News/Blog

Getting Through the Holidays With a Hospitalized Loved One

There are many reasons to love the holidays – whether it’s traditions, spending time with family and other loved ones, and a variety fun, rewarding activities. But it’s no secret that they can also be a time of stress, and if you’re a caregiver or family member of someone who’s in an inpatient rehab or long-term acute care hospital, the extra stress can add up in a hurry.

It can be easy to get overwhelmed this time of the year and slip into unhealthy habits such as overeating, skipping exercise, and getting less sleep. The following tips can help you deal with the stress and keep yourself on track until things return to “normal.”

Be mindful

Take stock and acknowledge all of your emotions throughout the day – fear, frustration, sadness, joy, etc. Remember, these emotions are perfectly normal, and there’s no need to overreact to any of them. Just acknowledge each moment (and thought) rather than letting your mind focus only on your growing to-do list.

Recognize the signs

More specifically, recognize the signs of burnout and stress. Prolonged stress drains your energy and motivation to provide the proper care and attention to patients and loved ones. And a good sign that you’re burned out is when you feel as if nothing you do as a caregiver will make a difference.

Prioritize

You know your calendar is going to full this time of the season as you juggle the duties of your family and your role as a caregiver. Prioritizing enables you to decide what obligations and traditions are expendable and those that aren’t.

Don’t neglect self-care

As a caregiver, you know that you must sometimes put the needs of others before your own but neglecting your self-care can exacerbate stress. Make sure that you’re getting proper exercise, proper sleep, that you’re participating in fun activities, and that you’re not overloading on sugary foods that can precede an emotional crash.

Seek support

Whether it’s through online message boards or support groups, it’s always a good idea to rely on others to help you carry the load. There’s nothing wrong with asking for help – both for yourself and those under your care. You can enlist the services of a home-cleaning business, or ask a friend about running errands for you. Remember there are only so many hours in a day and those hours can become limited during the holiday season.

Embrace new traditions

If long-held family traditions such as preparing, cooking, and serving large holiday meals are too much for you don’t be afraid to start new traditions, like eating out at a favorite restaurant instead. Or, you can also give the gift of time rather than give costly presents. Simplifying your holiday activities is a good strategy to reduce your levels of stress. You’ll still enjoy the spirit of the season while choosing the activities that are most meaningful to you and your family.

What are your hot buttons?

The holidays can stir up toxic activities or relatives that create more stress or unhappy memories. You may want to avoid certain places, events, and people – or, at the least, develop quick exit strategies.

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Treating Complications Caused by Diabetes at Long-Term Acute Care Hospitals

Diabetes is a disorder where either the body does not produce enough insulin or the cells in the body do not recognize the insulin. Often times, diabetes can be treated with exercise, a healthy diet and medication. But, complications can develop.

To understand diabetes, you first need to understand the role of insulin in your body. When you eat, your body turns your food into sugar, also called glucose. At that point, the pancreas releases insulin to open the body’s cells to allow the sugar to enter so it can be used for energy.

But with diabetes, the system doesn’t work.

Without insulin, the sugar stays and builds up in the blood. So the body’s cells starve from the lack of glucose. If left untreated, problems can develop with the skin, eyes, kidneys, nerves and heart.

Long-term acute care hospitals specialize in treating patients who may have more than one serious medical condition. Diabetes may be one of the conditions or may exacerbate existing conditions.

A common complication of diabetes is neuropathy, or nerve damage. According to the American Diabetes Association, about half of all people with diabetes have some form of nerve damage.  

Diabetic neuropathy often damages nerves in the legs or feet. Depending upon the affected nerves, symptoms can range from tingling, pain or numbness in the body’s limbs to problems with the digestive system, urinary tract, heart and blood vessels.

Because neuropathy can cause a lack of feeling in the limbs, especially the feet, injuries such as cuts can go unnoticed.

This can become serious. Not only does a person not feel if a foot becomes injured, but now if it is injured, the risk of infection is higher because diabetes restricts blood flow to the area. An infection can cause tissue to die and spread to the bone if not monitored properly.

Wound care treatments usually are provided to patients under these circumstances at long-term acute care hospitals. However, diabetic patients remain under close observation for other possible complications while being treated at the hospital as well.

Typically medical services at long-term acute care hospitals are tailored to the individual needs of patients. Many patients have more than one medical condition that needs to be treated at the same time – ranging from wound care and infectious diseases to strokes, respiratory failure or cardiovascular disease. Staff at long-term acute care hospitals take all that into account so the most effective care is provided to help patients heal.

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Understand Your Risk: COPD and Pneumonia

November is COPD Awareness Month, and it focuses on a disease that’s the third-leading cause of death in the United States. It’s also a disease that more people suffer from than ever before – while many others have it and don’t know it.

Fortunately, COPD and pneumonia are manageable with the right health care approach. Moreover, identifying who’s most at risk for developing COPD is clearly important, as is educating family members and caregivers about the disease and its effects.

What is COPD?

COPD (chronic obstructive pulmonary disease) is a lung condition that affects a person’s ability to breathe. Many serious and life-threatening complications can arise from COPD, including pneumonia.

What is Pneumonia?

Pneumonia is a lung infection that actually describes some 30 types of infections. It’s dangerous because it reduces the amount of oxygen in the body – sometimes greatly – and can be caused by viruses, bacteria, fungi, or inhaled particles or liquids. For COPD patients, life-threatening complications can develop rapidly and be fatal if not treated. People who suffer from COPD and other lung conditions are at a greater risk of developing pneumonia.

How is Pneumonia Treated?

If your physician suspects that you may be suffering from pneumonia, he or she may order a chest X-ray, CT scan, blood tests, and other tests to determine the cause of the infection. If it’s due to a bacterial infection, antibiotics will likely be your first treatment. It’s important to not only take antibiotics as directed but to take all of them. Halting your antibiotics can allow the bacteria to come back stronger than ever.

Viral pneumonia will likely require antiviral medications, and your doctor may prescribe an inhaler or oral steroid.

No matter the type of pneumonia, treatment must be immediate to prevent permanent damage to the lungs. Treatment may even include a stay in an intensive care unit, and a ventilator will speed oxygen to depleted cells, as well as eliminate excess carbon dioxide.

Who’s Most at Risk?

Smoking is the main risk for COPD and many people who smoke or used to smoke suffer from COPD. Other risk factors include:

  • Age. Most people who have COPD are at least 40 years old when they first notice symptoms.
  • Long-term exposure to lung irritants such as secondhand smoke, chemical fumes and dust from the workplace or environment, and air pollution.
  • Family history. People who have a family history of COPD are more likely to develop the disease, particularly if they smoke.

What are Symptoms?

The signs of COPD and pneumonia can include:

  • Shortness of breath that doesn’t improve but gets worse.
  • A chronic cough. In the case of pneumonia, you may cough up a dark yellow or green mucus.
  • Congestion that lasts for more than a few days.
  • Fever, chills, and ongoing fatigue.

At first, COPD may cause only mild symptoms, but symptoms grow worse over time. And severe COPD can cause other symptoms, such as a fast heartbeat, swelling of the feet, ankles, and legs, and weight loss.

The Importance of Prevention

If you suffer from COPD, it’s crucial that you do everything you can to prevent pneumonia. The easiest thing you can do is get an annual pneumonia vaccine. Getting a yearly flu shot is also important, because illnesses like the flu can easily lead to pneumonia in people with COPD. And keeping yourself as physically healthy as possible through diet and exercise is another important preventive measure.

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Functional Improvement: Amputation and Prosthetic Care

There’s no denying that amputation or the loss of a limb is a life-changing experience. It not only involves a tremendous physical loss, but also can be emotionally devastating. If you’re facing, or already have had, an amputation, know that you’re not alone – there’s around 1.7 million people living with limb loss in the U.S. alone.

Working with experienced professionals such as those at Ernest Health Systems who can help you through every step of the process – including prosthetic care – is vital.

Post-Operative Care

There are several options for post-operative care after you’ve had an amputation. In many cases, a rigid dressing is placed on the residual limb that protects the surgical site. A removable dressing can be taken off and put back on to allow medical staff to carefully monitor the surgical site.

Another option is a post-operative prosthesis that’s applied in the operating room immediately after surgery. Studies have shown that patients who wear an immediate prosthesis feel more optimistic and tend to recover more quickly than patients who don’t. It’s an option worth discussing with your physician and prosthetist.

Recovery

Putting things in perspective is an important early step in the recovery process. That’s not easy after a life-altering event such as an amputation, but your struggles with grief and acceptance are perfectly normal. It’s important that your friends and family will also struggle along with you, and it’s important to enjoy every success and accomplishment on your road to recovery while not focusing too much on the obstacles.

Physical Therapy

An important piece of your recovery is physical therapy. While it’s often challenging and hard work, physical therapy helps loosen the residual limb and increases muscle tone and coordination. It also helps keep joints flexible while teaching you how to use your prosthesis properly, particularly during daily activities.

Prosthetic care

Quality prosthetic care is essential to your recovery. Your prosthesis is a sophisticated tool designed to enhance your activity level and independence. As time goes on, you will become more dependent on it. Here are some things to keep in mind in terms of caring for your prosthesis.

  • Your prosthesis is a mechanical device that will sometimes require maintenance and repair. Visiting with your clinician at least once a year will help detect potential problems that can be resolved before your prosthesis becomes unusable.
  • Your medical team will give you a schedule that gradually increases the amount of time you wear your prosthesis. Everyone’s situation is different, but most people start with a couple of hours a day before progressing to wearing it all day after a few weeks.
  • It’s important to wear your shrinker or elastic bandage when you’re not wearing your prosthesis.
  • Using an assistive device such as a cane during the first several weeks will help you gradually get used to placing your weight on the prosthesis.
  • Remain physically active even when you’re not wearing your prosthesis. This will help build your stamina.

Personal Hygiene and Prosthetic Care

The residual limb can be subject to perspiration because it’s enclosed in a plastic socket. This can be a source of bacteria and should be monitored closely; you can try sprinkling baby powder on it or apply over-the-counter antiperspirant.

Rehabilitation and Teamwork

Your rehabilitation will be part of a process that involves a team of specially-trained people – including your physician, prosthetist, physical therapist, and other. This team will guide you and help you learn how to use your prosthesis correctly in a safe environment.

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What Your Long-Term Acute Care Team Should Look Like

Patients recovering from serious illnesses or injury often require additional critical care of complex conditions such as trauma, stroke, ventilator weaning, infectious diseases, and more. Dealing with these kinds of medical conditions requires the multi-faceted care of a professional team.

That’s a big part of what long-term acute care is: the involvement of a team that’s specifically trained to care for patients who need to stay in the hospital more than 25 days. What should you or your loved one’s long-term acute care team look like? Let’s take a look.

Certified Professionals

A long-term acute care team is likely to include a full-time medical director, as well as specially trained medical professionals such as physicians, nurses, therapists and specialists. All of them should have earned – and continue to earn and maintain – advanced certifications that provide them with in-depth knowledge needed to deliver exceptional care. These certifications include:

  • Critical Care Registered Nursing certifications
  • Certifications to treat adults who have suffered brain injuries and strokes
  • Advanced Cardiac Life Support certifications

The Members of Your Long-term Acute Care Team

Your long-term acute care team may include (depending on your specific needs):

1. Long-term Care Acute Physician

This is the physician who will lead your treatment team and help deliver a personalized plan for you. Your specific medical needs may also require the care of other physicians. The goal is to ensure that your care is complete and maximizes your recovery.

2. Long-term Acute Care Nurse

Your primary nurse will manage all aspects of your treatment and help personalize your care depending on your specific needs. In addition, patient care technicians will assist with hygiene and provide physical care to ensure your comfort.

3. Case Manager

Your case manager will provide you and your family with progress reports while also coordinating your discharge needs and planning. He or she will also answer your insurance coverage and billing questions.

4. Respiratory Therapist

Respiratory therapists serve a variety of important functions, including pulmonary support, specialized treatments, and will help to wean you off of a ventilator if needed.

5. Physical and Occupational Therapists

Your illness or injury may very well have left you with issues such as lack of mobility, balance, stamina, movement, and weakness – which is what your physical therapist will help you with.
The occupational therapist will assist and teach you to perform essential activities such as meal preparation, eating, personal hygiene and dressing.

6. Speech-language Pathologist

Your medical condition may have caused problems with your ability to speak, read, write, swallow, or understand. A speech-language pathologist will help you with these conditions.

7. Dietitian

It’s crucial that your diet include the necessary nutrition to help in your rehabilitation. Your dietitian will ensure that you’re getting the proper therapeutic diet, as well has providing you and your family members with nutrition guidelines to follow for when you return home.

8. Clinical Pharmacist

Your clinical pharmacist will work closely with the physician and nurses to manage your medication needs.

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The Importance of Ventilator Weaning in Recovery

There’s no question that mechanical ventilation has saved countless lives. It provides life-sustaining oxygen for patients who can’t breathe on their own – but weaning them off of a ventilator is a challenging task that requires a variety of skills, technologies, and teamwork.

Hospitals today are developing more effective weaning protocols while ventilator manufacturers are creating improved technology that helps better reach the goal of restoring full breathing function in patients whenever it’s possible. Here’s a look at the many factors that emphasize the importance, and challenge, of ventilator weaning.

The Challenges of Ventilator Weaning

Sedation is a fact of life for most patients on long-term ventilation, but sedation can prolong dependence on the ventilator, as well as impact cognitive functioning. Some doctors suggest using non-sedating medications, which allow for earlier weaning. The impact of heavy sedation includes not only cognitive effects, but also can result in long-term neurologic issues, and even post-traumatic stress disorder.

One of the challenges with sedation, however, is that it can affect every patient differently. Research has shown that patients who are typically calm in normal life will most likely remain calm on a ventilator, while patients who struggle with issues such as drugs, alcohol or anxiety issues can have more problems while on ventilation.

Another factor that has been shown to help hasten weaning is mobility. Hospitals that stress early mobilization programs for patients on ventilators have seen good results. It’s healthy for both the mind and body; in fact, the muscles in the diaphragm weaken because they don’t have to do any of their normal work during ventilation. Moreover, all of the muscles can weaken because they’re used much less than they were prior to the patient’s illness, and combined with sedation can result in weakness after just four or five days on a ventilator.

Enhanced Technology

The scientific community has made great strides in the past decade in terms of developing technology that prevents or limits complications associated with mechanical ventilation. Additionally, both safety and workflow have been improved to help enhance the ICU environment.

Additional improvements, such as the addition of microprocessor control and electronic medical record systems, have helped advance technology, as well. In general, devices today are more sensitive to patient interaction while capturing important patient clinical data. And having ventilator data remotely available provides access to clinicians with the necessary tools to make important decisions – whether they’re at the patient’s bedside or not.

The Importance of Teamwork

The process of successfully weaning a patient off of a ventilator is best served by a team approach that includes respiratory therapists, nurses, physicians, physical therapists and other clinicians. It’s important that all parties involved stick with protocols that may have been established by the respiratory therapist. Protocols also need to be reviewed periodically and compared with hospitals of similar size.

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Why Wound Care is a Critical Part of Recovery

To say wound care has been around a long time is an understatement. It can, in fact, be traced back to the earliest civilizations, and the ancient Greeks were among the first to stress the importance of wound healing.

Wound care has obviously come a long way since then, and it’s importance in the role of recovery cannot be stressed enough. Here’s a look at why would care plays such a vital role in the recovery process:

Wound Care: The Basics

There are two ways that wounds heal: regeneration or scar formation. During regeneration, tissue that has been damaged is replaced by tissue of the same type. This preserves the proper function of the area of the body that has been injured. In scar formation, the damaged tissue is replaced by fibrous scar tissue which doesn’t have the same properties as the original tissue.

The Importance of Wound Care in Recovery

Proper wound care prevents infection and other complications, and also helps speed up the healing process with less scarring.

 

  • Preventing Infection
    By keeping continual attention on the wound dressings and bandages the risk for infection and other complications is greatly decreased. A health professional can make medically-important decisions through changing the dressings, noting the wound’s progress, as well as by making observations of bleeding, temperature, discharge and smell. In general, wounds should be cleaned once a day with disinfectant specific to wound care, clean water or saline, as well as applying clean dressings.

  • Speeds Healing
    A potentially dangerous myth is that wounds heal faster if left uncovered, which simply isn’t true. Covering the wound throughout the healing process actually hastens the healing process. Moreover, properly maintained bandaging provides additional protection against infection.

  • Minimizes Scarring
    Keeping the wound soft through the healing process helps to minimize scars while not allowing hard scabs to form. Antibiotic ointments – and other treatment options recommended by your physician – applied during the early stages of healing will keep the skin around the wound soft and pliable.

 

Once the wound has healed enough that there’s no risk of infection, antibiotic ointment can be replaced with vitamin E oil, aloe vera gel, or petroleum jelly. Massaging the area while working with the thicker scar tissue to keep it from becoming stiff is also important. Softer skin will heal with a less noticeable scar.

It’s important to note that the wound healing process is complex and fragile. Interruption or failure can lead to non-healing chronic wounds involving factors such as diabetes, arterial or venous disease, infection, and the metabolic deficiencies of old age.

 

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Why a Flu Shot is the Best Way to Prevent Influenza

Influenza is a serious, potentially deadly disease that affects countless people in the United States every year. And flu “season” can last a long time – beginning as early as October and lasting even into late May. That said, flu shots are of utmost importance when it comes to preventing the virus for people of all ages, including people 65 and over, who can account for up to 90% of all flu-related deaths each year.

The Importance of A Flu Shot

Getting an annual flu vaccine (either a flu shot or nasal spray vaccine) is the best prevention of getting seasonal flu and potentially spreading it to others. The more people that get a flu shot, the lesser the spread of flu in a community. It’s recommended that anyone six months or older should get a flu shot.

The Best Flu Vaccines For 2016-17

The Centers for Disease Control recommends the injectable flu vaccine for 2016 and not the nasal spray vaccine. Both trivalent and quadrivalent vaccines will be available.

The trivalent flu vaccines include a high-dose shot and a shot made with adjuvant – which helps create a stronger immune response – that is approved for people 65 and over. Quadrivalent flu vaccination includes an intradermal shot, which is injected into the skin and not the muscle and uses a much smaller needle. The intradermal shot is approved for anyone from 18 to 64 years old.

How Flu Vaccines Work

Flu vaccines are effective because of antibodies that develop in the body shortly after vaccination. These antibodies provide protection against infection. Both trivalent and quadrivalent vaccines protect against against the influenza A viruses H1N1 and H3N2, as well as an influenza B virus. The quadrivalent vaccine also protects against an additional B virus.

Flu vaccines are often updated each year to keep pace with changing viruses.

Who Should Get Vaccinated

Again, the CDC recommends that anyone 6 months of age or older should get a flu vaccine every season. The flu vaccination is particularly important for anyone at high risk of developing serious complications from the virus. People who are 65 or over are considered high-risk because human immune systems weaken with age.

If vaccine supplies are limited, an importance is placed on making sure certain people get vaccinated, including:

  • People ages 50 and over
  • Children 6 months through 4 years
  • Women who are or will be pregnant during the influenza season, and women up to two weeks after delivery
  • People who are residents of nursing homes and other long-term care facilities.
  • Health care personnel
  • Household contacts and caregivers of people with medical conditions that put them at a higher risk for severe complications of the flu.

There are many others who are included on this list, so make sure to check with your physician or the CDC website to see if you qualify for the high-priority list.

With fall just around the corner, the importance of getting a flu shot for the 2016-17 season cannot be emphasized enough. Not doing so places your health – and potentially the health of others – at an unnecessary risk.

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The Importance of Palliative Care

When people think of palliative care they often think hospice. But they’re actually two different things. Palliative care is a new medical specialty that doesn’t focus only on the dying.

Here’s a look at what palliative care is, who’s it for, when it’s appropriate, and more.

What Is Palliative Care?

Palliative care refers to a form of medical care for people with serious illnesses. Provided by a team of doctors, nurses, social workers and others, palliative care focuses on relief from the symptoms (and stress) of serious illness. Improving the quality of life for both the patient and his or her family is the overall goal of palliative care.

How Is It Different From Hospice Care?

Patients that are eligible for hospice care must be suffering from a terminal illness, or be within six months of death. Hospice care generally relies upon a family caregiver, as well as a visiting nurse. Round-the-clock care is provided in a nursing home, a hospice facility, or occasionally in a hospital.

 

Palliative care, on the other hand, can be received by patients at any time, regardless of the stage or their illness or whether it’s terminal or not. While palliative care can be received and administered in the home, it’s most common to receive it in a hospital, nursing home or extended care facility.

Improving Quality of Life

Treating the stress and symptoms of people who are suffering from serious illnesses such as cancer, kidney disease, Alzheimer’s, Parkinson’s, COPD, and congestive heart failure is the focus of a palliative care team. Symptoms vary and may include depression, pain, nausea, loss of appetite, sleeping difficulties, fatigue, and so on.

 

Your palliative team will help give you control over your own care by helping you define your goals and understand your treatment options. They’re committed to helping you improve the quality of your life, as well as finding the strength to carry on with daily living. A palliative care team may also include a chaplain, psychologist or psychiatrist, dietitian, occupational therapist and others, depending on the patient’s needs.

When is Palliative Care Appropriate?

Again, palliative care doesn’t signal that a patient has given up all hope of recovery. In fact, some patients recover and move out of palliative care, while others – such as those with chronic diseases like COPD – may move in and out of palliative care as the need arises. Palliative care can transfer into hospice care when a cure proves elusive and death draws near.

 

By The Numbers

There are more than 1,400 hospital palliative care programs in the United States. The majority of large U.S. hospitals (more than 300 beds) now have a palliative care program, while more than half of smaller hospitals also provide palliative care.

 

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COPD Sufferers: What to Ask Your Healthcare Provider

If you’ve been diagnosed with chronic obstructive pulmonary disease (COPD)  you understandably have a lot of concerns. Aside from the breathing difficulties you’re experiencing, you have a lot of questions for your healthcare provider, including what is COPD and what are your treatment options. The bottom line is that your respiratory health is too important to not get all the information you can about COPD. Here are some important questions to ask your doctors.

What is COPD?

Your healthcare provider will tell you that COPD is a broad term to describe a variety of progressive lung diseases, including chronic bronchitis, asthma and emphysema. As you’re already aware, COPD’s primary symptom is increasing breathlessness as your body is unable to properly process oxygen through your lungs. You’ll also learn that you may have had COPD for longer than you think because you may not have noticed earlier symptoms. When it comes to their respiratory health, many people associate breathlessness as a natural part of aging, which isn’t true.

What causes COPD?

While your healthcare provider will tell you that smoking is the number one cause of COPD, he or she will also explain that there are other risk factors, as well. Those risks include genetic factors (AAT deficiency), working in high-risk industries that expose you to non-organic dust, such as mining and plastic manufacturing, as well as indoor pollution, such as second-hand smoke and radon.

What happens if I quit smoking?

If you’re a smoker, you’re well-aware of its dangers and harmful effects to your overall health, especially respiratory health. But here are some other facts you’ll want to take into consideration:

  • When you stop smoking the level of carbon monoxide in your blood is cut in half within 12 hours.
  • Your lungs will begin to repair themselves within a few weeks after you quit smoking.
  • By your 10th year of non-smoking, your lung cancer risk will be cut in half.

Will my medication have side effects?

Ask your doctor about any side effects that may occur from taking COPD medication. One important concern you should have is whether treatment for your condition could potentially damage other, healthy parts of your body.

What other changes can I make?

Quitting smoking will have a significant effect on the progression of COPD. But diet and exercise can also have a positive impact on your respiratory health. Ask your doctor about exercise programs designed specifically for COPD sufferers.

Will I need to be on oxygen?

Your doctor will measure the amount of oxygen in your blood by using a pulse oximeter, or by drawing blood. The goal is to keep your oxygen saturation level above 88 percent.

What stage am I in?

COPD is divided into four stages: mild, moderate, severe and very severe. Your doctor will determine what stage you’re in by using a pulmonary function test called spirometry. It’s important to note that COPD affects everyone differently, and can be determined by a variety of factors – including whether you smoke, how much you exercise, and your diet.

What shots or vaccines will I need?

It’s recommended that everyone with COPD should get a pneumonia shot – generally every five years – because pneumonia can easily deteriorate lung health. Flu shots are also important because the flu also weakens your lungs.

 

Choosing the right health provider is important in treating your overall respiratory health.

 

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