The winter discomfort

The winter discomfort

Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used for obstructive lung disease, which includes emphysema and chronic bronchitis. Patients suffering from COPD typically have airflow obstructions that are not fully reversible. Long-term exposure to pollutants and irritants causes inflammatory response in the lungs and results in narrowing of the small airways in the lungs. The poor airflow is usually diagnosed by lung function tests or Pulmonary Function Test (PFT). The main symptoms of COPD include shortness of breath, sputum production, wheezing and coughing. These symptoms are progressive in nature — they get worse with time.

The causes
There are various causes of COPD, of which the most prominent ones are genetics, air pollution and smoking. Bronchitis patients are known to suffer from COPD too. The winter season has serious health implications on COPD patients. Seasonal changes coupled with polluted air worsen respiratory problems. According to experts, the number of patients suffering from asthma and other respiratory disorders like COPD and allergic rhinitis shows a sharp upward trend during Diwali as well.

Adults exposed to high levels of air pollution during this time have shown increased incidences of chronic cough, sputum, and breathlessness. They are at an increased risk of developing asthma, allergic rhinitis, lower respiratory tract infections, and even early signs of lung cancer. The noxious fumes and gases take lot of time to dissipate, which means one can succumb to respiratory issues even during the days after the exposure. Firecrackers are known to cause chest and throat blockage and worsen problems for those already suffering from cough, cold and respiratory allergies.

Can it be cured?
Prevention is always better than cure. Hence, it is advisable to take precautionary measures like staying indoors and keeping windows closed, taking flu vaccine shots annually, taking prescribed medications and avoiding dust, smoke and pollutants as much as possible.

There is no permanent cure for COPD but symptoms can be treated and its progress can be slowed. Oxygen therapy can help COPD patients who do not get enough oxygen in their blood. Medications such as inhalers can help keep the condition under control. Breathing techniques such as breathing through pursed lips and diaphragmatic breathing can also help reduce shortness of breath. Certain lifestyle changes can also help one to stay active.

COPD can be prevented by improving the quality of indoor and outdoor air. Quitting smoking can be the first step towards alleviating COPD symptoms. Maintaining a healthy body weight can also help in the management of the condition. Pulmonary rehabilitation can also help patients to a great extent. These programmes involve exercise, counselling and disease management to achieve and maintain optimal functioning. A team of specialists work with the patient to improve his physical condition and manage the condition.

Home-based pulmonary rehabilitation is advised as an alternative to outpatient rehabilitation because of various reasons. In a home-based set-up, respiratory therapists, physiotherapists, occupational therapists, dieticians, trained nurses and professional caregivers work as a team to deliver a tailored programme. Frequent visits to the hospital, expensive inpatient programmes and anxiety and depression associated with hospitalisation can be avoided here. Evidence suggests that early discharge from the hospital into a home-based care setting is associated with comfort and a better quality of life.

A pre-exercise assessment, exercise ability test, BORG tests, PFT test and a six-minute exercise test are usually conducted on a COPD patient as a part of initial assessment, on the basis of which the treatment line is decided. An exercise schedule is customised according to the patient’s condition. Oxygen concentrators, non-invasive ventilators and BiPAP machines can also be used at one’s home for extreme cases.

(The author is medical director, Nightingales Home Healthcare)

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