Vol. XIX, No. 4, Fall 2011
Pulmonary disease is recognized as an increasingly important cause of morbidity and mortality in the United States and around the world. Chronic lung disease is the fourth leading cause of death in the United States, while influenza and pneumonia is also in the top ten at No. 8.
Fortunately, there are ways to minimize one’s risk.
Start with an awareness of your surroundings and take steps to reduce the triggers that cause shortness of breath.
We’ve all heard that during the winter months it’s important to stay away from those who have the flu or a respiratory infection. That leads people to avoid public places and spend more time at home. So, if that’s the case, that’s where you need to start in reducing the causes of irritation.
Any foreign matter that you breathe may cause an episode of coughing and shortness of breath, which in turn produces more mucus and still more shortness of breath.
So, avoid creating cooking fumes when using cooking oils, or food that produces excess cooking fumes. Replace your heater filter on a regular basis. There are washable furnace filters that will save you money, but clean them regularly according to the manufacturer’s instructions.
Clean those out-of-the-way places like the coils on the back of the refrigerator, ceiling fans and the water pan under the refrigerator. Avoid aerosol sprays that may contain toxic chemicals and use unscented cleaners containing natural ingredients. (Baking soda or a 50-50 solution of white vinegar and water is a good alternative cleanser.)
Mold is a problem during the fall and winter from leaves that are rotting in the yard. You can also have mold spores in your home anywhere there is water.
Check your basement for cracks in the foundation where water could leak in.
If you go out make sure to wash your hands after shaking hands, or blocking a cough. Avoid severe cold air; the extreme change in temperature is an irritant to your lungs. If you have to go out in the severe cold air, breathe through your nose. It warms the air. Try wearing a scarf or mask over your nose and mouth.
And be sure to rest when short of breath so you’re not tempted to breathe through your mouth.
Be aware of the warning signs of a flareup of shortness of breath:
If you experience any of these symptoms contact your doctor or go to the local walk-in center or emergency room. If you are having chest pain, blue lips or fingers, confusion, agitation, not thinking clearly, feel drowsy, or are very short of breath call 911 immediately.
The sooner you receive treatment the less likely you will need extended intensive hospital care.
If you should be hospitalized for an acute episode of shortness of breath, you may want to consider a pulmonary rehabilitation program upon discharge. Effective post-acute pulmonary programs focus on rehabilitation, exercise and patient education to empower the participants to achieve their highest level of functioning.
(The above article was prepared by the Pulmonary Specialty Program at Kindred Transitional Care and Rehabilitation-Forestview in Wareham, 508-295-6264 or www.kindredforestview.com. for information.)
By Richard W. Eckert
We all breathe. Every minute of every day, each day of our lives. Most of the time we barely give it thought. But for those who live with a progressive lung disease like COPD or Emphysema, breathing becomes an ordeal that may change from minute to minute. Understanding how these conditions actually affect how the lung works can be extremely helpful to a patient during the training period of rehabilitation.
The most common point that I share with patients is awareness of how your body is communicating to you, especially during physical stress. If you can recognize the early signs of S.O.B, (Shortness of Breath), you can avoid a more serious event.
As a clinician, I discuss lung tissue in terms of “compliance,” which is simply how the lung tissue functions during respiration. When you inhale, a volume of air enters the lung cavity which increases lung pressure. The increase in pressure helps to transfer oxygen onto the blood. During exhalation, the air exits the lung and reduces pressure, this helps lift CO2 from the surface of the blood. The cycle of breathing is how gas exchange occurs between the lung and the circulating blood in the body.
We are all taught that oxygen is good for us. True. We are also taught that CO2 is not good for us. Also true. In progressive lung diseases like COPD and emphysema, lung tissue becomes stiffer and does not function the way it was made to. This decrease in function results in more air trapped in the lung, and the result is that higher levels of CO2 remain on the blood. COPD patients are chronic CO2 retainers because of poor lung compliance.
During exercise, oxygen consumption increases, which in turn raises the levels of CO2 in the blood. Our brains measure CO2 in the blood and then increase the heart rate to compensate. As the heart begins to work harder, it forces the lungs to also increase their efforts. Unfortunately the brain and the heart do not understand that lungs are not functioning normally and cannot meet the immediate demand for gas exchange. This begins the cycle of breathlessness for a patient with a progressive lung disease.
For many patients, supplementary oxygen can improve the ability to maintain your accustomed standard of life. My consistent teaching point with patients is that regardless of supplementary oxygen, gas exchange still requires proper respiration. One of my favorite mental pictures is that oxygen is like nails to a carpenter; and that respiration (breathing) is like the hammer.
The key concept is for the patient to be thoughtful about increasing expiration times. This helps to reduce air volumes in the lung cavity which in turn reduces cavity pressures and helps to lift CO2 off of the blood.
The breathing cycle, “Smell The Flowers” for inhalation and “Blow Out The Candles” for expiration becomes the mantra. When shortness of breath occurs, stop what you are doing. Slow down your breathing and control your exhalation times until you have fully recovered. Always be thoughtful of how you breathe.
(Mr. Eckert is a Staff Respiratory Therapist with Cape Medical Supply.)