COPD Complications in Flu Season

COPD Complications in Flu Season

Because influenza primarily affects the respiratory tract, it is especially dangerous for individuals with COPD and other preexisting respiratory conditions. The rate of unfavorable outcomes for patients with respiratory diseases – like COPD – is significantly higher than for the general population who contract the flu.

Flu season is quickly approaching, which means patients with COPD should take extra precautions to protect themselves. If you do get the flu, there are special considerations to improve your chances of a full recovery.

Fighting the Flu Before Infection

There are steps you should take to minimize your chance of contracting the flu. These steps are important for everyone, but especially the elderly and people with chronic diseases such as COPD.

  1. Avoid contact with the virus. The flu is a highly contagious disease that can spread when you’re in contact with someone carrying the flu virus. If possible, avoid encountering sick people during flu season. If you yourself are sick with the flu, minimize contact with anyone who has COPD or other respiratory problems.
  2. Hygiene. During flu season, be especially conscious of your hygiene. Wash your hands regularly with soap and warm water. This is especially important when you’ve been in a highly populated area where germs are more likely to spread from person to person.
  3. Flu shots. A yearly flu vaccine is arguably the best way to protect yourself during flu season. The Centers for Disease Control recommends that everyone over the age of 6 months get vaccinated by the end of October each year. You’re especially encouraged to receive a flu shot if you’re over the age of 65, or if you have asthma or COPD.

If You Contract the Flu

If you’re exhibiting flu symptoms, call your doctor immediately. Symptoms include fever, shivering, headache, sore throat and cough.

You may be prescribed antiviral medications within 24 hours of your symptoms starting. These medicines can shorten the duration of your illness and make your symptoms milder, preventing serious complications.

New influenza strains are constantly emerging, indicating that the flu will remain a serious problem for the foreseeable future. Being proactive and vigilant can help prevent complications from the flu in patients with COPD.

The flu could trigger exacerbations for patients with COPD, worsening symptoms beyond the expected day-to-day variation. Inhaled bronchodilators, systemic corticosteroids and antibiotics may be prescribed to manage secondary complications.

For more information about flu prevention and complications for patients with COPD, ask your primary care physician or contact Pulmonary & Critical Care Medical Associates at (717) 234-2561 weekdays from 8 a.m. to 4:30 p.m.

Blood Test May Boost Lung Cancer Detection

Blood Test May Boost Lung Cancer Detection

Because of a new blood test, doctors are one step closer to easily detecting early-stage lung cancer. The test could ultimately lead to faster, more effective lung cancer detection worldwide.

In recent years, the U.S. Preventative Services Task Force has recommended regular CT scans for people at high risk of developing lung cancer. Early analysis indicates that these new blood tests could be a more effective way of detecting early-stage lung cancer among these individuals.

Details of the Blood Test

French researchers from World Health Organization’s International Agency for Research on Cancer developed the blood test. The test determines a person’s chance of developing lung cancer by looking at four specific protein biomarkers in the blood. Sixty-three percent of future lung cancer patients can be detected by this simple test.

Earlier in the summer, a study from the American Society of Clinical Oncology presented similar findings in blood tests designed to detect early-stage lung cancer. Researchers reported that almost half of early-stage lung cancers could be identified through the blood test. The tests are sometimes referred to as “liquid biopsies.”

Who This Benefits

Ultimately, the test will be helpful for identifying who would most benefit from further lung cancer screening. It is especially useful for those at higher risk for lung cancer, such as smokers, former smokers and people with long-term exposure to respiratory contaminates.

Blood could easily be drawn at a doctor’s office, making it a convenient and cost-effective way to detect early-stage lung cancer. Doctors would have results within 72 hours, compared to a week for patients who are screened through a CT scan. It could also potentially lessen the occurrence of false positive results.

Moving Forward

More data needs to be collected before the blood tests are widely used, but current results are promising.

It is already possible to detect late-stage lung cancer through blood tests, allowing doctors to assess genetic characteristics and formulate targeted treatment options.

The data from recent studies show that finding early-stage lung cancer through blood testing is a feasible possibility in the near future.

A New Way to Manage Your Health

RevUp Chronic Care Management Program

Pulmonary & Critical Care Medicine Associates (PCCMA) is excited to offer RevUp, a new way for patients with Medicare coverage to manage their health!

What is RevUp?

RevUp is a Chronic Care Management Program designed to help you stay connected and be supported between your PCCMA doctor visits.

You’ll be assigned a personal care team including a nutritionist, dietitian, physical therapist and nurse. The care team is available to answer your questions, provide health recommendations and coordinate with your doctor when necessary.

Think of this team as your health coaches and advocates, who can help keep you on the right track to manage your condition.

How does it work?

With RevUp, you can track your health online from home by logging your weight, blood pressure, blood sugar and more. Studies show that patients who actively track their health data see improvements in their health.

How can it help?

In many cases, RevUp has prevented health problems from progressing and even prevented visits to the hospital. Even if you’re in a good state of health now, RevUp can help you stay that way by monitoring your condition and providing suggestions about nutrition, pain management, exercise and more.

In short, RevUp will help you take charge of your health.

How do I get started?

For more information talk to your PCCMA provider or call 717-234-2561.

*Like all Medicare Part B services, a co-insurance payment is required. If you have a Medi-Gap-type supplemental medical policy, you may not be responsible for any payment. Patients who have not met their deductible for the year may be responsible for meeting their yearly deductible first, if they do not have secondary insurance or if their secondary insurance does not cover deductibles. Regardless of your insurance coverage, the front desk will be able to provide additional information regarding any billing concerns. You can call the front desk at 717-234-2561.

Popcorn Lung and E-Cigarettes

Popcorn Lung and E-Cigarettes

In recent years, e-cigarettes have emerged as a popular alternative to smoking. They are often used as a crutch to help adults quit smoking, but the use of e-cigarettes is higher among high school students than adults, according to the Office of the Surgeon General.

Like other tobacco products, e-cigarettes contain nicotine and other chemicals that can be detrimental to your health.

About E-Cigarettes

E-cigarettes are devices that heat liquid into an aerosol. That aerosol is then inhaled by the user. The liquid in an e-cigarette may contain nicotine, flavoring, heavy metals, ultrafine particles and volatile organic compounds. When these ingredients are inhaled into the lungs, they have the potential to cause serious harm.


One especially concerning ingredient is diacetyl, a chemical that has been linked to serious lung disease. Diacetyl was previously used to add buttery flavor to food products, such as popcorn. This is how the condition known as “popcorn lung” received its name.

In the early 2000s, major companies removed diacetyl from popcorn when it was found to be the likely cause of “popcorn lung” in factory workers who inhaled the chemical regularly. Diacetyl is now added to the juice of many e-cigarettes to complement flavors.

Diacetyl is not isolated to e-cigarettes. Traditional cigarettes also contain the harmful chemical, often in much higher doses.

Popcorn Lung

Popcorn lung is formally known as bronchiolitis obliterans. The disease causes scar tissue and inflammation in the lungs’ smallest airways. This obstruction leads to symptoms such as:

  • Wheezing
  • Coughing
  • Shortness of breath
  • Unexplained exhaustion

If you have any of these symptoms, you should seek medical attention to determine the underlying cause.

Harvard Research

During a 2015 Harvard study, researchers discovered that 39 of 51 e-cigarette brands contained diacetyl. Acetoin and 2,3-pentanedione (also known as acetylpropionyl), two other harmful chemicals, were also found in many brands. Only 8% of e-cigarettes tested were free of these three chemicals.

While there is currently no explicit link between e-cigarettes and popcorn lung, Harvard researchers have stated that the possibility should be explored through further research. Most health concerns regarding e-cigarettes have focused on nicotine, leaving much to be discovered.


E-cigarettes only came under control of the U.S. Food and Drug Administration in 2016. The FDA won’t require e-cigarette companies to submit their products and ingredients for review until 2022. The American Lung Association is urging the FDA to act quickly, especially given the popularity of e-cigarettes among our country’s youth.

How At-Home Breath Training Improves Life for Asthma Sufferers

At-Home Breath Training Improves Life for Asthma Sufferers

People who suffer from asthma are all too familiar with the uncomfortable symptoms, but self-taught breath retraining has been proven to help.

How the Exercises Help

In the same way physical exercise leads to stronger muscles, breathing exercises can help with ease of breathing throughout the day. In asthma patients, stale air can accumulate in the lungs, leading to a depletion of oxygen levels throughout the body. Breathing exercises help rid the lungs of that trapped air, also helping the diaphragm.

Lung function and airway inflammation aren’t physically improved by these exercises, but they can significantly enhance a patient’s quality of life.

Common Exercises

There are a variety of at-home breathing exercises commonly utilized by asthmatics. Here are three of the more common:

  • Diaphragmic Breathing — Also known as belly breathing, diaphragmic breathing is when you breathe in through your nose, then out through your mouth for at least two to three times longer than your inhale. While breathing, you should use your hands or a light object to observe your belly rising and falling as you breathe. Relax your neck and shoulders before starting. This exercise is designed to retrain your diaphragm, so it can be better used for normal breathing.
  • Pursed Lip Breathing — When performing pursed lip breathing exercise, you purse your lips, then breathe in through your nose and out through your mouth. Like diaphragmic breathing, you breathe out at least twice as long as you breathe in. The pursed lip breathing exercise keeps your airways open longer by reducing the number of breaths you take per minute.
  • The Buteyko Method — This is a common exercise used when an asthmatic is short of breath. It is a kind of hyperventilation-reduction technique where you breathe slowly and shallowly through your nose until the asthmatic episode passes.

Learning the Exercises

It is common for patients to have a few sessions with a medical professional to learn the many breath training exercises they’ll regularly complete at home. However, a recent study suggested that being taught via video could be just as effective in teaching the proper techniques.

Regardless of how patients learn the proper breathing exercises, the most important thing is staying consistent. Do the exercises as recommended by your doctor, often as part of your daily routine, to help manage your asthma symptoms.

Study Shows Benefits of Lung Cancer Screening

Study Shows Benefits of Lung Cancer Screening

New research led by the Veterans Health Administration (VHA) is bringing attention to lung cancer screening. Based on the research, researchers have improved screening criteria for those at risk of lung cancer.

Risks and Benefits of Lung Cancer Screening

Low-dose CT scans are most commonly used to test for lung cancer. There have always been pros and cons of being tested, but this new study gives insight into who benefits most from screening.

The decision to get tested can be beneficial for many people at risk for lung cancer. However, the scan might also set off a false alarm, causing unnecessary anxiety.

Many first-time scans are still needed to prevent just one death from the disease, but screening is known to be more beneficial for those at high risk of developing lung cancer. Early detection can lead to more effective treatments for those affected by lung cancer.

A Personalized Approach

The results of the recent VHA study can help doctors personalize their advice to patients.

Doctors have always considered how a patient’s individual risk of lung cancer compares to the potential harms and benefits of screening. Now, doctors will be able to take it a step further, factoring in a range of patient attitudes.

Calculating Risk

Not all patients feel the same way about screening and its potential consequences.

If a person has a life expectancy of more than ten years and a 0.3%-1.3% chance of lung cancer, they fall into a “high-risk” category of people who more often benefit from screening. Approximately half of all Americans who qualify for lung cancer screening under the current guidelines would qualify as high-risk.

For the remaining 50%, personal preference plays a larger role in comparing the risks and benefits of being screened. If a low-risk patient is uncomfortable with medical tests and the potential for follow-up scans, they and their doctor may decide that screening isn’t a good option.

Moving Forward

This recent study is another step toward increasing the efficiency of lung cancer screening.

The board-certified doctors and licensed medical staff at Pulmonary & Critical Care Medicine Associates provide comprehensive evaluation and care for lung conditions. To talk with a doctor, contact us.

Sleep Apnea Symptoms and Treatment

Sleep Apnea Symptoms and Treatment

Sleep apnea is a common sleep disorder, causing those affected to periodically stop breathing while asleep. Only 20% of the 18 million Americans with sleep apnea have been diagnosed and treated for the disease.

Common Symptoms

Adults with sleep apnea are likely to experience the following symptoms:

  • Dry mouth or headaches in the morning
  • Problems concentrating during the day
  • Excessive fatigue
  • Heartburn
  • Irritability
  • Decreased libido

Symptoms of sleep apnea vary in men, women and children. Women are more likely to report depression, headache, fatigue, anxiety and insomnia. In children, symptoms may include bedwetting, problems with academic performance, hyperactivity or an increase in asthma symptoms.

Some common signs of sleep apnea are loud snoring and visible changes in breathing pattern. These signs are typically observed during a sleep study that leads to diagnosis.


Once sleep apnea is diagnosed, the patient will work with their doctor to develop a treatment plan based on specifics of the diagnosis.

A breathing device, such as a CPAP (Continuous Positive Airway Pressure) machine, is a commonly recommended treatment option.

Those with mild sleep apnea may be prescribed a mouthpiece to wear while sleeping. The mouthpiece helps hold a patient’s jaw and/or tongue in place to prevent obstruction of the airway. Orofacial therapy also could help improve the tongue’s positioning and strengthen facial muscles.

If a patient’s sleep apnea is severe and doesn’t respond to other treatment, surgery may be required. Possible surgical procedures may be performed on the tonsils, jaw or trachea, depending on the cause of the sleep apnea.

Lifestyle Changes

Along with other treatment options, your doctor may also ask you to adopt healthy lifestyle changes. This includes minimizing the intake of alcohol and cigarettes, making heart-healthy eating choices and exercising regularly.

Untreated sleep apnea can lead to depression and heart disease, so it is important to consult your doctor if you are experiencing symptoms of sleep apnea.

PCCMA performs sleep studies at its in-house sleep lab and sleep labs affiliated with Geisinger Holy Spirit and UPMC Pinnacle. To schedule an appointment, please call us at (717) 234-2561 or complete our online appointment form.

PCCMA Introduces COPD Video Series (Part 2 of 2)

How to use your RESPIMAT inhaler
In our last blog post, we introduced the first two segments of Pulmonary & Critical Care Medicine Associates’ five-part video series explaining the many facets of Chronic Obstructive Pulmonary Disease (COPD). The segments were “Learning You Have COPD” and “Understanding COPD.”

The remaining segments of the video series focus on how to improve your quality of life with COPD and how to use a RESPIMAT inhaler.

Living Better With COPD

At just over seven minutes in length, the third section in PCCMA’s video series provides detailed insights into ways you can live better with COPD.

Elizabeth Tuttle, PA-C, discusses how certain medication and lifestyle changes can help you feel better over time. Specifically, she talks about the benefits of exercise, proper diet and quitting smoking. PCCMA has programs to help individuals who are trying to stop smoking and those who are trying to make healthier eating choices.

Elizabeth also helps you learn more about the disease, including what COPD does to your body and what triggers COPD symptoms.

You’ll then meet Henry Ostman, MD, FCCP, who emphasizes the importance of having a support system of friends and loved ones. If you’re lacking a strong support system, PCCMA doctors and medical staff can help. Additionally, you should tell your doctor if you have feelings of depression or disappointment.

Dr. Ostman concludes the segment by discussing why it is critical to take your medication as directed, including using rescue inhalers and daily inhalers.

How to Use a RESPIMAT Inhaler

This fourth video segment offers critical information for anyone using a RESPIMAT inhaler to help treat COPD. Joshua Hoffman, MD, explains what the inhaler is and how it works.

The segment also includes step-by-step instructions on how to use an inhaler. This portion of the video is especially valuable if you have never used a RESPIMAT inhaler before.

Managing COPD

Christopher Shaffer, MD, concludes the video series by summarizing the importance of treatment for living well with COPD.

Although there is no cure for COPD, symptoms can be managed.

The doctors and staff at Pulmonary & Critical Care Medicine Associates are ready to be your COPD care team and to be part of your support system.

If you have questions about COPD, or suffer from symptoms, please make an appointment or call us at (717) 234-2561.

PCCMA Introduces COPD Video Series (Part 1 of 2)

Learning You Have COPD

Chronic Obstructive Pulmonary Disease (COPD) is one of the most common conditions treated at Pulmonary & Critical Care Medicine Associates. While common, the COPD can be overwhelming, so it’s very important to educate yourself about the disease.

The doctors and medical staff at PCCMA created a five-part video series to help you and your loved ones understand COPD including how the disease is treated.

Throughout the series, PCCMA doctors and staff walk through COPD topics in detail. Animated videos of your lungs’ inner workings and portrayals of real people provide a visual representation of what to expect throughout a journey with COPD.

The first two videos in the series are titled “Learning You Have COPD” and “Understanding COPD.”

Learning You Have COPD

In this brief video, PCCMA doctors discuss the basics of COPD, what it means to live with this chronic condition and ways to treat it. This segment provides you with a foundation for what you’re learn in the rest of the video series.

You’ll meet Dr. Richard Evans, who will introduces the series and also highlights the importance of support groups. Dr. Baba H. Linmann then emphasizes how you can use information from the video to prepare for your doctor visit or to educate friends and family about the disease.

Understanding COPD

The “Understanding COPD” segment will help you fully understand the disease.

Dr. Rommel B. Bebe breaks down the definition of COPD and discusses symptoms of the disease. You’ll then hear from Dr. Hiren Shingala, who talks about what causes COPD and how the disease affects your lungs. Dr. Shingala also discusses the relationship between emphysema, chronic bronchitis and COPD.

Margarita E. Yoder, a nurse practitioner at PCCMA, concludes the segment by elaborating on chronic bronchitis and discussing the effect of “air trapping” on your everyday life. Margarita then describes how COPD is diagnosed and lifestyle choices you can make to improve quality of life with COPD.

The remaining segments of the video series are “Living Better with COPD,” “How to Use Your RESPIMAT Inhaler” and “What We Learned Today.” We’ll introduce these three videos in Part 2 of this post.

We hope you find the video series valuable!

Controlling Asthma During Spring

Controlling Asthma During Spring

The birds are chirping, the flowers are blooming … and pollen is filling the air.

While springtime is a season of rejuvenation, it also brings about a spike in asthma attacks, especially when pollen counts reach high levels.

Cause of Springtime Asthma Attacks

When flowers, weeds, trees, grass and other plants bloom in springtime, they release pollen into the air. Seasonal pollen can result in airway inflammation, which worsens underlying asthma conditions.

Ways to Prevent an Asthma Attack

The best way to keep asthma under control is by taking your asthma medications as prescribed by your doctor.

If you have asthma, you are likely familiar with an inhaler. Your doctor may also prescribe quick-relief medicine for flare-ups. Always make sure your asthma medications are on-hand and that they are filled before they run out.

For asthma sufferers who exercise outside, your doctor may recommend taking an antihistamine (like Claritin or Zyrtec) and/or two puffs from a short-acting emergency inhaler prior to outdoor activity.

Immunotherapy shots are another option suitable for some patients. Administered regularly over a period of time, immunotherapy shots can reduce the body’s reaction to allergens.

Here are additional tips to help control your asthma during spring:

  • Get tested for allergies. According to a study published in the journal of the American College of Allergy, Asthma and Immunology, nearly two-thirds of people with asthma also suffer from allergies. An allergy test can help you learn the triggers you should avoid.
  • Stay indoors in the morning. If possible, avoid the outdoors between 5 a.m. and 10 a.m. when pollen levels are at their highest. Check the pollen count in your area daily.
  • Wash off the pollen. Shower and wash your clothes after being outside. Pollen sticks to your body and can be transferred to household surfaces.
  • Shut the windows. Keep your home and car windows closed. It’s better to use air conditioning instead. In your car, set the air flow to recirculate so outside air isn’t introduced.
  • Avoid outside chores. If you can, get someone else to do your yard work and gardening. If you must do it yourself, wear a mask. Also, keep your grass short or opt for ground cover that doesn’t produce much pollen such as Irish moss.
  • Use the dryer. Dry your sheets and clothes indoors rather than on an outdoor clothesline.

The doctors at PCCMA evaluate and treat asthma, as well as other breathing problems. If you are concerned about asthma or are experiencing symptoms, schedule an appointment.

Lemoyne: 50 N. 12th Street, Lemoyne, PA 17043
Carlisle: 220 Wilson Street, Suite 104, Carlisle, PA 17013
York: 1750 5th Ave, Suite 300, York, PA 17403

Phone: (717) 234-2561

For medical emergencies, call 911.

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