A diagnosis of chronic obstructive pulmonary disease (COPD) might bring fear and uncertainty. But Leah Knabe, APRN, a family nurse practitioner in pulmonology at OSF HealthCare, is reminding you that treatment has progressed in recent years, and a diagnosis doesn’t automatically mean a reduced quality of life.

A recap

First, a recap. Knabe says COPD is an obstruction in the airways, typically caused by inflammation from an outside irritant.

“Symptoms typically are cough, shortness of breath and excess mucus production. There’s wheezing from inflammation in the airways. The little bronchioles in our lungs get tight. Good airflow and gas exchanges aren’t happening. It leads to that shortness of breath. The disease typically progresses [gets worse] over time,” Knabe explains.

Knabe says COPD is the third leading cause of death worldwide, and around 81% of cases are undiagnosed. That makes it all the more important for people with COPD to see their primary care provider or pulmonologist regularly. A person could be treated with steroids, antibiotics or go on oxygen. Smoking is the biggest risk factor for COPD, so you should avoid cigarettes and vapes to preserve lung function. People who work around chemicals, like farmers, custodians and factory workers, are also at a higher risk.

More on treatment

Knabe says that just in the last year, COPD treatment has gotten better, leading to more options for the patient.

“We’ve had biologics become approved for use in COPD patients. They’re an injection that helps manage the inflammation that flares up the symptoms,” Knabe outlines. “There are new inhalers. There are nebulized medications that have come onto the scene in the past year. Those help with shortness of breath. There are other recommendations through the Global Initiative For Chronic Obstructive Lung Disease. Those include the antibiotic medication azithromycin three times per week for really severe cases.

“Inhaler technique is something that is overlooked a lot for COPD patients. We need to make sure they have the right technique to get the medication where it needs to go,” Knabe adds. “If that’s an issue for our severe COPD patients, they do make medication for the nebulizer that can help. If you can’t pull that medicine from the inhaler down into your lungs, there’s the nebulizer machine that fumes the medication. They sit and breathe that in versus trying to physically pull it down with the inhaler.”

In other words, there is hope, Knabe says. The goal is to help the person breathe easier for a long time. But early detection is key.

Learn more

Read more about keeping your lungs healthy on the OSF HealthCare website.

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Humans are well-equipped to bounce back from most cases of respiratory illnesses like COVID-19, RSV and the flu. But in some cases, the impact on your lungs can be long-lasting, leading to chronic symptoms like difficulty breathing, fatigue or brain fog. You can also be at a higher risk for a blood clot or infection in your lungs.

“There’s damage to the lungs in the form of cellular damage, as well as immune system dysregulation and prolonged inflammation,” says Yiran Gong, MD, a pulmonologist at OSF HealthCare. “These can be the drivers of post-COVID syndrome, or extensive and persistent symptoms after the resolution of the viral illness.”

Dr. Gong admits the outlook can be daunting. But health care providers have several ways to attack the problem.

Pulmonary rehabilitation involves breathing exercises to “retrain your body on how to breathe,” Dr. Gong says. For people with post COVID-asthma, a provider may prescribe an inhaler to reduce inflammation in the lungs’ small airways.

“There are medications to slow the progression of pulmonary fibrosis [scarring]. However, these medications have not really been researched for COVID specifically just because of how short of a time COVID has been around,” Dr. Gong says. “People who do have extensive lung scarring will require referral to a transplant center.”

Staying on top of your health, such as being up to date on vaccines and practicing good hygiene (like washing your hands thoroughly and often), is a good way to avoid the illnesses that cause lung issues. But if you are dealing with chronic lung symptoms, Dr. Gong says you shouldn’t lose hope.

“See a physician. Make sure there’s not an underlying cause that hasn’t been treated,” he says. “Then you’ll work on optimizing lung function. Take it one step at a time.”

Read more about how to keep your lungs in top shape on the OSF HealthCare website.

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In the Midwest, you never know when the hot weather is truly gone for good. But as we leap into fall and cooler temperatures become more consistent, it’s important to prioritize our immune health.

To those without severe breathing disorders, the cool fall breeze can be welcome. But for those with chronic lung diseases, it can be a challenging time.

“Especially people with asthma or patients with emphysema or COPD, we notice some of their symptoms may come to the forefront with this change in weather” says Juanbosco Ayala, MD, a pulmonologist physician with OSF HealthCare. “Things such as cough, shortness of breath and wheezing are common symptoms that may unfold during this timeframe.”

With kids going back to school, fall sports in full swing, and viruses present in the workplace, fresh air can mean increased sickness.

Dr. Ayala says there are a few ways we can protect ourselves this fall.

“Having the flu vaccine is definitely a great way to protect ourselves. Also, recognize how your breathing is changing. Ask yourself if it is related to the temperatures changing, or if it’s a persistent cough that’s not going away. An increase in the sputum you make every day, as well as fevers, chills or night sweats can be cause for concern,” Dr. Ayala says.

While springtime allergies are more common and severe, Dr. Ayala says allergies can still persist into the fall months.

“We don’t see it as bad as the spring, but it’s still present. The bump you see in the spring is related to patients going outside a little more, or things changing in the springtime.”

The change in fall weather can also impact the way we sleep. As temperatures drop, the number of people sleeping with their windows for a little fresh air increases.  

“As far as patients with chronic sleep disorders, sleeping with the windows open is not an issue. They can definitely do that. The big thing is to continue their therapies, like wearing their CPAP every night as long as they can,” Dr. Ayala adds.

If cold-like symptoms persist, Dr. Ayala says it’s important to see your doctor right away. If there are concerns of a breathing or sleeping disorder, you may be referred to a pulmonologist or sleep doctor for further evaluation.

About 25 million Americans have asthma, according to the Asthma and Allergy Foundation of America. If you are part of that population, now is the time to prepare for what’s known as “Peak Week.” Officially, that would be September 15-21, just as summer turns to autumn.

Every person diagnosed with asthma should have an “asthma plan,” which includes prescriptions for medications and a list of best practices to limit exposure to asthma attack triggers.

The best thing you can do to prepare for “Peak Week” is to review your plan and take action as necessary:

• Make sure your prescriptions are filled.
• Make sure your rescue inhaler, if you need one, is up to date. Because they are used as needed, it’s easy to hang on to them for too long. Check the expiration date. If it has passed, get your prescription renewed.
• Know your triggers and symptoms. Avoid those things that cause you difficulty. And if you start feeling symptoms, use your rescue inhaler.

Video Interview Clips

Nearly 30 million adults in the United States are affected by obstructive sleep apnea and almost 80% of these cases are undiagnosed, according to the American Academy of Sleep Medicine (AASM).

The AASM has launched an awareness campaign for this condition, which costs more than $149 billion annually in health care costs, lost work productivity and workplace and motor vehicle accidents.

Juanbosco Ayala, MD, is a pulmonologist with OSF HealthCare. He says the most common sign of sleep apnea is an overall tiredness throughout the day.

“Patients feel very tired and don’t feel energized after waking up in the morning,” Dr. Ayala says. “They may have morning headaches, a dry mouth, and they may be told by their significant other that they snore or stop breathing in the middle of the night.”

Another common sign? Dozing off during the day.

“Whether it’s talking like we are, in a meeting, or watching a movie. It’s this excessive tiredness that leads to falling asleep quite easily. There are even patients who will fall asleep while driving. They get to a stop sign and for those two seconds they’re not paying attention, they’ll doze off,” Dr. Ayala says.

The most common treatment of sleep apnea, Dr. Ayala says, is the C-PAP machine.

“There’s a full face mask that encompasses a mask over the nose and mouth. There are patients that do well with just a nasal mask,” Dr. Ayala says.

As recently reported by doctors at OSF HealthCare, bad sleeping habits can have long-term consequences to our lives. Dr. Ayala says the same goes for sleep apnea.

“Long-term consequences typically involve either the heart or the lungs. Specifically long-standing hypertension and an entity called pulmonary hypertension can be something we see long-term from untreated sleep apnea,” Dr. Ayala says. “There’s also a significant risk for heart attacks and strokes.”

Dr. Ayala says some data suggests sleep apnea could also lead to cognitive impairment. He says sleep apnea is normally seen in overweight patients, but can be found in almost anyone.

“There is a subset of the population that is fit, not necessarily overweight, and they have sleep apnea,” Dr. Ayala says. “Sometimes not thinking about it leads to impediments in treatment.”

Dr. Ayala says the best thing you can do if you suspect you have sleep apnea is to see a health care provider. An OSF HealthCare provider can evaluate you and create a treatment plan moving forward.

Video Interview Clips

Pharmacies are dealing with a shortage nationwide of the medication used to treat breathing conditions as result of an Illinois manufacturer shutting down three facilities this year, and filing for bankruptcy in 2020.

Melody Bauman, a physician assistant with OSF Medical Group – Lung & Pulmonology, is keeping in close contact with pharmacies because of the shortage.

“They’re letting us know they have a backorder of albuterol,” Bauman says. “The good thing so far- is that it seems it’s only impacting the nebulize solution of albuterol. It’s a liquid vial that patients would put in a nebulizer to give themselves a breathing treatment or a mist."

Bauman says there are inhalers with the same medication her office can still prescribe patients. She says it’s important to take a deep breath during this shortage, and talk with your health care provider.

“The biggest thing I’d say is not to panic,” she says. “We are here to help patients navigate that process. Through the pandemic, we’ve had more and more issues with medication shortages in general. We’ve been able to find pivots along the way.”

Another tip Bauman shares is to check your albuterol stockpile at home.

“Make sure those medications are up to date. Usually for the nebulizer solution and the rescue inhalers, most of those will expire after a year,” Bauman says. “They’ve found with research that most of those medications aren’t harmful to use after their expiration date, but they probably won’t be as effective.”

Now that spring has arrived, allergy season has come along with it. Bauman offers to advice on how to breathe easier in the coming months.

“Limit that outside exposure if you know pollen is affecting you. Especially in the midday hours when we find that pollen tends to increase as the day goes on,” Bauman says. “Try to keep pets away from your bedroom and sleeping on your bed. Pets will bring pollen in, we don’t want that to be around as people are sleeping. Try to limit the windows being open, especially in the bedroom at night.”

Bauman also says air purifiers are a great help to make sure the air is safe to breathe inside your home.

There are other conditions that can affect someone’s breathing, such as asthma and chronic obstructive pulmonary disease (COPD).

While Bauman says the two conditions share a lot of the same symptoms, there are some key differences.

“Both have similar symptoms of shortness of breath, wheezing, coughing chest tightness,” Bauman says. “The main differences are with asthma, there’s some airway remodeling. The airways tend to get very inflamed and constrict. That’s usually either due to either genetics and/or environmental triggers patients experience.”

She adds while the airway obstruction can be partially reversible, that’s not the case with COPD.

“COPD is a group of lung diseases that most people will know either as emphysema or chronic bronchitis,” she says. “Those are progressive type diseases, in which the airway obstruction is usually irreversible. Most commonly, we see COPD because of people who have smoked long term.” 

If you are dealing with asthma or COPD symptoms, or other breathing difficulties, you can get help through lung & pulmonology services offered by OSF HealthCare.

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Television host Carson Daly is the latest celebrity to try what some call sleep divorce. Couples who sleep in the same bed but are not getting that coveted seven to eight hours of shut eye will slumber with some degree of separation: in the same bed but with separate blankets, in separate beds in the same room or in separate rooms.

Daly called the move the “best thing” for his marriage during a summer episode of the Today Show.

“We both, admittedly, slept better apart,” he said.

The concept is one worth exploring for couples who are kept up by snoring, restlessness, differences in sleep schedule or other nighttime issues, says Nadeem Ahmed, MD, a pulmonologist at OSF HealthCare in Alton, Illinois.

But let’s get one thing straight.

“I don’t like the term ‘sleep divorce’ because it tends to blame other people. It’s not a good word. It brings anxiety,” Dr. Ahmed says.

“I like to use ‘sleep alliance.’ They’re working together. They’re working things out. They want to make sure it’s healthy for both bed partners and the sleep disturbances don’t affect the other partner’s life,” he says.

Have the discussion

Dr. Ahmed says he encounters sleep issues, like snoring, in his practice “almost every day,” and many people are shy about it.

Every case is different. Dr. Ahmed says couples should first talk out their sleep issues and try to find a solution. The partners could try sleeping in separate beds during the week and in the same bed on the weekend so intimacy is not completely lost. Some mattresses have different firmness, temperature and slant on each side, which can help.

If needed, the partners should talk to a pulmonologist or psychologist.

“A lot of psychologists will do similar things that a physician will do. It’s just the comfort level of the person,” Dr. Ahmed explains. “Sometimes they don’t want to go to a medical doctor for the sleep problem. They would rather talk to a psychologist.”

“The idea is to discuss it with some type of professional,” he says.

Dr. Ahmed adds that sleeping separately should be a short-term solution.

“Tell your bed partner this is an issue, and we need to address it. As opposed to just getting mad or feeling crummy or sleepy the next day,” Dr. Ahmed says, “Because it can affect your job, like if you’re a machine operator or have to drive a truck.”

A major cause

Dr. Ahmed says a big cause of the restlessness that leads to sleep alliance discussions is sleep apnea, when people stop breathing during sleep. This can lead to loud snoring or body movement in bed and crabbiness or grogginess the next day.

Dr. Ahmed says there are two types of sleep apnea: obstructive and central. Obstructive sleep apnea is a product of obesity. Central sleep apnea is associated with neurological deficits like a stroke.

“[Sleep apnea] is not fatal because our brains are hard-wired to let you go to a certain time, and then it triggers you to take a breath,” Dr. Ahmed explains.

But, if the condition is left untreated, there is a litany of possible issues: hypertension, cardiac arrhythmia, diabetes, dementia, headaches and frequent urination.

Diagnosis of sleep apnea would involve a sleep study, either in your home or at a hospital.

Treatment options include a mask and machine combination known as a CPAP or BiPAP, a mouth guard or a small device that’s implanted in your body in outpatient surgery. All those options aim to help you breathe normally and sleep peacefully.

“Along with that, we have to stress lifestyle changes,” to rid oneself of sleep apnea, Dr. Ahmed adds. “Eating healthy. Losing weight. Getting exercise.”

Over-the-counter options for better sleep include melatonin, an eye mask, earplugs, thick window curtains, a plush mattress and sheets and a white noise device like a smart speaker. Don’t eat or drink, aside from water, a couple hours before bedtime, Dr. Ahmed also advises.

Learn more

Learn more about healthy sleep on the OSF HealthCare website. If you’re having sleep problems, especially if it’s impacting your daytime life, talk to your primary care provider, a pulmonologist or a behavioral health provider.

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A brawl is brewing between government regulators and the manufacturer of the best-selling e-cigarettes in the United States. The U.S. Food and Drug Administration (FDA) has agreed to pause its ban on products from vaping company Juul while the government reviews the company's electronic cigarettes. 

The FDA had banned the marketing and sales of all vaping products produced by the company, a decision that was appealed by Juul, yet applauded by health care professionals. 

“Why would we inhale anything in our lungs except good clean air?” remarks Dr. Patrick Whitten, an OSF HealthCare pulmonologist in Peoria, IL. “So it's just yet another step in the right direction to try to get people not to put anything in their lungs this damaging.”

The FDA claims Juul’s application for authorization lacks enough details about the chemical makeup of its vaping formulas, and doesn’t significantly prove that its e-cigarettes help adult smokers quit or reduce their smoking. 

Another concern of government regulators and health care providers alike is the increase in teen and adolescent vaping, and what Juul Labs, which is owned by Altria Group Inc., the maker of Marlboro cigarettes, is doing to prevent it. 

“The cigarette companies realize that it's important for them to get people hooked on these products because cigarettes kill people and if they kill their consumer, they have to replace that consumer or else they don't have a business model,” says Dr. Whitten. “So this despicable business model is to get younger smokers or younger people hooked on their products to continue to use. If they don't replace their consumers that they're killing off, they have no business.”

As the battle between the FDA and Juul continues in the courtroom, Dr. Whitten urges parents to be proactive at home. 

At high doses, nicotine can cause dizziness and vomiting. Users who refill their own cartridges are especially at risk for unsafe levels of the drug. Even more concerning, young children have been poisoned after coming in contact with the nicotine-containing liquid. Teens who use e-cigarettes may become addicted to nicotine, which can harm their developing brain. There’s also concern they may start smoking regular cigarettes. 

According the U.S. Centers for Disease Control and Prevention (CDC), in 2021, about one out of every 35 middle school students and one of every nine high school students reported that they had used electronic cigarettes in the past 30 days.

Dr. Whitten says a parent’s open and honest communication with their kids can help pave the way to a smoke and vape-free future. 

“Education is the key here,” he explains. “We can all learn things from each other, right? So even for our own kids, who we think are not going to be doing things like vaping, information is so important. So why they shouldn’t do things like that. So it's good to have that open dialogue between the parents and the kids.”

When it comes to both vaping and smoking, the top takeaway, according to Dr. Whitten, is to not start. And if you are a smoker to quit. He says it’s never too late – even for life long smokers. 

“It’s never, never too late to quit. When someone quits smoking, even within hours, some of the respiratory cells start to heal themselves a little bit. And you do reduce your risk for lung cancer over time. It's not back to zero, but you do decrease some of that risk if you quit smoking.”

For help quitting smoking, speak with your primary care physician. OSF HealthCare also offers structured programs to help individuals who want to quit. To learn more visit osfhealthcare.org and search “smoking cessation.”

Interview Clips - Dr. Patrick Whitten