Copd, which is short for chronic obstructive pulmonary disease, is a severe form of lung disease that is characterized by increased breathlessness and obstruction of airflow from the lungs. People who are suffering from copd are at an increased risk of developing lung cancer, heart diseases and many other conditions. It includes progressive lung diseases such as chronic bronchitis, emphysema, few forms of bronchiectasis and refractory (non-reversible) asthma. The former two are the most common conditions contributing to copd. 

Chronic bronchitis induces inflammation in the airway that carries air to the lungs and fills it with mucus. This either completely blocks the airway or narrows it, causing difficulty in breathing. However in emphysema, the air sacs inside the lungs which inflate and deflate as you breathe in and out, lose their elasticity due to which less air comes in and goes out leaving you breathless.

The best way to treat copd is to quit smoking. Your doctor may also prescribe you medications or ask you to enroll in a lung rehab program. 
Causes:
1. Smoking
Smoking is one of the most common causes of copd. This is because smoking is known to destroy the stretchy fibers in people's lungs and irritate the airways. Even passive smoking is unhealthy. About 90% of the people having copd are current or former smokers. 
2. Genetics
Some individuals suffer from copd even after refraining from smoking. Genes might be at the helm of copd in such a case. Aatd i. E. Alpha -1 antitrypsin deficiency, is a protein in the lungs, the lack of which is one of the most common genetic factor causing emphysema. 
3. Environmental factors
Breathing in harmful pollutants present in your environment is also one of the causes of copd. Fumes, dust or certain chemicals are a few examples of harmful lung irritants. Organic cooking fuel may also cause copd. Exposing yourself to the aforementioned environmental factors for a prolonged period of time increases your risk of developing copd substantially. 

Symptoms:
1. Shortness of breath especially after exercising
2. Wheezing
3. Tightness in your chest
4. Unintended weight loss
5. Lack of energy
6. Frequent respiratory infections
7. Wheezing
8. Cough accompanied by mucus

Diagnosis:
1. Physical exam where your doctor monitors the functioning of your lungs. 
2. Questioning about your past health (smoking or other harmful lung irritants).
3. Spirometry and other breathing tests.
4. Chest x-rays and other tests to eliminate other problems which could be causing your symptoms.

All About COPD!

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!

Spirometry is a common medical test that is conducted in order to detect whether your lungs are working properly. This is done by detecting the amount of air you can inhale and exhale along with the time taken to complete both of these procedures. Spirometry is useful to diagnose any underlying medical condition like asthma, Chronic Obtrusive Pulmonary Disease, persistent coughing or problem during breathing. If you are receiving treatment for chronic lung disorder, spirometry is also useful to check whether or not your lungs are responding to the specific kind of treatment.

Procedure: The process of spirometry involves the use a mouthpiece and a tube adjoined with a machine which displays the recorded results. Before the onset of the procedure, which generally takes place in a hospital, you will be prescribed by the doctor to wear comfortable clothing which will not restrict your normal breathing process and will be asked to have a light meal before the procedure. The procedure will be conducted while you are sitting. 

Spirometry takes an estimated amount of 15 minutes to get over with. The nurse will put a clip on your nose in order to close your nostrils. After that, you have to take a deep breath and then breathe out as hard as possible on the tube for a few seconds. You have to make sure that there's no air leakage during this procedure by putting your lips tightly over the tube. In order to arrive at a stable result, you have to conduct the test three times at least. If the results are hugely diverse, then you have to take the test again. The highest result among the three tests is usually denoted as the ultimate test result.

Risks: Spirometry is generally a low-risk inducing procedure. But in some cases, it might cause loss of breath, moments after the procedure. Also, spirometry should not be conducted if the patient has recently had a heart attack or surgery of the eye, abdomen or chest. If you are suffering from vomiting tendencies and you have regular instances of blood in your cough, you should also avoid spirometry.

The Procedure and Risks of Spirometry

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!

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!

COPD or Chronic Obstructive Pulmonary Disease is a lung disease wherein, it gets difficult for a person to breathe due to thickening and inflammation of airways. World COPD day is being celebrated on 16th November, in order to, raise  wareness about COPD. It is a group of progressive lung diseases, the most common ones of which are emphysema and chronic bronchitis. Emphysema destroys your lungs  air sacs while bronchitis leads to the inflammation and narrowing of your bronchial tubes.

Symptoms of COPD

The early symptoms of COPD include occasional shortness of breath, especially after physical exercise, mild and recurrent cough and having the urge to clear your throat many times. You may start avoiding physical activities eventually. Other symptoms, which follow include wheezing, chest tightness, chronic cough with mucus, an urge to clear mucus from the lungs, frequent flu, colds and fatigue.

Factors behind it
Smoking accounts for being the major cause of COPD in developed countries. Commonly, people over the age of 40 with a history of smoking are affected with COPD. The more you smoke, more are your chances of getting the condition increase. Exposure to chemicals and harmful fumes may also cause COPD. Long-term exposure to polluted air and inhaling dust are other causes. The deficiency of a protein called alpha-1-antitrypsin is also said to cause COPD.

Diagnosis
COPD is diagnosed on the basis of several tests and examinations. They include spirometry, which is a noninvasive test for assessing lung function, imaging tests such as a chest X-ray or CT scan which provides an image of the lung for observation. An arterial blood gas test is also carried out for measuring blood oxygen levels.

Treatment
The treatment options for COPD include the following:

Medication: Bronchodilators are used for relaxing the muscles of your lungs  airways which simplify breathing. They are taken via inhalers. Glucocorticosteroids may be added to reduce inflammation.
Oxygen therapy: When your blood oxygen levels are low, oxygen is given via masks and nasal prongs which help you to breathe better.
Surgery: Surgery is carried out in the case of severe COPD or when other treatment methods fail. Bullectomy is a common surgical procedure used, in which the large air sacs or  bullae  are removed from the lungs. The lung volume reduction surgery is also carried out in which damaged lung tissues are removed. Lung transplant is required in extreme cases.
Lifestyle changes: You need to make some lifestyle changes to alleviate the symptoms of COPD which include the following:
Quit smoking in case you are a regular smoker.
Avoid any form of second-hand smoke and chemical fumes.
Consume all the essential nutrients required by your body.
Consult a doctor about your exercise patterns.
In case you experience any symptom of COPD, you should consult a doctor immediately for quick diagnosis and proper treatment.

World COPD Day Special - Facts You Should Know About COPD

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