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 COPD Support News July 2, 2010
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Posted - Jul 02 2010 :  09:02:00 AM  Show Profile  Reply with Quote
Volume 10, Issue 31
July 2, 2010

...a special coverage program for uninsured Americans with medical problems was launched this week...the most ambitious early investment of (the) health care overhaul.

But here's the catch: Premiums will be a stretch for many, even after government subsidies to bring rates close to what healthier groups of people are charged. And $5 billion that Congress allocated to the program through 2013 could run out well before that.

The Pre-Existing Condition Insurance Plan began accepting applications in many states on Thursday, with coverage available as early as Aug. 1. Consumers can check availability in their states on a new website:

The goal is for all states to be enrolling people by the end of the summer.

"I would enroll as soon as you can," said Stephen Finan, policy director for the American Cancer Society Cancer Action Network. "These rates are going to be as affordable as consumers can get these days, particularly for a high-risk individual." Premiums will vary from state to state. In California, for example, the cost for a 50-year-old is estimated at $575 a month, with a $1,500 annual deductible and 15 percent co-insurance. Premiums in states with lower medical costs could be around $400 a month.

The insurance program is a stopgap fix for the most vulnerable until 2014, when core provisions of the new health care law take effect. At that time, insurance companies will be barred from turning away people in poor health, low- and middle-income households will get government assistance with premiums, and most Americans will be required to carry coverage.

To qualify for the temporary program, a person must have a pre-existing medical condition and must have been uninsured for six months or longer. The main beneficiaries are likely to be the self-employed and their families, and those who work for small employers that don't provide coverage. Only U.S. citizens and legal residents qualify. Millions fit that description...about 700,000 people (c)ould potentially sign up by 2013. Medicare economists earlier estimated the program would sign up 375,000 people this year, but run out of money around the end of 2011.

Launching the new program in about three months has not been easy. Most states have opted to administer their own plans, but about 20 have asked Washington to run the program directly for them.To make matters more confusing, most states already operate their own high-risk insurance pools, covering about 200,000 people in total. However, the state plans tend to charge significantly higher premiums than the new federal plan, and many offer skimpier coverage. Consumers will not be able to switch from state to federal coverage - unless they're willing to risk going six months without health insurance.

SOURCES: News items summarized in The COPD-NEWS are taken from secondary sources believed to be reliable. However, the COPD Family of Services does not verify their accuracy.

By Peter Gott, M.D. Newspaper Enterprise Association. Dear Dr. Gott: I am a 60-year-old female. After smoking for 40 years, I was finally able to stop. Now I suffer from emphysema, asthma, COPD and bulla disease. My white blood count has been high for years, and a year ago I was referred to an oncologist, who performed a bone-marrow biopsy. My count has been in the 15,000 to 17,000 range but never higher than 22,000. The oncologist wants to do another biopsy.This procedure is very painful, and I don't want to go through it again. Please let me know your opinion on this.

Dear Reader: There are five types of white blood cells — lymphocyytes, monocytes, basophils, eosinophils and neutrophils. Your oncologist is determining on a periodic basis how many white blood cells you have. The normal range is between 4,500 and 10,000 per microliter. An abnormally high count known as leukocytosis might indicate such conditions as leukemia, rheumatoid arthritis, tissue damage or infection. An abnormally low count known as leukopenia might indicate bone-marrow failure, a disorder of the liver or spleen, lupus or exposure to radiation.

The bone-marrow biopsy is commonly ordered if a person has an abnormal number of red or white blood cells on lab testing. The results can help a physician zero in on or exclude such conditions as cancer, anemia, leukemia, Hodgkin's disease and other possibilities. Because you had the test a year ago, my guess is that your oncologist may not have obtained a clear diagnosis then or wishes to determine any progression. To the best of my knowledge, this test is not performed annually. Because each case is different, that question should be presented to your oncologist or primary-care physician. I recommend that you undergo the procedure one more time to get to the bottom of the issue.

Atelectasis (at-uh-LEK-tuh-sis) is a condition in which one or more areas of your lungs collapse or don't inflate properly. If only a small area or a few small areas of the lungs are affected, you may have no signs or symptoms. If a large area or several large areas of the lungs are affected, they may not be able to deliver enough oxygen to your blood. This can cause symptoms and complications.

To understand atelectasis, it helps to understand how the lungs work. Your lungs are organs in your chest that allow your body to take in oxygen from the air. They also help remove carbon dioxide (a waste gas that can be toxic) from your body. When you breathe, air passes through your nose and mouth into your windpipe. The air then travels to your lungs' air sacs. These sacs are called alveoli (al-VEE-uhl-eye). Small blood vessels called capillaries run through the walls of the air sacs. When air reaches the air sacs, the oxygen in the air passes through the air sac walls into the blood in the capillaries. At the same time, carbon dioxide moves from the capillaries into the air sacs. This process is called gas exchange. The air sacs must remain open and filled with air for this process to work right. Surfactant (sur-FAK-tant), a liquid that coats the inside of the lungs, helps the air sacs stay open. Deep breathing and coughing also help keep the air sacs open. (Coughing helps clear mucus and other substances from your airways.)

In atelectasis, part of the lung collapses or doesn't inflate. The air sacs in that part of the lung are no longer filled with air. As a result, they can't take part in gas exchange. If only a small area or a few small areas of the lungs are affected, you may have no signs or symptoms. This is because the rest of the lung can bring in enough oxygen to make up for the collapsed part of the lung. If atelectasis affects a large area or several large areas of the lungs, your body's organs and tissues may not get enough oxygen-rich blood.

The outlook for atelectasis depends on its cause. In adults, atelectasis often is short term. The collapsed air sacs slowly refill with air once the cause of the atelectasis is resolved. If atelectasis persists, it may prevent the lung from properly clearing mucus. This can lead to infections (such as pneumonia). Atelectasis usually isn't life threatening.

COMMERCIAL FREE: We do not accept any paid advertising. Any corporations, products, medicines (prescription or non) mentioned in this newsletter are for informational purposes only and not to be construed as an endorsement or condemnation of same.

By Cole Petrochko, Staff Writer, MedPage Today. The maker of a nasal decongestant spray product has issued a voluntary recall due to self-imposed quality control precautions. Manufacturer Procter & Gamble Company recalled VapoSpray 4 Hour Nasal Spray by Sinex, also sold under the names Sinex Nasal Spray and Sinex Ultra Fine Mist, because of concerns that the products' formulations may not meet printed expiration dates on the packaging. There have been no adverse events reported related to these products, the company said in a prepared statement. Affected products are being pulled from store shelves and include all products with the UPC numbers:

4 Hour Nasal Spray and Sinex Nasal Spray: 3 23900 00082 7

Ultra Fine Mist: 3 23900 00085 8

Sprays with the above UPC codes and an expiration date earlier than June 2013 should be thrown out, the statement said. The Nasal Spray and Ultra Fine Mist packages were only sold prior to June 2009.

MEDICAL DECISIONS. Your physician should be consulted on all medical decisions. New procedures or drugs should not be started or stopped without such consultation. While we believe that our accumulated experience has value, and a unique perspective, you must accept it for what it is...the work of COPD patients. We vigorously encourage individuals with COPD to take an active part in the management of their disease. They do this through education and by sharing information and thoughts with their primary physician and pulmonoligist. However, medical decisions are based on complex medical principles and should be left to the medical practitioner who has been trained to diagnose and advise.

By Kathleen MacNaughton, RN. Eczema is an allergic skin condition that often accompanies both nasal allergies and asthma...For some people, it gets worse in cold weather, while in others, summer is the worst time. One thing is for sure, though, when the symptoms spiral out of control, the discomfort becomes almost unbearable.

Our expert, Sloane Miller, did a post explaining eczema and some of the ways to deal with it a couple of years ago (Item link immediately following this

Any allergy is best dealt with by preventing it from becoming a problem in the first place. It's no different with eczema. If you know what triggers it and can avoid those things, then do so. For instance, I'm allergic to wool, so I never wear wool clothing next to my skin. Sweating is another trigger, so I try to avoid hot, humid conditions as much as possible. Other people find that dry heat indoors during cold weather is a trigger, so they use a humidifier to keep their homes less dry. Of course, the usual culprits such as animal dander, dust, pollen and mold can also be triggers for eczema, so try to keep your exposure to them to a minimum. Dry skin is a big trigger, so anything you can do to maintain good skin care is also a great help. Another of our experts, Dr. James Thompson, talks about dry skin care in this article.

Skin Creams for Eczema
Prevention is great, as long as you're vigilant and you stay on top of things. But if you're anything like me, sooner or later, the rash will appear, you'll scratch and make it worse, and before you know it, you need some kind of treatment.

Here are some of your choices: Topical steroids. These are the old, tried and true, traditional treatment for eczema. They're also some of the most effective creams you can use. Cortisone formulas come in a variety of strengths and forms, including both creams and ointments. The lower strength formulas are available without a prescription. Topical steroids work well, but shouldn't be used for a long time as they can have side effects such as thinning of the skin, changes in skin pigmentation and absorption into the body.

Topical calcineurin inhibitors. This class of creams is one of the newer treatments for eczema. Examples are Elidel® and Protopic®. The great thing about these creams is that they are not steroids, so they do not have the troublesome side effects that steroid creams can have. They can even be safely used on the face and around the eyes.

If you suffer from eczema, definitely work on the prevention aspect, but also be prepared if and when you need to use medication to resolve your symptoms. Talk with your doctor about which approach will work best for your situation.

Sloane Miller, Author & psychotherapist: When I put on blush recently, I noticed a half inch patch of under-the-eye-eczema --a sure sign that the cold weather has begun. So when I got home that evening, even though it was late, I massaged in some olive oil.Yes. Olive oil. On eczema.

What is eczema? According to Health Central: "Eczema (atopic dermatitis) in children is often a red, itching, oozing, crusting dermatitis that tends to be localized primarily on the face and scalp, although spots can appear at other sites. In older children and adults, eczema appears as a red, itchy rash, sometimes with a thickening or discoloration of the skin. From puberty on, it usually appears as dry, itchy patches in the folds of the elbows and knees. "

How common is eczema? According to the American Academy of Dermatologists: "The National Institutes of Health estimates that 15 million people in the United States have some form of eczema. About 10 percent to 20 percent of all infants have eczema; however, in nearly half of these children, the disease will improve greatly by the time they are between five and 15 years of age. Others will have some form of the disease throughout their lives."

What causes eczema? From Health Central: "A person with eczema often has a history of allergic manifestations such as asthma or hay fever, or a family history of asthma, hay fever, or atopic dermatitis. Though much of atopic dermatitis is genetic and caused by the reactive immune system, eczema may be set off by extreme temperatures, stress, sweating, medication, clothing (especially wool or silk), grease, oils, soap and detergents, and environmental allergens. Dryness is perhaps the most important trigger. Drying soaps should be avoided, and the skin should be moisturized frequently."

How is eczema medically treated? "Topical steroids may be prescribed to reduce skin inflammation during an eczema flare-up. Systemic corticosteroids are sometimes prescribed in very severe cases and usually under the direction of a dermatologist. Topical immunomodulators, like Elidel, are relatively new drugs available for use in treating atopic eczema. Antihistamines may be prescribed to control itching; these medications, however, cause drowsiness and do not clear up the eczema. Antibiotics may be given if there is sign of bacterial infection."

How do I treat it without corticosteroids? These days, eczema is a minimal health issue for me and mainly due to the cold weather. Typically, the eczema on the tops of my hands during winter means dryness, cracking and bleeding. Eczema on my face is less extreme, more of a dry patch here and there that disallows the use of makeup because it's so dry and flaky.

I've been to many a dermatologist over the years and they have typically prescribed cortisone-based creams which cannot be used for too long as they thin the skin.

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The Newsletter, like all the other endeavors of the Family of COPD Support Programs, is provided to you by COPD-Support, Inc. a non-profit member organization with IRS designation 501(c)(3). If you would like to be involved and help us provide these programs to the individuals who benefit from them, please consider joining us as a member. Further information is available at:

Test Your Brain
How smart are you? Take this quick test to peek inside the power of your brain. Test adapted from the Mensa test by Dr. Abbie Salny and America Mensa Ltd., copyright 1992 and 2004

American Jamboree

Line up the cherry bombs and firecrackers

Spot the Differences

Tough USA Trivia

Andrew Rieu
America the Beautiful

76 Trombones

Until next Friday,

Joan Costello, Editor

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