal from the supermarket ▼ n our last issue I discussed how the actions of breathing, swallowing and speaking take place. It is a complex process that we don’t consciously think about until something goes wrong. In chronic lung disease the actions of breathing, speaking and swallowing can sometimes get mixed up. Here are some practical tips for overcoming any problems you may be having with these very important functions! Carers Energy conservation tip: Make the bed while you’re still in it! While you are still in (or on) the bed, pull the top sheet and blanket up on one side and smooth them out. Exit from the unmade side, which is then easy to finish. Questions Matter Frequently Asked Questions Caring in a Rural Area These Centres operate in each State and Territory to provide information and advice on the services in your area and general information. They will provide you with a Carer’s Support Kit free of charge which includes information on the various supports available and handy hints on caring. 2) Link in with other carers nearby Your most valuable resource will be other carers in similar situations. Through a local carer support network, you can share coping tips, receive moral and practical support. Contact details and a calendar of dates and locations of meetings is available from your Carers Resource Centre. If you are not able to attend meetings because of distance, you may be able to link in with the support groups through the phone. There may also be another carer living somewhere in your district who you can talk to. A local community nurse may be able to put you in touch with someone who needs support, just like you. 3) Useful Phone Numbers National Contacts: Carer Resource Centres Freecall 1800 242 636 Carer Respite Centres Freecall 1800 059 059 Countrylink Freecall 1800 026 222 State Carer Associations ACT Ph: 02 6288 New South Wales Ph: 02 9299 Northern Territory Ph: 08 8947 Queensland Ph: 07 3843 South Australia Ph: 08 8271 Tasmania Ph: 03 6231 Victoria Ph: 03 9650 Western Australia Ph: 08 9444 9722 1499 3877 1401 6288 5507 9966 5922 Q: What is my doctor looking for when he asks me about my sputum? sputum, note whether the colour is pale or dark, whether it is thick or thin, watery or dense. Symptoms which help your doctor to diagnose illnesses in the lungs include shortness of breath, pain, cough and the production of sputum (or phlegm). The characteristics of sputum are often extremely valuable in making a diagnosis. A Its not a pleasant topic, but its very important to monitor the type of sputum you are coughing up, so that you can give the doctor the information he/she needs to help make a diagnosis. Your doctor may ask, initially, if your cough is dry or moist. When sputum is produced (whether or not it can actually be coughed up) this indicates that there is some inflammation in the bronchial tubes, the passages which carry air to the lungs. These passages are lined by tiny glands which produce secretions when they become infected or inflamed. Sputum is only useful in diagnoses when it is known to have originated in the lower respiratory tract, ie, that it is “coughed up’ and not ‘spat out”. The questions that you should be able to answer for your doctor are: 1) What is the amount of sputum coughed up each day? This information is useful because some lung conditions produce more sputum than others. In the chronic condition called bronchiectasis, for example, large amounts may be produced every day, even when you are relatively well. 2) What is the colour of your sputum? Knowing the colour of your sputum can help your doctor diagnose the problem. When you look at your Green sputum often signifies a bacterial infection for which the treatment would be antibiotics. Brown sputum may result from blood leaking from small blood vessels, as often happens in infections. Bloody sputum is usually of greater concern and your doctor will need to investigate this immediately. 3) What is the shape of your sputum? Sometimes sputum may assume the shape of the bronchial tubes from which they were coughed. These may be strands or plugs and sometimes signify a rare allergic condition. 4) Does your sputum have an offensive smell or taste? When sputum has an offensive smell or taste certain infections are suspected. If a lung abscess is suspected, then a chest X-ray would be needed to help make a diagnosis. In general, remember that sputum is “better out than in”. Many of your doctor’s suggestions, whether physiotherapy, antibiotics, nebulizers, cough medicines, puffers or exercise, are aimed at removing as much as possible from your lungs and bronchial tubes. Keeping as active as possible, with regular deep breathing exercises, assists you in doing this. If you have a chronic condition a change in your sputum may indicate a need for a change in treatment, and so you should be vigilant in reporting changes in your sputum to your doctor. Thanks to Dr Jane Tolman for helping us answer this question. ■ What to do when... ...There’s an electricity blackout and you’re worried about your Oxygen concentrator: Some electricity suppliers keep a register of people on oxygen and other life support equipment, who they contact if there is going to be a power outage. Ring your electricity company to see what system they have in place. You need to be prepared in case of unplanned power cuts. When one occurs you should ring the electricity company to explain your situation, and ask them if they expect a long or short interruption to power. If you haven’t got a backup oxygen cylinder, you may feel safer phoning the ambulance and going to hospital. If you have a home generator, ensure that it produces the 240 volts required to run the concentrator. The most important thing is to remain calm and have a plan of action! ■ LungNet - Toll Free 1800 654 301 7 Education Leaflets The Australian Lung Foundation publishes leaflets on a wide range of lung health topics including Chronic Bronchitis and Emphysema, Home Oxygen Therapy, Obstructive Sleep Apnoea, Sarcoidosis, Bronchiectasis. For details of further topics available, call 1800 654 301. For a free copy, send a stamped, self-addressed DL sized envelope to The Australian Lung Foundation, Level 3, 454 Upper Edward Street, Spring Hill, Qld, 4000. ■ • • • • Snoring, Sleep Apnoea and Other Sleep Problems Booklet What is LungNet? This booklet, written for people with sleep related breathing problems and their families by Professor Rob Pierce and Dr Matthew Naughton on behalf of the Thoracic Society of Australia and New Zealand and the Australasian Sleep Association, has been reprinted and is now available for purchase from The ALF. Copies are $6.00 each (including GST), or bulk orders of 20 or more for $3.50 per booklet plus processing fee. For further information or to order, call us on 1800 654 301 or email [email protected]. ■ LungNet is a project of The Australian Lung Foundation. ■ Information on lung support groups, and a referral service to groups throughout Australia who are affiliated with LungNet ■ Advice and assistance to people wishing to establish support groups ■ Assistance to health professionals establishing support groups and pulmonary rehabilitation programs ■ A national LungNet News, containing up to date information on managing a chronic lung condition Statement The principal objectives of the Australian Lung Foundation are to assist the relief of people suffering from lung disease and to promote lung health in Australia by: 1. Raising funds in support of medical research into lung diseases. 2. Distributing research findings and knowledge. 3. Educating patients and the broader public on the treatment and prevention of lung disease. 4. Fostering patient support activities. 5. Influencing public and corporate policy to ensure a safe living and working environment. Are you on our mailing list? LungNet News is a free publication - all you have to do is complete the form below and post it back to: The Australian Lung Foundation Level 3, 454 Upper Edward Street, SPRING HILL Q 4000 ✃ ■ A communications link between support groups throughout Australia Mission LungNet provides: ■ A point of contact for group members with other groups when they travel and require “away from home” support Name: Mailing Address: Postcode: ■ Education seminars and events ■ A medium for lung support groups to participate in the promotion of lung health at a national level. My lung condition is: Lung support groups or patients do not pay any fees to be affiliated with LungNet. It is a community service to ensure patients can access and enjoy the benefits of a continuity of lung support around Australia. ■ I am a My date of birth is: patient carer health professional other (please indicate) I would also like to make a voluntary donation to The Australian Lung Foundation to help cover the costs of LungNet News. Enclosed is my donation of $ Method of Payment Disclaimer: The information contained in this newsletter is submitted from many different sources. The views expressed in this publication are not necessarily those of the editor or The Australian Lung Foundation. Medical information contained in this publication is intended to be used as a guide only, and not as an authoratitive statement. Please consult your general practitioner or respiratory physician if you have further questions relating to medical information contained in this newsletter. All rights reserved. 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