Chronic Obstructive Pulmonary Disease, abbreviated as COPD, is an umbrella term which refers to the group of lung infections and diseases that include emphysema, chronic bronchitis, and diseases of the small airways. Most people feel breathlessness, which is caused due to impairment of gaseous exchange that happens because of prolonged damage to the lungs over a period of time.

Symptoms such as fatigue, reduced tolerance to exercise, muscular dysfunction, breathlessness even after simple tasks like walking, anxiety, panic, depression, and mood disorders are associated with major chronic disorders of the respiratory system.

Pulmonary Rehabilitation:

Physiotherapy is an effective intervention to treat patients suffering from COPD. It is the part of a formal supervised, multidisciplinary, and an intensive Pulmonary Rehabilitation Program that helps in treating manifestations of the conditions like COPD and Asthma. It consists of exercises to improve and maintain good lung capacity, resistance training, aerobic exercises, and support to behavioural and lifestyle changes for promoting self- efficacy. Your physiotherapist will choose from the different techniques and positions used to remove the unwanted excess sputum from the lungs and airways. The main purpose of the Pulmonary Rehabilitation is to help in improving the psychological and physical conditions of the pulmonary patients, along with training them for health enhancement techniques. Also, it should be noted that Pulmonary Rehabilitation is the cornerstone of care for patients suffering from COPD that uses integrated care by exploring underutilized opportunities.

Benefits of Pulmonary Rehabilitation: 

There are well-researched evidences of the improvement in the capacity of exercising, less breathlessness and fatigue, better control over condition, and an overall improvement in the quality of life of the patients suffering from COPD and Asthma.

Also, undergoing Pulmonary Rehabilitation lowers the rate of admissions, and re-admissions in hospitals due to recurrence of the symptoms and the related conditions.

It has also been reported that if Pulmonary Rehabilitation is properly undertaken, there is nearly no need for systematic health review to check COPD.

Pulmonary Rehabilitation, being a comprehensive program, helps in restoring fitness and easy breathing through breathing techniques, nutrition, exercise, relaxation, emotional support, medications, self-management, and other strategies for a better life, mainly by helping the lungs and the heart to function better.

How It Works?

Exercise is the key to any Pulmonary Rehabilitation Program for helping the lungs and the heart to function better and adjust to the condition. Some of the following exercises can be recommended based on the medical history of the patient:

1. Lower Body Exercise focuses on the workout of legs via running on a treadmill or climbing the staircase for rigorous training.

2. Upper Body Exercise includes working up the muscles of the arm and the chest by tasks as simple as lifting arms against gravity.

3. Breathing Exercise helps people with weak breathing and increasing their breathing and lung capacity.

4. Strength Training helps in building endurance and better stamina through activities like weight-lifting.

Other than exercise, Pulmonary Rehabilitation Program focusses on helping patients build an understanding of their situation and amend their lifestyles accordingly. This includes helping them understand their medication plan, teaching them to use their inhalers right, quitting smoking, consuming a healthy and balanced diet, and other methods as may be suitable based on their specific condition. Also, they are made aware of their symptoms so that if there is any recurrence, it can be immediately reported to the concerned health professional. They are trained through counseling to manage and deal with panic, anxiety, and depression caused due to their condition.

Take Away: Pulmonary Rehabilitation Program is an effective intervention and the cornerstone of care for improving the psychological and physical conditions of the pulmonary patients, along with training them for health enhancement techniques. It helps in treating manifestations of the conditions like COPD and Asthma.

Pulmonary Rehabilitation For COPD & Asthma!

Chronic Bronchitis is a result of inflamed bronchioles (pipes carrying air to alveoli or balloons) that can produce mucus and lead to coughing and difficulty in breathing. When smoking causes inflammation of the bronchioles, constriction or squeezing takes place. This results in wheezing because air is travelling through narrowed tubes.

Emphysema, in short, is basically a dead lung. As smoke travels farther down your respiratory tract, the air sacs in your lungs (alveoli), start popping out or dying. Your bank of alveoli gets depleted over time as you continue your habits. You will notice as you increase your heart rate whether its by running or walking a flight of stairs this activity requires your red blood cells to move faster through the alveoli and have less time to receive oxygen from the lung. This leads to having less oxygen on red blood cells whose job is to deliver oxygen to the rest of the body.

Symptoms

In COPD, Both the airways(pipes) and lung parenchyma are affected by the disease and airflow limitation is progressive. COPD has been predominantly seen in patients above 40-yearold and frequent smokers.

The symptoms indicative of COPD are as follows:

 

1) Chronic cough - Also referred to as smoker's cough, the cough is relentless and does not subside with regular cough treatment. This is one of the first indications of COPD.
2) Mucus buildup - There is constant built up of mucus which gets expelled during coughing. The person never feels completely clear of mucus, and the regular cough expectorants do not help relieve the symptoms.
3) Fatigue associated with limited activity - As noted earlier, the reduced capacity of the organs limits their activities. Therefore, regular activities like walking short distances or climbing stairs can induce fatigue.
4) Shortness of breath - The above fatigue is associated with shortness of breath, even with small physical exertion. A person with COPD will see marked tiredness and reduced ability to perform routine chores and feel a tightness in the chest.
5) Wheezing - Passage of air through the obstructed air tubes produces a whistling sound or wheezing. It is more pronounced when there is mucus accumulation in the airways.

Rarely, Frequent respiratory infections, more frequent flu attacks, swelling of the feet and ankles, cardiovascular disease, weight loss, and morning headaches.

Treatment 

While there is no cure for COPD, once it sets, the following are some ways to slow its progression and reduce severity of the symptoms:

1) Bronchodilators - Dilate the air tubes and ease flow of air
2) Corticosteroids - Help reduce inflammation and thereby improve airflow through the tubes
3) Flu vaccination - Helps curb the frequent flu attacks
4) Antibiotics - To contain infections
5) Pulmonary rehabilitation - A combination of breathing exercise and patient education to improve lung function.
6) Oxygen therapy - In very severe cases, oxygen may be required.
7) Lifestyle changes - Eating healthy foods, preventing exposure to dust and smoke, quitting smoking, breathing exercises, bi-annual medical check-ups to monitor lung functions are essential.

Knowing that you have COPD is the first step towards managing COPD, which can be managed effectively.

COPD Is Broken Down To Clinical Scenarios - Chronic Bronchitis & Emphysema!

Chronic obstructive pulmonary disease is a long-term condition of the lungs where the flow of air to the lungs is restricted (obstructed). Symptoms include cough and breathlessness. The condition is most often caused by smoking and the most important treatment is to stop smoking. Inhalers are commonly used to ease symptoms. Other treatments such as steroids, antibiotics, oxygen, and mucus-thinning (mucolytic) medicines are sometimes prescribed in more severe cases, or during a flare-up (exacerbation) of symptoms.

What causes COPD?
Smoking is by far the biggest risk factor for COPD. The lining of the airways becomes inflamed and damaged by smoking. Cigarette smoking is the biggest risk factor.

Air pollution may cause some cases of COPD, or make the disease worse. Air pollution can be indoor air pollution or outdoor air pollution. Indoor air pollution seems to be involved in more cases of COPD than outdoor air pollution. Indoor air pollution includes fumes from indoor fires or stoves, and dust, fumes or chemicals present in some workplaces. The combined effect of exposure at work to air pollutants and smoking increases the chances of developing COPD.

A small number of people have a hereditary (genetic) risk of COPD due to very rare protein deficiencies that can lead to lung, liver and blood disorders. (The condition is called alpha 1 antitrypsin deficiency. Less than 1 in 100 cases of COPD are due to this.


COPD symptoms-


Cough is usually the first symptom to develop. It is produced with phlegm (sputum). It tends to come and go at first, and then gradually becomes more persistent (chronic). You may think of your cough as a 'smokers cough' in the early stages of the disease. It is when the breathlessness begins that people often become concerned.
Breathlessness (shortness of breath) and wheeze may occur only when you exert yourself at first. For example, when you climb the stairs. These symptoms tend to become gradually worse over the years if you continue to smoke. Difficulty with breathing may eventually become quite distressing.

Sputum - the damaged airways make a lot more mucus than normal. This forms sputum. You tend to cough up a lot of sputum each day.

Chest infections are more common if you have COPD. A sudden worsening of symptoms (such as when you have an infection) is called an exacerbation. Wheezing with cough and breathlessness may become worse than usual if you have a chest infection and you may cough more sputum. Sputum usually turns yellow or green during a chest infection. Chest infections can be caused by germs called bacteria or viruses. 
Other symptoms of COPD can be vaguer. Examples are weight loss, tiredness and ankle swelling.

What is the difference between COPD and asthma?


COPD and asthma cause similar symptoms - in particular difficulty breathing (breathlessness). However, they are completely different diseases. Briefly:

In COPD there is permanent damage to the airways. The narrowed airways are fixed, and so symptoms are persistent (chronic). Treatment to open up the airways is therefore limited.

In asthma, there is inflammation in the airways which makes the muscles in the airways narrow (constrict). This is temporary so the narrowing comes and goes. So, the symptoms tend to come and go, and vary in severity from time to time. Treatment to reduce inflammation and to open up the airways usually works well.

COPD is more likely than asthma to cause an ongoing cough with phlegm (sputum).

Waking at night with breathlessness or wheeze is common in asthma and uncommon in COPD.

COPD is rare before the age of 35, whilst asthma is common in under-35s.

There is more likely to be a history of asthma, allergies, eczema and hay fever (so-called atopy) in people with asthma.

Do I need any tests?

The most common test used in helping to diagnose the condition is called spirometry. This is a breathing test. You will be asked to breathe or blow into a small machine called a spirometer which will measure how well your lungs are working. This test can help make a diagnosis of COPD.


A chest X-Ray show signs of COPD and can be used to help exclude other serious conditions (including lung cancer). Occasionally, a special CT scan of the chest - high-resolution CT - is needed. A blood test to make sure you are not anemic is often helpful.

A pulse oximeter is a device which can be clipped on to your finger. It measures your heart rate (pulse) and the amount of oxygen in your circulation (oxygen saturation). Lower levels than normal tend to be found in people who have COPD, especially if you have a flare-up (exacerbation) of your symptoms.

COPD treatment-

Smoking cessation is the most important step towards treatment.
Inhalers

The main treatments are medications given in devices called inhalers. The medicine within the inhaler is in a powdered form which you breathe in (inhale). The medicines in standard inhalers reach the lungs better if used with a spacer device. Inhalers include one, two or even three types of medicines. They may include:


A bronchodilator agent - this is a medicine which opens up (dilates) the airways. Some work quickly but don't last very long; others are longer-acting.
A steroid - these reduce the inflammation in the airway, thereby reducing the swelling. This, in turn, adds to the space available for air to pass.
A medicine which helps to dry up the secretions produced by the airways.
Home oxygen
This may help some people with severe symptoms or end-stage COPD. It does not help in all cases. Unfortunately, just because you feel breathless with COPD it does not mean that oxygen will help you. Great care has to be taken with oxygen therapy. Too much oxygen can actually be harmful if you have COPD.
Regular follow up in OPD is an essential part of treatment success.

Chronic Obstructive Pulmonary Disease - Know More About It!

Pulmonary diseases are some of the most commonly experienced health conditions all over the world. Millions of people suffer due to various causes including genetics, smoking, pollutants and infection. Now lungs are one of the most important and complex organs of the body. They are the apparatus through which oxygen enters and carbon dioxide gets expelled. 

Lungs expand and contract on a constant basis to ensure that we can breathe properly. Let us find out more about lung or pulmonary diseases.

Asthma: This is one of the most common and potentially fatal conditions that affect children and adults. It grips the airways formed by the bronchi which branch off into smaller tubes from the main trachea that holds them. This condition causes inflammation, and even spasms, which can lead to wheezing and breathlessness. The main triggers of asthma attacks include allergies, infections and pollutants that may escape into the airways.
COPD: This is also known as Chronic Obstructive Pulmonary Disorder. It is an umbrella term used for various lung conditions that cause breathing difficulties due to an obstruction of the airways. Chronic bronchitis is one of the conditions that falls under COPD, and is usually characterised by persistent, hacking coughs.
Cystic Fibrosis: This is another condition that affects the airways by causing poor passage of mucus from the bronchial tubes. This condition is a genetic one where the mucus that gathers eventually becomes a lung infection.
Pneumonia: This is a condition that causes an infection in the alveoli, which are the tiny tubes that the airways branch into. These are air sacs that can catch myriad infections like pneumonia.
Tuberculosis: This is also a kind of pneumonia, which is caused by bacteria called Mycobacterium Tuberculosis. This condition usually attacks the air sacs of the lungs and can be a potentially fatal disease if it is not treated on time. The patient will require immediate hospitalisation.
Pulmonary Edema: This condition is caused by fluid leaks from the tiny blood vessels into the surrounding air sacs within the lungs. It can also be caused due to heart failure as well as back pressure which falls on the lungs. Direct injury to the lungs can also lead to this condition.
Lung Cancer: This is a fatal disease which can be found in any part of the lungs. It has many forms and the type as well as the location usually determines the kind of treatment option that will be followed.
Acute Respiratory Distress Syndrome: When the lungs suffer a sudden injury which is usually caused by a bout of serious illness, it is called ARDS. Treatment involves the use of life support ventilation.

All About Pulmonary Diseases

The lungs are made of tubes through, which air passes in and out for exchange of gases, taking in alveoli. It is a disease of alveoli to which finer air conducting tubes are attached. Over a period of time, with age and exposure to various agents, these tubules get obstructed. The amount of air that can pass through these is reduced, leading to reduced oxygen supply to the lungs and thereby the various body organs.

Symptoms
The symptoms of copd can be easily understood if we realize how copd is caused. The progressive blockage of the air tubes causes less oxygen to reach the tissues, which is the most essential agent for all tissues and organs to function. Reduced supply produces a generalized limitation in physical activity. There are two main components to copd - chronic bronchitis and emphysema. The symptoms indicative of copd are as follows:
1. Chronic cough - also referred to as smoker's cough, the cough is relentless and does not subside with regular cough treatment. This is one of the first indications of copd.
2. Mucus buildup - there is constant buildup of mucus which gets expelled during coughing. The person never feels completely clear of mucus, and the regular cough expectorants do not help relieve the symptoms.
3. Fatigue associated with limited activity - as noted earlier, the reduced capacity of the organs limits their activities. Therefore, regular activities like walking short distances or climbing stairs can induce fatigue.
4. Shortness of breath - the above fatigue is associated with shortness of breath, even with small physical exertion. A person with copd will see marked tiredness and reduced ability to perform routine chores and feel a tightness in the chest.
5. Wheezing - passage of air through the obstructed air tubes produces a whistling sound or wheezing. It is more pronounced when there is mucus accumulation in the airways.
Rarely, frequent respiratory infections, more frequent flu attacks, swelling of the feet and ankles, cardiovascular disease, weight loss, and morning headaches.

Treatment
While there is no cure for copd, once it sets, the following are some ways to slow its progression and reduce severity of the symptoms:
1. Bronchodilators - dilate the air tubes and ease flow of air
2. Corticosteroids - help reduce inflammation and thereby improve airflow through the tubes
3. Flu vaccination - helps curb the frequent flu attacks
4. Antibiotics - to contain infections
5. Pulmonary rehabilitation - a combination of breathing exercise and patient education to improve lung function.
6. Oxygen therapy - in very severe cases, oxygen may be required.
7. Lifestyle changes - eating healthy foods, preventing exposure to dust and smoke, quitting smoking, breathing exercises, bi-annual medical check-ups to monitor lung functions are essential.

Knowing that you have copd is the first step towards managing copd, which can be managed effectively.

Chronic Obstructive Pulmonary Disease - Symptoms and Treatment

COPD stands for Chronic Obstructive Pulmonary Disease and is generally used to describe a broad category of diseases. These include chronic bronchitis, emphysema, non-reversible asthma as well as some forms of bronchiectasis. All of these diseases, however, can be prevented from getting worse by taking similar measures as the causes of these diseases are very similar.

Here are the ways to prevent COPD exacerbations:
1. Cleanliness: It is crucial that you do not allow infections to set in. Infections are probably the worst type of exacerbation possible in COPD. All you need to do to prevent infection is to take a little care to ensure good hygiene. Wash your hands often and do not allow people with colds or flu to come close to you.

2. Take vaccines: Make sure your flu and pneumonia shots have not been missed.

3. Take medicines: It is crucial that medicines for your lungs are taken on schedule, if you have COPD. The possible medicines which you could take if your doctor prescribes it includes inhaled beta-agonists, steroids and anticholinergics.

4. Spirometry: Doctors often recommend the use of the portable Spirometry device, Spirometer, in case of COPD. Spirometers check the condition of the lungs by measuring various parameters to see how well the lungs are working. Spirometers can easily measure FEV1, a parameter which measures how much air can you blow out in one second. This is especially great if you do not know whether your condition has exacerbated or not.

5. Corticosteroid: It is another type of medicine used, which can prevent COPD exacerbations. In its place, even inhaled beta-agonists or anticholinergics can also be used.

Preventing COPD Exacerbations!

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