alpha-1 slams chronic obstructive pulmonary ... - copd canadacopdcanada.info › resources ›...

Addressing the needs of the Canadian COPD patient

ALPHA-1 SLAMS ONTARIODRUG COVERAGE: LOSS OFCOVERAGE FOR AUGMENTATIONTHERAPY LEAVES NEW PATIENTSSTRANDED ..............................1

AGING AND ITS IMPACT ONLUNG ELASTICITY: ACCELERATEDAGING MAY PLAY A ROLE IN THEDEVELOPMENT OF COPD ..........1

COPD PEOPLE: THERESA BUJTASPLAYS THE ORGAN AND SINGS INTHE CHURCH CHOIR ................7

Alpha-1 SlamsOntario DrugCoverage

According to a news release fromAlpha-1 Canada, if you have arare life-threatening disease

called alpha-1 antitrypsin deficiency,don’t work for the OntarioGovernment and don’t have privateinsurance the government is content tosee you waste away struggling for everybreath until you join other Ontarianson the lung transplant list.

If, on the other hand, you work for theGovernment of Ontario your augmentationtherapy is paid for by taxpayers.

The Ontario Liberal government’splatform states that providing high-qualityhealth care on the basis of need, rather thanthe ability to pay is a defining characteristic ofCanada and one of their core principles. It isthe most important thing a government cando to provide people with security. Ask DougCooper of Beamsville if the Ontariogovernment is delivering on this promise.

Doug was a high school teacher andreceived his lifesaving treatment, known asalpha-1 antitrypsin augmentation therapy,through the Halton school board. Dougretired recently and was told his treatmentwould no longer be covered. “I do not wantto die gasping for every breath when there istreatment available but beyond the reach ofordinary citizens,” Doug says.

After covering the treatment for 18years, in a cost cutting measure, the OntarioDrug Benefit Program ceased funding ofalpha-1 antitrypsin augmentation therapy fornewly prescribed patients. This therapy is theonly treatment available for lung-involvedpatients with alpha-1 antitrypsin deficiency.But the Ontario government continues to

Chronic Obstructive Pulmonary DiseaseLung Aging and How itAffects People with COPD

During normal aging, pulmonary function deteriorates progressively andpulmonary inflammation increases, accompanied in the lungs by the features ofemphysema. These features are accelerated in COPD. Cigarette smoke and

other oxidative stresses result in cells being no longer capable of dividing and this couldaccelerate lung aging. There is also evidence that anti-aging molecules are decreased inthe lungs of COPD patients, compared with smokers without chronic obstructivepulmonary disease, resulting in enhanced inflammation and further progression ofCOPD.

An enhanced orabnormal inflammatoryresponse to the lungs toinhaled particles andgases, usually fromcigarette smoke, isconsidered to be ageneral disease causingmechanism in chronicobstructive pulmonarydisease. There is arelationship betweenchronic inflammatorydiseases and aging, andthe processes involved inaging may provide anovel way of looking atthe origin, developmentand resultant effects ofCOPD. There is goodevidence linking agingand COPD.

There are a plethoraof hypotheses relating to

Ask Dr. Chapmanby Kenneth R. Chapman, MD,MSc,FRCPC, FACPDirector of the Asthma and AirwaysCentre of the University HealthNetwork, Toronto

Q I’ve been readingabout “stem celltherapy” online.

There are some private clinics advertisingstem cell treatments for COPD and some ofthe patients who’ve been there say they’refeeling much better. What is this treatmentand is it available in Canada?

A Lately I've been fielding a surprising number ofquestions about stem cell therapy. The subjectseems to have “gone viral” with numerous clinic

advertisements and patient testimonials appearing online.So what is stem cell therapy and is it something youshould pursue for the treatment of your COPD?

Continued on Page 2

Spring/Summer 2015 Volume 10 No. 1

Continued on Page 5

Publ

icat

ion

Mai

l Agr

eem

ent N

o. 4

0016

917

Continued on Page 5

living with copd_number V10-01-43HRREVISED_living with copd_number V9-01-25.qxd 2015-10-15 10:26 AM

2 • Living with COPD Spring/Summer 2015

Canada Post Canadian Publications Mail Sales Product Agreement Number 40016917Please forward all correspondence on circulation matters to: Chronicle Information Resources Ltd., 555 Burnhamthorpe Road, Ste 306,Toronto, Ont. M9C 2Y3Living with COPD is published for COPD Canada by Chroni cle Information Resources Ltd.Contents © 2015, Chronicle Companies, except where noted. Printed in Canada.Supported by an educational grant from Novartis Pharmaceuticals Canada Inc.

First, it mighthelp to know what

stem cells are. Most of us know from highschool biology that each cell in the body carries DNA, the body'sblueprint. Starting with a single fertilized egg, this blueprint directscells to become highly specialized cells, long and thin electrically-active cells we call nerve cells, tough flattened cells we called skincells, contracting cells we call muscles and calcium-impregnatedcells we call bone. If we could find early non-specialized stem cellsto work with and could teach them how to evolve into specializedcells, there is hope that we could replace disease-damaged cellswith healthy new cells.

Two types of stem cells are available. Embryonic stem cellsoffer the most exciting potential for regrowing new tissue but thefield is controversial because embryonic stem cells have beenharvested from aborted fetuses. However, there are also stem cellswithin our own bodies—although they are partially specialized andless flexible in terms of their ability to grow various types oftissue. If we can gather up, for example, fat tissue and select fromour sample the most primitive non-specialized cells, we have stemcells that might be encouraged to grow what doctors call“connective tissue”, the structural building blocks for much of thehuman body.

Superficially, finding and purifying stem cells and putting themin place to grow new tissue sounds like a wonderful way to treatdisease. But this concept leads to some challenging problems. Howdo we instruct the cell to grow into a highly specialized new typeof cell? What are the signals that would make the cell behave thisway? And for treating a disease, what happens to the diseasedtissue already in place? In the case of COPD, for example, whathappens to the inflamed and narrowed airway we are trying totreat? Is there some way to turn off the damaging inflammationsignal so that new cells have a chance to stay healthy? Simplyproviding some new building blocks for an airway won't necessarilyresult in the disappearance of the old and damaged airway and itsreplacement by a healthy, disease-free airway.

Research scientists are actively pursuing stem cell research fora variety of diseases and especially the neurologic diseases. Whatabout the clinics that are offering stem cell therapy for COPD? Aquick scan online shows that numerous clinics offer COPDtreatments but it’s disheartening to read their offerings with acritical eye. These clinics seem to be offering to harvest some ofyour body’s cells, probably with a superficial incision into the fattyarea in the front of the abdomen. These cells are handled in someway, presumably to purify stem cells, and the cells are reinjected.None of these details are spelled out on the website and there aredefinitely no promises made as to treatment outcomes. Theseclinics seem to be exploiting a legal grey zone. If they wereoffering a new and untested drug, the drug regulatory authoritiessuch as the FDA would prevent them from operating andadvertising their services. But because they’re offering a procedureon your body, they can operate with impunity. To my knowledge,there are no such clinics operating in Canada.

How can you evaluate what is being offered? I spent sometime with one website and we can call it the Acme Stem CellClinic. The Acme website is slick and encourages us to considerstem cell treatment for a variety of neurological conditions and, ofcourse, for COPD. The website itself offers no price quotationsbut from other reports online they seem to offer treatments forapproximately $15,000. They imply that they are conductingresearch and so I navigated to the website where responsibleresearchers outline their clinical trials in detail—clinicaltrial.gov. NoCOPD trials were listed for the Acme Stem Cell Clinic. Drillingdown further, the website mentions its staff. For medicalleadership, Acme’s medical director is a semi-retired surgeon whowould not appear to have any background in neurologic care orrespiratory disorders. Given that stem cell research has little ornothing to do with surgery, the choice of medical director ispuzzling. Another staffer is the PhD “scientific officer” whoseresearch is not described in detail but his business experience isoutlined clearly. No mention is made of research scientists inCOPD or any publications the clinic has produced. There appearsto be no affiliation with any research body, any university, anycollege or any major funding source such as the National Institutesof Health. Instead, the website offers patient testimonials. Weknow nothing about the lung function of COPD patients receivingtreatment but they appear to like the nurses at the clinic and speakglowingly of the travel arrangements that have been made forthem. And what about the patients who report that they feel muchbetter after such treatment? The placebo effect is well known andif you traveled to another country, invested many thousands ofhard-earned dollars in receiving a treatment for a disabling disease,you might want to believe that you are feeling better too. Theseclinics are offering an infusion of hope to desperate patients.Peddled online in this cynical way, stem cell therapy has becomethe 21st century equivalent of the snake oil salesman.

A word of cough caution! Stem cell research is a legitimateand exciting area of research when pursued by thoughtful researchscientists working in large groups and in the light of day. Alegitimate research trial does not charge its participants large sumsof money. Indeed, most trials offer patients a small reimbursementto patients for their time and incidental costs such astransportation and parking. So if you do run across the university-affiliated research trial using stem cell technology that asks forvolunteers and doesn't ask for payment, it might be worthpursuing. But what’s bubbling to the top of your Google search atthe moment is likely to be a scam.

Ask Dr. ChapmanContinued from Page 1

We invite your questions. Please mail questions to Ask Dr, Chapman c/oCOPD Canada, 555 Burnhamthorpe Rd., Suite 306, Toronto, Ont. M9C2Y3. Or you can e-mail questions to: [email protected]

Dr. Chapman is Director of the Asthma and Airway Centre for theUniversity Health Network, President of the Canadian Network for AsthmaCare and Director of the Canadian Registry for Alpha 1 Anti-trypsinDeficiency. A graduate of the University of Toronto and a former memberof the faculty at Case Western Reserve University, he is now a Professorof Medince at the Univsersiity of Toronto.


Pulse: News about COPDPedometer-Based Program Increases

Physical Activity Level n Santiago, Chile / It is known that physical inactivity is associated with increased

morbidity and mortality in COPD. Researchers in Santiago found that apedometer-based program produced clinically important improvements in phys-ical activity and health status in COPD. Pulmonary rehabilitation is known toimprove exercise capacity, but treatment remains limited because of resourceconstraints. Therefore, there is a need to find additional effective and scalableinterventions that are cheap to implement and which can improve physicalactivity levels in COPD patients. The aim of this study was to determine if athree-month pedometer-based program could be useful to increase daily stepcount in stable outpatients with COPD. The researchers found that the groupthat used pedometers in the study had significantly greater improvements inphysical activity; 3,080 steps/day versus 1,950 steps/day, than patients receiv-ing activity encouragement only. The researchers concluded that a simple physi-cal activity enhancement program using pedometers can effectively improvephysical activity level and quality of life in COPD patients.8 http://tinyurl.com/kre6hqw

COPD Tied to Raised Risk for Sudden Cardiac Death n Ghent, Belgium / A new European study finds that chronic obstructive pulmonary dis-

ease might also raise a person’s odds for sudden cardiac death. COPD is a pro-gressive and incurable illness that involves a combination of emphysema andbronchitis, and is often tied to smoking. The researchers said that the disease hasalready been associated with an increased risk of heart disease and sudden car-diac death in certain high-risk patient populations. Now, the new study “shows thatCOPD is a risk indicator for sudden cardiac death in the general population, andthat the risk increases with COPD severity," wrote a team led by Dr. Lies Lahousse,a postdoctoral researcher at Ghent University Hospital in Belgium. One expert inthe United States said that even though the study can't prove that COPD helps trig-ger sudden cardiac death, the European findings aren't surprising. “Many patientswho have COPD are or were smokers, and smoking is the number one cause ofheart disease,” said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospitalin New York City. “COPD is also associated with cardiac arrhythmia, such as atrialfibrillation,” he added. Atrial fibrillation is an irregular heartbeat. “These eventscan lead to sudden cardiac death.” The new study involved more than 13,000people aged 45 and older, more than 1,600 of whom were diagnosed withCOPD. Over the course of the study, 39 per cent of the participants died. Ofthose deaths, 551 were related to sudden cardiac death.8 http://tinyurl.com/lx7n4l2

Living with COPD Spring/Summer 2015 • 3


Pulse: News about COPDAbout 1 in 7 Older Adults Has Some Form ofLung Diseasen Atlanta, Ga. / Nearly 15 per cent, or about one out of seven, middle-aged and

older U.S. adults suffer from lung disorders such as asthma or chronic obstructivepulmonary disease (COPD). While 10 per cent of those people experience mildbreathing problems, more than one-third of them report moderate or severe respi-ratory symptoms, the U.S. Centers for Disease Control and Prevention (CDC)reported. For the report, CDC researchers analysed national survey data on adultsages 40 to 79 between 2007 and 2012. The research team looked at results ofbreathing tests or self-reported oxygen use to determine the prevalence of lungobstruction. “The number of adults with lung obstruction has remained fairly stablesince the last time these data were collected, in 2007 to 2010,” said lead authorTimothy Tilert, a data analyst with CDC's National Center for Health Statistics.According to the report, the incidence and severity of these lung diseases weresimilar for men and women, but prevalence increased with age. Tilert said the sur-vey did not consider COPD and asthma individually, so separate figures for eachdisorder aren’t available. However, because of the age of the population in thestudy these data probably are picking up more cases of COPD than asthma.8 http://tinyurl.com/l3jwztk

Scientists Coax Stem Cells to Form 3-D Mini Lungs n Ann Arbor, Mich. / 3D structures that mimic the structure and complexity of human

lungs have been developed as models to study how organs form, change withdisease, and how they might respond to new drugs, says senior study authorJason R. Spence, PhD, assistant professor of internal medicine and cell anddevelopmental biology at the University of Michigan Medical School. The scien-tists succeeded in growing structures resembling both the large airways knownas bronchi and small lung sacs called alveoli. Since the mini lung structureswere developed in a dish, they lack several components of the human lung,including blood vessels, which are a critical component of gas exchange duringbreathing. Still, the organoids (as the mini-lungs are referred to) may serve as adiscovery tool for researchers as they take basic science ideas into new clinicalinnovations. A practical solution lies in using the 3-D structures as a next stepfrom, or complement to, animal research.8 http://tinyurl.com/obefv2l



Join today:The COPD Canada web site is your portal to

our association, new and varied educational

materials, medical resources and community

interaction. Membership is free of

charge but is restricted to individuals living with

COPD or their caregivers.

Joining is fast and easy.

Just visit our web sitewww.copdcanada.info and

click on membership and follow the step by step

instructions. Once you’ve joined you will begin receiving our “Living with COPD” newsletter

and will have complimentary access to all COPD Canada seminars, on-line discussion forums and our

member chat section.COPD CANADA, 555 Burnhamthorpe Rd., Suite 306, Toronto, Ont. M9C 2Y3. For more information

contact: Henry Roberts, email: [email protected], telephone 416-465-6995

COPD Canada’s web resourcewww.copdcanada.info

Living with COPD Spring/Summer 2014/2015 • 5

provide funding for thetreatment for people who work in the broader public sector.Fewer than 40 Ontarians are currently receiving this therapy(some funded through private insurance). As many as 10 newlydiagnosed Ontarians have been denied funding by the OntarioDrug Benefits Program.

“Alpha-1 antitrypsin deficiency is a rare condition that isoften misdiagnosed as asthma or COPD. We did a survey andfound that in Canada, it takes on average 9.9 years from the timesymptoms appear until an accurate diagnosis is obtained. Waitingthis long to find out what is wrong and then being deniedtreatment because you can’t afford it is a situation the Canadianhealthcare system was designed to prevent, not cause,” says JimMundy, executive director of Alpha-1 Canada; an Ontario-basednational patient support organization (more information availableat www.alpha1canada.ca

Dr. Ken Chapman of the University of Toronto andToronto Western Hospital is a world renowned researcher on thisand other airway diseases. In a submission to the Ontariogovernment, Dr. Chapman said, “Decisions outside of Ontarioreflect the growing body of medical evidence that augmentationtherapy not only reduces the rate of lung function decline (byconventional lung function monitoring) but preserves lung tissue(as measured by the latest in X-ray technology) and reducesmortality. When more and more private and public payers areadding augmentation therapy to their lists of treatments coveredit is disturbing that Ontario would ignore its own policy on thetreatment of rare diseases.”

But, the Ontario government has chosen to stop funding forthis lifesaving treatment.

Alpha-1 continued from Page 1 the development of COPD. Acentral feature is the change from the normal inflammatoryresponse to cigarette smoke in the lungs, which occurs in allsmokers, to the enhanced or abnormal immune responses in thelungs which characterize the development of COPD. Twoprocesses are considered to be important disease causingmechanisms as part of this abnormal inflammatory response.These processes result in the failure of repair mechanisms, whichresult in the alveolar destruction in emphysema and remodelling ofthe small airways.

Recent evidence suggests that the persistence of chronicinflammation in the lungs in COPD may involve the aging of cellsand the their inability to divide. There are features of acceleratedaging in COPD patients, particularly in emphysema. In addition,COPD is associated with systemic features such as increased riskof osteoporosis and cardiovascular disease and, which also may belinked to accelerated aging. This, together with the fact that thepresence of COPD is age-dependent, suggests a close relationshipbetween the pathogenesis of COPD and aging processes.

Aging or the inability of cell division has been defined as theprogressive decline in homoeostasis which occurs after thereproductive phase of life and leads to increasing risk of diseaseor death. Biological aging, although normally linked tochronological age, can occur earlier in life and is thought to resultfrom a failure of organ or cell maintenance or repair, particularly afailure to protect DNA against oxidative injury; thus aging resultsfrom an accumulation of molecular damage. The resulting cellulardefects can in turn enhance inflammation and so worsen existingdamage. Cellular aging, or senescence, results in a series ofalterations in cell morphology and function, including the loss ofthe ability to proliferate. A number of molecular and cellularmechanisms are associated with cellular aging, includingaccumulation of DNA damage, impairment of DNA repair,

Lung Aging continued from Page 1

Continued on Page 6


W hat are the key factors that influence the decisionto stop smoking? A recent study in England exploredissues relating to smoking behaviour and intention to

quit that might be used to help develop cessation interventions.The researchers explored the average participant’s knowledge ofsmoking related diseases, with a particular emphasis on chronicobstructive pulmonary disease (COPD). Using focus groups andsemi-structured interviews participants were allowed to expresstheir feelings and experiences regarding strategies to stop smoking.The participants in the study were in smoking cessation programs.They found that their knowledge of COPD, a smoking-relateddisease was limited. What knowledge they did have about COPDtended to be through the lived experience of friends or familymembers who had been diagnosed with the condition.

Smokers’ concerns around risk of disease were influenced bytheir social context and were more focussed on how their smokingmight impact on the health of their family and friends, rather thanhow it might impact on them as individuals. Participants felt thatgenetic risk information would have a limited impact onmotivation to quit. Genetic risk was considered to be a difficultconcept to understand, particularly as it does not mean anindividual will definitely develop a smoking related disease.

In terms of cessation approaches, the use of visual media wasconsistently supported, as was the use of materials that linkeddirectly with life experiences. Images of children inhaling secondhand smoke for example, had a particularly strong impact. Risk to

themselves as a smoker had little impact on decision to changebehaviour, but the impact of their behaviour on the risk ofcausing illness in others held much more weight. Participantsconsistently reported that relationships with either their children,or with other family members were primary drivers in theirdecision to stop smoking or reduce the amount they smoked.Those who were ex-smokers felt this had influenced their ownsmoking behaviour and could also be used as a lever to promotecessation in others. As well as being fearful of exposing childrenand family members to harm through second hand smoke,participants were aware that smoking impacted negatively upontheir ability to participate in family life.

It was also noted that finances acted as key motivator indeciding to change smoking behaviour which gives greatercredence to large taxes on tobacco products. For some, thefinancial burden associated with smoking was the main factor thattriggered a desire to quit, that health had very little bearing andthat the decision to quit was a purely financial one.

Smoking cessation is an important focus of many health caresystems and in some jurisdictions smokers wishing to quit canaccess support free-of-charge. Since the early 1990s, the Universityof Ottawa Heart Institute (UOHI) has been offering smokingcessation services to its patients through an outpatient programcalled the Quit Smoking Program (QSP). This program is availableto smokers in the Ottawa area and can be accessed throughclinician or self-referral. UOHI smoking cessation expertsrecognized the need to support hospital in-patients with theirnicotine addiction resulting in the development of the Ottawa

Model for Smoke Cessation:www.http://ottawamodel.ottawahealth.ca

Motivating CigaretteSmokers To Quit

altering the activity of geneswithout changing their structure, increased production of freeradicals and protein damage, and telomere attrition. Cellular agingand cell arrest not only occur after exhaustion of a predeterminedproliferative capacity, but also can be induced by external stresses,such as oxidative stress.

Several clinical observations support the hypothesis thataccelerated aging may play a role in the development of COPD.Lung function declines with age in healthy individuals and this isaccelerated in patients with COPD. Those older than 65 yearshaving a higher disease rate than younger groups, independent oftheir history of exposure to tobacco smoke. The aging lung showsprogressive distal air space enlargement, with loss of gas-exchanging surface area and the support of the alveolarattachments for peripheral airways. Although these structuralchanges are thought to be non-destructive, in contrast withsmoking-induced emphysema, they do have functionalconsequences, resulting in a loss of elastic recoil of the lungs, anincrease in residual volume and functional residual capacity orover-inflation of the lungs. In addition, there is associated elastinfibre fragmentation. This loss of elastin fibres is similar to thatwhich occurs with aging in the skin, resulting in loss of elasticityand skin wrinkling which is enhanced by smoking. Interestingly, thedegree of skin wrinkling correlates with quantitative measurementsof emphysema by CT (computed tomography) scanning. Thuscigarette smoking produces a loss of elasticity both in the lungsand systemically in the skin, suggesting that cigarette smoke may

accelerate the aging process. Cigarette smoking also results in cellular aging. Cigarette

smoking is an important risk factor in many age-related diseasesand is associated with increased systemic inflammation andoxidative stress. This is thought to contribute to the othermanifestations of COPD, such as muscle wasting, cardiovasculardisease and osteoporosis, which are also characteristics of aging.These observations are compatible with COPD as a syndrome ofaccelerated aging.

For more information:http://www.ncbi.nlm.nih.gov/pubmed/19614601

Before makingmedical decisionsYour physician should be consulted on all medical decisions.New procedures or drugs should not be started or stoppedwithout such consultation. While we believe that ouraccumulated experience has value, and a unique perspective,you must accept it for what it is...the work of COPD patients.We vigorously encourage individuals with COPD to take anactive part in the management of their disease. You can do thisthrough education and by sharing information and thoughtswith your primary care physician and respirologist. Medicaldecisions are based on complex medical principles and shouldbe left to the medical practitioner who has been trained todiagnose and advise.

Lung Aging continued from Page 5



Theresa Bujtas is originallyfrom Manitou—a little placejust south of Winnipeg. Shemoved to St. Catharines in1967. Theresa is married withtwo grown children, adaughter and a son. She andher husband are emptynesters, as their children havemoved out and have newfamilies of their own. Her sonand his wife have two boysand live in New Jersey.Theresa visits her son andgrandchildren at least fourtimes per year. She takes thetrain from Niagara Falls, N.Y.to Penn Station. It’s about anine hour trek. Since shedoesn’t like to fly, it works wellfor her. Her son has his ownbusiness, a custom boatcanvas business, which hasbeen very lucrative. It helpsthat he’s near the ocean. Herdaughter and husband live inSt. Catharines with one son.She is an educationalassistant who works out of theSchool Support Services in theSpecial EducationDepartment. Theresa is retirednow but was a nurse whospecialized in obstetrics,working in labour anddelivery rooms. She heldvarious positions at herfacility, working in riskmanagement, medical/legalaffairs as well as infectioncontrol. She has had asthmaall of her life and wasdiagnosed with COPD in2003 after a bout ofpneumonia that put her inhospital. It was there that therespirologist diagnosed herCOPD.

COPD peopleTheresa Bujtas

Living with COPD Spring/Summer2015 • 7

How was your COPD diagnosed?

The respirologist noticed I had clubbingat my fingertips during my examination

when I had pneumonia. I had a bron-choscopy, MRI and CAT scan. They foundthat I have a lot of scarring in my lungs.How do you feel now?I’m feeling great today. I was at the gymconnected with Brock University; they havea SeniorFit Exercise Program. I’ve beengoing there since November 2013. Studentsfrom the Kinesiology Program introduce usto the various machines/weights and moni-tor the proper use. I was fortunate to have astudent who set up four different programsfor me that I can do there. Some exercises Ican also do at home.How often do you go?I go from 8 to 10 in the morning, onMondays, Wednesdays and Fridays. Thewarm up for my cardio is on the rowingmachine and treadmill. The rowing machineis fantastic for me and gives me a wholebody work-out. At intervals I monitor myoxygen saturation and my cardio.Do you have other activities?I’m involved in a lot of music at the church.I’m one of the organists/pianists and alsosing in the church choir. I find the singing isa very good breathing exercise for my lungs.Have you been playing the keyboard forvery long?I played the piano and organ when I was inhigh school. Then I took a break when Ihad the children. I got back into it about 12years ago. We have a beautiful Yamaha digi-tal piano at the church that will do justabout any instrument you want it to do.Is it a large parish?We have about 800 families. It’s a veryactive parish in quite an old church. I amactive in The Catholic Woman’s League as

well. The League focuses on the spiritualdevelopment for women, enhances the roleof women in society, defends Christian edu-cation and contributes to social justice. Weresearch various issues, for example;labelling of ingredients on canned foods;mandatory labelling of genetically modifiedfood products. Resolutions are presented tothe provincial and national level of govern-ments.Is your husband involved in outsideactivities?He’s a member of the Lion’s club and anavid golfer. We travelled some in the past, tothe Caribbean, Rome and we’ve been on aMediterranean cruise. I’m not comfortableflying now so that limits what we can do.Do you have other hobbies?I enjoy sewing and gardening. We live in acondo, but we do have little flower gardensin the front and back which is enough gar-dening for me.How do you suspect you got COPD?My parents smoked their whole lives, so sec-ond hand smoke is the only thing I can thinkof. Also, smoke was everywhere when wewere growing up; in restaurants and bars. Iremember the air being so thick with smoke.You mentioned that you exacerbate quiteoften. Are there triggers that you avoid?I did get a lot of sinus infections in the pastand have been free of exacerbations foralmost two years. This I can attribute to theroutine exercise program, singing and anactive lifestyle. I avoid people who havecolds and crowds as much as I can especial-ly in flu season. The scent of perfume,scented candles and most cleaning productsare triggers I try to avoid.

More information about Brock University’sexercise program can be found at

brocku.ca/health-well-being


alpha-1 slams chronic obstructive pulmonary ... - copd canadacopdcanada.info › resources ›...

Documents