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
Here are a few simple
ideas to help you make
sure you’re getting
> 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
> Drink sparkling water as
an alternative to
> Stay inside an air-conditioned
area, especially during the hottest part of the day.
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
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
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
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
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.
people in the
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.
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
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
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
If you’re taking
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
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
Summer 2013 | Breathing Easy Outlook 3
What You Should Know
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
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
• 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
To Live a
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
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.
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
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
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
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
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
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
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
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
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
> 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
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.
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
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
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
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
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.