Podcasts about copd

Joining us today is our good friend and colleague, Jim LaValle, a Clinical Pharmacist, Author, Board Certified Clinical Nutritionist, and Health Expert.  Jim joins us to discuss a very exciting, NEWLY published study that shows that Kyolic Aged Garlic Extract supplements can significantly reduce periodontal pocket depth – a key indicator of gingivitis and periodontal disease progression.It's an alarming fact, but periodontal disease affects most adults in America.According to the National Institutes of Health, nearly HALF of American adults over the age of 30 suffer from some form of periodontal disease which is linked to tooth loss and systemic conditions like cardiovascular disease, type 2 diabetes, COPD, and other respiratory issues.In the latest study, which appeared in the February 2025 issue of Biomedical Reports, 300 otherwise healthy adults with moderate-to-severe periodontal disease were divided into four treatment groups—three groups who were assigned to take various doses of AGE and one control group. Over the next 18 months, researchers found that the participants supplementing with AGE experienced marked reductions in periodontal pocket depth - a key indicator of disease progression—compared to those taking the placebo.The study, which was conducted by scientists at the Hebrew University of Jerusalem, also demonstrated that a greater daily AGE intake led to better outcomes. Statistical modeling confirmed that improvements were most strongly associated with participants' baseline pocket depths, smoking status, and AGE dosage.Learn more about KyolicLearn more about Jim LaValleKyolic Aged Garlic Extract formulas are available at your local health food store and Online.For more information about Kyolic, or to find a retailer near you, visit Kyolic.com 

Johnny Mac presents five uplifting news stories from Britain and beyond: A 63-year-old army veteran named Nick, suffering from COPD, arthritis, and PTSD, received a major surprise when a cleaning company owner cleared his overgrown backyard and raised about $14,000 for him via GoFundMe. In Norway, a hiker discovered an Iron Age reindeer trap that dates back between 500 AD and 500 BC. Conservationists in the Caribbean successfully boosted the population of the critically endangered lesser Antillean iguana on Anguilla's Prickly Pear East island. GameStop in Texas conducted its most valuable trade-in ever by paying a customer over $30,000 for a rare Pokemon card. In New York, a loose horse running along the Van Wick Expressway near JFK Airport was safely captured and returned to Curley's Cowboy Center.John also hosts Daily Comedy NewsUnlock an ad-free podcast experience with Caloroga Shark Media!  For Apple users, hit the banner which says Uninterrupted Listening on your Apple podcasts app. FSubscribe now for exclusive shows like 'Palace Intrigue,' and get bonus content from Deep Crown (our exclusive Palace Insider!) Or get 'Daily Comedy News,' and '5 Good News Stories' with no commercials! Plans start at $4.99 per month, or save 20% with a yearly plan at $49.99. Join today and help support the show!Get more info from Caloroga Shark Media and if you have any comments, suggestions, or just want to get in touch our email is info@caloroga.com

Klinisch Relevant ist Dein Wissenspartner für das Gesundheitswesen. Drei mal pro Woche, nämlich dienstags, donnerstags und samstags, versorgen wir Dich mit unserem Podcast und liefern Dir Fachwissen für Deine klinische Praxis. Weitere Infos findest Du unter https://klinisch-relevant.de

VOV1 - Khi thời tiết chuyển lạnh, những người mắc bệnh phổi tắc nghẽn mạn tính (hay còn gọi là COPD) rất dễ phải đối mặt với những đợt tái phát bệnh. Đường thở bị kích thích nhiều hơn, chức năng hô hấp suy giảm, khiến người bệnh ho nhiều, khó thở và có nguy cơ nhập viện cao.Bên cạnh phác đồ điều trị của bác sĩ, hiện nay nhiều người quan tâm đến việc kết hợp các thảo dược tự nhiên để hỗ trợ làm dịu đường thở, giảm ho, tiêu đờm và tăng cường sức đề kháng trong mùa lạnh. Để giúp quý vị hiểu rõ hơn về chủ đề này, chương trình Chuyên gia của bạn này, chúng tôi mời Bác sỹ chuyên khoa 1 Nguyễn Hồng Hải chia sẻ những kiến thức hữu ích như: Vì sao COPD dễ tái phát khi trời lạnh? Những thảo dược nào có thể hỗ trợ đường hô hấp? Cách sử dụng thảo dược đúng, an toàn và phù hợp cùng các biện pháp phòng bệnh hiệu quả trong mùa lạnh.

As hospitals across the U.S. shorten length of stay and push more recovery into the home, families are increasingly left to manage complex care needs without formal training or support. Roughly one in five patients with chronic conditions like COPD or congestive heart failure is readmitted within 30 days—a cycle that costs the healthcare system billions annually and places enormous strain on caregivers. Against the backdrop of hospital-at-home models, aging demographics, and caregiver burnout, in-home senior care has become a critical piece of the post-acute care puzzle.So how can families ensure their loved ones are truly supported at home—not just medically, but functionally and emotionally—after discharge?In this episode of I Don't Care, host Dr. Kevin Stevenson sits down with Lance Summey, Franchise Owner at Home Instead. Together, they unpack the realities of nonmedical in-home senior care, how it integrates with hospitals, home health, and hospice, and why seemingly “small” daily tasks can dramatically impact health outcomes.Key Topics Covered in This Episode…Why nonmedical care matters: How help with activities of daily living—bathing, dressing, meals, transportation, and companionship—directly influences clinical outcomes and reduces hospital readmissions.Hospital-to-home transitions: The growing importance of in-home care as hospitals discharge patients earlier and rely on the home environment to support recovery.Caregiver burden and sustainability: Why family caregivers often reach a breaking point, and how professional in-home care allows loved ones to remain family—not full-time caregivers.Lance Summey is a franchise owner with Home Instead, the world's largest provider of nonmedical in-home senior care. He holds a Master's in Social Work from Baylor University and brings firsthand experience from both hospital systems and personal family caregiving. Motivated by his mother's battle with breast cancer and his grandmother's experience with multiple sclerosis, Summey has dedicated his career to bridging gaps in post-acute and long-term care—particularly where traditional medical models fall short. His work focuses on reducing hospital readmissions, integrating care teams, and supporting families through some of life's most challenging transitions.

In the hospital setting, neurologists may be responsible for managing common end-of-life symptoms. Comprehensive end-of-life care integrates knowledge of the biomedical aspects of disease with patients' values and preferences for care; psychosocial, cultural, and spiritual needs; and support for patients and their families. In this episode, Teshamae Monteith, MD, FAAN, speaks with Claudia Z. Chou, MD, author of the article "End-of-Life Care and Hospice" in the Continuum® December 2025 Neuropalliative Care issue. Dr. Monteith is the associate editor of Continuum® Audio and an associate professor of clinical neurology at the University of Miami Miller School of Medicine in Miami, Florida. Dr. Knox is an assistant professor of neurology and a consultant in the Division of Community Internal Medicine, Geriatrics and Palliative Care at Mayo Clinic in Rochester, Minnesota. Additional Resources Read the article: End-of-Life Care and Hospice Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @headacheMD Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Monteith: This is Dr Teshamae Monteith. Today I'm interviewing Dr Claudia Chou about her article on end-of-life care and hospice, which is found in the December 2025 Continuum issue on neuropalliative care. Welcome to our podcast. How are you? Dr Chou: I'm doing well. Thank you for having me. This is really exciting to be here. Dr Monteith: Absolutely. So, why don't you introduce yourself to our audience? Dr Chou: Sure. My name is Claudia Chou. I am a full time hospice and palliative medicine physician at Mayo Clinic in Rochester. I'm trained in neurology, movement disorders, and hospice and palliative medicine. I'm also passionate about education, and I'm the program director for the Hospice and Palliative Medicine fellowship here. Dr Monteith: Cool. So just learning about your training, I kind of have an idea of how you got into this work, but why don't you tell me what inspired you to get into this area? Dr Chou: It was chance, actually. And really just good luck, being in the right place at the right time. I was in my residency and felt like I was missing something in my training. I was seeing these patients who were suffering strokes and had acute decline in functional status. We were seeing patients with new diagnosis of glioblastoma and knowing what that future looked like for them. And while I went into neurology because of a love of neuroscience, localizing the lesion, all of those things that we all love about neurology, I still felt like I didn't have the skill set to serve patients where they perhaps needed me the most in those difficult times where they were dealing with serious illness and functional decline. And so, the serendipitous thing was that I saw a grand rounds presentation by someone who works in neurology and palliative care for people with Parkinson's disease. And truly, it's not an exaggeration to say that by the end of that lecture, I said, I need to do palliative care, I need to rotate in this, I need to learn more. I think this is what I've been missing. And I had plans to practice both movement disorders neurology and palliative care, but I finished training in 2020… and that was not a long time ago. We can think of all the things that were going on, all the different global forces that were influencing our day-to-day decisions. And the way things worked out, staying in palliative care was really what my family and I needed. Dr Monteith: Wow, so that's really interesting. Must have been a great lecturer. Dr Chou: Yes, like one of the best.  Dr Monteith: So why don't you tell me about the objectives of your article? Dr Chou: The objectives may be to fill in some of the gaps in knowledge that may be present for the general neurologist. We learn so much in neurology training, so much about how to diagnose and treat diseases, and I think I would argue that this really is part and parcel of all we should be doing. We are the experts in these diseases, and just because we're shifting to end-of-life or transitioning to a different type of care doesn't mean that we back out of someone's care entirely or transition over to a hospice or palliative care expert. It is part of our job to be there and guide patients and their care partners through this next phase. You know, I'm not saying we all need to be hospice and palliative care experts, but we need to be able to take those first steps with patients and their care partners. And so, I think objectives are really to focus in on, what are those core pieces of knowledge for end-of-life care and understanding hospice so we can take those first steps with patients and their care partners? Dr Monteith: So, why don't you give us some of those essential points in your article? Dr Chou: Yeah. In one section of the article, I talk about common symptoms that someone might experience at the end of life and how we might manage those. These days, a lot of hospitals have order sets that talk us through those symptoms. We can check things off of a drop-down menu. And yet I think there's a little bit more nuance to that. There may be situations in which we would choose one medication over another. There may be medications that we've never really thought of in terms of symptom management before. Something that I learned in my hospice and palliative medicine fellowship was that haloperidol can be helpful for nausea. I know that's usually not one of our go-tos in neurology for any number of reasons. So, I think that extra knowledge can take us pretty far when we're managing end of life symptoms, particularly in the hospital setting. And then I think the other component is the hospice component. A lot of us may have not had experience talking about hospice, talking about what hospice can provide, and again, knowing how to take those first steps with patients. We may be referring to social work or palliative medicine to start those conversations. But again, I think this is something that's definitely learnable and something that should be part of our skill set in neurology. Dr Monteith: Great. And so, when you speak about symptom management and being more comfortable with the tools that we have, how can we be more efficient and more effective at that? Dr Chou: Think about what the common symptoms are at end of life. We may know this kind of intuitively, but what we commonly see are things like pain, nausea, dyspnea, anxiety, delirium or agitation. And so, I think having a little bit of a checklist in mind can be helpful. You know, how can I systematically think through a differential, almost, for why my patient might be uncomfortable? Why they might be restless? Have I thought through these different symptoms? Can I try a medication from my tool kit? See if that works, and if it does, we can continue on. If not, what's the next thing that I can pivot to? So, I think these are common skills for a little bit of a differential diagnosis, if you will, and how to work through these problems just with the end-of-life lens on it. Dr Monteith: So, are there any, like, validated tools or checklists that are freely available? Dr Chou: I don't think there's been anything particularly validated for end-of-life care in neurologic disease. And so, a lot of our treatments and our approaches are empiric, but I don't think there's been anything validated, per se. Dr Monteith: Great. So, why don't we talk a little bit about the approach to discussions on hospice? We all, as you kind of alluded to, want to be effective neurologists, care for our patients, but we sometimes deal with very debilitating diseases. And so, when we think that or suspect that our patient is kind of terminally ill, how do we approach that to our patients? Of course, our patients come from different backgrounds, different experiences. So, what is your approach? Dr Chou: So, when we talk about hospice and when a patient may be appropriate for hospice, we have to acknowledge that we think that they may be in the last six months of their disease. We as the neurologist are the experts in their disease and the best ones to weigh in on that prognosis. The patient and their care partners then have to accept that the type of care that hospice provides is what makes sense for them. Hospice focuses on comfort and treating a patient's comfort as the primary goal. Hospice is not as interested in treating cancer, say, to prolong life. Hospice is not as interested in life-prolonging measures and treatments that are not focused at comfort and quality of life. And so, when we have that alignment between our understanding of a patient's disease and their prognosis and the patient care partner's goal is to focus on comfort and quality of life above all else, that's when we have a patient who might be appropriate for hospice and ready to hear more about what that actually entails. Dr Monteith: And what are some, maybe, myths that neurologist healthcare professionals may have about hospice that you really want us to kind of have some clarity on? Dr Chou: That's a great question. What we often tell patients is that hospice's goal is to help patients live as well as possible in the time that they have left. Again, our primary objective is not life prolongation, but quality of life. Hospice's goal is also not to speed up or slow down the natural dying process. Sometimes we do get questions about that: can't you make this go faster or we're ready for the end. But really, we are there to help patients along the natural journey that their body is taking them on. And I think hospice care can actually be complex. In the inpatient setting, in particular in neurology, we may be seeing patients who have suffered large strokes and have perhaps only days to a few weeks of life left. But in the outpatient setting and in the home hospice setting, patients can be on hospice for many months, and so they will have new care needs, new urinary tract infections, sometimes new rashes, the need to change their insulin regimens around to avoid extremes of hyperglycemia or hypoglycemia. So, there is a lot of complexity in that care and a lot that can be wrapped up under that quality-of-life and comfort umbrella. Dr Monteith: And to get someone to hospice requires a bit of prognostication, right? Six months of prediction in terms of a terminal illness. I know there's some nuances to that. So how can you make us feel more comfortable about making the recommendations for hospice? Dr Chou: I think this is a big challenge in the field. We're normally guided by Medicare guidelines that say when a patient might be hospice-appropriate. And so, for a neurologic disease, this really only encompasses four conditions: ALS, stroke, coma, and Alzheimer's dementia. And we can think of all the other diseases that are not encompassed in those four. And so, I think we say that we paint the picture of what it means to have a prognosis of six months or less. So, from the neurologic side, that can be, what do you know about this disease and what end-stage might look like? What is the pattern of the patient's functional decline? What are they needing more help with? Are there other factors at play such as heart failure or COPD that may in and of themselves not be a qualifying diagnosis for hospice, but when it's taken together in the whole clinical picture, you have a patient who's very ill and one that you're worried may die in the next six months or less? Dr Monteith: Then you also had some nice charts on kind of disease-specific guidelines. Can you take us a little bit through that? Dr Chou: The article does contain tables about specific criteria that may qualify someone for hospice with these neurologic conditions. And they are pretty dense. I know they're a checklist of a lot of different things. And so, how we practice is by trying to refer patients to hospice based on those guidelines as much as possible and then using our own clinical judgment as well, what we have seen through taking care of patients through the years. So, again, really going back to that decline. What is making you feel uncomfortable about this patient's prognosis? What is making you feel like, gosh, this patient could be well supported by hospice, and they could have six months or less? So, all of that should go into your decision as well. And all of that should go into your discussion with the patient and their care partners. Dr Monteith: Yeah. And reading your article, what stood out was all the services that patients can receive under hospice. So, I think sometimes people think, okay, this is terminal illness, let's get to hospice for whatever reasons, but not necessarily all the lists and lists and lists of benefits of hospice. So, I don't know that everyone's aware of all those benefits. So, can you talk to us a little bit about that? Dr Chou: Yeah, I like that you brought that up because that's also something that I often say to patients and their care partners when we're talking about hospice. When the time is right for a patient to enroll in hospice, they should not feel like they're giving anything up. There should be no more clinical trial that they're hoping to chase down, and so they should just feel like they're gaining all of those good supports: care that comes to their home, a team that knows them well, someone that's available twenty-four hours a day by phone and can actually even come into the home setting if needed to help with symptom management. Hospice comes as well with the psychosocial supports for just coping with what dying looks like. We know that's not easy to be thinking about dying for oneself, or for a family member or care partner to be losing their loved one. So, all of those supports are built into hospice. I did want to make a distinction, too, that hospice does not provide custodial care, which I explain to patients as care of the body, those daily needs for bathing, dressing, eating, etc. Sometimes patients are interested in hospice because they're needing more help at home, and I have to tell them that unfortunately, our healthcare system is not built for that. And if that's the sole reason that someone is interested in hospice, we have to think about a different approach, because that is not part of the hospice benefit.  Dr Monteith: Thank you for that. And then I learned about concurrent care. So why don't you tell us a little bit about that? That's a little bit of a nuance, right? Dr Chou: Yeah, that is a little bit of a nuance. And so, typically when patients are enrolling in hospice, they are transitioning from care the way that it's normally conducted in our healthcare system. So, outpatient visits to all of the specialists and to their primary care providers, the chance to go to the ER or the ICU for higher levels of care. And yet there are a subset of patients who can still have all of those cares alongside hospice care. That really applies to two specific populations: veterans who are receiving care through the Veterans Administration, and then younger patients, so twenty six years old and less, can receive that care through, essentially, a pediatric carve out. Dr Monteith: Great. Well, I mean, you gave so much information in your article, so our listeners are going to have to read it. I don't want you to spill everything, but if you can just kind of give me a sense what you want a neurologist to take away from your article, I think that would be helpful. Dr Chou: I think what I want neurologist to take away is that, again, this is something that is part of what we do as neurologists. This is part of our skill set, and this is part of what it means to take good care of patients. I think what we do in this transition period from kind of usual cares, diagnosis, full treatment to end of life, really can have impact on patients and their care partners. It's not uncommon for me to hear from family members who have had another loved one go through hospice about how that experience was positive or negative. And so, we can think about the influence for years to come, even, because of how well we can handle these transitions. That really can be more than the patient in front of us in their journey. That is really important, but it can also have wide-reaching implications beyond that. Dr Monteith: Excellent. And I know we were talking earlier a little bit about your excitement with the field and where it's going. So why don't you share some of that excitement? Dr Chou: Yeah. And so, I think there is a lot still to come in the field of neuropalliative care, particularly from an evidence base. I know we talked a lot about the soft skills, about presence and communication, but we are clinicians at heart, and we need to practice from an evidence base. I know that's been harder in palliative care, but we have some international work groups that really are trying to come together, see what our approaches look like, see where standardization may need to happen or where our differences are actually our strength. I think there can be a lot of variability in what palliative care looks like. So, my hope is that evidence base is coming through these collaborations. I know it's hard to have a conversation these days without talking about artificial intelligence, but that is certainly a hope. When you look at morbidity, when you look at patients with these complicated disease courses, what is pointing you in the direction of, again, a prognosis of six months or less or a patient who may do better with this disease versus not? And so, I think there's a lot to come from the artificial intelligence and big data realm. For the trainees listening out there, there is no better time to be excited about neuropalliative care and to be thinking about neuropalliative care. I said that I stumbled upon this field, and hopefully someone is inspired as well by listening to these podcasts and reading Continuum to know what this field is really about. And so, it's been exponential growth since I joined this field. We have medical students now who want to come into neuropalliative care as a profession. We have clinicians who are directors of neuropalliative care at their institutions. We have an international neuropalliative care society and neuropalliative care at AAN. And I think we are moving closer to that dream for all of us, which is that patients living with serious neurologic illness can be supported throughout that journey. High-quality, evidence-based palliative care. We're not there yet, but I think it is a possibility that we reach that in my lifetime. Dr Monteith: Well, excellent. I look forward to maybe another revision of this article with some of that work incorporated. And it's been wonderful to talk to you and to reflect on how better to approach patients that are towards the end of life and to help them with that decision-making process. Thank you so much.  Dr Chou: Yeah, thank you for having me. And we're very excited about this issue. Dr Monteith: Today. I've been interviewing Dr Claudia Chou about her article on end-of-life care and hospice, which is found in the December 2025 Continuum issue on neuropalliative care. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

As winter brings a rise in respiratory illnesses across the Mid West, staying well and out of hospital has never been more important. Carmel McInerney, Respiratory Advanced Nurse Practitioner at Ennis Hospital, is urging people to take simple, practical steps to protect their lung health in the coming weeks. Alan Morrissey spoke to Carmel about a range of topics from flu and COVID-19 vaccination to managing asthma and COPD and knowing when to seek help.

#hirdetés A beszélgetés támogatója a SANOFI Hungary. A COPD világszerte 390 millió embert érint, mégis nagyon kevesen tudnak erről a krónikus tüdőbetegségről, így például arról, milyen kapcsolata van az immunrendszerrel. Hogyan működik a légutak védőrendszere, és miért hibásodik meg? Miért létfontosságú a sport, és hogyan végezzünk légzőgyakorlatokat? Ezekről a témákról is szó esett a HVG egészségpodcastjának legújabb adásában.

In this latest episode of Primordial: The Podcast, hosts Moose and Dewsbury once again stretch the definition of “content” to breaking point with possibly the most anticlimactic prize draw of all time. Thanks to GDPR, they can't even say who won a thing. Meh.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://links.primordialradio.com/listen⁠Thankfully they're joined by DJ/streamer/PRFam member Alex Walker aka. Runny to discuss his upcoming 24-hour streaming event to raise awareness for COPD. There will be horror games, challenges, hot sauce and even hotter leg wax, but it'll all be to raise some money for a great cause close to Alex's heart. Website - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://primordialradio.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Discord - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://primordialradio.com/discord⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://links.primordialradio.com/youtube⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Spotify Playlist - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://links.primordialradio.com/spotify⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠SOCIALFacebook - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.facebook.com/primordialradio⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/primordialradio⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠TikTok - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://tiktok.com/@primordialradio⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠METAL FOR GOOD CHARITYCheck out our chosen charity, Metal For Good, and the great work they do - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://metalforgood.org⁠⁠⁠⁠

FOR MEDICAL PROFESSIONALS:SIGN UP FOR OUR FREE TRAINING Jan 10th! The Countertransference & Chronic Illness Intensive https://www.thechronicillnesstherapist.com/countertransference-chronic-illness-intensive

For more information regarding this CME/CE activity and to complete the CME/CE requirements and claim credit for this activity, visit:https://www.mycme.com/courses/responding-to-the-science-biologics-in-practice-in-copd-10511SummaryThis enduring podcast activity provides pulmonologists and clinicians managing COPD with timely updates on the evolving role of biologics management. Featuring expert discussions, the program explores recent GOLD guideline revisions, the integration of new and emerging biologic therapies, and evidence-based decision-making based on clinical trial data and real-world practice.Covering guidelines, clinical trials, and clinical scenario, this activity emphasizes the translation of complex data into practical strategies. Learners will gain improved knowledge and competence related to patient selection, eosinophil thresholds, and clinical decision making.This podcast was recorded and is being used with permission of the presenters.Learning ObjectivesDiscuss recent evidence surrounding the use of biologic agents in the management of patients with COPD, including patient populations and outcomesIntegrate the use of biologic agents into the management of patients with COPD based on guidelines and clinical evidence for new and emerging agentsThis activity is accredited for CME/CE CreditThe National Association for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.The National Association for Continuing Education designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.The National Association for Continuing Education is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 121222. This activity is approved for 0.25 contact hours (which includes 0.25 hours of pharmacology).For additional information about the accreditation of this program, please contact NACE at info@naceonline.com.Summary of Individual DisclosuresPlease review faculty and planner disclosures here. Disclosure of Commercial SupportThis educational activity is supported by an independent medical education grant from GSK and an independent educational grant from Regeneron Pharmaceuticals, Inc and Sanofi.Please visit http://naceonline.com to engage in more live and on demand CME/CE content.

Some people have wonderful experiences with hospice, and other people say the experience was terrible. What's the difference?If your loved one is sick enough to need hospice, it's a highly stressful time for your whole family. Whether your loved one has cancer, dementia, ALS, COPD or another serious illness, making the decision for when to request hospice care is tough.Once you've made the decision to start hospice, how do you make sure that your loved one and your family get the very best hospice care? In this episode we discuss the 10 ways to be sure you get the very best hospice care.Caring for you as you care for them.Dr. Deliahttps://doctordelia.comBe sure to subscribe to The Integrative Palliative Podcast here: https://podcasts.apple.com/us/podcast/the-integrative-palliative-podcast/id1617730043Coping Courageously: A Heart-Centered Guide for Navigating a Loved One's Illness Without Losing Yourself is available here: www.copingcourageously.com Please review this podcast wherever you listen and forward your favorite episode to a friend! And be sure to subscribe!Sign up to stay connected and learn about upcoming programs:https://trainings.integrativepalliative.com/IPI-stay-in-touchI'm thrilled to be listed in Feedspot's top 15 palliative podcasts!https://blog.feedspot.com/palliative_care_podcasts/

Please visit answersincme.com/860/MED-RESP-03658-replay to participate, download slides and supporting materials, complete the post test, and get a certificate. In this activity, experts in pulmonary medicine discuss how to integrate biologics into individualized treatment plans for chronic obstructive pulmonary disease (COPD), featuring insights from a patient advocate. Upon completion of this activity, participants should be better able to: Specify the rationale for targeting eosinophilic inflammation in COPD; Differentiate available and late-stage emerging biologic therapies based on the latest clinical evidence in COPD; Identify patients with COPD who are appropriate candidates for biologic therapy; and Outline strategies to optimally incorporate biologic therapies into treatment plans for patients with COPD.

Please visit answersincme.com/860/MED-RESP-03658-replay to participate, download slides and supporting materials, complete the post test, and get a certificate. In this activity, experts in pulmonary medicine discuss how to integrate biologics into individualized treatment plans for chronic obstructive pulmonary disease (COPD), featuring insights from a patient advocate. Upon completion of this activity, participants should be better able to: Specify the rationale for targeting eosinophilic inflammation in COPD; Differentiate available and late-stage emerging biologic therapies based on the latest clinical evidence in COPD; Identify patients with COPD who are appropriate candidates for biologic therapy; and Outline strategies to optimally incorporate biologic therapies into treatment plans for patients with COPD.

This activity was supported by an educational grant from Viatris Specialty LLC. Please go to  ⁠⁠academiccme.com/epccopdpod2⁠ and complete the evaluation to receive your CE/CME Credit. Credit is available through September 29, 2026.

Jennifer Keeley and Mary Whittenhall, experienced nurse practitioners in the field of pulmonary hypertension, discuss the management of cough in patients receiving inhaled therapies for pulmonary hypertension and interstitial lung disease. #GossamerBioPartner #sponsored This Special Edition episode is sponsored by Gossamer Bio. Jennifer Keeley, DPN: My name's Jennifer Keeley. I'm a nurse practitioner and I practice in a large academic institution in Pittsburgh, Pennsylvania, Allegheny Health Network, specifically Allegheny General Hospital. I am a nurse practitioner there and have been in the clinic over 10 years, and in the PH space as a nurse practitioner for over 15 years, as a registered nurse for almost 20 years. So, I have a lot of experience and I'm really excited to be here today to talk about inhaled therapies and cough. Mary Whittenhall, MSN: My name is Mary Whittenhall. I'm also a nurse practitioner. I am currently an advanced practice provider at Pulmonary and Sleep Associates in East Providence, Rhode Island. I've been in pulmonary hypertension for about 11 years now. In that time, I have worked in a variety of settings, both inpatient and outpatient, managing patients with pulmonary vascular disease, and have also touched upon patients with interstitial lung disease and pulmonary hypertension.  I get very excited when I hear about new opportunities for our PH patients. I think a lot about even when I started in pulmonary hypertension and the therapies that were available to our patients. Many of these therapies had been around for a little bit of time. But also something that I think is extremely exciting is that there's just been a rapid progression in development of therapies. And now, with the focus of looking at these therapies as potentially disease modifying, not necessarily slowing the progression of disease. With the advent of all of these new therapies, there become more options for our patients, as well. Often, patients can't tolerate some of the medications that we have due to side effects and despite lots of work to manage these side effects, the patients are not always successful. One of the great things being involved in an academic center is that we have the ability to help link patients to cutting edge research, particularly looking at a new drug that is an inhaled therapy that has shown significant promise in improving the lives of patients with pulmonary hypertension. As a part of the PH community, we all do quite a bit of networking with each other, as well as with our patients and other colleagues in the space. In that time, we did network regarding the study and have participated in some activities where we're looking at the data from the Phase 2 part of this trial and then also looking at some of the side effect management related to the medication, which seemingly is well tolerated. However, for some patients it may not come extremely easy. I think that's where the role of the nurse or the advanced practice provider really comes in this space is that we have a real strong dedication to helping educate patients about ways to manage these side effects. We want patients to be able to continue with therapies. We don't want them to say, "Well, this isn't working for me, it's time to move on." I think that we have a lot of strategies and a lot of experience with trying to help patients really figure out the best way to manage these things and to be confident that they can continue on with obviously the biggest benefit of improving their pulmonary vascular disease. Jennifer Keeley, DPN: We actually met at an advisory board last year. It was an advisory board consistent of registered nurses and nurse practitioners who, just like Mary and myself, have vast experience with patients and therapies, not just in the inhaled space, but more conventional pulmonary vasodilator medications that have been used in our patients for many, many years. As Mary had suggested before, when we start to think about newer agents, many, many of them are not the conventional pulmonary vasodilator medications, but disease modifying agents. Now, we've acquired an armamentarium of medications. So, inhaled delivery is just a really great option to avoid systemic side effects on top of each other. Our PH patients today, many of them are on more than three therapies, many of them are on four or even more therapies, so the delivery of the medication is just one aspect. When we talk about cough and side effects, I like to think about it and explain to my patient when we talk about side effects, particularly cough, to imagine a Venn diagram with cough being in the middle and what affects cough. You see this outward circle, how we deliver it, what kind of device we deliver it in. The drug, how small, large are the particle size? Is it easy enough to use for our patients? The formulation, is it dry powdered versus inhaled aerosolized? And then finally, just the patient themselves. What's their background? What type of PAH do they have? So, we can talk a little bit more about this, but just to get us started, this is how this developed and we had a lovely advisory board meeting with seralutinib and Gossamer Bio, and this was the outcome of it. We produced a lovely poster. This is a conversation if you will, that Mary and I are going to have based on what we talked about and the poster production, that came out of that wonderful advisory board. Mary Whittenhall, MSN: Inhaled therapies are unique in a way in that they actually have direct access to the lungs. So, when you think of an oral medication, an oral medication needs to be digested in the gut and sometimes that systemic digestion takes a while. Additionally, it's also often that we see patients that have more systemic side effects when we're using an oral formulation. Intravenous or subcutaneous formulations of these medications tend to cause pretty strong systemic side effects for patients, and there tends to be a lot of management that we need to do to help make these side effects more tolerable. For most of our patients, I say to them, "You're going to think I'm cruel because I don't really want these side effects to go away." In a way, we look at them almost as if you have a cup and your cup is full of water and after the top of the water hits the rim of the cup, then the water starts to spill over onto the sides of the cup. I think of other medications that we typically prescribe for patients in that way that when we get that spill over, so to speak, it's an indication that we've actually targeted all of those receptors that we want to help with vasodilation. Now that we're looking at other medications that don't really necessarily look at vasodilation, we're looking more at treating the blood vessels in a different way or affecting the process for which those blood vessels become diseased. I think that the side effects become different and I think they become less. In working with inhaled therapies, as you can imagine, the number one side effect that most patients will complain of is cough. Sometimes we have patients who have an underlying cough already, and that's usually not related to PAH, but in PH-ILD where we now have an FDA indication to use another inhaled therapy, we've seen in treating these patients that baseline cough is something that is extremely problematic for them before they even start therapies. So, trying to find ways to improve that baseline cough, treat any underlying symptoms, things like acid reflux as well, that may cause that, treating seasonal allergies, et cetera, and then, obviously, managing any additional overlapping side effects that may occur because of the new therapy that they're on. Jennifer Keeley, DPN: I think that's a really important part, is to talk with the patient, educate the patient on these inhaled therapies. First and foremost, that cough is almost an expected side effect. These are patients particularly with our interstitial lung disease patients that have PAH, cough is a part of their daily life. It's important to document and ascertain what these patients' baseline cough is. In many, many clinics, particularly pulmonary PAH clinics, and I'm sure much like Mary's, many of my colleagues have recommended using validated cough questionnaires so that we can get a really, really good baseline of what that patient's baseline cough is. Are you coughing at night? Do you have mucus? How long have you been coughing? Does it interfere with the quality of your life? Do you cough at night? Does it keep you up? Does it interrupt your sleep? Those kinds of things that help differentiate acute cough versus chronic cough. Many of these patients cough every day. They also have other inhaled therapies such as our ILD patients that are also on corticosteroids, many of them on inhaled corticosteroid therapy that can thin the oral pharynx, the posterior pharynx, and really affect the degree of nerve innervation in the posterior pharynx in the mouth. So, just really understanding what the patient's baseline cough is and educating them on the fact that cough is likely going to be a side effect with the use of this inhaled therapy. Certainly, as we continue to use the therapy, we would hope that the cough can be mitigated either through some lifestyle modifications, some natural remedies, and even some medical remedies such as bronchodilators. But really teaching the patient about the medication and inherently that this is likely going to induce a cough, but that we have mitigation strategies to help dissipate the cough. I always like to tell my patients also in the clinical trials, particularly the Phase 2 clinical trials that are out there that patients had a lot of cough. The patients on drug that were in most of the Phase 2 clinical trials for seralutinib and even for treprostinil inhaled, 30 to 40% of them experienced cough. But at the same token, the placebo-based patients that did not receive drug in these Phase 2 clinical trials also had a lot of cough. So, what that's telling you is yes, you're going to get probably some more cough, but it's likely not going to be that much or more far advanced than the cough that you're already experiencing. I also think it's important to tell these patients, many, many patients that experienced cough did not stop the medication. Actually, in these Phase 2 clinical trials, very few stop the medication. So, that gives you a really good big picture that we are pretty good at educating our patients how to mitigate cough, and if we aren't, then we should learn how to do so. Mary Whittenhall, MSN: I think it's important for us to set some expectations for patients when we're talking about cough. We've already discussed a bit that cough can happen for people from other things outside of their lung disease, but it's important to also look at what may be causing the cough when we are giving a patient an inhaled therapy. So, any type of inhaled therapy, whether that be a dry powder, a mist, whether that's nebulized or through in actuated inhaler, there are particles inside of that medication as it's going in and those little particles, when your lungs inhale that medication, those particles are penetrating your lungs and your lungs are not accustomed to them being there. It's almost as if your lungs are saying, "I don't recognize this. I don't know why this is here," and it may feel like it's an irritant, so you may start coughing as a result of that, but the cough is not necessarily a bad thing. Those particles are there, and the job is to essentially help deliver the medicine to penetrate that lung tissue and then for your body then to absorb the medicine. Your airways and your blood vessels inside of your lungs are extremely close to each other. So, when you inhale that medication, those little blood vessels are also right next to where those airways are, and then that is how those blood vessels then absorb that medication, because they're so close to the site at which those particles come into your lungs. Jennifer Keeley, DPN: I think this is an important concept to understand. They choose the form of delivery based on the goal of delivering the most medication efficiently to the distal bronchioles. That's where the disease is. It's in the distal arteries. So, trying to formulate how we get these very powerful, oftentimes disease modifying agents into the periphery of the lungs can be very challenging. Dry powdered inhaler is one form that the variability of delivery is not as dispersed as an aerosolized. So, it's more efficient delivery to the place where the medication needs to work the best, and that's in the distal periphery of the lungs. Unfortunately, one thing you have to deal with is that oftentimes these medications, dry powdered medications, not just in the PH space, but there's a lot of other dry powdered inhalers in the COPD space, as well. Oftentimes, what happens is these powdered particles get dispersed extra thoracically. So, they get dispersed in the oral mucosa, in the posterior pharynx, on the way down into the stomach. That's wherein we have to deal with mitigating side effects. The biggest side effect of these particles, even though they're very small, is cough. So, technique comes into play. Mitigating things to coat the posterior pharynx come into play. Re-education comes into play. Show me again how you're doing this inhalation, because I don't think that you're holding this okay. In one instance, I had a patient that was inhaling dry powdered inhaler with the medication right out of the refrigerator. So, the medication was cold. It was clumping at the back of her throat. All of these things really take into consideration how we most efficiently get the medicine to these pulmonary arterial hypertension patients where their disease is oftentimes very difficult to get to, and other forms of medications that are systemic, orals, parenterals that have first pass metabolism, and so you're going to get more side effects from those medications. So, I always teach my patients, "Hey, we're a couple steps ahead because we're bypassing the type of metabolism that you get with orals and even parenterals." Mary Whittenhall, MSN: There are so many challenges that these patients face. Oftentimes, patients have never been sick before they develop this, and now we're putting them on multiple therapies, multiple modalities, telling them that there's going to be side effects and they need to learn how to manage them. It's certainly a lot to handle. But I think one of the best things that we have in our PH community is that we really work so hard to partner with the patients and their loved ones and forming this relationship, fostering that relationship as time goes on, I believe that these patients really do trust us and that what we're telling them is things are going to be okay. We are going to be there by your side. We're not going to give you this medicine and then say, "See you in six months. Hope everything goes well." We're really going to be working with them. In some cases in my specialty clinic, we have nurses, we have a pharmacist, a pharmacy tech, and then our advanced practice providers that check in with these patients quite regularly. We are actually taking the initiative to reach out to them versus the patient who may be having trouble advocating for themselves or feeling like, "Really, I don't want to be a pain, but this is challenging for me." We are really in touch with them, and that connection also helps to keep patients on therapy. So, what are some of the specific techniques to manage or mitigate cough? This is something that was a real hot topic at our last advisory meeting. We put together a bunch of folks in the room who deal with other inhaled therapies and patients that have cough and said, "Well, what do you tell patients to do?" First and foremost is to look at any other potentially underlying conditions that may be causing cough and ensure that treatment of those underlying conditions is optimized. I think cough is actually the number one referral for any type of pulmonary practice, but it is a really, really broad differential when it comes down to it. We obviously look first at things like environmental factors. If this could be seasonal allergies, then we try treating patients with antihistamines. Perhaps some of those are intranasal, as well, that may help with some things like rhinorrhea or post nasal drip. Acid reflux is actually a huge, huge reason for cough. Many patients say, 'Well, I don't get acid reflux. I don't feel that burning in my chest after I eat," but come to find out that it can actually be a silent trigger. So, treating patients with medicines that help to reduce acid or suppress acid will oftentimes help with that cough. On top of that, when we're dealing with patients that are on inhalers and now we're adding another inhaled therapy. I find that for some patients that are on actual inhalers that sometimes they do better with nebulized treatments. The nebulized treatments are slower, and may have a bit of a better penetration into the lungs and the patients tend to like it. It is one of those things that you do need to be compliant with in order to really see the benefits to it. I will say that oftentimes, again, partnering with the patient, giving them specific instructions about how to do all of this, we can really see some improvement to those symptoms. Then, there's just basic over-the counter measures and precautions, things like making sure that when you're eating that you're not laying down at least for 60 minutes after you've been eating. If you do have acid reflux, trying to sleep with two pillows or a wedge pillow, that can help to keep the head of your bed elevated. Some of our patients have those really fancy adjustable beds that are also quite helpful for that. I think that sometimes things like basic cough drops actually can be quite wonderful and helpful. Drinking very cold or very warm water or tea, adding some honey to that if a patient isn't diabetic, things like that tend to really help with cough. We reinforce these measures when we start therapies like this. Jennifer Keeley, DPN: In terms of mitigation, I think it's really important on technique. This is why, as Mary had alluded to, it's so important to follow up closely with these patients, particularly our elderly patients who sometimes don't, if they have connective tissue disease or scleroderma, have a lot of good fine motor coordination. A couple of things that I wanted to touch on with regards to that… One, these inhalers are typically high resistance, low flow. So, these are not the type of patients that need to be taking in very forceful inhalations with these inhalers and thank goodness, because we're talking about patients that have inflammatory interstitial lung disease, as well as pulmonary vascular disease. So their degree of inspiratory effort is actually minimal to disperse that medication to the distal pulmonary bronchials. It's equivalent to them taking a deep breath in when you ask them to auscultate their lungs. So it's not a big forceful breath. The other thing is too, a lot of times, sometimes more variability in the disbursement of the drug is better in compliance with some patients. Dry-powdered inhalers, again, do not take a very big forceful effort, but some of them, because they are powder, some of the medication will actually hit the back of the throat as it goes down and can cause some irritation, whereas the nebulized form does have a variability in disbursement and can be more easily tolerated in some. The other issue is the technique itself. Oftentimes, we ask them in some of the inhaled therapies to lower the device itself so that the tongue doesn't protrude and get in the way, because if medication gets on the tongue, the next swallow that they take, that medication is going to hit their posterior pharynx, and they're going to probably cough pretty aggressively. I always start off by telling my patients, "Cough is not a bad thing. It's actually a protective reflex and it's involuntary. So, if you cough, don't actually negate it. Don't think it's a bad thing." It's actually a very protective mechanism that avoids irritation in most of our patients probably already irritated mucosa. So, that's how I like to start the conversation. There's so many good techniques that we can share with them over time, and I might add that each patient is different. Each patient needs to have a personalized plan. When we talk about giving patients warm tea, typically chamomile, chamomile tea in itself is anti-inflammatory. Then, when you add something like honey, which is also a soothing, anti-inflammatory natural remedy, you have to really think to yourself, "They're getting honey. If they're diabetic, we don't want to give them too much honey." But, you have to make sure that their swallowing technique is good. There's no aspiration there, particularly if we give them cough drops. Then, just simple things that actually numb or anesthetize the back of the throat are very, very helpful for elderly patients who do have very friable tissue and mucosa from previous therapies like inhaled corticosteroids, as I had talked about before. Dairy products, I tend to ask my patients to avoid those. They can produce a lot of mucus, which these coughs that we see in our inhaled therapy patients are typically tend to be dry coughs, but some patients that have concomitant asthma, COPD, along with their ILD that are using these inhaled therapies can actually have more of a congested mucoid cough. So, avoiding dairy before and after use is always very smart. Avoiding alcohol, avoiding acidic drinks like orange juice, also very, very helpful. Mary Whittenhall, MSN: The part about technique I think is so, so important here. Oftentimes, when patients start these therapies, when they are approved in that space, the specialty pharmacy has a nurse educator that will come out to the patient's home and provide education not only about the medication, but about the administration of that medication. In many cases, the patients will take their first dose while the nurse is present so that the nurse can then critique whether or not the patient took it appropriately and how they tolerated it. I'm going to give a shout out to our nurse educators from the specialty pharmacies, because they are also a really crucial set of eyes and ears for us out in the community. They do provide education to the patients in the home. We have had situations where the patient has done well while the nurse is there, and then two weeks later we get a call from the patient saying, "I can't do this. This isn't working for me." And I'll say, "Okay. Well, you have a couple options. We can have you come in to the clinic and I want you to bring your device with you, and I would like to watch you do a treatment, or I can have the nurse come out and see you again and go over that." And they'll say, "I already know what I'm doing. I don't need that." But in many instances, we have found that they have adjusted their technique. They might've gotten into some bad habit since the nurse has left them. So, really reinforcing that is important. The other thing that I wanted to bring up is that some of our patients with connective tissue disease also have thickness in their tongues. So, their tongues become thicker and more sclerotome as their connective tissue disease progresses. For some of those patients, it is actually hard for them to get their tongue flat enough so that they can get the medication down into their lungs. So, working with those patients to find strategies to help rectify that. I will say that it is not impossible, it just takes maybe a little extra work. Jennifer Keeley, DPN: Inhaled therapies in themselves are pretty portable. Mary had alluded to a little bit earlier, our patients with pulmonary vascular disease, PAH, that are on parenteral therapies, delivering the conventional pulmonary vasodilator therapies. As we get into the new disease modifying agents such as seralutinib, which are anti-fibrotic, anti-inflammatory, anti-prolific medications, these are portable therapies that are actually modifying the disease. So they're portable. They're easy to use. They're easy to use for our patients, again, that are elderly or are younger and are still working, they have a professional life, they don't have to wear a pump that's 24/7 oftentimes. They can use these inhaled therapies first to see if they can avoid parenteral therapy with prostacyclins. Their quality of life is improved immensely. When you can take an inhaled therapy two to four times a day and really improve quality of life, decrease cough, decrease dyspnea, or shortness of breath on exertion. Sometimes, these patients that do very, very well can actually reduce their supplemental oxygen needs. Just improving their walk distances without having to stop or have excessive dyspnea, improves their quality of life. More time spent with loved ones and more time spent in social environments rather than sitting at home. These wonderful inhaled portable therapies have significantly changed our patients' lives and improved their quality of lives. Mary Whittenhall, MSN: This community I think is phenomenal. It's made up of so many great people. There are many patients who have been a part of this space for a long time who really want to help other patients who may be newer to the journey than them. I'm a big advocate for support groups. We've had an extremely active support group in our area for a long time, and I often partner some of my patients that have been with me for quite some time with some of the new patients that may need a bit more help. I can tell them things and my colleagues can tell them things. Oftentimes, the same message doesn't resonate. It resonates differently, I think when it comes from a peer, a patient who may have experienced the same thing as them. One of the things that I really try to drive home with our patients is just that sense of empowerment. Connect with these other folks in the community. They want to help you. They remember what it feels like being newly diagnosed or starting a new therapy or transitioning from another therapy. What that change is like. One of the other things I tell my patients is that we all sit at the same table. I'm not better than you. Maybe I have this information, but this information is for you. It's for you to take and to improve your life. If that information doesn't work for you, then you come back to me with some feedback and we come up with something else that's going to be more helpful to you. I really think having an equal playing field with them and having a very open and honest dialogue is what is going to help our patients do the best. If patients don't feel comfortable reaching out to other local patients or connecting with an in-person support group, there are tons of online resources through the PHA, through phaware®, Team Phenomenal Hope, lots of great groups out there that do things virtually. I think in some ways for some patients, anonymity is important, so being able to protect that is an option for them, but to be able to still get what they need so they can become the best advocate for themselves that they can. Jennifer Keeley, DPN: I stress so importantly to my patients, we are here today in this great environment and we have the armamentarium of medications to treat because of patients just like you that have contributed to the science of the disease and implemented themselves and engaged in these clinical trials. Right now we have an ongoing clinical trial for seralutinib called PROSERA, that's enrolling as we speak. Patients are the best advocates, not only for themselves, but for other patients, and they talk. There's a lot of social media out there where patients communicate amongst themselves and they say, "Through the help of my provider and through the help of my family, I was hesitant to start this additional therapy." They do have, at this juncture, and I don't think it's such a bad thing, they do have a little bit of a pharmacy burden now. Again, these aren't our patients that are on one or two therapies. They're on four or more oftentimes. When you take in our ILD patients, they're also on disease modifying agents, as well, for their interstitial lung disease. So again, I think it's really important for patients to communicate amongst themselves and share their ups and downs in the disease, but also share the rewards that come with surviving and living with PAH. I think one thing that we really do have to understand though is like many other chronic diseases, PH is a personalized disease. You need to have a personalized approach for your patients. That's why it's so very important to do a really good history of your patients and understand not only what their baseline cough is, but who they are, what their personal history is. Are they working? Who's helping to care for them? Who's helping to make that chamomile tea with honey? Who's going to the store to get that? A personalized approach is so important for these patients, I can't stress that enough. Mary Whittenhall, MSN: Special thanks to everybody involved in this project. This was extremely exciting. To my co-podcaster, Jennifer Keeley, who is amazing, and all of us in the PH community are extremely lucky to have her. We are all aware that you are all rare, and we are grateful to be able to help you in this journey. Jennifer Keeley, DPN: Thank you so much, Mary, and what a pleasure it's been to speak with you about cough and inhaled therapies, and thank you to Gossamer Bio for this opportunity and for the opportunity that led to this podcast, which was a significant advisory board amongst specialists in our field, advanced practice providers and registered nurses who were able to convene in a great open space and talk about this. I think this moves our science forward. It helps us to talk about the disease and take better care of our patients. Again, my name is Jennifer Keeley. It's been such a pleasure to deal with my good friend Mary Whittenhall today, and we're aware that our patients are very rare. Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Follow us on instagram, facebook and x.com @phaware. Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com Like, Subscribe and Follow us: www.phawarepodcast.com. #phawareMD #PHILD @GossamerBio @AHNtoday

Dame Emma Walmsley, Chief Executive one of Britain's biggest pharmaceutical companies GSK (GlaxoSmithKline), says the company is prioritising the United States for product launches and investment, citing its scale, commercial opportunities and favourable business environment. She confirms GSK will invest four times more in the US than in the UK over the coming years, making America the company's primary growth and innovation focus.Explaining GSK's investment strategy, Dame Emma Walmsley points to the US market's scale and competitiveness, boosted by recent government policy. She welcomes a new UK-US agreement removing tariffs and recognising pharmaceutical innovation, but warns of challenges for Britain's life sciences sector. Despite the UK's strong scientific heritage, she notes it accounts for just 2% of GSK's sales, compared with more than half in the US.Dame Emma Walmsley stresses the UK must stay competitive to attract foreign investment, warning that other countries increasingly treat life sciences as a strategic industry. She confirms the UK will pay more for medicines under the new agreement, with NHS costs for new drugs expected to rise by 25%. While medicines make up only 9% of NHS spending—lower than in many countries—she acknowledges budget pressures and the need for careful prioritisation.Dame Emma Walmsley also reveals GSK is close to winning approval for the world's first six-monthly asthma drug, expected to cut the most severe attacks requiring hospitalisation by more than 70%. She calls the breakthrough a major advance for patients and healthcare systems, with the potential to deliver significant cost savings and improve quality of life for millions worldwide. She also comments on the surge in obesity and weight-loss treatments, noting GSK is not a major player but admires the scientific progress. Instead, the company is focusing on high-burden diseases such as liver disease and chronic obstructive pulmonary disease (COPD), with trials under way and hopes for further breakthroughs.Finally, Dame Emma Walmsley reflects on a turbulent period when activist investors questioned her leadership and forced her to reapply for her own job, amid concerns over GSK's share price performance versus rivals.Presenter: Simon Jack Producer: Ollie Smith/ Olie D'Albertanson00:00 Sean Farrington and BBC Business Editor Simon Jack intro pod 03:00 Dame Emma Walmsley joins the pod 03:53 Change agenda & US market focus and investment 07:18 New asthma drug approval on the horizon 08:19 GSK's scale and global impact 12:03 GSK to invest four times more in the US than the UK 14:54 UK to pay more for drugs after UK-US deal 16:56 GSK new asthma drug breakthrough 19:48 GSK's approach to obesity and weight loss drugs 28:23 Women in leadership at GSK 32:47 Shareholder revolt and leadership challenges

Join My Private Group: ⁠https://theaxioncollective.manus.space/⁠Email List: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://huntershealthhacks.beehiiv.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Get My Book On Amazon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://a.co/d/avbaV48Download⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠The Peptide Cheat Sheet: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://peptidecheatsheet.carrd.co/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Download The Bioregulator Cheat Sheet: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://bioregulatorcheatsheet.carrd.co/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠1 On 1 Coaching Application: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://hunterwilliamscoaching.carrd.co/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Book A Call With Me: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://hunterwilliamscall.carrd.co/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Supplement Sources: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://hunterwilliamssupplements.carrd.co/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Amazon Storefront: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.amazon.com/shop/hunterwilliams/list/WE16G2223BXA?ref_=cm_sw_r_cp_ud_aipsflist_R7QWQC0P1RACB2ETY3DY⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Socials:Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/hunterwilliamscoaching/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Video Topic Request: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://hunterwilliamsvideotopic.carrd.co/⁠In this episode, I'm diving into something that I honestly didn't realize was as big of an issue as it is until it hit my own family: lung health. Earlier this year my father-in-law was hospitalized with what the doctors loosely labeled as COPD—trouble breathing, fluid in the lungs, inflammation, all the scary stuff that makes you realize how fragile life can be. When he finally got home from the hospital, I put him on a very specific peptide stack designed for deep respiratory repair, and the results were nothing short of incredible.That experience inspired today's episode. I walk you through the exact peptide stack we used to regenerate lung tissue, modulate inflammation, and get him back on his feet WAY faster than the standard prognosis. We're talking about Bronchogen, Chonluten, VIP (Vasoactive Intestinal Peptide), TB-500, and GHK-Cu—each of them working on different mechanistic pathways ranging from DNA-level gene expression to immune modulation to fibrosis prevention.You'll hear the science, the clinical evidence, the dosing, and—maybe most importantly—why this stack worked so well for a real human being in a real crisis. And yes, even if you're “healthy,” these peptides have profound regenerative and anti-aging properties for the lungs that make them worth understanding.Chronic respiratory disease is the third leading cause of death worldwide. Over 454 million people suffer from lung-related conditions. And when you see those numbers—and then see firsthand how quickly lung tissue can repair with the right tools—you start to understand why peptide-based regenerative medicine is the future.Whether you're dealing with COPD, bronchitis, long-haul viral issues, inflammation, fibrosis, smoker's lungs, or you simply want to bulletproof your respiratory system as you age… this episode is for you.As always, make sure you're on my email list so you stay connected no matter what platform bans me next. That's where all my best content lives, including updates when I release episodes like this one.I'm so grateful for each and every one of you who listens, comments, uses my codes, and shares this work. This truly is a dream come true, and your support allows me to bring the highest-quality peptide and hormone optimization content to the world.Strap in—and let's get into the peptide stack for lung health.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/PTU865. CME/MOC/AAPA credit will be available until December 12, 2026.Addressing an Exacerbating Issue in COPD: Strategies for Individualized Targeted Biologic Therapy to Improve Quality of Life In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca Pharmaceuticals.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/PTU865. CME/MOC/AAPA credit will be available until December 12, 2026.Addressing an Exacerbating Issue in COPD: Strategies for Individualized Targeted Biologic Therapy to Improve Quality of Life In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca Pharmaceuticals.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/PTU865. CME/MOC/AAPA credit will be available until December 12, 2026.Addressing an Exacerbating Issue in COPD: Strategies for Individualized Targeted Biologic Therapy to Improve Quality of Life In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca Pharmaceuticals.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/PTU865. CME/MOC/AAPA credit will be available until December 12, 2026.Addressing an Exacerbating Issue in COPD: Strategies for Individualized Targeted Biologic Therapy to Improve Quality of Life In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca Pharmaceuticals.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/PTU865. CME/MOC/AAPA credit will be available until December 12, 2026.Addressing an Exacerbating Issue in COPD: Strategies for Individualized Targeted Biologic Therapy to Improve Quality of Life In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca Pharmaceuticals.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/PTU865. CME/MOC/AAPA credit will be available until December 12, 2026.Addressing an Exacerbating Issue in COPD: Strategies for Individualized Targeted Biologic Therapy to Improve Quality of Life In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca Pharmaceuticals.Disclosure information is available at the beginning of the video presentation.

Let's start your week strong with a quick tip you can incorporate right away. In this Mo's Monday Minute shortie episode, I'm talking about the 50-50 Club in COPD patients and how to know when you need to quickly intervene. ___________________ FREE CLASS - If all you've heard are nursing school horror stories, then you need this class! Join me in this on-demand session where I dispel all those nursing school myths and show you that YES...you can thrive in nursing school without it taking over your life! 20 Secrets of Successful Nursing Students – Learn key strategies that will help you be a successful nursing student with this FREE guide! All Straight A Nursing Resources - Check out everything Straight A Nursing has to offer, including free resources and online courses to help you succeed!

Dr. Faisal Khan talks about how treatment of Asthma and COPD has evolved and new options to help patients with ongoing management of their condition.

Jamie Hartmann-Boyce and Nicola Lindson discuss emerging evidence in e-cigarette research and interview Elly Leavens, University of Kansas Medical Center, USA. Associate Professor Jamie Hartmann-Boyce and Associate Professor Nicola Lindson discuss the new evidence in e-cigarette research and interview Dr. Elly Leavens, Assistant Professor in the Department of Population Health at the University of Kansas Medical Center. In the November 2025 podcast Elly Leavens talks about her recent pilot trial published in Frontiers in Public Health, called 'E-cigarette puff topography instruction to enhance switching among COPD patients who smoke'. This pilot study was supported by funds from the Cancer Prevention and Control Program within the University of Kansas Cancer Center, as well as by the National Cancer Institute. The 46 participants who smoked and had chronic obstructive pulmonary disease (COPD) completed a 12-week e-cigarette switching trial in which they were randomized to brief advice or low intensity, or high-intensity puffing topography training. Elly Leavens and colleagues found that e-cigarettes had potential to minimize harm in COPD patients who smoke, but that, puff topography training did not change switch success or reduction in cigarette smoking as compared to the brief advice to switch. This podcast is a companion to the electronic cigarettes Cochrane living systematic review and Interventions for quitting vaping review and shares the evidence from the monthly searches. Our searches for the EC for smoking cessation review carried out on 1st November 2025 found: 1 new study (10.1037/adb0001100); 2 ongoing new studies (NCT07172438; NCT07202039); and 1 linked report reported in this podcast (10.3389/fpubh.2025.1664400). Our search for our interventions for quitting vaping review carried out 1st November 2025 found: 1 new ongoing study (NCT07207850). For further details see our webpage under 'Monthly search findings': https://www.cebm.ox.ac.uk/research/electronic-cigarettes-for-smoking-cessation-cochrane-living-systematic-review-1 For more information on the full Cochrane review of E-cigarettes for smoking cessation updated in January 2025 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub10/full For more information on the full Cochrane review of Interventions for quitting vaping published in January 2025 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD016058.pub3/full This podcast is supported by Cancer Research UK.

Dr. Sumedha Sonde, pulmonologist and critical care physician at Hamilton Physician Group - Specialty Care in Dalton, Georgia. Dr. Sonde completed residency training in Anesthesia and Pain Management and additional residency training in Internal Medicine. She then completed a Pulmonary and Critical Care fellowship in New York.Dr. Sonde treats patients with sleep or pulmonary disorders. chronic obstructive pulmonary disease (also referred to as COPD), asthma, pulmonary fibrosis, lung cancer, COVID conditions, pneumonia, acute and chronic pulmonary hypersensitivity conditions, pulmonary hypertension, bronchiolitis, and more. For more information or an appointment at Hamilton Physician Group - Specialty Care, call 706-529-3072 or visit VitruvianHealth.com/specialtycare. This program in no way seeks to diagnose or treat illness or to replace professional medical care. Please see your healthcare provider if you have a health problem.

Dr. Sumedha Sonde, pulmonologist and critical care physician at Hamilton Physician Group - Specialty Care in Dalton, Georgia. Dr. Sonde completed residency training in Anesthesia and Pain Management and additional residency training in Internal Medicine. She then completed a Pulmonary and Critical Care fellowship in New York.Dr. Sonde treats patients with sleep or pulmonary disorders. chronic obstructive pulmonary disease (also referred to as COPD), asthma, pulmonary fibrosis, lung cancer, COVID conditions, pneumonia, acute and chronic pulmonary hypersensitivity conditions, pulmonary hypertension, bronchiolitis, and more. For more information or an appointment at Hamilton Physician Group - Specialty Care, call 706-529-3072 or visit VitruvianHealth.com/specialtycare. This program in no way seeks to diagnose or treat illness or to replace professional medical care. Please see your healthcare provider if you have a health problem.

Chronic obstructive pulmonary disease (COPD) care is evolving—learn how communication and patient empowerment are transforming treatment. Credit available for this activity expires: 11/28/2026 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/patients-progressing-ai-cdk4-6-inhibitors-biomarkers-2025a1000wtp?ecd=bdc_podcast_libsyn_mscpedu

On this episode of the Real Life Pharmacology Podcast, I cover albuterol pharmacology, adverse effects, and a rare indication for this classic respiratory medication. Albuterol is a short-acting beta-2 adrenergic agonist (SABA) that works by stimulating beta-2 receptors in the bronchial smooth muscle. This stimulation activates adenylate cyclase, increases cyclic AMP, and leads to relaxation of airway smooth muscle. The end result is rapid bronchodilation, making albuterol effective for quick relief of acute bronchospasm in conditions such as asthma and COPD. Common adverse effects occur due to both beta-2 and some unintended beta-1 receptor stimulation. Patients may experience tremors, nervousness, headache, or tachycardia. Higher doses or frequent use can lead to hypokalemia because beta-2 stimulation drives potassium into cells. Some individuals may also report palpitations or feelings of anxiety. These effects are generally mild and transient but can be more pronounced in older adults, those with cardiovascular disease, or when albuterol is used excessively. Albuterol has several clinically relevant drug interactions. Concomitant use with non-selective beta-blockers (such as propranolol) can blunt its bronchodilatory effect and may precipitate bronchospasm in susceptible individuals. Using albuterol with other sympathomimetics can enhance cardiovascular stimulation, increasing the risk of tachycardia or hypertension. Diuretics, especially loop or thiazide types, may compound albuterol-induced hypokalemia. Additionally, monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants can potentiate the effects of albuterol and increase the risk of cardiovascular adverse reactions. Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE! Support The Podcast and Check Out These Amazing Resources! NAPLEX Study Materials BCPS Study Materials BCACP Study Materials BCGP Study Materials BCMTMS Study Materials Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated) Guide to Drug Food Interactions (Amazon Best Seller) Pharmacy Technician Study Guide by Meded101

 Smoking is the main risk factor for COPD in the United States and many other countries. However, it is important to recall that there are other causes of COPD, from birth experiences to environmental exposures. COPD expert Meilan K. Han MD, MS, University of Michigan Health, discusses non-smoking causes of COPD, what patients can do to manage their symptoms, and how clinicians and communities can help. Air Health Our Health podcast creator Erika Moseson, MD, MA, of Legacy Health in Oregon hosts. Patient resources: - ATS COPD resources: https://site.thoracic.org/patient-resources/chronic-obstructive-pulmonary-disease-copd - GOLD COPD resources: https://goldcopd.org/patients-advocacy-groups/ - American Lung Association COPD resources: https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/resource-library  - UpToDate COPD resources: https://www.uptodate.com/contents/stable-copd-overview-of-management 

Dr. Sumedha Sonde, pulmonologist and critical care physician at Hamilton Physician Group - Specialty Care in Dalton, Georgia. Dr. Sonde completed residency training in Anesthesia and Pain Management and additional residency training in Internal Medicine. She then completed a Pulmonary and Critical Care fellowship in New York.Dr. Sonde treats patients with sleep or pulmonary disorders. chronic obstructive pulmonary disease (also referred to as COPD), asthma, pulmonary fibrosis, lung cancer, COVID conditions, pneumonia, acute and chronic pulmonary hypersensitivity conditions, pulmonary hypertension, bronchiolitis, and more. For more information or an appointment at Hamilton Physician Group - Specialty Care, call 706-529-3072 or visit VitruvianHealth.com/specialtycare. This program in no way seeks to diagnose or treat illness or to replace professional medical care. Please see your healthcare provider if you have a health problem.

Dr Neil Greening and Dr Hnin Aung join Diana Stanley to discuss a new multidimensional prognostic risk stratification model for COPD exacerbations.click here to read the full article: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(25)00362-5/fulltextContinue this conversation on social!Follow us today at...https://thelancet.bsky.social/https://instagram.com/thelancetgrouphttps://facebook.com/thelancetmedicaljournalhttps://linkedIn.com/company/the-lancethttps://youtube.com/thelancettv

Are you looking beyond the lung to provide holistic care for your patients with multimorbid chronic obstructive pulmonary disease (COPD)? Credit available for this activity expires: 11/26/2025 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/coexisting-comorbidities-advancing-holistic-care-copd-2025a1000uiz?ecd=bdc_podcast_libsyn_mscpedu

Dr. Lee is joined by Mary Fornehed to highlight the importance of COPD Awareness Month. Mary shares her background—from growing up in a medical family to earning her degrees at Tennessee Tech and Vanderbilt—and her extensive work in pulmonary critical care. She breaks down what COPD is, the most common symptoms, and why patients are more susceptible to frequent infections. Mary also discusses risk factors such as smoking, the impact of aging on lung capacity, and the role of pulmonary clinics in patient care. Together, they clear up several common myths and offer listeners a clearer understanding of this serious condition. Listen To The Local Matters Podcast Today! News Talk 94.1

“OMM helps us look beyond the place where pain shows up and understand what may be contributing to it.” —Dr. Drew RoseIn this episode of the Real Health Podcast, Ron Hunninghake, MD, sits down with Drew Rose, DO, to explore how Osteopathic Manipulative Medicine (OMM) offers a hands-on way of understanding the body's structure and movement patterns. Dr. Drew explains how structure and function are interconnected, why touch can offer insight that standard testing may not provide, and how OMM can be used as part of an individualized approach for people navigating chronic pain, headaches, fatigue, inflammatory conditions, COPD, fibromyalgia, and other complex concerns.He also shares lessons from his years practicing hospital and ICU medicine, including why one-size-fits-all care often falls short—and how osteopathic principles offer a deeper perspective on what the body may be signaling.Highlights include:→ What OMM is and how it differs from chiropractic care→ Why osteopathic medicine focuses on structure and function→ How foot and gait mechanics can influence low back pain→ What NASA research revealed about cranial motion→ How hands-on assessment can offer a different perspective than imaging alone→ Using OMM within individualized care for chronic and complex concerns→ The role of lymphatic flow, fascia, and subtle motion→ How OMM complements the Riordan Clinic approach to whole-person careAbout Drew Rose, DODrew Rose, DO, is an internal medicine physician with advanced training in Osteopathic Manipulative Medicine. Before joining Riordan Clinic, he spent six years practicing hospital and ICU medicine in Kansas. He brings a whole-person, hands-on approach to patient care, integrating structural evaluation, osteopathic principles, and nutritional insights to support alignment, mobility, and overall well-being. Learn more about Dr. Drew or schedule a new patient appointment.Episode Links & ResourcesLearn more about the Riordan ClinicListen to more episodes of the Real Health PodcastEpisode Chapters00:00 Welcome + introducing OMM01:10 MD vs DO vs chiropractic training02:46 Structure, function, and whole-body evaluation04:18 Low back pain and the kinetic chain06:01 Foot mechanics and alignment07:34 Cranial motion, NASA research, and headaches10:14 OMM and migraines12:19 Foundational osteopathic principles14:11 OMM in chronic and complex experience17:22 Nervous system sensitization and subtle motion20:05 Individualized care in hospital medicine22:12 How OMM complements whole-person careDisclaimerThe information contained on the Real Health Podcast and the resources mentioned are for educational purposes only. They are not intended as and shall not be understood or construed as medical or health advice. The information contained on this podcast is not a substitute for medical or health advice from a professional who is aware of the facts and circumstances of your individual situation. Information provided by hosts and guests on the Real Health Podcast or the use of any products or services mentioned does not create a practitioner-patient relationship between you and any persons affiliated with this podcast.Topics we explore in this episode:osteopathic medicine, OMM, osteopathic manipulative medicine, cranial motion, cranial rhythmic impulse, chronic pain, migraines, headaches, low back pain, gait mechanics, kinetic chain, lymphatic flow, fascia, COPD, fibromyalgia, chronic fatigue, integrative medicine, functional medicine, hands-on medicine, individualized care, whole-person health, Riordan Clinic providers, structural alignment, root-cause perspective

Exercise is key for managing symptoms for COPD patients. On World COPD Day, host Amy Attaway, MD, Cleveland Clinic, talks to Rachel Evans, MD, University of Leicester, and Russell Winwood, a patient advocate known as the "COPD Athlete", about how exercise can improve patient outcomes. They also discuss the annual Big Baton Pass, an international COPD awareness event, the importance for pulmonary rehabilitation, and the community built around COPD advocacy and support for patients. Learn more about the COPD Baton Pass: https://copdbatonpass.org/ 

一、【20251109人間菩提】改變自己 互相度化 耕耘自己的心，播下善種與人分享，當他人接收到了善的種子，又再傳遞下去，便是相互地度化。一人之力雖渺小，但人人都發一念心開始做慈濟，便會結下善的循環，帶動更多的人一同投入菩薩道。 當年慈濟從「五毛錢」起家，開辦義診所時，因為花東交通的不便，使有些本該可以挽回的生命，就此以遺憾作結。因此慈濟醫院建院時，人人的一念善心，紛紛盡自己最大的力量，才有如今的醫院。 人，在這世間的生命法則都同，總是不知自己的時日還有多少。 上人希望大家能把握因緣將善法傳遞開來，讓家裡及周遭的人也都能認識善法，共闢人間菩薩道。 二、健康100分~守護呼吸健康: 肺阻塞的預防與保健 花蓮慈濟醫院有「肺部守門員」之稱的胸腔科醫師劉迪塑，深入解析國人十大死因之一的「慢性下呼吸道疾病」，其中最普遍也最容易被忽略的就是「慢性阻塞性肺疾病」（COPD，又稱肺阻塞）。劉醫師指出，肺阻塞屬於退化性肺部疾病，特別好發於抽煙族群，其中部分人體質對煙害更敏感，從40歲左右就開始出現症狀。如果從20多歲開始吸菸，到了四、五十歲肺功能便可能明顯下降。正常人肺功能會隨年齡自然退化，但肺阻塞患者的退化速度可能是一般人的兩倍，因此「及早預防」遠比治療更關鍵，因為肺功能一旦衰退便是不可逆的。 在預防方面，劉醫師強調最重要的就是「遠離煙害」。不僅不要吸菸，也要避免一手煙、二手煙與環境污染，如汽機車廢氣、工業排放等。若已經有煙癮，目前有尼古丁替代品、戒菸藥物及醫療院所的戒菸門診可協助增加成功率，越早戒菸越能延緩肺功能惡化。 第二個保健關鍵是「運動」。雖然肺功能退化不可逆，但透過提升心肺耐力與肺活量，可減輕呼吸困難與提升生活品質。世界衛生組織建議每週至少需 150 分鐘中等強度運動，心跳維持在最大心跳（220－年齡）的 65%～75%。劉醫師提醒，運動其實不難達成，可分段累積，例如走路、爬樓梯、以走路取代交通工具皆屬中等強度活動。超慢跑也是很好的選擇，不受天氣限制且可依個人狀況漸進增加時間。 此外，他也分享兩個肺阻塞患者常用的實用呼吸技巧，其中最重要的是「噘嘴式呼吸」。透過縮脣、延長吐氣時間，可維持吐氣時的正壓，避免肺泡塌陷，使氣體能更順利排出，改善呼吸困難。 整體而言，只要戒菸、遠離污染、規律運動並學習正確呼吸技巧，即可大幅延緩肺功能退化，重新找回呼吸的自主權。

This episode opens with a seemingly routine flu call that unravels into a life-threatening respiratory crisis. Through the story of a COPD patient in distress, it explores how influenza can trigger cascading airway inflammation, gas-exchange failure, and sepsis. The script challenges medics to rethink “just the flu” as a high-stakes emergency demanding sharp assessment and timely intervention.

Intravenous dihydropyridine calcium channel blockers can quietly worsen oxygenation by blunting hypoxic pulmonary vasoconstriction. In this episode, we break down the bedside mechanism, which agents are implicated, who's at highest risk (post-op atelectasis, obesity, pneumonia, focal ARDS, COPD), how soon it happens, and exactly what to do.The Vasopressor & Inotrope HandbookAmazon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/47qJZe1⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Affiliate Link)My Store: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Use "podcast" to save 10%)Citations:Weir EK, López-Barneo J, Buckler KJ, Archer SL. Acute oxygen-sensing mechanisms. N Engl J Med. 2005 Nov 10;353(19):2042-55. doi: 10.1056/NEJMra050002. PMID: 16282179; PMCID: PMC2803102.Weir EK, Olschewski A. Role of ion channels in acute and chronic responses of the pulmonary vasculature to hypoxia. Cardiovasc Res. 2006 Sep 1;71(4):630-41. doi: 10.1016/j.cardiores.2006.04.014. Epub 2006 Apr 27. PMID: 16828723.Lumb AB, Slinger P. Hypoxic pulmonary vasoconstriction: physiology and anesthetic implications. Anesthesiology. 2015 Apr;122(4):932-46. doi: 10.1097/ALN.0000000000000569. PMID: 25587641.Timour G, Fréderic V, Olivier S, Shango DN. Nicardipine-induced acute respiratory failure: Case report and literature review. Clin Case Rep. 2023 May 1;11(5):e7186. doi: 10.1002/ccr3.7186. PMID: 37143457; PMCID: PMC10151601.McMurtry IF, Davidson AB, Reeves JT, Grover RF. Inhibition of hypoxic pulmonary vasoconstriction by calcium antagonists in isolated rat lungs. Circ Res. 1976 Feb;38(2):99-104. doi: 10.1161/01.RES.38.2.99. PMID: 1245025.Simonneau G, Escourrou P, Duroux P, Lockhart A. Inhibition of hypoxic pulmonary vasoconstriction by nifedipine. N Engl J Med. 1981 Jun 25;304(26):1582-5. doi: 10.1056/NEJM198106253042606. PMID: 7231503.Kennedy T, Summer W. Inhibition of hypoxic pulmonary vasoconstriction by nifedipine. Am J Cardiol. 1982 Oct;50(4):864-8. doi: 10.1016/0002-9149(82)91246-2. PMID: 7124646.Chrétien B, Decros JB, Suard F, Dolladille C, Fischer MO, Alexandre J, Descamps R. Hypoxia Associated With Dihydropyridine Calcium Channel Inhibitors: A Pharmacovigilance Study in VigiBase. Clin Pharmacol Ther. 2023 Sep;114(3):686-692. doi: 10.1002/cpt.2970. Epub 2023 Jun 29. PMID: 37309986.Burghuber OC. Nifedipine attenuates acute hypoxic pulmonary vasoconstriction in patients with chronic obstructive pulmonary disease. Respiration. 1987;52(2):86-93. doi: 10.1159/000195309. PMID: 3671896.Suard F, Mombrun M, Fischer MO, Hanouz JL, Decros JB, Derville S, Gakuba C, Al Issa G, Menard C, Chretien B, Descamps R. Oxygenation Effects of Antihypertensive Agents in Intensive Care: A Prospective Comparative Study of Nicardipine and Urapidil. Clin Pharmacol Ther. 2025 Mar;117(3):742-748. doi: 10.1002/cpt.3509. Epub 2024 Nov 27. PMID: 39604146.

How would you manage this patient whose chronic obstructive pulmonary disease (COPD) symptoms are not well controlled? Credit available for this activity expires: 10/30/26 Earn Credit / Learning Objectives & Disclosures:  https://www.medscape.org/viewarticle/breathing-new-life-copd-empowering-patients-through-therapy-2025a1000teq?ecd=bdc_podcast_libsyn_mscpedu  

 Chronic Obstructive Pulmonary Disease (COPD) is a group of lung diseases that cause airflow obstruction and other respiratory problems. There are various options for treating COPD, including the highly effective controller medication that helps improve a patient's lung function in the long-term. But as Antonio R. Anzueto, MD, professor of pulmonary and critical care at the University of Texas Health, San Antonio, explains, it is not easy for patients to use these medications. Listen as Dr. Anzueto and host Amy Attaway, MD, Cleveland Clinic, discuss the effectiveness of different COPD treatments, how COPD can affect other organs, and how AI might play into diagnosing COPD as technology advances. Support for this podcast is brought to you by Viatris and Theravance BioPharma. 

Ever had a patient swear it's their lungs—but the problem's really their heart? In this episode, we dig into cardiac dyspnea, the kind of shortness of breath that starts in the left ventricle, not the bronchi. You'll learn how pressure backs up into the pulmonary circuit, why patients can't lie flat without gasping, and what separates heart failure breathlessness from COPD or asthma. Perfect for paramedics who want to sharpen their clinical instincts and catch the subtle signs before the monitor does.

Airsupra is a combination inhaler that contains albuterol and budesonide, approved for as-needed use in adults with asthma. It represents the first rescue inhaler to combine a short-acting beta-2 agonist (SABA) with an inhaled corticosteroid (ICS) in a single device. The albuterol component provides rapid bronchodilation by relaxing airway smooth muscle, while budesonide works to reduce airway inflammation and mucus production. This dual mechanism allows Airsupra to not only relieve acute bronchoconstriction but also address the underlying inflammatory process that contributes to asthma exacerbations. Clinically, Airsupra is indicated for as-needed treatment or prevention of bronchoconstriction in adults with asthma, but it is not approved for COPD. The typical dosing is two inhalations as needed, with a maximum of six doses (12 inhalations) in a 24-hour period. The rationale for its use aligns with recent asthma guideline updates, which emphasize minimizing SABA-only use because it fails to address inflammation and may contribute to worse outcomes over time. Common adverse effects include tremor, nervousness, tachycardia, and hypokalemia from albuterol, as well as oral thrush and hoarseness from budesonide. Patients should rinse and spit after each use to reduce the risk of oral candidiasis. Drug interactions can occur with non-selective beta-blockers, which may blunt albuterol's effects. CYP3A4 also plays a role in budesonide metabolism. Systemic absorption typically isn't too much of an issue with infrequent use.

Episode 2708 - Vinnie Tortorich and Chris Shaffer welcome call-in guests to discuss motivation sparked by one foot in the grave, and pushback from family. https://vinnietortorich.com/2025/10/one-foot-in-the-grave-episode-2708 PLEASE SUPPORT OUR SPONSORS   YOU CAN WATCH THIS EPISODE ON YOUTUBE - One Foot In The Grave Social media concerns. (2:00) Vinnie had an experience over X years ago regarding American Girl dolls. (4:00) There was a miscommunication, and he had to stay up all night to correct the mistake. Vinnie had only suggested making a fitness-themed doll. Eric is the first guest caller. (18:00) He's lost some weight with NSNG® and has spine issues. Eric is looking forward to Vinnie's workout videos that will be released in the NSNG® VIP group. They discuss issues Eric has had dealing with cholesterol and his doctor. (30:00) The ratio between HDL and Triglycerides is a better indicator of heart health. Carbohydrates really don't help you build muscle; 5g of creatine is better. (43:00) Some sports or competitions can be fueled with a small sugar trickle because blood glycogen gets used up so quickly. Examples would be kickboxing or boxing. Family Pushback Scott is the next guest. He has lost 325 pounds after starting NSNG® after hearing Vinnie on Mike Rowe's podcast. Why does it take people to be told they have one foot in the grave before it sparks change? (48:00) Scott's wife has lost over 100 pounds, and his son has lost 90 pounds! Scott has reversed COPD and congestive heart failure symptoms. (55:00) Hobbies are important to help your mind explore. (1:01:00) Scott has had family blowback about his new healthy lifestyle. A family member reported him to Adult Protective Services! (1:04:00) He had to go through three months of investigation. The accusation was abuse because of the change in eating and daily walks. Scott's wife has lowered her A1C and gotten off of insulin. (1:11:00) Vinnie shares a story about an NSNG® follower named Robert Stanton. (1:19:00) If you are interested in the NSNG® VIP group, it will be reopening soon. But you can get on the wait list - More News If you are interested in the NSNG® VIP group, it will be reopening soon. But you can get on the wait list - Don't forget to check out Serena Scott Thomas on Days of Our Lives on the Peacock channel.  “Dirty Keto” is available on Amazon! You can purchase or rent it . Make sure you watch, rate, and review it! Eat Happy Italian, Anna's next cookbook, is available!  You can go to  You can order it from .  Anna's recipes are in her cookbooks, website, and Substack–they will spice up your day!  Don't forget you can invest in Anna's Eat Happy Kitchen through StartEngine.  Details are at Eat Happy Kitchen.    PURCHASE  DIRTY KETO (2024) The documentary launched in August 2024! Order it TODAY! This is Vinnie's fourth documentary in just over five years. Visit my new Documentaries HQ to find my films everywhere:  Then, please share my fact-based, health-focused documentary series with your friends and family. Additionally, the more views, the better it ranks, so please watch it again with a new friend! REVIEWS: Please submit your REVIEW after you watch my films. Your positive REVIEW does matter! PURCHASE BEYOND IMPOSSIBLE (2022) Visit my new Documentaries HQ to find my films everywhere:  REVIEWS: Please submit your REVIEW after you watch my films. Your positive REVIEW does matter! FAT: A DOCUMENTARY 2 (2021) Visit my new Documentaries HQ to find my films everywhere:  FAT: A DOCUMENTARY (2019) Visit my new Documentaries HQ to find my films everywhere: 

DMSO is an "umbrella remedy" capable of treating a wide range of challenging ailments due to its combination of therapeutic properties (e.g., reducing inflammation, improving circulation, and reviving dying cells). It also rapidly transports substances dissolved in it through the skin and throughout the body These benefits are also seen when DMSO is combined with a variety of natural therapies – in many cases, allowing the mixture to treat challenging conditions neither could treat alone DMSO is commonly combined with proven nutraceuticals, such as vitamins and antioxidants These combinations effectively treat a myriad of diseases, including skin cancer, prostate enlargement, cataracts, CRPS, fatigue, lost smell or hearing, osteoarthritis, COPD, and tinnitus This article will review the basics of botanical DMSO combinations, the literature supporting it, and show how these mixtures can be used to treat many additional challenging medical conditions

Luca is a 68 year old male with moderate COPD who is referred for physical therapy to improve exercise tolerance. He reports dyspnea with minimal exertion and has a 6-minute walk test distance of 250 meters. His resting oxygen saturation is 92% on room air. Which of the following is the MOST appropriate initial exercise approach?A) Interval training with short work and rest periods at moderate intensityB) Continuous training at 75% of peak work rate to build enduranceC) Resisted walking with a weighted vest to strengthen lower extremitiesD) Breathing retraining combined with unsupported upper extremity exercisesJoin the FREE Facebook Group: www.nptegroup.com

GOLD Updates, Novel Treatments, and Managing Comorbidities in COPD Care Level up your COPD care with practical, evidence-based strategies. Learn how to confirm airflow obstruction with spirometry (and use LLN/Z-scores thoughtfully), stage patients with the A/B/E framework, and build treatment around long-acting bronchodilation—adding ICS selectively based on exacerbations and eosinophils. We'll highlight the nonpharmacologic moves that change outcomes (smoking cessation, vaccination, pulmonary rehab, oxygen when indicated), when to reach for add-ons (azithromycin, roflumilast), how to approach chronic hypercapnia with home NIV, and what's new (hello, ensifentrine). Pulmonologist and longtime Curbsiders member Dr. Cyrus Askin (@Askins_Razor ) returns to share real-world pearls for diagnosing, treating, and managing comorbidities in COPD. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case 1 Diagnostic Workup Understanding the Ratio, LLN/Z-Scores, and Equity Symptom abd Risk Staging (A/B/E) Case 2 Foundational Care  Initial Inhaler Strategy  Progression & Hypercapnia: NIV & Adherence Counseling Add-On Pharmacologic Options for Frequent Exacerbators What's New and Emerging Comorbidities and When to Refer  Take-Home Points Recap Plugs, CME, and Credits Credits Written and produced by Paul Wurtz MD. Show notes, cover art, and infographic also created by Paul Wurtz MD. Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Cyrus Askin MD   Sponsor - Freed Use code: CURB50 to get $50 off your first month when you subscribe at freed.ai Sponsor - Grammarly Sign up for FREE and experience how Grammarly can elevate your professional writing from start to finish. Visit Grammarly.com/podcast Sponsor -Locumstory Learn about locums and get insights from real-life physicians, PAs and NPs at Locumstory.com

When a trusted doctor changed his medication without consulting his psychiatrist, what started as a routine visit spiraled into a night of crisis. After three weeks of worsening mood and breathing problems, her husband — already battling long-term depression and COPD — texted that it was “over.” She raced home, instinct telling her where he would be. What followed was part survival story, part mystery: she pulled the garage door open, grabbed the keys from the ignition and called 911. He was rushed to the hospital and later admitted to a psychiatric facility. Doctors said he should not have survived as long as he did, yet he pulled through. But the story doesn't end with medicine and ER lights. On the drive home from the hospital, she looked into her rearview mirror and saw a face appear — her father-in-law, the very man who had taken his own life the same way years earlier. He told her, without words, that he'd been with his son in the garage and saved him that day. Her husband didn't believe at first. But between the inexplicable survival and that rearview encounter, the family was left asking: coincidence, guardian spirit, or something else? #MiracleSurvival #GuardianSpirit #MentalHealth #DepressionRecovery #Paranormal #TrueGhostStory #RearviewApparition #MedicalMistake #NearDeath #RealGhostStoriesOnline Love real ghost stories? Don't just listen—join us on YouTube and be part of the largest community of real paranormal encounters anywhere. Subscribe now and never miss a chilling new story: