Chronic Obstructive Pulmonary Disease

This chronic condition of the lungs is also known as COPD and is responsible for a large number of admissions to hospital. Losing your breath is said to be one of the most frightening experiences possible, and so any support and information is extremely important.

As it develops over the years many early sufferers are unaware of the changes to their lung tissue and so miss out on ways to prevent its long term effects. There is usually a history of smoking though by no means always. Working conditions where the environment is polluted almost always leads to deterioration of the function of the lungs. 

The first signs are moderate breathlessness and a recurrent cough, sometimes producing secretions. These signs and symptoms become more obvious over time and are then mentioned, usually, to the GP. Lung function tests are carried out and hopefully a full assessment by a respiratory health professional. There is much advice which can be given at this stage and joining a pulmonary rehabilitation course can be of great benefit.

Someting to stress at his stage is teaching the sufferer to take control of his condition and manage his breathlessness so as to enable him to lead an active, high quaility life.

Two stories to encourage you:

I had one patient who was continually in and out of hospital with very disabling lung function, limiting him to home and hospital. As he learnt how to manage his breathlessness and improve the strength and endurance of his body through exercises, he was able to serve on a committee dedicated to improving the quailty of life of other COPD sufferes. He was indeed able to participate in a meeting with ministers at Westminster to share his story, giving real meaning to his life.

Another lady who walked round with an oxygen pack on her back and who, what we call desaturated quickly, that is the level of oxygen in her blood dropped  on exertion, was able to join a cruise to the Antartic! She said she knew what to do if she became breathless and knew it would pass. Meeting up with others with the same conditions and fears is very supportive and participants cheer each other on.

I would strongly advise you to approach your GP and ask to be referred to a Pulmonary Rehabilitation group. The outcomes are often amazing but quailty of life is nearly always improved. If this is not available start your own walking programme where you gradually increase the distance walked, even if only by a metre or two. Make some obvious markers eg walk to front door, then going on to walk to the gate. When breathless stop and concentrate on gently breathing out, longer each time until you feel able to continue.

It is always a good idea to have a prescription of suitable anti-biotics at hand should you suspect an infection is developing. Most GP's are happy to do this provided you contact them to let them know. they may ask you to come in. There is a very helpful routine to follow in order to help get the secretions out more easily and to keep a good blood supply to the lungs. It is called Active Cycle of Breathing,  (ACB) There may well be a respiratory team in the community who can teach you how to follow a cycle of breathing and huffing.  There is a document with a visual description of this routine attached below.

It is very important to drink plenty of water so as to keep secretions thin and so more easily coughed up. Plenty of high energy food is also important as the body is working hard to keep you breathing. 

ADVICE FOR ACUTE RESPIRIATORY DISTRESS

One of the main reasons for dialling 999 when distressed by shortness of breath is the fear of dying by suffocation, being unable to regain sufficient air flow. It is as, if not more so, frightening as a heart attack. The answer is actually reassuringly simple and needs no professional help although it is comforting to have trained medical staff at hand.

The secret is to concentrate on what we call expiration. This is focussing on getting as much air out of the lungs as possible each time one breaths out. The chest should sink down more with each breath, really squeezing the last bit of air out, each time a little more than the previous breath. The reason why you do this is to get as much of the stale air out making place for the fresh air. Because the airways narrow as you breath out it is difficult to get enough air out when you are struggling to breath. Within a few minutes you will find that your breath is returning to normal and you feel you are getting enough air.

Knowing you can regain control over breathlessness is one of the most reassuring techniques you can learn. It enables you to extend your world and do so much more. Ask for help from your GP surgery if you want a physiotherapist from the Respiriatory Team in the community to call. This is also a technique that should be taught at a course of Pulmonary Rehabilitation.

  1. ACBT