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Lung Disease: Facts You Need To Know
In August 2019, Angie Abad went to the ER to be treated for a respiratory infection. Medical workers there tested her and prescribed meds, but Abad "never really felt right after that."
After a second respiratory infection and growing problems with breathing, her local hospital still couldn't put a finger on the problem. Finally, a more specialized hospital nearby ran more breathing and lung tests and diagnosed her with the lung disease COPD.
But the diagnosis and the treatments that followed -- including extra oxygen, a nebulizer, and an inhaler -- still left Abad, who is 50 and lives in Denver, without answers to mounting questions. She felt even worse about her condition because she'd watched her father die of the same disease 8 years before.
"I didn't know any questions to ask my pulmonologist," Abad says. "I've just taken the meds she's put me on and left it at that. No one has told me what to expect, possible side effects of meds, or [other] things I would experience."
She didn't find much more support from friends, either. "When you tell people about your diagnosis of COPD, they say, 'Oh,'" she says. "There isn't enough awareness. People don't understand the daily struggles of this disease."
David Mannino, MD, a pulmonologist in Lexington, KY, and the medical director and co-founder of the COPD Foundation, agrees that too many people with lung disease remain in the dark after diagnosis.
On top of people not knowing what questions to ask, "One of the challenges we always seem to have is, a lot of people think it's some type of death sentence. It's not," he says. Mannino has been treating some COPD patients for 15 to 20 years.
Another factor is people with COPD perhaps not knowing they can seek -- and deserve -- support. "A lot of people go into it with shame and blame," Mannino says. For example, smokers might react to their diagnosis by realizing their habit helped set the stage to get the disease. But the guilt should stop there.
"You are dealing with something that is incredibly addicting," Mannino says. "And it's not that way by accident," he says, referring to tobacco companies' longtime knowledge of the harms the substance causes. Even if you can trace the cause of COPD to your lifestyle, this is a time to be gentle on yourself.
Abad filled the many gaps in her grasp of her medical condition "through research, COPD groups, and personal experience."
Her journey has turned up many points she feels are key for people with lung disease to cover with their doctors, answers she wished she'd had all along. They include:
A special question for her was if altitude makes COPD worse. She's newly moved to Denver, which clocks in at 1 mile above sea level. A higher altitude can tax your breathing, mainly at first.
Mannino says he often hears people who have moderate to severe COPD say they wished they'd gone to a pulmonary rehab center or other educational program years before. In these programs, people learn earlier rather than later how to, for example, stretch and breathe properly. They're also taught to fend off panic attacks and times when they can't catch their breath with methods like pursed lip breathing. It's a technique in which you inhale through your nose and breathe out through puckered lips.
Some exercises can actually be fun, Mannino notes, such as playing the harmonica. The higher notes provide ideal breathing workouts.
Such programs also teach people with lung disease how to use meds and lung devices the right way. "Patients learn too late that different respiratory meds require different techniques as to how to use them correctly," Mannino says. "Even physicians might not know how to use these correctly."
However, "the number of rehab programs for COPD are far too few," especially in rural places, he says. The COVID-19 pandemic and its limits on people getting together for anything "nonessential" has made it even harder to get into these programs. Doctors also expect some people who've had COVID will need pulmonary rehab, which will put more strain on the system.
Technology has made it simple for anyone to access disease support, though. A number of lung disease management apps have sprung up, including a free app through the COPD Foundation called the COPD Pocket Consultant Guide. It's designed for people with the disease and their families. You can download it from the foundation website or Google Play.
The app includes links for the right way to use meds, easy ways to track your schedules, and other useful tools rehab programs cover. "You can even print out [info] sheets to give the doctor" to prompt helpful questions and start talks that can sharpen your insights into your condition, Mannino says.
Lung Disease
Increasing level of pollution has made breathing in urban areas very difficult, raising the incidence of respiratory problems. Out of the world's top 20 cities with polluted air, 13 belong to India and according to the World health Organisation (WHO) report published in 2011, lung diseases rank 2ndin the list of top 20 causes of death. Naturally, lung disease is a big health issue that needs to be addressed. Here are some facts about lung disease you should know about.
To understand the condition of your lungs, you need to first understand how the lungs function. Lungs are soft organs present on both right and left side of the chest. They are protected by a had covering called the ribcage. Each lung is made of sections called lobes. The main function of the lungs is to make oxygen available for purifying blood and to and eliminate carbondioxide from impure blood or deoxygenated blood. So when you breathe, air travels down your windpipe (trachea). The windpipe bifurcates with each branch entering each of the lungs. Into the lungs, the windpipe is further branched to tubes called bronchioles that end in small sacs called alveoli, where the inhaled air reaches for delivering oxygen.
A lung disease or disorder occurs in the various structures of lungs and disrupts its functioning. It can vary from a mild common cold to life-threatening conditions like pneumonia and cancer. Lung disease can be caused by infections, inflammation, obstruction of airways, decreased lung function, problems related to pulmonary circulation, etc. Smoking, infections, air pollution, genetics, exposure to asbestos, etc. Can cause various lung diseases.
TypesThe common as well as rare types of lung disease include -
Causes'In any form of lung disease mainly the breathing gets affected,' says Dr Animesh Arya, Senior Consultant, Respiratory Medicine, Delhi based Sri Balaji Action Medical Institute. Here are some common forms of lung diseases he explains. 1. Asthma:It is the most common lung disease triggered by allergies, infections and pollutants that harm the airways and cause inflammation. 2. Acute bronchitis: Bronchitis is the inflammation of the air passage. Acute bronchitis is caused by viral or bacterial respiratory infections. 3. Chronic Obstructive Pulmonary Disease (COPD): It a group of diseases that causes breathing difficulties and interfere with the exhalation process of breathing. 4. Chronic bronchitis: It is a type of COPD caused mainly due to smoking. 5. Emphysema: It is a COPD caused by environmental factors and may also be triggered by allergens or organisms that cause diseases like pneumonia and tuberculosis. Apart from these common forms of lung diseases, other rare lung diseases include: 6. Cystic fibrosis: It is rare lung disease caused by genetic mutation that results in excess mucus production causing blockage of airways. 7. Acute respiratory distress syndrome (ARDS): It is a medical emergency caused as a result of lung injury due to a severe illness. 8. Lung cancer: It can affect any part of the lung. It is mainly caused due to smoking. Here are 10 common symptoms of lung cancer you need to know. 9. Interstitial lung disease: This is a group of diseases affecting the interstitium, a thin lining separating the air sacs.
Symptoms'Bronchitis, asthma, COPD, lung infections and pulmonary fibrosis have similar symptoms even though they are very different in nature,' says Dr Arya. He lists a few common symptoms of lung diseases:
In most cases, chronic cough, chest pain and breathing difficulties necessitate a lung function test. But your doctor might first take a look at the results of your blood test that may indicate whether you have any kind of lung infection. Otherwise, based on your symptoms your doctor might recommend the following lung function tests for you, as explained by Dr Arya.
'If any of the above mentioned symptoms persist for a long time, it is better to consult a doctor immediately for diagnosis,' says Dr Arya. The management of lung disease depends on the type of lung disease you're diagnosed with but largely medication is the main treatment option for lung disease patients.
When Lung Disease Interrupts Your Exercise Routine
Exercise is great for your health, strength, and quality of life. But if you have chronic lung disease, symptoms like shortness of breath may make you afraid to work out.
Lung disease can interrupt your exercise routine, making it harder to be as active or independent as you once were, says Pat Owens, 76, who lives alone in Tucson, AZ. She uses supplemental oxygen to support her breathing during exercises like squats, leg lifts, and balancing on one leg while she holds onto the kitchen sink.
"I also have some exercise and stretching tapes. I walk inside and when I can, I walk outside too. I do all my own housework, shopping, and laundry," says Owens, who has chronic obstructive pulmonary disease (COPD). "I try to stay as active as I can, so I can continue to care for myself. My only obstacle is that I can't move around as fast as I used to. It takes me longer to do things, but at least I get things done."
If you haven't exercised for a while due to lung disease, start again slowly, says pulmonologist Albert Rizzo, MD, chief medical officer of the American Lung Association.
"Just pace yourself. Listen to your body and slowly increase your activity," he says. "Exercise is so important for building your muscle strength and breathing, but also improves your mood. You can even do exercises while you're sitting in a chair. It can be something simple, like walking back and forth to your mailbox or around the block."
Somer Love, 41, was a high school swimmer, diver, and cheerleader, and enjoyed skiing and volleyball growing up in Utah. She has cystic fibrosis, a chronic lung disease with symptoms like shortness of breath, congestion, and frequent infections that can keep her from being active.
"Some days, just walking to the bathroom or kitchen can be exhausting. When I am able to, I go on walks outside. Maybe that's because we are living through a global pandemic, and it's my only way to be out in the world and not quarantined away," Love says. "I live for my walks and so does my dog, Tulip. I am grateful for those days that I'm able to get outside and make it happen."
Love tries to do resistance exercises for muscle tone and to help her clear and strengthen her lungs. If her chronic lung disease sidelines her at times, she may start up again with just 1 or 2 minutes of bouncing on a small rebounder trampoline. "Something else I'm really proud of is that this year, I found my inner yogi as well. I've really enjoyed experimenting with yoga and listening to my body."
Lung disease symptoms may make you afraid to exercise, but it's actually good for your lungs, says Frank C. Sciurba, MD, director of the Emphysema/COPD Research Center at the University of Pittsburgh Medical Center.
"Your reflex is to avoid any activity that may trigger your shortness of breath. You can become deconditioned and out of shape," Sciurba says. "If you get more exercise, you'll be able to do more and your conditioning will improve. You may be afraid to push yourself if you have shortness of breath."
Pulmonary rehab, where a respiratory therapist shows you how to safely exercise, build strength and stamina, and breathe more efficiently, may help you get active again.
"You may start out with strength exercises with resistance bands, light weights, or squats, then work up to walking on a treadmill," he says. Upper-body exercises help improve breathing too. "The muscles you use when you're short of breath are the same as the ones you use when you do arm work. Train your muscles to do those moves without shortness of breath."
Lung disease can make once-doable activities now seem very hard, and that's scary, says Trina Limberg, a respiratory therapist at Pulmonary Care Consulting and Training in San Diego, CA.
"If your muscles decondition, you may feel that your legs can't support your body weight or your arms can't handle carrying groceries," Limberg says. "You have more breathlessness during ordinary activities, and your world starts to shrink."
Lung disease often causes depression or anxiety too, she says. If symptoms interrupt activities you enjoy, like playing golf, your self-esteem can plummet. Rehab can help you exercise safely with less breathlessness.
"You can learn to use your lungs more efficiently and learn pacing and new breathing techniques. You can achieve high levels of fitness that can be surprising and very encouraging."
If you have supplemental oxygen, be sure to use it when you exercise. Your doctor can adjust your flow rate to support your breathing during workouts.
"If I'm going to exercise, I need oxygen," says Valerie Chang, who has COPD. She uses portable oxygen concentrators with extra batteries on walks or when she uses a rowing machine at her Honolulu home. "I listen to podcasts while I row. One of the advantages of rowing is that you can stay stationary. I can plug in my oxygen and row, and just think or meditate while I exercise."
You can also use a pulse oximeter, a small device clipped to your finger that tests oxygen levels in your blood, when you work out, Rizzo says. Don't be alarmed if the number drops during a strenuous activity. "Just slow down and let your number come back up."
Love knows she may need a lung transplant one day. She says that regular exercise could help her delay surgery, and it has also improved her sleep quality and energy levels.
"It's not always easy. I can't just walk out my front door and go on a walk. There's a lot that I have to factor in, such as air quality, the temperature, if I have a full oxygen tank. I have to have my pulse oximeter in my hand at all times," she says.
A year ago, an infection caused Love's lung function to plummet. She didn't know if she could rebound and exercise again, but she started slowly to build stamina and confidence.
"A cold or virus can be devastating for someone with chronic lung disease. So, I just started moving, taking baby steps, walking short distances, and experimenting with yoga," she says. She slowly extended her walks and held yoga poses longer each time. She takes online yoga classes designed for people with advanced lung disease on a platform called Beam. "Seeing my body begin to heal and feel stronger again was exciting and energizing. I was hooked, and dare I say, I started loving exercise again."
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