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Welcome from Vantage Business Support & Insurance Services
As an added benefit to our customers and associates VANTAGE is publishing a semimonthly newsletter with information, interactive tools, podcasts and other resources to help you live healthier. We will explore topics on total health and resources for you and your family, including fitness, nutrition, mental and physical health, weight management and more.
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Managing Stress and COPD
 Stress and COPD frequently go together. What's more, COPD stress can lead to worsening COPD symptoms, anxiety, and depression. Here's how you can stop it.
Stress due to chronic obstructive pulmonary disease (COPD) is different from everyday stress. When you live with COPD, the anxiety caused from being short of breath is always with you. Stress and COPD are closely linked because everybody has an alarm system deep in their brains that detects a breathing problem. If your "breathing alarm system" detects that you're not getting enough air, it sends out a warning that feels like a sudden rush of anxiety. When you have COPD, you're always struggling to get enough air, so your alarm system can become hyperactive. That can be a constant source of stress.
To further complicate matters, this stress can make your COPD symptoms worse, says Daniel F. Dilling, MD, a pulmonary and critical care specialist at Loyola University Medical Center in Chicago.
COPD Stress, Anxiety, and Depression
A study published in the journal Multidisciplinary Respiratory Medicine reports that anxiety and depression are common in people with COPD. Examining data from 60 study participants with COPD, the researchers found that anxiety was present in 41.7 percent of them and depression in 46.7 percent. They also found that depression and anxiety increase as COPD progresses and that both conditions are closely linked to shortness of breath and inability to exercise.
Another study looked at the stress of physical and mental fatigue in COPD. Published in the International Journal of Chronic Obstructive Pulmonary Disease it involved 42 people with COPD who were participating in a pulmonary rehabilitation program. About 95 percent of them reported physical fatigue, 70 percent reported mental fatigue, 43 percent reported anxiety, and 21 percent reported depression.
"Stress, anxiety, and depression are all common with COPD," notes Jessica Bon, MD, a pulmonary specialist and assistant professor of medicine at the University of Pittsburgh. "Shortness of breath can make normal stress much worse and can even lead to panic attacks."
COPD Stress: Tips for Stress Management
Even without COPD, stress is part of life. Start by identifying all the stressors in your life and see which ones you can reduce or avoid. Maybe you need to work on relationships or money problems, or do a better job of pacing yourself and setting priorities.
Specific COPD stress management tips to help you cope include:
* Try relaxation techniques to diffuse stress. This could involve meditation, deep breathing, guided muscle relaxation, or any activity that helps you let go of stress.
* Get more exercise. Exercise is a proven way to reduce stress. Even gentle activities that don't affect your breathing are beneficial. "Many people with COPD benefit from an exercise like yoga that combines movement with focused breathing," says Dr. Bon.
* Get restful sleep. Sleeping well is often a problem for people with COPD. Developing good sleep habits can help: Keep to a sleep schedule, resist napping, avoid caffeine and exercising later in the day, and limit your bedroom to sleeping — no work or late-night TV watching.
* Make your diet more nutritious. Foods high in sugar and empty calories, caffeine, and alcohol can drain your energy and add to your stress. Of course, don't smoke and avoid exposure to secondhand smoke.
* Learn COPD breathing exercises. These specialized breathing exercises can help reduce stress and any fear of being short of breath.
* Ask your doctor for help. When stress leads to depression or anxiety that makes your COPD worse, your doctor can recommend a mental health counselor to work through emotional issues with you. "Medications may also be helpful at times," says Bon. "Antidepressants called SSRIs have been found to be helpful for COPD depression."
* Have a good support system. Sometimes you will need assistance with daily living. Ask your friends and loved ones to become part of your support system. Let them help you lighten your load. Bon says that "joining a COPD support group is another good way to reduce stress."
One final tip is to get yourself into a good pulmonary rehabilitation program. "The most important thing for COPD and stress reduction is education, support, counseling, and exercise," advises Dr. Drilling. "You can get all that in pulmonary rehabilitation. It is the number one thing you can do for COPD."
Stress is part of life for everybody, however COPD stress can be more constant and more dangerous than other forms of stress since it can also complicate the condition . The combination of unmanaged stress and COPD can make your COPD symptoms worse and can lead to fear, panic, anxiety, and depression. If stress is making your COPD worse, and you can't manage it on your own, work with your doctor on a stress relief plan.
SOURCE: Chris Iliades, MD Medically reviewed by Niya Jones, MD, MPH
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DID YOU KNOW???
Cholesterol
 You may wonder why, if cholesterol is so bad for you, it is present in your body in the first place. The answer is that cholesterol is not all bad and is, in fact, necessary for life. Your liver manufactures cholesterol for a reason: It is essential for the production of cell membranes and sex hormones, such as estrogen and testosterone. Cholesterol is even added to infant formula because it's necessary for normal growth and development. We also obtain cholesterol from animal food sources, such as dairy and meat. (Plant foods like fruits, vegetables, and legumes contain no cholesterol.) Although cholesterol is essential to life, we don't need very much of it to keep our bodies running well. Our cells take whatever cholesterol is necessary for maintenance and cell repair and store the excess for future use. The problem is that many of us eat a diet that is too high in saturated fat and trans fats, and this can stimulate the liver to produce more cholesterol than the body needs.
During a discussion with a patient recently, she asked me, "What's the difference between good and bad cholesterol? Isn't it all the same when it's building up in my arteries?" The answer is that it's not the cholesterol itself that is good or bad, but the particles that carry it. These particles are called lipoproteins (the lipo is short for lipid, which means fat). High-density lipoprotein (HDL) and low-density lipoprotein (LDL) are two of them. It's the protein part of the lipoprotein particle that acts like a shuttle bus, transporting the cholesterol (and other fats like triglycerides) through your bloodstream to where they are used, stored, or excreted by the body. Lipoproteins are necessary for transporting fats because fat is not soluble in water or in blood.
As it turns out, it's LDL, the so-called "bad" cholesterol, that is doing a lot of the shuttle bus driving. You'd think that this job would make LDL "good." But what makes LDL "bad" is that in excess it can cause us trouble. All cells have special receptors, or binders, that latch onto LDL, pulling it into the cells, where it is used as needed. When these cells have had their fill of cholesterol, they stop making receptors, which allows the rest of the LDL to stay in the bloodstream. Some of this excess LDL deposits its cholesterol "baggage" in our artery walls - including those of the heart - resulting in the formation of soft atherosclerotic plaques.
The job of clearing the blood vessels of this excess LDL falls to the HDL particles, which is why HDL is often referred to as "good" cholesterol. The makeup of the cholesterol itself in both LDL and HDL particles is the same; it is the direction in which the lipoprotein shuttle bus is driving that determines whether the particle is considered good or bad. HDL is good because it serves as a scavenger, removing LDL cholesterol from the cells and plaques and carrying it back to the liver for excretion in the bile, which empties into the intestine so it can be flushed out of our bodies in our stool. This is called reverse cholesterol transport.
How Much Cholesterol Is Too Much?
The Standard Lipid Profile, the heart disease screening lab test used by most doctors, measures your total cholesterol, HDL ("good") cholesterol, LDL ("bad") cholesterol, and triglycerides. In the mid-1980s, the federal government and the American Heart Association joined forces to create the National Cholesterol Education Program (NCEP) to educate the public about the importance of maintaining normal cholesterol. Based on the NCEP guidelines, total cholesterol should be 200 mg/dL or less for everyone. What follows are the NCEP guidelines for LDL, HDL, and triglycerides.
THE NCEP GUIDELINES FOR LDL CHOLESTEROL
99 mg/dL or below is optimal.
100-129 mg/dL is slightly higher than optimal.
130-159 mg/dL is borderline high.
160-189 mg/dL is high.
Anything over 190 mg/dL is very high.
I advise my high-risk patients to get their LDL down to 70 mg/dL. There is some evidence, however, that very high-risk people should get their LDL down even lower. Regardless of risk factors, I think it's advisable for everyone to keep their LDL as low as possible.
THE NCEP GUIDELINES FOR HDL CHOLESTEROL
For both sexes, optimal levels of HDL are 60 mg/dL and over. While the NCEP Guidelines do not differentiate HDL levels for men and women, the American Heart Association does, and I agree. It defines an HDL of less than 50 mg/dL as a risk factor for women and an HDL of less than 40 mg/dL as a risk factor for
THE NCEP GUIDELINES FOR TRIGLYCERIDES
149 mg/dL or under is normal.
150-199 mg/dL is borderline high.
200-499 mg/dL is high.
500 mg/dL is very high.
SOURCE: Arthur Agatston MD
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Here's your "QuoteAction" for this issue:
"The true test of character is not how much we know how to do, but how we behave when we don't know what to do."
Educator, John Holt
Your action for today is to think of a recent time when you didn't know what to do and reflect if you acted in a way that is in accordance with your values.
Have an extraordinary day!
SOURCE: Betty Jo Waxman
Productive Learning & Leisure, LLC |
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Disclaimer of Liability
Our firm provides the information in this e-newsletter for general guidance only, and does not constitute the provision of legal advice, tax advice, accounting services, investment advice, or professional consulting of any kind. The information provided herein should not be used as a substitute for consultation with professional tax, accounting, legal, or other competent advisers. Before making any decision or taking any action, you should consult a professional adviser who has been provided with all pertinent facts relevant to your particular situation. Tax articles in this e-newsletter are not intended to be used, and cannot be used by any taxpayer, for the purpose of avoiding accuracy-related penalties that may be imposed on the taxpayer. The information is provided "as is," with no assurance or guarantee of completeness, accuracy, or timeliness of the information, and without warranty of any kind, express or implied, including but not limited to warranties of performance, merchantability, and fitness for a particular purpose.
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