10 Essential Health Tips (The Basics to Practice Every Day)

1. Move More
Make it a daily challenge to find ways to move your body. Climb stairs if given a choice between that and escalators or elevators. Walk your dog; chase your kids; toss balls with friends, mow the lawn. Anything that moves your limbs is not only a fitness tool, it's a stress buster. Think 'move' in small increments of time. It doesn't have to be an hour in the gym or a 45-minute aerobic dance class or tai chi or kickboxing. But that's great when you're up to it. Meanwhile, move more. Thought for the day: Cha, Cha, Cha…. Then do it!

2. Cut Fat
Avoid the obvious such as fried foods, burgers and other fatty meats (i.e. pork, bacon, ham, salami, ribs and sausage). Dairy products such as cheese, cottage cheese, milk and cream should be eaten in low fat versions. Nuts and sandwich meats, mayonnaise, margarine, butter and sauces should be eaten in limited amounts. Most are available in lower fat versions such as substitute butter, fat free cheeses and mayonnaise. Thought for the day: Lean, mean, fat-burning machine…. Then be one!

3. Quit Smoking
The jury is definitely in on this verdict. Ever since 1960 when the Surgeon General announced that smoking was harmful to your health, Americans have been reducing their use of tobacco products that kill. Just recently, we've seen a surge in smoking in adolescents and teens. Could it be the Hollywood influence? It seems the stars in every movie of late smoke cigarettes. Beware. Warn your children of the false romance or 'tough guy' stance of Hollywood smokers. Thought for the day: Give up just one cigarette…. the next one.



4. Reduce Stress
Easier said than done, stress busters come in many forms. Some techniques recommended by experts are to think positive thoughts. Spend 30 minutes a day doing something you like. (i.e.,Soak in a hot tub; walk on the beach or in a park; read a good book; visit a friend; play with your dog; listen to soothing music; watch a funny movie. Get a massage, a facial or a haircut. Meditate. Count to ten before losing your temper or getting aggravated. Avoid difficult people when possible. Thought for the day: When seeing red, think pink clouds….then float on them.

5. Protect Yourself from Pollution
If you can't live in a smog-free environment, at least avoid smoke-filled rooms, high traffic areas, breathing in highway fumes and exercising near busy thoroughfares. Exercise outside when the smog rating is low. Exercise indoors in air conditioning when air quality is good. Plant lots of shrubbery in your yard. It's a good pollution and dirt from the street deterrent. Thought for the day: 'Smoke gets in your eyes'…and your mouth, and your nose and your lungs as do pollutants….hum the tune daily.

6. Wear Your Seat Belt
Statistics show that seat belts add to longevity and help alleviate potential injuries in car crashes. Thought for the day: Buckle down and buckle up.

7. Floss Your Teeth
Recent studies make a direct connection between longevity and teeth flossing. Nobody knows exactly why. Perhaps it's because people who floss tend to be more health conscious than people who don't? Thought for the day: Floss and be your body's boss.

8. Avoid Excessive Drinking
While recent studies show a glass of wine or one drink a day (two for men) can help protect against heart disease, more than that can cause other health problems such as liver and kidney disease and cancer. Thought for the day: A jug of wine should last a long time.

9. Keep a Positive Mental Outlook
There's a definitive connection between living well and healthfully and having a cheerful outlook on life. Thought for the day: You can't be unhappy when you're smiling or singing.

10. Choose Your Parents Well
The link between genetics and health is a powerful one. But just because one or both of your parents died young in ill health doesn't mean you cannot counteract the genetic pool handed you. Thought for the day: Follow these basic tips for healthy living and you can better control your own destiny.

http://www.health-fitness-tips.com/features/10-essential-health-tips.htm

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Tips to Control Cough

1. Breathe the steam from a vaporizer, hot shower, or pan of boiling water. The moist air will soothe the airways and loosen sinus congestion and phlegm in your throat and lungs. A few drops of the oil of eucalyptus will help this process.
2. Elevate the head of your bed. This will allow your sinuses and nasal passages to drain better and not create that "tickle" in your throat.
3. Stop smoking. Passive smoke or other irritants, such as chemicals, can be a cause. Household cleaners, new carpeting, paneling and mattresses are some of the many possible sources of chemical irritants.
4. Drink at least 8 eight ounce glasses of water. This is especially important if your cough is due to an illness. Water is the best expectorant you can take and will help thin the mucus and loosen the cough.
   
5. Do not use over-the-counter expectorant cough remedies as they just suppress the symptoms and do not address the underlying problem. If you have the kind of cough with mucus you want to get it out of your respiratory system, not suppress it. Try one of the natural expectorant remedies below.
6. Try eating hot chili peppers, horseradish or other spicy foods. They will help loosen mucus.
7. During the winter, if your house is dry, use a humidifier and a cool-mist vaporizer in your bedroom at night. This will help thin the mucus. Be sure to thoroughly clean the vaporizer, as it can harbor bacteria.
8. Drink hot tea to break up the mucus and open and moisten the airways.
9. Cough drops or hard candy will help stop the tickle if you have a dry cough and will moisten the throat.
10. Avoid foods that increase the production of mucus, such as dairy products, meat and fried foods.
11. Hot packs placed on your throat and chest are very soothing.

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Avoid Diet Mistakes Tips

Diet Mistakes Can Influence Weight

Simple diet mistakes can derail your best efforts to get back into that favorite pair of jeans. If the scale seems stuck, or your weight drops off only to bounce back up, there's a chance you could be making one of these 12 weight loss blunders.

Relying on Crash Diets

Determined to lose 10 pounds fast, you turn to a crash diet. Perhaps your plan calls for nothing but grapefruit or cabbage soup each day. You slash your daily calories to fewer than 1,000 -- and sure enough, the pounds melt away. But when you eat so few calories, you train your metabolism to slow down. Once the diet is over, you have a body that burns calories more slowly -- and gains weight more quickly -- than ever before.

Skipping Breakfast

Skipping breakfast seems like a simple way to cut calories, but the result can be insatiable hunger the rest of the day. This may lead to unplanned snacking at the office and eating a super-size portion at lunch, making calorie counts soars. But breakfasts that are high in protein and fiber can reduce hunger throughout the day. In fact, studies show people who eat breakfast every morning are more likely to maintain a healthy weight.

Losing Track of Your Snacks

Maybe you count calories meticulously at every meal, but what about all those nibbles in between? There's the bag of pretzels at your desk, the little slice of cake at an office party, the taste of your son's ice cream cone. All of this mindless munching adds up and could sabotage an otherwise well-planned diet. If you're serious about counting calories, you may want to use a notebook to keep track of each bite.

Not Snacking at All

While mindless snacking can pad your waistline, thoughtful snacking may do just the opposite. People who eat several small meals and snacks a day are more likely to control hunger and lose weight. Snacking helps keep your metabolism in high gear, especially if the snacks are protein-rich. Nuts are a good, high-protein choice, and research suggests people who snack on nuts tend to be slimmer than those who don't.

Loading Up on Low-Fat

Low-fat products can play an important role in your diet. Just remember that low-fat isn't the same as low-calorie and it's not a license to take second and third helpings. If you pile your plate with low-fat cake, you may end up eating more calories than if you had a smaller slice of regular cake. The best way to know how much fat, sugar, and calories you're getting is to check the nutritional label.

Sipping Too Many Calories

When counting calories, many of us tend to overlook what's in our drinks. This is a big mistake when you consider that some fancy coffees and alcoholic beverages have more than 500 calories. Even the calories in fruit juice and soda can add up quickly. What's worse is that liquid calories don't curb hunger. You're not going to eat any less after a high-calorie drink.

Drinking Too Little Water

This is one of the simplest diet blunders to fix. Water is essential for burning calories. If you let yourself get dehydrated, your metabolism drags -- and that means slower weight loss. Research suggests adults who drink eight or more glasses of water per day burn more calories than those who drink less. So try adding a glass of water to every meal and snack.

Ditching Dairy

Milk, cheese, and ice cream are taboo for many dieters, but ditching dairy foods may be counterproductive. Some research suggests the body burns more fat when it gets enough calcium and produces more fat when it's calcium-deprived. Calcium supplements do not appear to yield the same benefits, so dairy may have other compounds at work as well. Most dietitians recommend sticking to nonfat or low-fat milk, cheese, and yogurt.

Taking the Drive-Through Bait

The drive-through is convenient after a hectic day, and you can always order the salad or other healthier option. But once you're there, can you resist that milkshake or other treat? And if you allow yourself the ease of fast food once, it could become a habit. According to one long-term study, people who ate fast food more than twice a week gained 10 more pounds than those who had it less than once a week.

Weighing Yourself Every Day

Weighing yourself daily is a recipe for frustration and doesn't yield useful information. It's more important to look for a long-term trend with weekly weigh-ins. If your goal is to lose 1 or 2 pounds a week, you'll be satisfied to see those full-pound drops when you step on the scale. The result is more motivating that the confusing swings that may accompany daily weigh-ins.

Setting Unrealistic Goals

Telling yourself you'll lose 20 pounds your first week is probably setting yourself up for failure. If you know you won't be able to do it, you may never start your diet in the first place. If you do diet and lose 5 pounds in a week, instead of celebrating, you may feel discouraged that you didn't reach your goal. A realistic goal is vital to successful dieting. If you're not sure what your goal should be, talk to a dietitian.

Avoiding Exercise

When you don't exercise, you place the entire burden of weight loss on your diet. If you become more active, you can eat more of the things you like -- and still lose weight. The key is finding an exercise you enjoy. If the treadmill seems tedious, try swimming, ballet, biking, or Ping-Pong, all of which burn more calories than walking. Spend time at different activities until you find one you want to do on most days.

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Quit-Smoking 13 Tips to End Your Addiction

No. 1: Know Why You Want to Quit

So you want to quit smoking, but do you know why? “Because it's bad for you” isn't good enough. To get motivated, you need a powerful, personal reason to quit. Maybe you want to protect your family from secondhand smoke. Maybe the thought of lung cancer frightens you. Or maybe you'd like to look and feel younger. Choose a reason that is strong enough to outweigh the urge to light up.

No. 2: Don't Go Cold Turkey

It may be tempting to toss your cigarettes and declare you've quit, plain and simple. But going cold turkey isn't easy to do. Among those who try to stop smoking without therapy or medication, 95% end up relapsing. The reason is that smoking is an addiction. The brain depends on nicotine. In its absence, the symptoms of nicotine withdrawal occur.

No. 3: Try Nicotine-Replacement Therapy

When you stop smoking, nicotine withdrawal may make you frustrated, depressed, restless, or angry. The craving for “just one drag” may be overwhelming. Nicotine-replacement therapy can reduce these feelings. Studies suggest nicotine gum, lozenges, and patches can help double your chances of quitting successfully when used with an intensive behavioral program. But using these products while smoking is generally not recommended.

No. 4: Ask About Prescription Pills

To ease nicotine withdrawal without using products that contain nicotine, ask your doctor about prescription medications. There are pills that reduce cravings by altering the areas of the brain affected by nicotine. This change may also make smoking less satisfying if you do pick up a cigarette. Other drugs can help reduce troubling withdrawal symptoms, such as depression or inability to concentrate.

No. 5: Don't Go It Alone

Tell your friends, family, and co-workers that you're trying to quit. Their encouragement could make the difference. You may also want to join a support group or talk to a counselor. Behavioral therapy is a type of counseling that helps you identify and stick to quit-smoking strategies. Combine behavioral therapy with nicotine-replacement products or medication to boost your odds of success.

No. 6: Manage Stress

One reason people smoke is that the nicotine helps them relax. Once you quit, you'll need another way to cope with stress. Try getting regular massages, listening to relaxing music, or learning yoga or tai chi. If possible, avoid stressful situations during the first few weeks after you stop smoking.

No. 7: Avoid Alcohol & Other Triggers

Certain activities may boost your urge to smoke. Alcohol is one of the most common triggers, so try to drink less when you first quit. If coffee is a trigger, switch to tea for a few weeks. And if you usually smoke after meals, find something else to do instead, like brushing your teeth or chewing gum.

No. 8: Clean House

Once you've smoked your last cigarette, toss all of your ashtrays and lighters. Wash any clothes that smell like smoke and clean your carpets, draperies, and upholstery. Use air fresheners to help rid your home of that familiar scent. You don't want to see or smell anything that reminds you of smoking.

No. 9: Try and Try Again

It's very common to have a relapse. Many smokers try several times before giving up cigarettes for good. Examine the emotions and circumstances that lead to your relapse. Use it as an opportunity to reaffirm your commitment to quitting. Once you've made the decision to try again, set a “quit date” within the next month.

No. 10: Get Moving

Physical activity can reduce nicotine cravings and ease some withdrawal symptoms. When you want to reach for a cigarette, put on your inline skates or jogging shoes instead. Even mild exercise is helpful, such as walking the dog or pulling weeds in the garden. The extra calories you burn will also ward off weight gain as you quit smoking.

No. 11: Eat Fruits & Veggies

Don't try to diet while giving up cigarettes – too much deprivation is bound to backfire. Instead, focus on eating more fruits, vegetables, and low-fat dairy products. A Duke University study suggests these foods make cigarettes taste terrible. This gives you a leg up in fighting your cravings while providing disease-fighting nutrients.

No. 12: Choose Your Reward

In addition to the tremendous health benefits, one of the perks of giving up cigarettes is all the money you will save. Reward yourself by spending part of it on something fun.

No. 13: Do It for Your Health

There's more than the monetary reward to consider. Smoking cessation has immediate health benefits. It lowers your blood pressure and reduces your pulse after only 20 minutes. Within a day, oxygen and carbon monoxide levels in your blood return to normal, and risk of a heart attack decreases. Long-term benefits include a reduced risk for coronary heart disease, stroke, lung cancer, and other cancers.

from http://www.medicinenet.com/quit_smoking_tips_pictures_slideshow/article.htm

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Foods That Help or Harm Your Sleep

What You Eat Affects How You Sleep

If you could pick the right foods to help you get the best sleep possible, wouldn't you? And if you knew which foods would hinder your restful slumber, wouldn't you avoid them? Now's your chance to learn which foods to eat, and which to steer clear of for a good night's sleep.

Reach for Tryptophan-Rich Foods

We've all heard of warm milk's magical ability to send us off to dreamland. Do you know why it's true? Dairy foods contain tryptophan, which is a sleep-promoting substance. Other tryptophan-containing foods include poultry, bananas, oats, and honey.

Indulge Your Craving for Carbs

Carbohydrate-rich foods complement dairy foods by increasing the level of sleep-inducing tryptophan in the blood. So a few perfect late night snacks to get you snoozing might include a bowl of cereal and milk, yogurt and crackers, or bread and cheese. Avoid an all-carb snack that's also high in sugar, since the sugar low that will follow may disturb your sleep.

Have a Snack Before Bedtime

If you struggle with insomnia, a little food in your stomach may help you sleep. But don't use this as an open invitation to pig out. Keep the snack small. A heavy meal will tax your digestive system, making you uncomfortable and unable to get soothing ZZZs.

Put Down the Burger and Fries!

As if you needed another reason to avoid high-fat foods, research now shows that the more fat you consume during the day, the less likely you will be to have a restful night.

Beware of Hidden Caffeine

It's no surprise that an evening cup of coffee might disrupt your sleep. Even moderate caffeine can cause sleep disturbances. But don't forget about less obvious caffeine sources, like chocolate, cola, tea and decaffeinated coffee. For better sleep, cut all caffeine from your diet after noon each day.

Medications May Contain Caffeine

Some over-the-counter and prescription drugs contain caffeine, too, such as pain relievers, weight loss pills, diuretics, and cold medicines. These and other medications may have as much or even more caffeine than a cup of coffee. Check the label of nonprescription drugs or the prescription drug information sheet to see if your medicine interferes with sleep or can cause insomnia.

Skip the Nightcap

Here's the catch-22 with alcohol: It may help you fall asleep faster, but you may experience frequent awakenings, less restful sleep, headaches, night sweats and nightmares. If you're consuming alcohol in the evening, balance each drink with a glass a water to dilute the alcohol's effects.

Beware of Heavy, Spicy Foods

Lying down with a full belly can make you uncomfortable, since the digestive system slows down when you sleep. And spicy cuisine can lead to heartburn or GERD. Make sure to finish a heavy meal at least four hours before bedtime.

Keep Protein to a Minimum at Bedtime

Sorry Atkins. Protein, an essential part of our daytime fare, is a poor choice for a bedtime snack. Protein-rich foods are harder to digest. So skip the high-protein snack before bedtime and opt for a glass of warm milk or some sleep-friendly carbs, like crackers.

Cut the Fluids by 8 P.M.

Yes, staying hydrated throughout the day is great for your body, but curtail your fluid intake before bed. You're sure to have interrupted sleep if you're constantly getting up to go to the bathroom.

Don't Be Fooled by a Relaxing Smoke

Nicotine is a stimulant, with effects similar to caffeine. Avoid smoking before bedtime or if you wake up in the middle of the night.

From http://www.medicinenet.com/foods_that_help_harm_sleep_slideshow/article.htm

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10 Tips for a Healthy Night's Sleep

What is insomnia?

Insomnia is a condition in which you have trouble falling or staying asleep. Some people with insomnia may fall asleep easily but wake up too soon. Other people may have the opposite problem, or they have trouble with both falling asleep and staying asleep. The end result is poor-quality sleep that doesn't leave you feeling refreshed when you wake up.

What is transient insomnia?

Transient, or short-term, insomnia is inadequate or poor-quality sleep lasting anywhere from one night to a few weeks. Transient insomnia can be a single episode or recurring episodes of insomnia separated by periods of normal sleep.

On the following slides, MedicineNet provides sleeping tips intended to help overcome transient insomnia and maximize the chance of getting a healthy night's sleep:

Sleep tip #1

Keep the room free of clutter and distractions. Be sure you have the right bed and mattress for your needs. The wrong mattress can lead to musculoskeletal problems and sleep disturbances.

Sleep tip #2

Use the bed only for sleeping and sex. Avoid use of the bed for watching TV, eating, working, or any other activities. If you are one of the many people who wish to use the bed for a bit of nighttime reading, read only pleasure books in bed.

Sleep tip #3

Therapists often use "reconditioning" as part of a treatment plan for insomnia. With this method, people are "reconditioned" to associate the bed with sleep. If you find yourself unable to sleep at all, get out of bed and move to another room, so that you only associate the bed with sleep and not with wakefulness.

Sleep tip #4

Establish a regular sleep-wake cycle. Your body will learn to set its internal clock to your schedule and will eventually respond to internal cues to become sleepy at a given time and to awaken at a given time. A good way to begin this is by getting up at the same time every morning, even on weekends.

Sleep tip #5

No matter how tempting it may be, an afternoon nap can make falling asleep at night even harder. "Extra" sleep on weekends can also throw off your sleep schedule and worsen midweek insomnia.

Sleep tip #6

Limit your consumption of caffeine in the afternoon and evening. Remember that eating chocolates and drinking cocoa and colas also are sources of caffeine.

Sleep tip #7

Don't drink any alcoholic beverages in the few hours prior to going to bed. Excessive amounts of alcohol at any time in the day can also disrupt sleep patterns and lead to unsatisfying sleep. Cigarette smoking can also worsen insomnia.

Sleep tip #8

Fit in some exercise during the day, but don't exercise strenuously right before bedtime.

Sleep tip #9

Eating heavily in the evening or eating just prior to going to bed can disrupt your sleep.

Sleep tip #10

Establish a "winding down" period in the evenings just prior to bedtime. Try to free your mind of distracting or troublesome thoughts and engage in a relaxing, enjoyable activity like reading, listening to music, or watching a pleasant film.

From http://www.medicinenet.com/10_tips_avoid_insomnia_pictures_slideshow/article.htm

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Diabetes Mellitus

What is diabetes?

Diabetes mellitus is a group of metabolic diseases characterized by high blood sugar (glucose) levels, that result from defects in insulin secretion, or action, or both. Diabetes mellitus, commonly referred to as diabetes (as it will be in this article) was first identified as a disease associated with "sweet urine," and excessive muscle loss in the ancient world. Elevated levels of blood glucose (hyperglycemia) lead to spillage of glucose into the urine, hence the term sweet urine.

Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level. In patients with diabetes, the absence or insufficient production of insulin causes hyperglycemia. Diabetes is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime.

What is the impact of diabetes?

Over time, diabetes can lead to blindness, kidney failure, and nerve damage. These types of damage are the result of damage to small vessels, referred to as microvascular disease. Diabetes is also an important factor in accelerating the hardening and narrowing of the arteries (atherosclerosis), leading to strokes, coronary heart disease, and other large blood vessel diseases. This is referred to as macrovascular disease. Diabetes affects approximately 17 million people (about 8% of the population) in the United States. In addition, an estimated additional 12 million people in the United States have diabetes and don't even know it.

From an economic perspective, the total annual cost of diabetes in 1997 was estimated to be 98 billion dollars in the United States. The per capita cost resulting from diabetes in 1997 amounted to $10,071.00; while healthcare costs for people without diabetes incurred a per capita cost of $2,699.00. During this same year, 13.9 million days of hospital stay were attributed to diabetes, while 30.3 million physician office visits were diabetes related. Remember, these numbers reflect only the population in the United States. Globally, the statistics are staggering.

Diabetes is the third leading cause of death in the United States after heart disease and cancer.

What causes diabetes?

Insufficient production of insulin (either absolutely or relative to the body's needs), production of defective insulin (which is uncommon), or the inability of cells to use insulin properly and efficiently leads to hyperglycemia and diabetes. This latter condition affects mostly the cells of muscle and fat tissues, and results in a condition known as "insulin resistance." This is the primary problem in type 2 diabetes. The absolute lack of insulin, usually secondary to a destructive process affecting the insulin producing beta cells in the pancreas, is the main disorder in type 1 diabetes. In type 2 diabetes, there also is a steady decline of beta cells that adds to the process of elevated blood sugars. Essentially, if someone is resistant to insulin, the body can, to some degree, increase production of insulin and overcome the level of resistance. After time, if production decreases and insulin cannot be released as vigorously, hyperglycemia develops.

Glucose is a simple sugar found in food. Glucose is an essential nutrient that provides energy for the proper functioning of the body cells. Carbohydrates are broken down in the small intestine and the glucose in digested food is then absorbed by the intestinal cells into the bloodstream, and is carried by the bloodstream to all the cells in the body where it is utilized. However, glucose cannot enter the cells alone and needs insulin to aid in its transport into the cells. Without insulin, the cells become starved of glucose energy despite the presence of abundant glucose in the bloodstream. In certain types of diabetes, the cells' inability to utilize glucose gives rise to the ironic situation of "starvation in the midst of plenty". The abundant, unutilized glucose is wastefully excreted in the urine.

Insulin is a hormone that is produced by specialized cells (beta cells) of the pancreas. (The pancreas is a deep-seated organ in the abdomen located behind the stomach.) In addition to helping glucose enter the cells, insulin is also important in tightly regulating the level of glucose in the blood. After a meal, the blood glucose level rises. In response to the increased glucose level, the pancreas normally releases more insulin into the bloodstream to help glucose enter the cells and lower blood glucose levels after a meal. When the blood glucose levels are lowered, the insulin release from the pancreas is turned down. It is important to note that even in the fasting state there is a low steady release of insulin than fluctuates a bit and helps to maintain a steady blood sugar level during fasting. In normal individuals, such a regulatory system helps to keep blood glucose levels in a tightly controlled range. As outlined above, in patients with diabetes, the insulin is either absent, relatively insufficient for the body's needs, or not used properly by the body. All of these factors cause elevated levels of blood glucose (hyperglycemia).

• diabetes are related to elevated blood sugar levels, and loss of glucose in the urine. High amounts of glucose in the urine can cause increased urine output and lead to dehydration. Dehydration causes increased thirst and water consumption.
  
• The inability of insulin to perform normally has effects on protein, fat and carbohydrate metabolism. Insulin is an anabolic hormone, that is, one that encourages storage of fat and protein.
  
• A relative or absolute insulin deficiency eventually leads to weight loss despite an increase in appetite.
  
• Some untreated diabetes patients also complain of fatigue, nausea and vomiting.
  
• Patients with diabetes are prone to developing infections of the bladder, skin, and vaginal areas.
  
• Fluctuations in blood glucose levels can lead to blurred vision. Extremely elevated glucose levels can lead to lethargy and coma.

How is diabetes diagnosed?

The fasting blood glucose (sugar) test is the preferred way to diagnose diabetes. It is easy to perform and convenient. After the person has fasted overnight (at least 8 hours), a single sample of blood is drawn and sent to the laboratory for analysis. This can also be done accurately in a doctor's office using a glucose meter.

• Normal fasting plasma glucose levels are less than 100 milligrams per deciliter (mg/dl).
  
• Fasting plasma glucose levels of more than 126 mg/dl on two or more tests on different days indicate diabetes.
  
• A random blood glucose test can also be used to diagnose diabetes. A blood glucose level of 200 mg/dl or higher indicates diabetes.

When fasting blood glucose stays above 100mg/dl, but in the range of 100-126mg/dl, this is known as impaired fasting glucose (IFG). While patients with IFG do not have the diagnosis of diabetes, this condition carries with it its own risks and concerns, and is addressed elsewhere.

The oral glucose tolerance test

Though not routinely used anymore, the oral glucose tolerance test (OGTT) is a gold standard for making the diagnosis of type 2 diabetes. It is still commonly used for diagnosing gestational diabetes and in conditions of pre-diabetes, such as polycystic ovary syndrome. With an oral glucose tolerance test, the person fasts overnight (at least eight but not more than 16 hours). Then first, the fasting plasma glucose is tested. After this test, the person receives 75 grams of glucose (100 grams for pregnant women). There are several methods employed by obstetricians to do this test, but the one described here is standard. Usually, the glucose is in a sweet-tasting liquid that the person drinks. Blood samples are taken at specific intervals to measure the blood glucose.

For the test to give reliable results:

• the person must be in good health (not have any other illnesses, not even a cold).
  
• the person should be normally active (not lying down, for example, as an inpatient in a hospital), and
  
• the person should not be taking medicines that could affect the blood glucose.
  
• For three days before the test, the person should have eaten a diet high in carbohydrates (200-300 grams per day).
  
• The morning of the test, the person should not smoke or drink coffee.

Evaluating the results of the oral glucose tolerance test

Glucose tolerance tests may lead to one of the following diagnoses:

• Normal response: A person is said to have a normal response when the 2-hour glucose level is less than 140 mg/dl, and all values between 0 and 2 hours are less than 200 mg/dl.
  
  
• Impaired glucose tolerance: A person is said to have impaired glucose tolerance when the fasting plasma glucose is less than 126 mg/dl and the 2-hour glucose level is between 140 and 199 mg/dl.
  
• Diabetes: A person has diabetes when two diagnostic tests done on different days show that the blood glucose level is high.
  
• Gestational diabetes: A woman has gestational diabetes when she has any two of the following: a 100g OGTT, a fasting plasma glucose of more than 95 mg/dl, a 1-hour glucose level of more than 180 mg/dl, a 2-hour glucose level of more than 155 mg/dl, or a 3-hour glucose level of more than 140 mg/dl.

Diabetes At A Glance

• Diabetes is a chronic condition associated with abnormally high levels of sugar (glucose) in the blood.
  
• Insulin produced by the pancreas lowers blood glucose.
  
• Absence or insufficient production of insulin causes diabetes.
  
• The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent).
  
• Symptoms of diabetes include increased urine output, thirst and hunger as well as fatigue.
  
• Diabetes is diagnosed by blood sugar (glucose) testing.
  
• The major complications of diabetes are both acute and chronic.
  
  
  • Acutely: dangerously elevated blood sugar, abnormally low blood sugar due to diabetes medications may occur.
    
    
  • Chronically: disease of the blood vessels (both small and large) which can damage the eye, kidneys, nerves, and heart may occur
    
  
  
• Diabetes treatment depends on the type and severity of the diabetes. Type 1 diabetes is treated with insulin, exercise, and a diabetic diet. Type 2 diabetes is first treated with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugars, oral medications are used. If oral medications are still insufficient, insulin medications are considered.

From http://www.medicinenet.com/diabetes_mellitus/

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Asthma

Asthma is a chronic inflammation of the bronchial tubes (airways) that causes swelling and narrowing (constriction) of the airways. The result is difficulty breathing. The bronchial narrowing is usually either totally or at least partially reversible with treatments.

Bronchial tubes that are chronically inflamed may become overly sensitive to allergens (specific triggers) or irritants (nonspecific triggers). The airways may become "twitchy" and remain in a state of heightened sensitivity. This is called "bronchial hyperreactivity" (BHR). It is likely that there is a spectrum of bronchial hyperreactivity in all individuals. However, it is clear that asthmatics and allergic individuals (without apparent asthma) have a greater degree of bronchial hyperreactivity than nonasthmatic and nonallergic people. In sensitive individuals, the bronchial tubes are more likely to swell and constrict when exposed to triggers such as allergens, tobacco smoke, or exercise. Amongst asthmatics, some may have mild BHR and no symptoms while others may have severe BHR and chronic symptoms.

Asthma affects people differently. Each individual is unique in their degree of reactivity to environmental triggers. This naturally influences the type and dose of medication prescribed, which may vary from one individual to another.

How does asthma affect breathing?

Asthma causes a narrowing of the breathing airways, which interferes with the normal movement of air in and out of the lungs. Asthma involves only the bronchial tubes and does not affect the air sacs or the lung tissue. The narrowing that occurs in asthma is caused by three major factors: inflammation, bronchospasm, and hyperreactivity.

Inflammation

The first and most important factor causing narrowing of the bronchial tubes is inflammation. The bronchial tubes become red, irritated, and swollen. This inflammation increases the thickness of the wall of the bronchial tubes and thus results in a smaller passageway for air to flow through. The inflammation occurs in response to an allergen or irritant and results from the action of chemical mediators (histamine, leukotrienes, and others). The inflamed tissues produce an excess amount of "sticky" mucus into the tubes. The mucus can clump together and form "plugs" that can clog the smaller airways. Specialized allergy and inflammation cells (eosinophils and white blood cells), which accumulate at the site, cause tissue damage. These damaged cells are shed into the airways, thereby contributing to the narrowing.

Bronchospasm

The muscles around the bronchial tubes tighten during an attack of asthma. This muscle constriction of the airways is called bronchospasm. Bronchospasm causes the airway to narrow further. Chemical mediators and nerves in the bronchial tubes cause the muscles to constrict. Bronchospasm can occur in all humans and can be brought on by inhaling cold or dry air.

Hyperreactivity (hypersensitivity)

In patients with asthma, the chronically inflamed and constricted airways become highly sensitive, or reactive, to triggers such as allergens, irritants, and infections. Exposure to these triggers may result in progressively more inflammation and narrowing.

The combination of these three factors results in difficulty with breathing out, or exhaling. As a result, the air needs to be forcefully exhaled to overcome the narrowing, thereby causing the typical "wheezing" sound. People with asthma also frequently "cough" in an attempt to expel the thick mucus plugs. Reducing the flow of air may result in less oxygen passing into the bloodstream, and if very severe, carbon dioxide may dangerously accumulate in the blood.

The importance of inflammation

Inflammation, or swelling, is a normal response of the body to injury or infection. The blood flow increases to the affected site and cells rush in and ward off the offending problem. The healing process has begun. Usually, when the healing is complete, the inflammation subsides. Sometimes, the healing process causes scarring. The central issue in asthma, however, is that the inflammation does not resolve completely on its own. In the short term, this results in recurrent "attacks" of asthma. In the long term, it may lead to permanent thickening of the bronchial walls, called airway "remodeling." If this occurs, the narrowing of the bronchial tubes may become irreversible and poorly responsive to medications. Therefore, the goals of asthma treatment are: (1) in the short term, to control airway inflammation in order to reduce the reactivity of the airways; and (2) in the long term, to prevent airway remodeling.

Allergy assist

The hallmark of managing asthma is the prevention and treatment of airway inflammation. It is also likely that control of the inflammation will prevent airway remodeling and thereby prevent permanent loss of lung function.

Various triggers in susceptible individuals result in airway inflammation. Prolonged inflammation induces a state of airway hyperreactivity, which might progress to airway remodeling unless treated effectively.

Which triggers cause an asthma attack?

Asthma symptoms may be activated or aggravated by many agents. Not all asthmatics react to the same triggers. Additionally, the effect that each trigger has on the lungs varies from one individual to another. In general, the severity of your asthma depends on how many agents activate your symptoms and how sensitive your lungs are to them. Most of these triggers can also worsen nasal or eye symptoms.

Triggers fall into two categories:

• Allergens ("specific")
• Nonallergens -- mostly irritants (nonspecific)

Once your bronchial tubes (nose and eyes) become inflamed from an allergic exposure, a re-exposure to the offending allergens will often activate symptoms. These "reactive" bronchial tubes might also respond to other triggers, such as exercise, infections, and other irritants. The following is a simple checklist.

Common Asthma Triggers:

Allergens

• "Seasonal" pollens
• Year-round dust mites, molds, pets, and insect parts
• Foods, such as fish, egg, peanuts, nuts, cow's milk, and soy
• Additives, such as sulfites
• Work-related agents, such as latex

Allergy fact

About 80% of children and 50% of adults with asthma also have allergies.

Irritants

• Respiratory infections, such as those caused by viral "colds," bronchitis, and sinusitis
  
• Drugs, such as aspirin, other NSAIDs (nonsteroidal antiinflammatory drugs), and beta blockers (used to treat blood pressure and other heart conditions)
  
• Tobacco smoke
  
• Outdoor factors, such as smog, weather changes, and diesel fumes
  
• Indoor factors, such as paint, detergents, deodorants, chemicals, and perfumes
  
• Nighttime
  
• GERD (gastroesophageal reflux disorder)
  
• Exercise, especially under cold dry conditions
  
• Work-related factors, such as chemicals, dusts, gases, and metals
  
• Emotional factors, such as laughing, crying, yelling, and distress
  
• Hormonal factors, such as in premenstrual syndrom

The many faces of asthma

The many potential triggers of asthma largely explain the different ways in which asthma can present. In most cases, the disease starts in early childhood from age 2 to 6 years. In this age group, the cause of asthma is often linked to exposure to allergens, such as dust mites, tobacco smoke, and viral respiratory infections. In very young children, less than 2 years of age, asthma can be difficult to diagnose with certainty. Wheezing at this age often follows a viral infection and might disappear later, without ever leading to asthma. Asthma, however, can develop again in adulthood. Adult-onset asthma occurs more often in women, mostly middle-aged, and frequently follows a respiratory tract infection. The triggers in this group are usually nonallergic in nature.

Types: allergic (extrinsic) and nonallergic (intrinsic) asthma

Your doctor may refer to asthma as being "extrinsic" or "intrinsic." A better understanding of the nature of asthma can help explain the differences between them. Extrinsic, or allergic asthma, is more common (90% of all cases) and typically develops in childhood. Approximately 80% of children with asthma also have documented allergies. Typically, there is a family history of allergies. Additionally, other allergic conditions, such as nasal allergies or eczema, are often also present. Allergic asthma often goes into remission in early adulthood. However, in 75% of cases, the asthma reappears later.

Intrinsic asthma represents about 10% of all cases. It usually develops after the age of 30 and is not typically associated with allergies. Women are more frequently involved and many cases seem to follow a respiratory tract infection. The condition can be difficult to treat and symptoms are often chronic and year-round.

Typical symptoms and signs of asthma

The symptoms of asthma vary from person to person and in any individual from time to time. It is important to remember that many of these symptoms can be subtle and similar to those seen in other conditions. All of the symptoms mentioned below can be present in other respiratory, and sometimes, in heart conditions. This potential confusion makes identifying the settings in which the symptoms occur and diagnostic testing very important in recognizing this disorder.

The four major recognized symptoms:

• Shortness of breath: especially with exertion or at night
  
• Wheezing: a whistling or hissing sound when breathing out
  
• Coughing: may be chronic, is usually worse at night and early morning, and may occur after exercise or when exposed to cold, dry air
  
• Chest tightness: may occur with or without the above symptoms

What medications are used in the treatment of asthma?

Most asthma medications work by relaxing bronchospasm (bronchodilators) or reducing inflammation (corticosteroids). In the treatment of asthma, inhaled medications are generally preferred over tablet or liquid medicines, which are swallowed (oral medications). Inhaled medications act directly on the airway surface and airway muscles where the asthma problems initiate. Absorption of inhaled medications into the rest of the body is minimal. Therefore, adverse side effects are fewer as compared to oral medications. Inhaled medications include beta-2 agonists, anticholinergics, corticosteroids, and cromolyn sodium. Oral medications include aminophylline, leukotriene antagonists, beta-2 agonists, and corticosteroid tablets.

Historically, one of the first medications used for asthma was adrenaline (epinephrine). Adrenaline has a rapid onset of action in opening the airways (bronchodilation). It is still often used in emergency situations for asthma. Unfortunately, adrenaline has many side effects, including rapid heart rate, headache, nausea, vomiting, restlessness, and a sense of panic.

Medications chemically similar to adrenaline have been developed. These medications, called beta-2 agonists, have the bronchodilating benefits of adrenaline without many of its unwanted side effects. Beta-2 agonists are inhaled bronchodilators which are called "agonists" because they promote the action of the beta-2 receptor of bronchial wall muscle. This receptor acts to relax the muscular wall of the airways (bronchi), resulting in bronchodilation. The bronchodilator action of beta-2 agonists starts within minutes after inhalation and lasts for about four hours. Examples of these medications include albuterol (Ventolin HFA, Proventil HFA), levalbuterolmetaproterenol (Alupent), pirbuterol acetate (Maxair), and terbutaline sulfate (Brethaire). Recently, chlorofluorocarbons (CFCs) have been removed from all MDI inhalers because of the environmental effects on the ozone layer. These have been replaced by a new propellant, hydroflouroalkane (HFA). Patients may notice that the jet they feel in the back of their throat is less intense when compared with the CFC inhaler. They should be instructed that they are still receiving the same amount of medication though it may feel different than their older inhaler. Another very important point that patients must be aware of is that "floating" these new inhalers does not help in determining the amount of medication left in the MDI. In the past, the CFC devices could be floated in a bowl of water. With more medicine in the inhaler, the canister would sink and gradually float as it emptied. This is not the case with the HFA inhalers, as floating will actually clog the inhaler. The number of accuations must be counted to determine if medication is still left in the inhaler. Shaking the inhaler is not an effective method of determining how much medication is left. Often propellant (HFA) will continue to come out of the inhaler even after the medication is used up. At the present, only one albuterol inhaler comes with a counter device and this is Ventolin HFA. (Xopenex),

A new group of long-acting beta-2 agonists has been developed with a sustained duration of effect of 12 hours. These inhalers can be taken twice a day. Salmeterol xinafoate (Serevent) and formoterol (Foradil) are examples of this group of medications. The long-acting beta-2 agonists should not used for acute attacks. Beta-2 agonists can have side effects, such as anxiety, tremor, palpitations or fast heart rate, and lowering of blood potassium. There is data to suggest that taking long-acting beta-2 agonists alone may be life-threatening. They are best taken along with inhaled corticosteroids (see below).

Just as beta-2 agonists can dilate the airways, beta blocker medications impair the relaxation of bronchial muscle by beta-2 receptors and can cause constriction of airways, aggravating asthma. Therefore, beta blockers, such as the blood pressure medications propanolol (Inderal) and atenolol (Tenormin), should be avoided by asthma patients if possible.

The anticholinergic agents act on a different type of nerves than the beta-2 agonists to achieve a similar relaxation and opening of the airway passages. These two groups of bronchodilator inhalers when used together can produce an enhanced bronchodilation effect. An example of a commonly used anticholinergic agent is ipratropium bromide(Atrovent). Ipratropium takes longer to work as compared with the beta-2 agonists, with peak effectiveness occurring two hours after intake and lasting six hours. These agents are more effective in patients with COPD.

When symptoms of asthma are difficult to control with beta-2 agonists, inhaled corticosteroids (cortisone) are often added. Corticosteroids can improve lung function and reduce airway obstruction over time. Examples of inhaled corticosteroids include beclomethasone dipropionate (Beclovent, Qvar, and Vanceril), triamcinolone acetonide (Azmacort), budesonide (Pulmocort), and flunisolide (Aerobid). The ideal dose of corticosteroids is still unknown. The side effects of inhaled corticosteroids include hoarseness, loss of voice, and oral yeast infections. Early use of inhaled corticosteroids may prevent irreversible damage to the airways.

To decrease the deposition of medications on the throat and increase the amount reaching the airways, spacers can be helpful. Spacers are tube-like chambers attached to the outlet of the MDI canister. Spacer devices can hold the released medications long enough for patients to inhale them slowly and deeply into the lungs. A spacing device placed between the mouth and the MDI can improve medication delivery and reduce the side effects on the mouth and throat. Rinsing out the mouth after use of a steroid inhaler also can decrease these side effects.

Combination inhaler therapy is now available for the treatment of asthma. These medications include Advair (fluticasone and salmeterol) and Symbicort (budesonide and formoteral). Symbicort uses the standard MDI inhaler device (a counter device will be added in the near future). Advair has a unique powdered delivery system with a built-in counter.

Cromolyn sodium (Intal) prevents the release of certain chemicals in the lungs, such as histamine, which can cause asthma. Exactly how cromolyn works to prevent asthma needs further research. Cromolyn is not a corticosteroid and is usually not associated with significant side effects. Cromolyn is useful in preventing asthma but has limited effectiveness once acute asthma starts. Cromolyn can help prevent asthma triggered by exercise, cold air, and allergic substances, such as cat dander. Cromolyn may be used in children as well as adults.

Theophylline (Theodur, Theoair, Slo-bid, Uniphyl, Theo-24) and aminophylline are examples of methylxanthines. Methylxanthines are administered orally or intravenously. Before the inhalers became popular, methylxanthines were the mainstay of treatment of asthma. Caffeine that is in common coffee and soft drinks is also a methylxanthine drug! Theophylline relaxes the muscles surrounding the air passages and prevents certain cells lining the bronchi (mast cells) from releasing chemicals, such as histamine, which can cause asthma. Theophylline can also act as a mild diuretic, causing an increase in urination. For asthma that is difficult to control, methylxanthines can still play an important role. Dosage levels of theophylline or aminophylline are closely monitored. Excessive levels can lead to nausea, vomiting, heart-rhythm problems, and even seizures. In certain medical conditions, such as heart failure or cirrhosis, dosages of methylxanthines are lowered to avoid excessive blood levels. Drug interactions with other medications, such as cimetidine (Tagamet), calcium channel blockers (Procardia), quinolonesallopurinol (Xyloprim) can further affect drug blood levels. (Cipro), and

Corticosteroids are given orally for severe asthma unresponsive to other medications. Unfortunately, high doses of corticosteroids over long periods can have serious side effects, including osteoporosis, bone fractures, diabetes mellitus, high blood pressure, thinning of the skin and easy bruising, insomnia, emotional changes, and weight gain.

Expectorants help thin airway mucus, making it easier to clear the mucus by coughing. Potassium iodide is not commonly used and has the potential side effects of acne, increased salivation, hives, and thyroid problems. Guaifenesin (Entex, Humibid) can increase the production of fluid in the lungs and help to decrease the apparent thickness of the mucus but can also be an airway irritant for some people.

In addition to bronchodilator medications for those patients with atopic asthma, avoiding allergens or other irritants can be very important. In patients who cannot avoid the allergens, or in those whose symptoms cannot be controlled by medications, allergy shots are considered. The benefits of allergy shots (desensitization) in the prevention of asthma has not been firmly established. Some doctors are still concerned about the risk of anaphylaxis, which occurs in one in 2 million doses given. Allergy shots most commonly benefit children allergic to house dust mites. Other benefits can be seen with pollens and animal dander.

In some asthma patients, avoidance of aspirin, or other NSAIDs (commonly used in treating arthritis inflammation) is important. In other patients, adequate treatment of backflow of stomach acid (esophageal reflux) prevents irritation of the airways. Measures to prevent esophageal reflux include medications, weight loss, dietary changes, and stopping cigarettes, coffee, and alcohol. Examples of medications used to reduce reflux include omeprazole (Prilosec) and ranitidine (Zantac). Patients with severe reflux problems causing lung problems may need surgery to strengthen the esophageal sphincter in order to prevent acid reflux (fundoplicationGastroesophageal Reflux Disease article. surgery). For further information, please read the

From http://www.medicinenet.com/asthma/

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Emphysema, Chronic Bronchitis, and Colds

Introduction

If you have emphysema or chronic bronchitis, you know how miserable it feels when you catch a cold. After all, breathing is difficult enough with a chronic obstructive pulmonary disease (COPD). Not only does catching a cold worsen your ability to breathe and be active, but the cold virus increases your chance of getting a more serious respiratory tract infection. Here's what you must know to stay well.

What is emphysema and chronic bronchitis?

Emphysema and chronic bronchitis are chronic (long-term) lung diseases that make it hard to breathe. Both diseases are chronic obstructive pulmonary diseases (COPD), meaning they are conditions that cause a limitation in airflow. Emphysema and chronic bronchitis can occur separately or together and are usually the result of cigarette smoking. In addition, although it happens rarely, a genetic form of emphysema can occur early in adulthood, even if you never smoked.

In the United States, COPD is vastly under diagnosed. While only 15 to 20 percent of smokers are diagnosed with COPD, experts believe the majority of smokers develop some degree of airflow obstruction.

Emphysema comes on gradually after years of exposure to irritants such as cigarette smoke. With emphysema, the tiny air sacs in the lungs become damaged. Because the tiny sacs lose their "stretch," less air gets in and out of the lungs. This causes you to feel short of breath.

With chronic bronchitis, the airways that carry air to the lungs are inflamed and produce a lot of mucus. The mucus and inflammation cause the airways to narrow or become obstructed, making it difficult to breathe. Once the airways are irritated over a long period, the lining of the airways becomes thickened. This thickening of the airways results in an irritating cough, hampered airflow, and lung scarring. The damaged airways then become a breeding place for bacterial infections such as pneumonia.

What happens with emphysema and chronic bronchitis and colds?

A cold is a viral respiratory illness that mainly affects your nose and throat but in some instances can affect your airways. When you have emphysema or chronic bronchitis, you already have some difficulty breathing because of the damaged airways and lungs. Catching a respiratory virus along with COPD can hinder breathing even more and can cause the following changes in your symptoms:

• An increase in phlegm
  
  
• An increase in the thickness or stickiness of the phlegm
  
  
• A change in phlegm color to yellow or green
  
  
• A presence of blood in the phlegm
  
  
• An increase in the severity of shortness of breath, cough, or wheezing
  
  
• A general feeling of ill health
  
  
• Difficulty sleeping
  
  
• Increased fatigue

Why should I take colds seriously with emphysema or chronic bronchitis?

Catching a cold with emphysema or chronic bronchitis may also lead to bacterial infections such as pneumonia. This occurs because of the airway obstruction and the inability to cough out infected secretions of mucus.

Sometimes, patients with COPD are hospitalized because of a respiratory infection and the worsening of their symptoms. Treatment may include inhaled medications, oxygen, and antibiotics to treat any bacterial infection. Antibiotics do not treat a cold.

To avoid more serious problems with emphysema, chronic bronchitis, and colds, it's important to always alert your doctor if your cold symptoms get worse. Don't wait until you have more serious breathing problems to contact your doctor.

Which cold treatment should I use with emphysema or chronic bronchitis?

First, it is important to stay on your prescribed medications for emphysema and chronic bronchitis. Then, to decide how to treat cold symptoms, it's best to talk with your doctor. You might treat the body aches and fever associated with a cold with acetaminophen or ibuprofen. In addition, you should avoid antihistamines that thicken mucus and make it even more difficult to cough up.

Most over-the-counter cold remedies are generally safe for people with emphysema and chronic bronchitis. However, decongestants raise blood pressure and some of the medications used to treat emphysema and chronic bronchitis also raise heart rate. So, use decongestants with caution. Again, ask your doctor about medications for cold symptoms.

Can I prevent colds if I have emphysema or chronic bronchitis?

The following guidelines can help:

• Good hygiene can decrease respiratory infections such as colds. Prevent the spread of a cold virus by making sure you and your family members wash your hands regularly.
  
  
• Check with your doctor about a pneumonia and influenza vaccine. You need a flu shot every year. One pneumonia shot is usually enough to protect you from a specific type of bacterial pneumonia.
  
  
• Avoid crowds during cold and flu season, since colds and flu can cause serious problems for people with COPD.
  
  
• Pay attention to healthy lifestyle habits by avoiding cigarette smoke and air pollutants; eating a balanced, healthy diet; and exercising to stay strong.
  
  
• Sinus infections can trigger breathing problems for those with emphysema and chronic bronchitis. Be aware of your sinus symptoms and report them immediately to your doctor to prevent worsening of breathing difficulties.

From http://www.medicinenet.com/emphysema_chronic_bronchitis_and_colds/

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