DOC TALK
Keep your lungs healthy
DR.R.NARASIMHAN
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Answers to some frequently asked questions on pulmonary disease.
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Photos: K. Ananthan and K. Bhagya Prakash
Stop smoking: Tobacco attacks the lungs from day one.
Chronic Obstructive Pulmonary Disease (COPD) is crippling because it is a progressive disease. We have been endowed with such reserves that we do not realise the damage caused to the lungs by smoking.
Smoking attacks the lungs from day one and studies have shown that complete cessation is the only way to arrest the decline of the accelerated fall in lung function. Here is some more information on COPD.
What is COPD?
COPD encompasses two important diseases: Chronic bronchitis and Emphysema. Chronic bronchitis is inflamed and narrowed airways that make breathing difficult; so that the patient is left breathless. In emphysema the lungs are enlarged but not working.
Take the example of a balloon. A balloon can be inflated up to a point where you can see the expansion. Beyond this, you cannot see the balloon growing though you continue to blow. Your lungs in emphysema are like an inflated balloon that cannot be blown any further without becoming breathless.
What causes it?
Smoking is the single most important cause. Other causes are increasing pollution -both outdoor and indoor pollution; cooking with coal; exposure to industrial dust and congenital enzyme deficiency.
How can a smoker not develop COPD?
Simple. Stop smoking. It is never too late. The benefits start immediately. Once the smoker stops, the decline of the lung function reduces immediately and it approaches that of the non-smoker.
Can COPD patients exercise?
The patient will feel breathless but if he rests it will disappear and the exercise can be continued. Breathlessness can be scary but the worst thing is to stop exercising.
Some tips: start using the stairs. Whenever you feel breathless rest for a while and continue. This will make your walk on plains easy. If you don't, you will eventually become breathless even for simple tasks.
Sometimes breathing through the pursed lips can help you overcome breathlessness. Regular walking for 30 minutes is a good way to keep your lungs healthy.
Do diets play a role in COPD management?
Yes diets can complement your management. Eat lots of vegetables and fruits. Avoid foods that are hard to digest like oily and spicy foods, onion, ice cream with nuts etc.
If you are not well eat short small soft foods. Foods rich in carbohydrates like pasta and proteins like chicken and fish are preferable. But if you are overweight it can add to your problems.
Is there a role for home oxygen therapy?
If one winds up in hospital too frequently there is a need for home oxygen treatment. Oxygen should be given for a minimum of 16 hours a day in severe cases. This can be delivered by various means.
Oxygen cylinder: This may need regular refills and is ideally used at night and after meals.
Oxygen concentrator: Concentrators take in normal air, remove some nitrogen and deliver oxygen. But if the oxygen requirement is more than five litres this won't help.
Oxygen should always be delivered via Vent masks and not via nasal canulas or routine masks.
Will vaccines help prevent infections?
There are two kinds of vaccines. One is a pneumococcal vaccine to be given once in five years to prevent pneumococcal infections.
The other is an influenza vaccine that has to be given once in a year. Now there is an oral vaccine that is given sub-lingual to prevent bacterial infections. Reducing infections in COPD prevent long-term morbidity.
Can I monitor my illness myself?
Yes. Use a pocket spirometer that will measure the pulmonary function and a oxygen pulse meter, which measures one's oxygen saturation. If you notice a difference in the values visit the doctor.
Although COPD is different from asthma don't be alarmed. The patient's quality of life will be good if he follows his physician's advice.
The writer is a Respiratory Physician based in Chennai. E-mail: drrnarasimhan@gmail.com
When to see the doctor?
Coughing out blood
More phlegm and change in colour
Fever
Getting more breathless, worsening of spirometry values and decrease in oxygen saturation
Swollen legs and face
Excessive day time sleepiness
Mood swings
Make things worse
Continued smoking
Not taking recommended treatment
Being irregular with inhalers
Not dealing with other illnesses
Not keeping regular appointments with physician
Limited interaction with friends
No exercise
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