Helpful Hints for Respiratory Patients

INTRODUCTION

The following nonmedical hints and suggestions are intended to ease living with Chronic Obstructive Pulmonary Disease (COPD). They have been assembled from actual daily practice by members of the Respiratory Club, a support group for Pulmonary patients and their families, jointly sponsored by the American Lung Association of Connecticut and Gaylord Hospital in Willingford, Connecticut.

We, the club members, offer you ideas we have had to learn, in large part, by ourselves. We hope these suggestions may help speed your adjustment to a more secure, leisurely and pleasant way of life.

PACING

Pacing ourselves is one of the most important things we all have to learn. A prime consideration in regulating the tempo of daily living should be the awareness that your limits will fluctuate from day to day or even hour to hour.

There will be times when you will wake up and know almost immediately it is a day for just loafing. Or you may awake feeling super and up to a special task that you have been saving for a good day. The important thing is to learn to trust your own feelings and go with them.

Don't take on more than you can handle comfortably and when you feel tired, QUIT. Remember, energy is like money in the bank -- to be spent wisely. Repeated overspending puts one in debt physically as well as financially.

Pacing ourselves is one of the most important things we all have to learn.

There will, of course be many occasions when you may want to expend a little more physical energy than usual. These could range from washing windows to enjoying sex.

It is good for us to try to extend ourselves, if it is done with a little common sense. Here are a few suggestions that will help.

1. Wait until an hour or more after eating. Digestion draws blood, with its oxygen, away from muscles leaving them less able to cope with extra demands. This is the very same reason that children are taught not to go swimming right after meals.

2. You may find you feel your best soon after taking your medicine or having breathing treatment.

3. Those who have had an aerosol inhaler prescribed by their physician can use it to help a special effort, being careful NEVER to use more than prescribed.

4. Pace yourself and don't rush.

5. If you feel breathless, use pursed lip breathing. Remember -- this really helps and you can do it anytime, any place.

Don't permit yourself to be overburdened either by possessions or old habits. You will be amazed when you learn how many energy wasters you can eliminate with no noticeable loss.

It is important to remember that each COPD patient is unique. No two have exactly the same needs. You will find here some suggestions which will help you greatly and others which may seem nonsensical to you. All we can say is that each helped one or more of us.

WAKING UP

This is always a difficult moment for some folks and if you are not feeling up to snuff, it can be a real chore. Some hints:

Soft music is more pleasant than an alarm if you are easily startled.
Try some stretching and relaxing exercises while still lying down. These do help to get your body in gear for the day as every cat in the world knows.
Making a bed is one of the most demanding of household tasks, and if you must do it yourself, try this: half make your bed while you're still in it. Pull the top sheet and blanket up on one side and smooth them out. Exit from the unmade side, which is then easy to finish.
If you find that a bedspread is an unnecessary frill which only adds work, leave yours off.
An aid to making your bed while still in (or on) it is to mark the center of each sheet and blanket in a small permanent way, such as with a colored stitch or pen mark, on the top hem. While you are still sitting on your bed it is easy to line up the marks in the center. When you do get up everything will be in the right place.
Before getting all the way up, however, it is a big help to do some of your dressing sitting on the edge of your bed. Every night leave your robe and slippers or shoes, socks, and underwear where they are easy to reach in the morning. This will require less effort and help to keep you warm if your room is on the cold side.
Incidently, if you share quarters with another person, persuade him/her to let you have the bureau drawers which are easier to reach- saves bending.
If you have a room to yourself, make it a habit to put most often used items such as socks and underwear in the most convenient places and seldom used things in the far-away bottom drawers and top shelves.

BATHING

If for some reason you find a shower or bathtub too demanding, a great solution is to get a bath stool. This is waterproof and goes right into the tub. It can be removed easily and make a nice seat when giving yourself a pedicure or just drying your feet and legs. For bathing, use a hand spray which may be attached to the tub faucet or shower head. You may find bathing this way so pleasant that you will wonder why you didn't always do this.
A nice, long terry robe will eliminate the effort of drying altogether, just blot.
When excess humidity bothers you, leave the bathroom door open and be sure to use your bathroom exhaust fan if you have one. If you feel weak, don't take a bath or shower when you are alone.
It is not necessary to get wet all over, all at once to be clean. A "basin bath" can be taken in place of a tub bath and is a lot less taxing.
Those using oxygen through a long tube may find it makes bathing easier if the tube is passed over the shower curtain rod and thus out of the way.
Shaving or making up is much easier if you have a low mirror so that you can site down while doing either.
Incidently, it is OK to remove the nasal cannula briefly to wash your face, shave or apply makeup.

GROOMING

Many of us find that B scents are irritating and unpleasant. Try to avoid toiletries that are too heavily perfumed. These may leave you and your friends gasping.
Women are advised to avoid elaborate hairdos which will need tiresome setting and extended use of hand-held blowers and dryers. ( Men too!)
Also, MOST IMPORTANT, we are in agreement that the use of all kinds of aerosols and sprays, except those prescribed by a physician, is a bad idea. We all have sufficient respiratory problems without adding to them by inhaling unknown substances. Many sprays may be alright, but why take chances? There are many good liquid or gel type hair dressings, and the roll-on or solid deodorants are excellent. Some of these products are now available unscented.
If you are troubled by occasional accidental loss of urine brought on by coughing, overexertion or stress, the small flat sanitary pads with adhesive backs may be useful in keeping neat.

DRESSING

Quite a few of us feel that it is a good idea to finish dressing before breakfast. It gets the day off to a good start.

We all have personal tastes in clothing but there is one consideration which affects most COPD people. It is a bad idea to restrict chest and abdominal expansion. For this reason, belts, bras, and girdles that are tight should be avoided. Fortunately, we live in an era where "anything goes" clothing wise; if a choice must be made between style and comfort, opt for comfort every time.
Men may find that suspenders are more comfortable than belts.
Most women find that slacks and socks are much easier to put on than struggling into panty hose. Both sexes, however should avoid socks and stockings having elastic bands which may bind the leg and restrict circulation.
You can place your underwear inside your pants and put them on together.
Almost all of us prefer slip-on type shoes -- no bending over to tie the shoe lace! Putting on any kind of shoe is made much easier if you use a long ( 12"-18") shoehorn.
Women who have given up bras may find camisoles a comfortable and pretty substitute. Another alternative is to try a sports bra for firm, yet soft, support. An advantage to these bras is that they are made of materials which keep you cool and wick perspiration away from the body. If you are a woman who has given up girdles -- ENJOY!
Both men and women should avoid tight neck bands. Although some gentlemen still prefer neckties, an open neck with a loosely tied scarf, kerchief or bolo, is both attractive and much more comfortable. Another option is a colored T -- shirt under an open neck sport shirt. For more formal occasions, a clip-on tie is a good compromise between formality and comfort.
Many of us are bothered by extremes of temperature and may find that cotton underclothing is more comfortable than synthetic. Some nationwide mail order houses carry complete lines of cotton undergarments including "vests" for women.
"Long johns" are back in style for both sexes. Some of the new colored varieties, originally made for skiers, are quite attractive. They are most comfortable when worn under wide legged slacks.
If you are not too active and sit a lot, a large shawl is really great for occasional shivers. It is much easier to put on and to take off than a sweater. The men should be reminded that President Lincoln often wore a shawl, even in public. After all, a shawl is nothing more than a loose cape ( which F.D.R. often wore).

MEDICATIONS

Those of us who take pills and are also slightly forgetful have found that a pillbox with separate compartment for each day of the week most useful. Your druggist should carry them. However, if you are taking many pills, it will be better to lay out a day's supply each morning. There are several ways of doing this and here is one....
Some fast food places have little 1 oz. plastic cups with snap on lids for ketchup, etc. in take-out orders. (Get your friends to save some for you.) Have one cup for each pill-taking occasion during the day. Label or mark each cup with the time and the contents to be taken. Keep them in plain sight with a small clock near by and a pad and
Other containers such as egg boxes or cleaned plastic pill bottles with original labels removed can be used in the same way. Something with a fairly snug cover is preferable. Whatever you put them in, it is important to keep pills away from heat and moisture.
Whenever you get a new medicine or a refill from the drugstore, figure how long it will last and mark on the calender the time to reorder. This may save you from running out of a necessary medication in the middle of the night or on a holiday weekend.
NEVER USE ANYONE ELSE'S MEDICINE!!!!! Nowhere is it more evident how different we all are than in the medicines which help us individually. Two people may have the same disease and the same symptoms and yet respond to the same medicine in entirely different ways.
This cannot be stressed too Bly. Never hesitate to ask for more information regarding your medicine or to tell your doctor when your medicine does not seem to be working for you. Never make changes in the dosage unless your doctor agrees. Keep a record of medicines that don't agree with you. It is easy to forget. In addition to swallowing medicines, many of us must also learn to inhale them.

RESPIRATORY THERAPY

If it is necessary for you to take breathing treatments at home, try to get all of your equipment together in a convenient place where it can be left from treatment to treatment. Being near a bathroom or kitchen where it would be easy to clean equipment is helpful, but, of course if you take treatments during the night, the first consideration may be to have your equipment near your bed.
An ideal arrangement is to have a small table with a drawer or a flat topped desk in front of a window. Outside the window might be a good place to put a bird feeder. It is nice to have something to watch, read or listen to while taking a treatment. One word of caution, when you are finished, don't leave any medication sitting in the sun.
You may find it difficult to listen to anything with a machine going. A radio or TV set with a small earphone attachment will solve this problem.
Have a small clock handy to time your treatments.
If you must measure a medication with an eye dropper, be sure there are no air bubbles in it before starting to measure.
An excellent place to store small pieces of equipment such as tubes, medicine cups and mouthpieces is in one or two food storage boxes with lock tops. A good size is about 6" x 8" x 2 1/2". These will fit in a small drawer out of sight and parts that need sterilizing or soaking can be done right in the container.
All equipment should be kept clean and should be sterilized as directed. Don't worry if your friend has been taught different methods to do this. It seems to be like making a mint julep -- several different recipes but the same end result.
When you disassemble your equipment to clean it after a treatment, you may find the plastic hose is difficult to pull loose. Try pulling it off while the machine is still running. The added "push" of the compressor will help loosen the hose.
If you are using a mechanical nebulizer and feel that you are not getting enough mist, check the hose coupling. Occasionally vibrations cause these to work loose. Just hand-tighten.
Any small piece of equipment with a motor or compressor will be much quieter if you put some kind of thick pad under it. Folded fabric or newspaper may suffice.
Some of these machines have a small air filter which should be changed once in a while. Ask your supplier to give you some. They are easy to change.
Last but not least -- most medical equipment used at home can be purchased. In many cases this may be cheaper than monthly rental, but you will be responsible for repairs. Ask your supplier and compare.

OXYGEN

Those of us who use oxygen recommend your supplier to come visit you to explain all the technical aspects of your equipment's operation. Get their emergency phone number and procedures to follow in case of technical questions or concerns about the equipment. However, since oxygen itself is a prescribed drug, questions about amount and usage are for your physician to answer.

Some portable oxygen units (oxygen walkers) come equipped with a loose scale on the side for measuring the weight of the liquid oxygen. Those who use this type of system over a period of time often learn to estimate the weight fairly accurately. In this case the scale can be removed, leaving a leather loop with snap in place. The oxygen tubing can be threaded through this loop to eliminate some of the strain on the point of attachment of the tube to the pack. This helps prevent the tubing from being accidentally disconnected. The same method can be used to temporarily shorten the tube by looping it through several times.
It is important to find out approximately how long each portable unit supply will last you specifically. Learn to time your outings so that you don't run short.
If you have been out with a portable liquid unit and have returned home with no immediate plans to go out soon, you can transfer your long house tubing to the portable unit to use up the remaining oxygen it holds. This utilizes oxygen which would otherwise leak away.
When using oxygen, try to inhale through your nose ( a good idea anyway). Inhaling through your mouth can be very drying, and some of the oxygen may be wasted.
Change nasal cannulas fairly often particularly if the prongs become soiled or uncomfortable. In many places they are free from your suppliers.
Don't be embarrassed by the occasional attention your oxygen unit and tubing may attract. Most people know what they are and give them no more thought than a hearing aid. Others, who may not be familiar with this equipment, are interested in learning what it is. They appreciate your taking the time to explain what it does and why you must use it.

WORK AT HOME OR ABROAD

This is where some of us temporarily bog down. Each COPD person must find his/her own work ethic. Just remember this: nowhere is it written that any job must be finished as fast as possible. Many good books and paintings have been literally years in the making. If you don't feel like building a World Trade Center today, how about trying to lay a couple of bricks?

Most jobs, excluding prize fighting, call for some skill which may be useful in a less physical way than is common practice. Very few Respiratory Club members hold full time jobs, yet here are some of the part time jobs they do perform: management consulting; newspaper, radio and TV publicity; lobbying for a worthy cause; bookkeeping at home for a small neighborhood store; mechanical and electrical designing; handcrafting gifts to sell; telephoning and doing mailings for a political party -- the list goes on. There are as many different things that we can do as there are people. This includes you. Don't be afraid to start small. It sure beats not starting at all.

While you are planning a new mini career, the housework piles up. Our Respiratory Club hints to make it easier fall into four general groups. The first of which is...

LIFTING AND TOTING

Get yourself a small utility cart, the kind with three shelves. As you move about doing chores, use your cart to carry everything needing transferral from one place to another.
Pick up last night's newspaper, some soiled clothes for the laundry, a couple of used dishes, books to go back to the library, clean towels for the bathroom, etc. Try to travel in a circle and avoid going back and forth.
Using a cart and working in a circle is very effective whether you live in a single room or a two story house (have a cart on each floor).
If you do have a single room or a small apartment it is especially important to maintain reasonable order. Living in untidy quarters can be very depressing. Try to stay on top of things and create a pleasant ambience for yourself. It will make you feel better.
Carrying things downstairs is not a problem for most of us. Carrying them up may be a different story. There is one way: On an exhale, lift your burden two or three steps and put it down, rest. Climb two or three steps, rest again. Repeat. This may be a little slow, but it is possible to do the job without knocking yourself out.
If you live where you must climb stairs, you might consider a mechanical chair lift, but they are very expensive. In any case, it is a good idea to have a chair to sit on or a table to lean on when you reach the top.

SOME CLEANING TOOLS

One of the handiest of gadgets is a pair of pickup tongs (these look like giant scissors) used for retrieving things from hard to reach places. Most medical supply houses stock these.
There is also a type of pickup tongs which expands in criss-cross fashion. They are made up of metal or wood and make it possible to pick up very small objects without bending. Marvelous, but hard to find. If you are lucky enough to find them, try slipping a small piece of rubber tubing over each end; this makes it easier to grasp things.
Another pickup device is a magnet on a short string. This will stick to your cart so you will always have it with you. Great for thumbtacks, lost hairpins, etc.., but no good, alas, for brass pins.
If you must use a vacuum, which is not such a great idea, at least use a machine with a disposable bag and remove with extreme care. It is hard to imagine anything more irritating to lungs than shaking out a dust bag. A small hand vacuum is easy to use for spot cleanups and can stay on your cart.

There are now vacuum cleaners available which have better filtering methods to keep dust from escaping from the machine once it has been vacuumed. Ask around at a large department store or specialty stores in your area.

Sweeping and feather dusting are out, for obvious reasons, but if you feel compelled to use a broom or dry mop, protect yourself by wrapping the working end in a damp cloth.
A damp cloth for dusting is also good but if you hesitate to use one on wood furniture, here is a good disposable duster you can make for yourself. Get a roll of crinkly paper towels and a bottle of lemon oil from a hardware store. Tear towel in sections and fold in quarters, put about 4 or 5 coin sized dots of oil on each towel and roll up tight. Store in a plastic bag or glass jar. Use and throw away.
Even with precautions, housework is apt to stir up dust. If you must do a dusty job, the best idea is to use a mask.
Around the house the "no aerosol" rule applies with no "ifs, ands or buts." Don't even think of inhaling oven cleaner or bathroom cleaner, any of which may contain lye, ammonia or other "goodies"!
Avoid using anything harmful that can vaporize, such as kerosene, mothballs and solvents. Avoid, also, as far as possible, powders; if they must be used, handle with extreme care.
Have good ventilation and an adequate supply of fresh air at all times.

IN THE KITCHEN

Don't try to get everything done at once, set smaller goals. Almost all jobs can be divided into sections. For instance -- clean the top shelf of the refrigerator today and the bottom shelf tomorrow or next week. Take comfort in the thought that the longer you put a job off, the longer it won't need redoing.
Plan your meals when you are neither hungry nor tired. Light, well balanced meals are too important to leave to impulse.
The details of diet planning vary for each person and are too complex to go into here. One thing, however, is true for all of us with COPD. A number of small meals is always better than a few large ones. Common sense tells us that the more room the stomach takes up, the less room there is for air in the lungs. Also, as previously mentioned, prolonged digestion draws blood and oxygen to the stomach and away from other parts of the body which may need them more.
Utilize convenience foods when desired, but remember that many packaged foods have high salt and sugar contents which may be banned if you are on a special diet. Learn to read labels.
Keep plenty of water and/or fruit juices in the refrigerator.
If you enjoy cooking, it is often almost as easy to make double or triple amount of your specialties. Freeze the excess in meal-size containers and enjoy some cook-free meals when you feel like a day off.
If you can afford one, a microwave oven may prove a boon in reducing kitchen time and temperatures. A slow-cooking electric crockpot may make things easier, too.
When cooking, always use your exhaust fan, or make sure there is good ventilation.
If you are bothered by the heat, try using a small portable fan when cooking or ironing. In fact such a portable fan is useful in any room, not only to cool you off but also to help overcome shortness of breath brought on by exertion or stress. It is also useful for blowing all sorts of offensive or irritating odors away from you, should the need arise. A portable fan may deserve a place on your "supply wagon."
When tidying up after a meal, assemble all items which need putting away in one spot. Then sit down and put them away.
Put your most used pots and pans back on the stove and leave them there and instead of putting your dishes and silver away, reset the table for your next meal.

GARDENING

If you enjoy gardening (and have a yard!), there are ways to make it easier. The first is obvious -- a riding mower, preferably with a self starter. This can be a real morale booster.
The second is old fashioned but good -- a small floral or scuffle hoe. These are light and easy to handle. Cut down weeds while they are still small and leave them where they fall, good mulch.
Some other easy-to-handle, lightweight tools are a floral rake which is about 7" wide; a three-pronged cultivator with a handle about 3' long and a nylon garden hose which rolls up flat on its own reel. One of these hoses, 50' long with its reel, weighs only 2 1/2 lbs. And can be carried in one hand.
Another great boon to some gardeners is a folding stool. If bending over cuts off your wind, try gardening sitting down. Use a long handled spear type weeder, a clam rake about 18" long for leaves and your pickup scissors or tongs which are useful for removing gardening debris from the ground. These few short hand tools and the aforementioned folding stool can all be carried in a shallow garden basket.
Here's how to make an easy flower garden. In the fall, gather as many seeds as possible from easy to grow hardy annuals. In the spring, sow (each kind separately), scattering by hand in prepared beds. Rake in and tamp lightly. When they come up, hoe down all but a few. What is left will give you a nice display without the hard work of transplanting seedlings.
If you live where there is no space for your own garden, you may be able to have a window box or several shelves for plants inside the window. Even in a limited space, growing things can be one of the most rewarding pursuits there are.
It is important to know if you are allergic to the things that you grow in your garden and lawn. If you are and don't want to give up your gardening, use a dust mask when you work.

GOING OUT

This is a good place to repeat that all COPD people are different in many ways. One way is in our reactions to weather. Some like it hot, some like it cold, some damp, some dry. The point is that if it is your kind of day, try to get out and enjoy.
One thing which does bother us all considerably is air pollution. Find out where you can get a daily air quality report from your area and use it when making your plans for the day.
Before going out, however, it is a good idea to make preparations for your homecoming. Of course, we should learn to stop whatever it is we are doing before fatigue sets in, but sometimes this is easier said than done, particularly when away from home. At a time when you are the most apt to be tired, it is lovely to come home and have nothing to do but relax.
Before leaving, lay out your comfortable clothes and slippers, leave a drink in a handy thermos, set out whatever utensils you will need for your evening meal, even turn down your bed for a quick nap, whatever makes you feel good. Then homecoming can be more than just a relief, it can be a real pleasure.
Try to get yourself a warm, lightweight coat for winter. Down is ideal. A heavy winter coat can wear you out before you are out the front door.
In cold weather, also wear a nice long, warm scarf, and if it gets too cold or windy, do not hesitate to wind it across your nose. Some of us, however, prefer a cold-weather mask. There is one being made now of soft sponge which is quite comfortable to wear. Mask or scarf is a personal choice, either has merit.
Those of you who do consider outdoor walking may find that a cane seat or shooting stick is a real help. It gives you a cane to lean on and a small seat if you feel like resting.

RIDING AND DRIVING

If you have trouble getting from spot A to spot B, it matters not whether the problem arises in your legs or your lungs, you do have trouble walking and are entitled to a "handicapped" parking permit. It is simple to obtain in most places. Write to your State Motor Vehicle Department for an application. Get one and use it. When you use a "handicapped" parking space make sure you display your permit; not only is this required by the law in many states, it may help persuade the weight lifters and other robust types that they are illegally parked in an area reserved for the handicapped.
If you travel with someone else and know you may have to sit in the car for fairly long periods of time, make up a kit of helpful things for yourself and keep it in the car. In a shopping bag, for instance, include a small lap robe, pad and pencil, a paperback or two, (poetry is ideal if you like it), tissues, a package of pre-moistened wipes and whatever else suits your fancy. It also helps to carry a large piece of cardboard to use as a sunscreen if necessary.
A coffee can with a snap on plastic lid makes a dandy emergency urinal.
If you do drive and find that you must put gas in your car yourself, try to get upwind from the pump so that you do not gas yourself as well as the car.
It is an excellent idea for any driver to have a CB radio in the car to use if it is necessary to call for help in an emergency. For people with breathing problems it may be an absolute necessity. Try to imagine changing a tire, walking to the next off-ramp to call for help or hiking a long distance carrying a can of gas and you'll know why.
When driving, practice doing breathing exercises while waiting for red lights to change -- it beats fuming. Indeed, you should take a couple of minutes or even seconds to do breathing exercises whenever you come to a natural stopping place, a red light, a TV commercial, end of a chapter in a book or "whatever" -- like now!

TRAVELING

If you plan an intercity trip, think of taking a bus. They do have advantages, including generally landing you in the middle of town where there is other local transportation available -- not out in the boondocks somewhere. On interstate buses, the federal smoking laws are generally observed and the drivers are most helpful. Sit in the front and if you have any special problems, tell the driver.
When you must travel alone, travel light. Get a small suitcase on wheels. There are also wheeled suitcase carriers. They are good but somewhat clumsy and just one more thing to carry around.
Those of us who have to travel on subways recommend staying out of them if at all possible. Most subways and elevated train lines can only be used by making long and exhausting stair climbs. This may be made many times more difficult by being caught in rush hour crowds which force you to move faster than is comfortable.
In addition, the air in many subway systems leaves a lot to be desired.
All in all, subways can provide a very threatening environment for anyone with respiratory problems. We all Bly advise sticking to surface transportation wherever it is available.
As a result of the Americans With Disabilities Act, many communities are reevaluating the accessibility of their public transportation and providing free, low-cost, or special-arrangement transportation for the elderly or physically challenged.
Whenever possible, avoid any kind of travel during rush hours. It is pleasant to be able to move at your own speed and with a little luck get a seat.
Traveling with oxygen and traveling on planes are two subjects well covered in other places. Ask your local Lung Association or your oxygen supplier for information.

SHOPPING

If you are going shopping with an oxygen carrier, try to find a shopping cart on your way into the store. Put your oxygen pack in the cart while you shop.
When you go shopping try to pick an off day and hour (not Friday or Saturday at high noon). This way you will be able to move at a leisurely pace and avoid being jostled.
It is also helpful to stay out of all sorts of crowds, particularly indoors. Aside from the fact that the air may be smoky and generally unpleasant, you run a high risk of having someone sneeze or cough in your face.
Don't be afraid to ask someone to stop smoking near you. We all have a right to breathe smoke-free air, as most people are beginning to realize.
In many areas there are "no smoking" laws. Familiarize yourself with these and if you are in a store or restaurant where these laws are not observed, speak to the manager. Don't forget, you are the customer and are doing the proprietor a favor by being there.
Shopping for clothing, especially dresses and slacks, can be exhausting even to one in the best of health. Know your measurements (write them down) and carry a small rolled up tape measure with you. If you see something you like, check with the tape to see if it will fit you before you buy. Have an understanding with the store that if it isn't satisfactory it can be returned.
When you have a fairly large grocery order, have all the "spoilables," such as frozen foods, packed in a separate bag. When you get home, you can put away whatever needs refrigeration. Leave the rest for later when you feel more energetic or a "helper" can lend a hand.
Incidently, it won't hurt to wash your hands extra well when you get home. It is known that colds can spread through hands as well as through the air.

It may be a good idea to carry a small tube of alcohol gel or anti-bacterial hand wash for those times when bathroom facilities are few and far-between.

REST AND RECREATION

We all seem to be in agreement that the most important and lasting pleasure any of us can have is the company of good friends. The mobile society we live in often makes it difficult to keep in touch with all acquaintances. Many of us live far from our birthplaces and early ties, and sometimes feel that after a certain age it is hard to start making new friends. THIS IS NOT TRUE.

One of the best ways to make friends with whom you can share common interests and problems is to join a Respiratory Club. If you can't find such a group, get in touch with your local Lung Association or your hospital respiratory department.
This may be a good spot to stop for a moment and consider a matter of special concern to those of us who live alone -- how to get help quickly when it may be needed.
The phone buddy system can be a big help and provide a special feeling of security.
Make arrangements to have a relative or a friend call at the same time every day to make sure you are OK. If you plan to be out, let them know ahead of time to save needless concern.
Get to know neighbors who can see your windows and arrange a signal they can see. For instance if a shade is pulled down every evening or a certain lamp is lit, it is a sign you're OK. If this isn't done, ask your neighbors to investigate.
If you live in an apartment, let the neighbors on all sides of you know that if they hear you pounding you need help.
Somewhere near you is someone who needs your friendship and help too. Once you have gotten in touch with others, you will be amazed to find how rewarding it can be.
Consider buying a cordless phone and carrying it around with you in your cart or in a small pouch. This way, if you run into trouble, you will have a phone readily available to summon help.
Many companies now offer monitoring services. They provide a "panic button," worn on a chain around the neck, which can summon emergency help.
Alone or with company, there are many entertaining things to do at home besides watching TV. Many are more fun; here are a few:
Something that many of us have forgotten about are board games. There are probably some around your house that have not been used in a long time: Checkers, Parcheesi, Monopoly, Scrabble, etc. There are also dominos and many two-or-more-handed card games such as whist, pinochle, rummy or canasta.
If you are a chess buff, you might enjoy joining a chess club. It is also fun to play games through the mail or over the phone or Internet.
It may sound antisocial, but to many, solitaire can be very relaxing. There are several paperback books of solitaire games. Try learning a new game or two.
Jigsaw puzzles can also while away many hours and provide a real sense of accomplishment when done.
Do you like to read? Build up a supply of paperbacks for days when you can't get out to the library. Many libraries have a free paperback swap shelf. If yours doesn't, ask the librarian to start one. You can also get good books cheaply at flea markets or garage sales. Also try swapping with friends, neighbors and relatives. If you can't get out, find out if your library has a home delivery service -- many do.
Computers are really useful tools for keeping in touch when you are unable to leave your home. If you have Internet access, you can e-mail your friends and relatives, join on-line support groups and chat rooms, do research, take courses and read books on-line, and even order goods and services without ever having to leave your home (or even your desk)! Even if you don't have Internet access, you can load games onto your computer and while away the hours playing. Most of the games mentioned previously have conmputer versions, and now you don't even need another person or other persons present to play: the computer can fill in the empty seats.
Is there something you have always wanted to learn? Now is the time. Many local schools have adult classes in the evening on a staggering assortment of subjects. If you prefer to learn in the relaxing atmosphere of your home, there are literally hundreds of correspondence or online courses to choose from, from bookkeeping to weather forecasting.
If you have always wanted to learn a language there are good home study courses with records. This is more fun if you find someone to practice your new language with. A telephone pen pal might be just the thing.
If you find your previous hobbies too demanding, try a scaled-down version for the time being. Cabinet makers may find great pleasure in the growing hobby of making scale model furniture; machinists might enjoy making a scale model locomotive or assembling a clock; a dressmaker could make and dress period costume dolls.
Is a superactive dog too much to handle? Try a small, quiet cat. If allergies forbid either, tropical fish, while not very affectionate, are beautiful and fascinating. A bird feeder near your favorite window can provide hours of pleasure. If, for some reason, all of these are out, a large stuffed critter has its uses as a confidant, punching bag or pillow. Make sure you are not allergic to furry pets. If so, it may be best to do without them.
Needlework of all kinds gives many people both relaxation and pleasure. You men, don't forget Rosie Greer and his needlepoint. It is also a fact that at least half of the world's champion knitters and crocheters have been men. Try it, you may find you like it.
If you like to paint, try watercolors for a change of pace. They are lightweight if you want to go sketching, odorless and dry fast. To develop a technique for using them, try some new coloring books for adults. These are really great for everyone, not just artists.
This may be a good time to learn to play a musical instrument; piano or guitar for instance. The wind instruments are out -- no tubas!
Nowadays almost anything you could possibly want to buy can be purchased through the mail or through the Internet. So, "let your fingers do the walking" not only through the phone book but also through a whole world of mail order catalogs and online. Many pleasant evenings can be spent sitting in your favorite (not too soft) easy chair and shopping. As mentioned previously, the Internet revolution has made it possible to purchase all sorts of goods and services by computer.
There are many, many other suggestions we could make, but the aforementioned will give you some ideas.

TO BED

Go to bed in easy stages so that you arrive there relaxed, not worn out. For example, put on your night clothes and a comfortable robe, then read or watch TV for awhile.
Plan your sleeping area so that everything you may need will be handy. The most important things being a light and a telephone. Have any emergency numbers you think you might need taped to the phone and easy to read.
Other helpful things are: a clock radio with an ear plug for late night listening if you have a sleeping companion; medication as need be; a glass of water and a small snack if you are so inclined; and a urinal in a safe and easy to reach place. (Little known fact, there are also urinals made for women.)
An electric blanket is a must. No other blanket is necessary. They are lightweight, comfortable, and make bed making a cinch.
Some sort of night light is a real necessity. It lessens the possibility of being disoriented if you waken suddenly and helps you locate things you may need in a hurry.
There is now a light which throws the time on the ceiling and numerous small lamps which plug directly into a wall outlet. Watching a lava light may also serve to relax you and make you go to sleep. Best of all is a lighted aquarium which, in a darkened room, is absolutely enchanting.
Some find this a perfect time to do some muscle relaxing exercises.
Pull your night cap (no kidding) down over your ears, say your prayers if so inclined, and go to sleep.