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

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!

Pulmonary hypertension mainly occurs due to narrowing of the arteries of the lungs as a result of which the flow of blood is restricted. In this kind of condition, blood fails to carry oxygen to your heart and thus your heart gets adversely affected. The blood pressure of your body will get increased to a great extent if this situation remains untreated, thus leading to bdreadful consequenses, specifically situation like heart failure, serious pulmonary diseases, blood clots in lungs and congenial heart defects, etc.

There are certain forms of pulmonary hypertension, which are serious in nature and worsen with time, so much so that they are even fatal at times. It also includes forms which are non curable in nature, however, in order to improve the quality of life, symptoms can be reduced with proper treatment. The treatment for pulmonary hypertension is often complex and it takes some time to find the most appropriate treatment and requires extensive follow-up care. Your doctor might also need to change your treatment if it's no longer effective. However, when pulmonary hypertension is caused by another condition, your doctor will treat the underlying cause whenever possible.

Common treatments for pulmonary hypertension:

Medications

1. Blood vessel dilators (vasodilators): vasodilators open narrowed blood vessels. They are one of the most commonly prescribed vasodilators for pulmonary hypertension is epoprostenol (flolan, veletri). The drawback to epoprostenol is that the effect lasts only for few minutes. This drug is continuously injected through an intravenous (iv) catheter via a small pump that you wear in a pack on your belt or shoulder.

2. Ventavis: another form of the drug, iloprost (ventavis), can be inhaled six to nine times a day through a nebulizer, a machine that vaporizes your medication. Because it's inhaled, it goes directly to the lungs.

3. Treprostinil (tyvaso, remodulin, orenitram): it is another form of the drug, which can be given four times a day and can be inhaled or can be taken as an oral medication and can also be administered through injection.

4. Endothelin receptor antagonists: these medications reverse the effect of endothelin, a substance in the walls of blood vessels that causes them to narrow. These drugs may improve your energy level and symptoms. However, these drugs shouldn't be taken if you're pregnant. Also, these drugs can damage your liver and you may need monthly liver monitoring.

6. Sildenafil and tadalafil: sildenafil (revatio, viagra) and tadalafil (cialis, adcirca) are sometimes used to treat pulmonary hypertension. These drugs work by opening the blood vessels in the lungs to allow blood to flow through more easily.

6. High-dose calcium channel blockers: these drugs help relax the muscles in the walls of your blood vessels. They include medications, such as amlodipine (norvasc), diltiazem (cardizem, tiazac, others) and nifedipine (procardia, others). Although calcium channel blockers can be effective, only a small number of people with pulmonary hypertension respond to them.

7. Soluble guanylate cyclase (sgc) stimulator: soluble guanylate cyclase (sgc) stimulators (adempas) interact with nitric oxide and help relax the pulmonary arteries and lower the pressure within the arteries. These medications should not be taken if you're pregnant. They can sometimes cause dizziness or nausea.

8. Anticoagulants: your doctor is likely to prescribe the anticoagulant warfarin (coumadin, jantoven) to help prevent the formation of blood clots within the small pulmonary arteries. Because anticoagulants prevent normal blood coagulation, they increase your risk of bleeding complications. Take warfarin exactly as prescribed, because warfarin can cause severe side effects if taken incorrectly. If you're taking warfarin, your doctor will ask you to have periodic blood tests to check how well the drug is working. Many other drugs, herbal supplements and foods can interact with warfarin, so be sure your doctor knows all of the medications you're taking.

9. Digoxin: digoxin (lanoxin) can help the heart beat stronger and pump more blood. It can help control the heart rate if you experience arrhythmias.

10. Diuretics: commonly known as water pills, these medications help eliminate excess fluid from your body. This reduces the amount of work your heart has to do. They may also be used to limit fluid buildup in your lungs.

11. Oxygen: your doctor might suggest that you sometimes breathe pure oxygen, a treatment known as oxygen therapy, to help treat pulmonary hypertension, especially if you live at a high altitude or have sleep apnea. Some people who have pulmonary hypertension eventually require continuous oxygen therapy.

Surgeries

1. Atrial septostomy: if medications don't control your pulmonary hypertension, this open heart surgery might be an option. In an atrial septostomy, a surgeon will create an opening between the upper left and right chambers of your heart (atria) to relieve the pressure on the right side of your heart.

2. Lung transplantation: in some cases, a lung or heart lung transplant might be an option, especially for younger people who have idiopathic pulmonary arterial hypertension.

Reducing complications

1. The complications need to be reduced by taking proper health care. Healthy diet needs to be taken regularly along with proper medications. Smoking should be stopped and exercising sessions should be attended daily without any fail

2. Overweight or obesity needs to be controlled properly for reducing the complications. Specialized caring strategies need to be maintained for avoiding severe kinds of health complications that are quite annoying.

Pulmonary Hypertension: How to Treat It?

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 or COPD for short is a respiratory disease that makes it increasingly difficult to breathe; the lungs stop functioning properly. There are mainly two categories of COPD which are emphysema and chronic bronchitis. The primary reason for COPD is longstanding exposure to substances such as cigarette smoke, chemical fumes and air pollutants that damage the lungs gradually.

Initially, the symptoms of COPD may be really mild but over time it may become extremely severe. These include symptoms such as:

Shortness of breath
Coughing with mucous formation
Wheezing or gasping
Tightness in the chest
Feeling tired constantly after doing normal daily activities or after exercising.
In the long run, the damages can prove to be permanent.

Of the two subtypes mentioned, bronchitis is when the airways become inflamed as well as narrowed. People suffering from bronchitis tend to produce sputum which is basically a combination of mucus and saliva.
And the other subtype, Emphysema is the condition when the air sacs in the lungs become affected. The air sacs degenerate and become baggy with lots of holes in it. This, in turn, traps air. This narrows the airways making it difficult to breathe. In COPD, there is a narrowing of the lungs because:

The lining of the airway becomes inflamed
The lining of the airways which is elastic flops
The tissues of the lungs become damaged so there is an exertion on the airway.
COPD, in the long run, can lead to a number of health complications such as heart disorders, lung cancer, respiratory infections, depression and high blood pressure. COPD is treatable but not curable because it is a life-long condition. The following are some of the treatment methods for COPD:

Oxygen Therapy- If you are experiencing low levels of oxygen then opting for a portable oxygen unit will be extremely beneficial.
Medication- Bronchodilators help in relaxing the airway muscles for comfortable breathing. These medications are usually taken via an inhaler. Other medications include corticosteroids, theophylline, vaccines and antibiotics/antivirals.
Surgery- Surgery is usually advised as the last step when the COPD condition has become so severe that all other methods of treatment have failed. This is, more possible, in the case of emphysema. There are mainly two surgical methods: one is bullectomy when the surgeons remove the damaged air sacs. The other method is lung volume reduction which removes the lung tissues that have become damaged.
Adopting certain lifestyle changes can provide relief for the time being. Such alterations include:

Quit smoking immediately, if you haven t already.
Try to avoid passive smoking as much as possible. Passive smoking is as damaging as firsthand smoking.
Give your body the daily dose of nutrition so that the immune system doesn t falter as well.

Better Living with COPD - A Patient Guide!

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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