COPD, also known as Chronic Obstructive Pulmonary Disease is a chronic medical condition that triggers extensive damage to the lungs, interfering with its functioning. In COPD, the lungs and the air sacs or the alveoli undergo severe inflammation that gives rise to a host of complications including wheezing, shortness of breath and other related breathing troubles. While an early medical assistance is instrumental in proper management and treatment of COPD, in most cases, the associated symptoms and discomfort appear at a later stage (when the lungs have already undergone damage and inflammation). Thus, a proper awareness about COPD is necessary. In this article, we will discuss some important points related to COPD to help people understand the condition better.

While there can be a plethora of triggers, two of the medical conditions that elevate the incidence of COPD are Chronic Bronchitis and Emphysema. The bronchial tubules functions as a carrier transporting the air (oxygenated and deoxygenated) from the lungs to the different body parts and vice versa. 

In case of Chronic Bronchitis, the lining of these tubules undergo severe inflammation. 
In the case of Emphysema, the inner walls of the alveoli may rupture resulting in deleterious consequences including breathlessness.
For long people were of the opinion that COPD only affects people who smoke. However, various surveys suggest that COPD does affect non-smokers as well. While smoking does make a person more susceptible to the condition (COPD as well as Chronic Bronchitis and Emphysema), other factors such as chronic and severe neonatal lung ailments or prolonged exposure to the harmful gases and lung irritants can also act as triggers.

Though the incidences of COPD are relatively higher in people above 45 years, the young adults or the middle-aged can also be affected. Also, COPD is not limited to males and can affect females as well. Some of the symptoms associated with COPD include chest tightness, wheezing, breathlessness, chronic cough (often with mucus). These symptoms are quite similar to those of Asthma with people often confusing between the conditions. Thus, a proper diagnosis is vital. Spirometry is a lung test used in the diagnosis of COPD. This test evaluates the functioning of the lungs by measuring the amount of air inhaled and exhaled.

When we talk about the treatment or management of COPD, quitting smoking does improve the condition. For people with breathing troubles and chronic cough, the Bronchodilators (can be long-acting or short-acting Bronchodilators depending on the extent of the discomfort) comes as a great relief. The use of corticosteroids (inhaled) can go a long way to alleviate the inflammation of the airways.

In extreme cases with reduced oxygen reaching the blood, a person may need Oxygen Therapy to improve the condition. Of late the Pulmonary rehabilitation program have been benefiting people in dealing with COPD better. The program involves an amalgamation of counselling sessions to educate the people about the diet and nutrition, precautions to be followed along with some healthy lifestyle changes.

COPD - Things You Must Always Remember!

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

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!

Myth: COPD is an incurable chronic lung disease mainly affecting the aged people (above 60 years).
Fact: There is no denying the fact that COPD is indeed a chronic disorder that severely affects the lungs and its functioning. However, with timely diagnosis and treatment, the condition and the deleterious consequences can be managed and controlled significantly. Since COPD triggers breathing problems (the airflow from the lungs gets obstructed), the use of bronchodilators, oxygen therapy or corticosteroids can be highly beneficial. Though COPD is rare among young adults, the condition can affect people in their late 30's or early 40's as well.

Myth: COPD only affects people who smoke.
Fact: Smoking is one of the triggers for COPD, but the condition can also affect people who have never smoked in their lifetime. Factors such as neonatal chronic lung disease or prolonged exposure to substances that cause lung irritation and damage (toxic industrial fumes and chemicals) can play a pivotal role in triggering COPD. COPD can also be a genetic predisposition.

Myth: People with COPD should avoid exercise and physical activities.



Fact: Mild to moderate exercise (especially breathing exercise) are indeed helpful and go a long way in the effective management of COPD. Exercising regularly (for 20-30 minutes or as the doctor recommended) help to lower the blood pressure and improve the circulation that provides fruitful results for people with breathing problems. However, doctors do advise people with shortness of breath to avoid strenuous exercise.

Myth: COPD only affects the lungs.
Fact: With time and left unmanaged and untreated, COPD acts as a catalyst making a person more susceptible to heart ailments. In some cases, the condition can also trigger depression and anxiety.

Myth: In the case of COPD, giving up on smoking will not produce any positive results.
Fact: Giving up on smoking may not help to reverse the damage that has already been caused by COPD. However, quitting smoking along with proper medications and lifestyle changes does help to control the condition better. In some instances, there were also significant improvements in the associated symptoms (such as shortness of breath, fatigue, wheezing, a chronic cough).

Myth: COPD is another name for Asthma.
Fact: Many people confuse COPD with Asthma. Though some symptoms may appear identical (such as wheezing, shortness of breath), the conditions are different and so are their treatments. In case you have a concern or query you can always consult an expert & get answers to your questions.

COPD - Are You Aware Of These Myths & Facts?

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, 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!

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