A Dialogue Between Physician and Patient

If you have COPD -- Chronic Obstructive Pulmonary Disease, sometimes called Chronic Obstructive Lung Disease (COLD) -- or if you care for or take care of someone who has COPD, we wrote this book for you. We are two medical experts and a successful COPD patient with hard-won experience. We explain, from your point of view, the conditions causing COPD, the available medical and surgical treatment options, and how your efforts can determine the outcome.

Dialogue, good communication between doctor and patient is fundamental for success in managing COPD. Dialogue enables you to communicate and collaborate with each other, and with other care givers, to assure the best possible results.

Why is the doctor-patient relationship so important? Medical treatment can provide the most benefit when the patient and the physician work together, when each listens to and respects the other, and when the patient takes responsibility for his or her health. This dialogue is a skill which must be learned by doctors and by patients. Therefore, this book is intended to help you manage COPD, to help you talk with your doctor, if you are a patient; and with your patients, if you are a doctor.

Clinical and scientific information was written by the professional team of Brooke Nicotra, M.D., a pulmonary lung specialist, and Rick Carter, Ph.D., an exercise physiologist who specializes in improving function in the body even when disease is present. Jo-Von Tucker provides her insights, experience, and techniques, drawn from her experience living with COPD.

This book includes a mixture of advice and experience, suggestions, tips and helpful tools for managing COPD.

Maintaining the Best Possible Quality of Life

Courage and Information for Life with Chronic Obstructive Pulmonary Disease is intended as a practical and flexible guide to help you, your family and friends. COPD is a term commonly applied to any or all of: emphysema, asthmatic bronchitis, and chronic bronchitis.

This book is designed for those with little medical knowledge of COPD, as well as for those with some medical background. It is based on recommendations from experts for diagnosis and treatment of COPD. We hope that it addresses the most important issues facing anyone with this disease.

COPD is not like most health problems. Chronic means long term, so it will not go away. While there is no cure for COPD, nor for the diseases of COPD, there are many things you and your caregivers can do to minimize the impact. Your best chance of living a full life in spite of COPD is to actively manage your own health care--but you need to learn how. As you are the main person responsible for managing your disease process, you must learn how to work with the guidance provided by your doctor, and use your own management skills, to form an effective partnership for a productive and active life. The things you do at home every day will affect your life and abilities in the years to come:

Because your part is so vital, you need good information, so this book provides the information you need, and references to other sources of information to enable you to live, and live well.

Getting the Best Care

Learn as much as you can about your disease and your medicines.

Ask questions. This book can help you decide which questions to ask, so write a list and take it with you when you see your doctor or other health care provider.

Give information. Tell your doctor what your symptoms have been since your last visit. Be honest. Tell your doctor if you have had a change in your normal daily activity level. Talk about your medications and bring these with you at each visit. Discuss problems and concerns about any aspect of your medical management. Review your goals and talk with your doctor about these goals.

Follow directions. Write down what you are supposed to do. Repeat back what you think your doctor wants you to do. Be clear on all instructions before you leave the office. Take your medicines, and if on supplemental oxygen, use each as they are prescribed. Do not vary. If the medicines are too expensive or they don't seem to be working, tell your doctor, there may be other solutions.

Keep your appointments. Remind yourself to keep all appointments with your physician even if you are feeling better. If you cannot make an appointment, notify your physician as much in advance as possible and if you need to, request to speak with the doctor's nurse.

Pulmonary Rehabilitation Programs

Pulmonary rehabilitation programs are available in many hospitals and rehab facilities in many countries. The programs are intended to educate people about lung disease, and to teach closely-supervised exercises to restore as much physical conditioning and muscle toning as possible. This education will significantly add to the quality of life of a person with COPD.

The rehab/education sessions may last for six to eight weeks or longer with two-hour sessions two or three times a week. One hour is usually reserved for active exercise and physical therapy, and one for education or psychological counseling to help you cope with COPD and its impact.

You probably need to be referred by your doctor, and go through tests to be accepted into a pulmonary rehab program.

Dr. Brian Tiep and Dr. Tom Petty, whose Forewords open this book, are two of the leaders of pulmonary rehabilitation. Dr. Petty is considered by many as the modern-day father of pulmonary medicine, a tireless educator and champion of innovation. Dr. Tiep is one of the nation's pioneers of specially-developed pulmonary rehab programs for COPD treatment. They, and other experts in this field, are strong proponents of the roles of exercise, fitness, education, and mental attitude in restoring quality of life.

Their work demonstrates enormous benefits to people who commit themselves to a rehab program, so more and more facilities for such care and treatment are springing up around the U.S. and elsewhere. Australia, for example, has an active and growing community of pulmonary rehab programs with strong lung-support groups.

If you are able to enroll in a rehabilitation program, you will find this book helpful during the course and after it ends. However, even if you are unable to participate in a formal rehabilitation program, you can use this book to help build your own program, working closely with your doctors and other health care professionals.

How to Use This Handbook

Scientific, medical, or technical terms are defined the first time they are used. A Glossary provides a list of terms and explanations. Definitions are written in plain English.

This book covers breathing, diseases affecting breathing, diagnosis, medical and surgical interventions, nutrition, exercise, and the impact of smoking and stopping smoking. There is also extensive information and guidance on how your own outlook and determination, and the support of your family and friends, can make a difference. We encourage you to learn as much as you can about your medical problem.

Some of the most common questions about COPD are answered at the beginning of the book.

We encourage you to work closely with your doctors, nurses, respiratory therapist, exercise specialist, and nutritionist. Together, you can create a solid management plan and carry it through.

Use the space on each page for notes, and take this book to your next visit with your doctor or other health professional to get the answers for your specific needs. This book is intended to guide you in working with your doctors and other health professionals. It cannot replace their professional knowledge and concern. Please pay special attention to specific hazards and dangers that are flagged by the WARNING heading.

Rick Carter, Brooke Nicotra, and Jo-Von Tucker

The Voice of Each Author

Because there are three authors, they sometimes speak together and sometimes separately. We have used different typographic styles for clarity. The type style in this paragraph [not reproduced online] represents all three authors or the two medical professionals.

The style of this paragraph [not reproduced online] represents the voice of Jo-Von Tucker, telling her personal experiences and ideas and her understanding of the whole range of healing concepts; in addition to her interpretation of the scientific-professional-medical. Her personal experience provides the voice and perspective of a person with COPD. ......
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COPD-Courage and Information
Courage and Information Readers praise | A book to help you help yourself | Foreword by Brian L. Tiep, MD | Foreword by Thomas L. Petty MD | Introduction | Table of Contents | The Devastation of the Diagnosis (Jo-Von Tucker) | Appreciation of Jo-Von Tucker | Feature story | Courage: Authors | BUY Courage and Information | Seeing the story
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