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Develop A Positive Attitude
When one is diagnosed with COPD, the danger bells in the mind begin to ring.  Fear, concern, anxiety, and depression begin to replace common sense because of the unknown factors of the affliction.  Usually when one is diagnosed, there is already some loss of quality of life because of shortness of breath after �normal� exertion. We must learn to accept that, plan to try to minimize it, be thankful for the things we can still do, and not fret over what is lost.

Quit Smoking
Yep, papapoo is going to bug you about this too.  Smoking brings about most, but not all, COPD.  Smoking has destroyed part of your lungs and that will not come back.  In addition, emphysema is a progressive disease which means that it will slowly get worse.  However, if you quit smoking, the rate at which this deterioration is slowed is dramatic and (if you will also do some other things) may very well approach the natural deterioration of lung function which is inherent with individuals as they reach their senior years.

Get Involved In A "Wellness Program"
The multi-disciplinary pulmonary rehab program does more than exercise although exercise is certainly a good part of it.  The multi-disciplinary rehab program has been dubbed by many as a �Wellness Program� and well deserves the title. The Wellness program includes exercise to build you physically (which in turn means the muscles can use less oxygen more effectively), education to explain what is happening to you, advice on how to better cope with the day to day struggle including tips on energy saving, and periodic counsel on your progress.  Unfortunately, finding a Wellness Program is not as easy as it may seem and you may need to settle for something less and augment it with personal education. 

Choose Competent Medical Help
Select a primary care physician and a doctor of pulmonary medicine to help you manage your affliction.  It has been my experience that if you take the time to learn what you can do to help yourself, your physicians will go out of their way to enter into a partnership with you to seek that goal.  On the other hand, if you go into the doctor�s office, sit like a bump on the log, show no knowledge of your affliction or interest in finding out about it, the doctor is likely going to take the path of least resistance and prescribe what will best relieve the symptoms and spend their valuable time with someone who really cares.  It is important that you have this medical support because they can guide you through proper treatment, but it is just as important that you take an active role in that care.

Learn What You Can About Your Affliction
Search the web, read books, go to organizations which provide booklets (like the American Lung Association), join an online support group, talk to others, and listen to what your doctor has to say. Knowledge is power!  I have heard it said that one who does not listen to what their doctor says is a fool.  It is also true that one who listens to their doctor without understanding what they are saying is foolish!

Avoid Infection
One of the weapons that devil-COPD has is infection of the lungs.  Each episode of infection takes its toll on the lungs that can not be regained.  Now, everyone is likely to get an infection for one reason or the other but it is necessary to avoid those infections to the maximum extent possible.  In this regard, it is important that you and everyone in your family wash your hands at any hint of contamination (like after blowing the nose or covering a cough).  A waterless hand sanitizer (like germ-x from Walmart) will make this task less painless.  It is also important that if you detect an infection building, to get prompt medical attention and an antibiotic to fight it.  Unfortunately, it will be necessary to establish some rules with family and friends that may not sit too well like:
If you are sick, please do not visit me.
Don�t bring the grandkids around if they are sick.
Please wash your hands (or use the hand sanitizer) when you should
No smoking in the house
Please check with me just before you do visit.  If I am feeling  poorly, I will be a bad host and you will only do me more harm.

Join A Support Group
You are not alone in this struggle with COPD. Those that have the affliction and are going to be best equipped to handle it are those who share their knowledge, hopes, and fears with others who are also afflicted.  The best support group is the one that will bring you in physical contact with others.  The second is to join an online support mailing list like the Family of COPD Support Services.  Of course logic tells us that if you join both, you will have the best of two worlds.

Learn How To Breathe Correctly
Two methods, pursed-lip breathing and diaphragmatic breathing, make up what I like to call �lunger breathing�. These methods not only help you to breathe with less physical stress, they also go far to expel the excess carbon dioxide in your system which is usually the real source of your difficulty in breathing.  There is a short discussion of these breathing methods at http://papapoo.com/breathing.html   These breathing methods will go far in relieving that �out of breath feeling� and can help control the �panic� when breathing becomes difficult.

Take Your Medications As Prescribed
Establish a schedule for taking your medications and if you are like most of us, you may want to invest in a small pill organizer.  That way you will only have to get all those bottles out once a week or so.  It does no good for your doctor to prescribe a certain medication and you smile pleasantly and then not even fill the prescription.  If the cost of the medication is a problem, then be candid with your doctor and say so.  Believe it or not, even though that professional may drive a BMW, play golf on Wednesday afternoons, and charge a bundle for his or her smile, most of them understand the problems of the real world and may be able to help you.  Sometimes there are cheaper drugs which can do the same job,  professional samples,  and also programs to help those who can not afford the proper medications.

Eat Properly
Now I am not a nut on diet, but it stands to reason that you need to control your diet to the extent that you are not harming yourself.  I can not recommend any particular kind of diet or even give general guidelines because first, I am not qualified to do so, and secondly there are a number of �brands� of COPD.  Some need a diet augmentation to gain weight while others need restricted intake to lose weight.  When I first broached the subject with my doctor, his advice was simply �Work on a xxxx calorie diet and eat smarter�.  Diet is certainly one of the things that you need to discuss with your doctor and then develop a list of undesirable foods that affect you.  Remember also that many of your diet restrictions are not really because of the COPD but because of other things that you may have or develop because of COPD or the medications you take to control it.  Diet is certainly one of the things that prove the point, �We Are All Different.�  You still must decide what is right for you to eat based on your doctor's recommendations and advice.�

Maintain That Positive Attitude
No matter how hard we work at staying well, there is a time when the devil-COPD will get the better of us.  When that happens, accept the temporary need for increased intervention with strong medications by your physician and work hard, both physically and mentally, to bounce back.

Write Papapoo
January 2001
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