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COPD – Be aware and Ease your breath

Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of deaths in the world, and projected to be 3rd leading cause by 2020. COPD represents an important public health challenge that is both preventable and treatable. Public awareness about COPD will help in better COPD care. Theme for world COPD day is “All together TO END COPD”

Chronic obstructive pulmonary disease is a condition in which airway in lungs became inflamed and narrowed and air sacs became damaged. COPD makes it difficult to empty air out of the lungs because of narrowed airways and makes patient feel out of breath. This means your lungs are less able to take in oxygen and get rid of carbon dioxide.

• Emphysema – damage to air sacs in the lungs making the lungs baggy and full of bigger holes which trap air.
• Chronic bronchitis – long-term inflammation of airways making it narrower, which causes a persistent cough and sputum.

Most common cause of COPD is cigarette smoking. Increase number of years of smoking is directly related to severity of the disease even after stopping smoking. Passive smokers are also at risk. Smoke from other sources (burning coal, wood and cowdung), air pollution, dust, fumes and chemicals have contributed to cases of COPD.

The chemical in the smoke irritates the lungs lining causing inflammation and then scarring. This scarring over years (mostly after age of 35 years) causes permanent damage to the lungs causing COPD.

Some people develop COPD because of alpha-1-antitrypsin (an enzyme) deficiency- genetic.

1. Feels short of breath especially when moving around
2. Persistent cough with phlegm(mucus)
3. Wheezing (whistling or squeaking noise while breathing)

Other symptoms are weight loss, tiredness, swollen ankles, chest tightness and coughing out blood.

The problem gets gradually worse over time and can affect normal activities. Treatment gets the condition under control but damage already caused cannot be reversed.

Sometimes there may be periods when symptoms get suddenly worse – known as a flare-up or exacerbation.

1. Chest X-ray
2. Spirometry- This test helps to show how well lungs are working and includes breathing into a machine that measures lung functions.
3. Blood tests- To see for high levels of red blood cells (polycythaemia) and low iron levels (anaemia).

Other tests which may be done are electrocardiogram (ECG), 2D ECHO (ultrasound of heart), Arterial blood gas, Exercise test (6 min walk test), CT scan of chest and sputum (phlegm) test.

There’s currently no cure for chronic obstructive pulmonary disease (COPD), however treatment can help to slow the progression of the condition and control the symptoms.

1. Bronchodilator – type of medicine that you inhale to open up your airways and help you breathe more easily. Given in form of nebulization, inhalers or systemic route as per necessity. You may require more than one inhalers and correct technique of inhaler use is most important for proper drug delivery.
2. Oxygen – titrate to improve the patient’s hypoxemia with a target saturation of 88-92%. Sometimes, you may be prescribed ambulatory oxygen support or Long term oxygen support at home.
3. Steroids – during flare ups, help reduce inflammation and swelling in your airways.
4. Antibiotics – for infective flare-ups.
5. Mucolytics – make sputum thinner and easier to cough up
6. Mechanical ventilation – Worsenig breathing difficulty or significant CO2 retention despite treatment warrants ventilatory support.
7. Pulmonary rehabilitation – is a programme of exercise and education designed for people living with COPD. Purse lip breathing -include inhalation of air – purse your lips (as if you are starting to whistle)- slowly breathe out . Other technique include- coordinate breathing, Deep breathing, Huff- cough, Diaphragmatic breathing.
8. Lung volume reduction Surgery or a lung transplant – although this is only an option for people with advanced disease.

Have queries or concern ?

• Smoking cessation.
• Influenza and pneumococcal vaccination.
• Use of proper inhaler technique
• Treatment with long acting bronchodilators with or without corticosteroids.
• Eat well (Low carb, high fiber diet) and stay a healthy weight.
• Breathing techniques and certain positions
• Avoid environmental triggers

It is very important to come forward and get yourself examined if you have above mentioned symptoms to make early diagnosis and treatment to prevent progression of the disease.

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