COPD – Chronic Obstructive Pulmonary Disease
28
November

By Adem Lewis / in , , /


COPD, which is the same thing as
emphysema, is a very common, preventable, treatable disease that unfortunately, just tends to be progressive. COPD involves a problem of getting air out. So people with COPD can breathe in just fine, just as normal as anybody, when they blow out their airways collapse and then the air gets trapped their chest. Now that you have a better understanding of what COPD means, we’re going to talk about the most important thing you can do for your health. So what we need to remember with COPD is that when we move slower we can move further. Every time we cut our speed in half we double our distance. Every time we cut our breathing rate in half, we
double the amount of air we move. The things that are most important for COPD are: Stopping Smoking, which we’ve already talked about, will talk about. Weight Loss: If you’re carrying too much weight, and Exercise. Our medicines, which we’ll talk about
further, are designed to decrease wheezing and to eliminate mucus.
Because if we’re short on air sacs we can’t have half of the ones that are left, full of mucus. One caveat is that patients should not smoke with their oxygen on. This has happened in the past and I’ve actually seen patients who blew up their faces by smoking with the oxygen on and so, if you’re bad enough that you need oxygen you shouldn’t be smoking anyway. So the most important thing you can do
with the diagnosis of COPD or with health in general is to not smoke. Not
smoking is the only intervention that’s been shown to help decrease the rate of
lung function decline, and this only not only includes cigarettes it also includes other smoking products
such as marijuana, pipe tobacco use, e-cigarettes, etc. Something also
important is to really once you’ve quit smoking, or you plan to stop smoking, is
to really discuss it with loved ones, family members and friends, so that they
know your plans. So that hopefully you can get tobacco out of the environment. One: it’ll help you from not
relapsing. And Two: it will reduce further lung damage from secondhand smoke. So, you know, a
huge thing I always talk to patients about is, you know, it’s very important to get all tobacco products outside of the house. Once you remove them, spend time cleaning the walls, the carpet, just really removing all that continued
tobacco and nicotine. The most successful really have and getting patients to quit
smoking comes with a counseling visit or also following a counseling helpline and
that is a free number that anybody can call anytime of the day to get support
to help them really work through those tobacco cravings. That, plus medication is really been shown to be beneficial. There’s over the counter medications
that do not require prescription, such as nicotine patch, or gum, or
lozenges for example. And there also are some medications that are prescription
medications that your physician should be able to discuss with you in detail.
That way you can pick which one works best for you. If you have COPD, you are
going to need or benefit from, inhalers. There are more and more
inhalers, inhaled medicines, coming out all the time. And our inhalers, they will improve your lung function, but they do not fix COPD. They will help improve your
quality of life, and and they may improve your lung function, a little bit, but it
will not reverse COPD. One convenient thing is that more and more inhalers are
coming out in combination products and so if this patient needs to be on an
inhaled steroid and a long-acting bronchodilator there’s a combination for
that. So we look at inhalers on two broad categories of long-acting inhaler a
short-acting inhaler and with our long-acting inhalers what we’re looking
at is trying to relieve your shortness of breath and your cough through the
course of the day. On the short acting inhaler we’re looking at that patient who’s
was really having sudden shortness of breath, that’s really affecting them right
now. Whether it’s related to something they just did or the heat or anything
like that. And that short-acting inhaler will help you to get rid of that
shortness of breath in that immediate time period. They’re also making the delivery
systems more convenient and easier to manage, but even then as the COPD
progresses you are possibly going to need nebulizer medicines, which is a
little compressor and put some liquid medicine into a container, and then over
10 minutes or so repeatedly inhale that medicine, which is a lot easier to get it
down the lungs than trying to do everything at once with an inhaler and
have a brief chance of getting the medicine in there. When we try to go
towards nebulizers is in patients who are having trouble using an inhaler,
whether it could be from other reasons like arthritis or anything like that, or
also in patients who are really short of breath, and you are at that point in time
where you don’t have the ability to take a long enough breath in to use the
inhaler. And that’s what a nebulizer allows you to take that medication over
a longer period of time. With an inhaler using it right and not breathing too
fast, which can be frequently a problem, is very important. Patients tend to
people tend to think that I have to take this inhale it really fast and I have to
push it and sucking as hard and fast as I can. What we actually find is that you need
to slow your breath down so that we’re getting the medicine down to the parts
that your lungs where it’s going to actually do the most benefit. It is
important not to inhale really cold air, you can wrap your nose and mouth with a
scarf, or you can even get a ski mask type of thing, but even if the weather’s
40 degrees or below it can have a chill in the air and may trigger some
bronchospasm. So it’s one more thing that you can do to try to stay healthy, don’t have to sit at home in the rocking
chair but try not to inhale extremely cold air. If you have COPD and you develop the flu, that can lead to something much more serious such as pneumonia. So keeping up on the vaccine is key. And obviously use common sense, don’t get out in the the really cold weather. Don’t keep your routine doctor’s
appointment if there’s ice on the ground. You don’t want to add a broken hip to
the list of problems. And then the same applies to the really hot humid air, even
for people who don’t have lung problems, it almost feels like you’re breathing
liquid some of these human Kansas days… So the air conditioner is your friend,
in the car or in the house, to get rid of that humidity. As respiratory
therapist I love to talk about mucus. So mucus is made mostly up of water and so when we get dry, dehydrated, the mucus gets thick and sticky like concrete. It’s hard to cough it up, it all gets
packed down in there. So you have to keep hydrated. Drink plenty of water. If it
changes color, smell, taste, you need to contact your physician and let them know. You’ve just got to be aware of your symptoms and when they’re not right, when they’re
abnormal, you need to be calling your pulmonologist and letting them know.
You’ll know when to call your doctor, but don’t wait too long, that’s what’s important. If you call your pulmonary specialist,
even in the middle of the night, you’ve talked to a doctor, and that’s really
important. That’s reassuring to know that you can do that. So don’t wait too long
to call. If you have COPD there is a wonderful thing called pulmonary
rehabilitation or pulmonary rehab we have a wonderful program at Lawrence
Memorial Hospital and there are many reasons to go. One is that you’re already
so short of breath from the lung trouble and then that makes it hard to exercise
and so then you might sit around a lot and so then you begin to have muscle
wasting and pretty soon you are also suffering from deconditioning along with
the COPD. And so if you go to pulmonary rehab, they very carefully help you to
exercise monitoring the heart and monitoring the rate
at which you progress. And so you can gradually get rid of any component that
is due to the deconditioning. Just like medications and seeing your doctor
regularly coming to pulmonary rehab needs to be a part of your treatment
plan. When they come in they’re meeting with us, and when I mean us, they’re meeting with respiratory therapists nursing and exercise specialist. And what we are
going to do for them is develop this individualized treatment plan that is
going to focus on what their needs are in regards to their COPD and at the same
time develop an exercise routine for them. So we are going to figure out their
oxygen needs we’re going to talk about their pulmonary medications, inhalers and
other medications. We talk about nutrition and weight management. We talk about smoking cessation and how to best manage their exacerbations of their COPD. You will enjoy pulmonary rehab you have a group of peers you’ll often learn ideas suggestions from other folks who are suffering the same things that you’re suffering and so that’s a really good support group. But it is individualized, so it’s based on their needs and their capabilities as far as
their physical function. And by building that strength and endurance and reducing
your shortness of breath. Hopefully that you can then do more
activities, have a more active lifestyle and that will improve your quality of life. That’s what we’re really looking at because that’s what COPD really affects. And so what we concentrate on is how do we deal with this handicap? We deal with it by walking slower, walking more, learning how to use our medications, learning when to the call the doctor. If I get a cold, or I get yellow or green mucus…because our role as pulmonary physicians is to keep people out of trouble and prevent
hospitalizations. Every time a patient gets hospitalized with COPD, it takes
four to six weeks just to get back to where they started before they got sick. So, we want to decrease that risk if
we can. Our goal is to keep you well, if we can
keep you well, with a combination of good follow up with your physician, your
pulmonary specialist and pulmonary rehab, your quality of life will be better. No doubt about it. I promise you.


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