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.

What is Oxygen Therapy?

Oxygen Therapy

Oxygen therapy, also known as supplemental oxygen, is the use of oxygen as a medical treatment.

Oxygen is used to treat hypoxia (deficiency in the amount of oxygen reaching body tissues) or hypoxemia (an abnormally low concentration of oxygen in the blood).

Hypoxia and hypoxemia can be the result of a wide range of conditions including:

  • Chronic obstructive pulmonary disease (COPD)
  • Asthma
  • Pneumonia
  • Cystic fibrosis
  • Sleep apnea
  • Pulmonary fibrosis
  • Severe asthma
  • Lung disease
  • Trauma to the respiratory system

Oxygen therapy is commonly administered in a hospital setting; however, the therapy also can be used at home. The treatment is usually delivered through a nasal prong device, called a nasal cannula, or a face mask.

Types of Oxygen Therapy

There are three common systems used for at-home oxygen therapy:

  • Compressed oxygen. This system uses oxygen stored under pressure in a metal cylinder. This is what most people think of when they hear “oxygen therapy.”
  • Liquid system. This system uses a combination of a bulk reservoir, stored in a permanent location, and a portable unit for convenience. A liquid system uses no electricity and the portable unit is smaller and lighter than a compressed oxygen unit.
  • Oxygen concentrators. This system works like an air conditioner. It removes air from the home environment but, instead of making that air cooler, it takes oxygen from the air and delivers that oxygen to patients.

A doctor will recommend the best type of oxygen therapy system based on a patient’s diagnosis and lifestyle.


While oxygen therapy isn’t a treatment that can cure a medical condition, it can help improve symptoms, organ function and quality of life. Specifically, it has the potential to alleviate shortness of breath, reduce fatigue caused by low blood oxygen levels and improve sleep.

Side Effects

During oxygen therapy, patients may experience side effects from the treatment such as a dry or bloody nose, tiredness and morning headaches.

Oxygen therapy is generally safe and most patients find that any side effects are well worth the benefits of treatment.


Oxygen is non-flammable, but oxygen therapy systems may pose a combustion risk. Patients should never use flammable materials during oxygen therapy.

Patients using oxygen therapy also should take precautions when traveling. Contact airlines, buses and cruise ships well in advance to alert them of your oxygen therapy. When traveling via car, keep air flowing. If using compressed oxygen, keep the oxygen tank upright on the floor.

Detecting and Treating Lung Cancer

Detecting and Treating Lung CancerLung cancer is the leading cause of cancer death in the United States. Lung cancer is most often caused by cigarette smoke, but it also can be caused by other environmental factors.

The two most common types of lung cancer are small-cell lung cancer and non-small cell lung cancer. Non-small cell lung cancer is the more common type, accounting for 85% of lung cancers. Doctors differentiate between these types of cancer by studying lung cells at a microscopic level.

A patient’s medical history and symptoms, along with findings from a physical exam, will determine how his or her cancer is diagnosed, while results of diagnostic tests will determine the stage of the cancer and treatment options.



Early detection can significantly improve the ability to successfully treat lung cancer.

A screening test for lung cancer is performed before a patient has any symptoms that indicate cancer is present. When abnormalities are found early on a screening test, the cancer can be easier to treat.

The main screening test to detect lung cancer is a low-dose CT scan. If a screening test discovers an abnormality, the next step is a diagnostic test.

A diagnostic test is used to determine if abnormality in the screening test is cancerous. The test involves taking and studying sample tissue or fluid from around the lung.

If a diagnostic test reveals cancerous cells, a staging test is conducted. A staging test determines the state of the cancer based on where the cancer cells are located, the growth of the cancerous tissue (e.g. the size of the tumor) and whether the cancer has spread elsewhere in the body.

For non-small cell lung cancer, there are four stages with stage one being the earliest and stage four being the most advanced. There are two stages of small cell lung cancer; a limited stage and extensive stage. Lung cancer diagnosis is largely based on how far the cancer has spread.



Methods to treat lung cancer include surgery, radiation, radiofrequency ablation, chemotherapy, targeted treatments and immunotherapy. These methods can be used alone or in combination.

The type of treatment a doctor recommends will depend on the patient’s type and stage of cancer. Possible side effects also are taking into consideration.



PCCMA, Central Pennsylvania’s largest independent pulmonary practice group, performs screenings to detect lung cancer and other lung diseases.

To request an appointment, or a consultation for a second opinion, please complete this online appointment form or call us at (717) 234-2561.

Sleep Study: A Simple Exam Can Lead to a Better Night’s Sleep

Sleep Study: A Simple Exam Can Lead to a Better Night's Sleep
PCCMA’s sleep labs have the comforts of a hotel room.

If you are having sleep-related problems, your doctor may recommend that you participate in a sleep study.

Diagnosing and treating difficulties with sleep is important because, left untreated, they can lead to other conditions such as high blood pressure, heart disease and depression.

Continue reading “Sleep Study: A Simple Exam Can Lead to a Better Night’s Sleep”

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