BREATHING EASIER November 30, 2021 Horizon’s UPSTREAM program improves quality of life for patients living with COPD An estimated 1.6 million Canadians live with chronic obstructive pulmonary disease (COPD), yet health care providers believe that almost as many have COPD and don’t know it. November is COPD Awareness Month. COPD is a disease where people have difficulty breathing because of narrowing of the airways and hyperinflation of the lungs. It is the third leading cause of death, and the number one cause of hospitalization in Canada. Horizon’s UPSTREAM and INSPIRED programs, available at several hospitals and health centres across Horizon, screen patients and clients for COPD and provide diagnosis, education and support. Finding hope through treatment James MacDougall, a patient of the UPSTREAM program at Horizon’s Oromocto Public Hospital, was diagnosed with COPD 30 years ago. James was a smoker until the age of 35 when he quit on his own due to sore, tender lungs. After his COPD diagnosis at the age of 49, he began using Salbutamol, a medication to treat wheezing and shortness of breath by opening the airways in the lungs. However, this soon turned into an addiction as James began taking it at 15-minute intervals. “After my Salbutamol use was well on its way, I was also diagnosed with atrial fibrillation,” said James. “I had to go through life quite carefully, saving both energy and breath.” One night, in March 2017, James woke up in deep distress. “I was suffocating, had hardly any air intake and was practically blacking out,” he explained. James’ family doctor gave him a dose of prednisone to decrease inflammation caused by COPD, and antibiotics, and referred him for respiratory therapy treatment through the UPSTREAM program at Horizon’s Oromocto Public Hospital. “That initial visit was very valuable to me,” said James. “I was given several tests and above all, was given the confidence that I was not nearing the so-called end. The respiratory therapist, Teena Hackett, recommended an inhaler, Tudorza, and I am faithfully taking that along with other related medications which allow me to do physical work for practically a full day. Teena has worked wonders for me and checks my condition yearly.” Improved quality of life through treatment and support Three years ago, Howard Miller, a patient of the UPSTREAM program, was experiencing shortness of breath, which prompted him to visit the Emergency Department. He was hospitalized and diagnosed with COPD. Howard began attending sessions with Teena through the UPSTREAM program at Horizon’s Oromocto Community Health Centre. Teena has helped him meet his goals to improve his breathing. “I had to try a number of puffers over the years until I found one that worked best,” said Howard. “I’ve recently found a COPD support group in the Fredericton area that will soon begin meeting to share experiences, which I am looking forward to.” Howard quit smoking four years ago, and today is doing well. “What I’ve eaten, where I’ve been, or the humidity can sometimes trigger my COPD, however, I’m able to get it back under control when it acts up.” After initial testing, James and Howard were both offered education and follow-up support by Teena. “Making a plan of action: understanding what is happening, what might happen, and what to do if something happens, can be reassuring and help people manage their COPD at home so they don’t need to go to the hospital,” said Teena. “Follow-up support is very individualized. It includes monitoring breathing tests over time, making medication changes as needed, and connecting patients to other services which might be helpful, such as dietitians, social work, and pulmonary rehab programs.” Teena says people with COPD, including James and Howard, are some of the bravest people she’s ever met. “They show up for appointments despite the weight of their fears, and it is my hope they leave my office feeling a little bit lighter.” Knowing the signs of COPD People with COPD usually have one or more of the following symptoms: a cough that lasts a long time (3+ months)a cough with mucusshortness of breath while doing everyday activities, such as climbing a flight of stairs or carrying grocerieslung infections (colds and the flu) that may last longer than usualwheezing (a whistling sound when you breathe)feeling tiredunintentional weight loss Smokers and former smokers are at a higher risk of developing COPD. If you are concerned about your breathing, talk with your family physician or primary health care provider. Horizon’s UPSTREAM and INSPIRED programs Through Horizon’s UPSTREAM and INSPIRED programs, you will meet with a certified respiratory educator who will have you perform a breathing test to assess your COPD, or to confirm a diagnosis. The educator will work with you / your family to: determine how they can help you meet your goals to improve your breathingprovide education about COPDoptimize your medications, in partnership with your physician or nurse practitionerdevelop an action plan for when your breathing worsens