Articles on chronic lower respiratory diseases

Simple Breathing Exercises for Chronic Obstructive Pulmonary Diseases

Dr. Radhika Bharath, Physiotherapist
What is COPD?Chronic Obstructive Pulmonary Disease (COPD) is characterized by breathlessness (short of breath) or getting tired while breathing. COPD is an umbrella term for conditions such as chronic bronchitis, emphysema or a combination of both.Exercises of COPD• Deep breathing exercise:1) Diaphragmatic Breathing:- Sit Upright with back support- Look straight with chin neutral.- Place both your hands (palms one over the other) on your stomach (mid- abdomen)- Now take a deep breath in through your nose and feel your stomach move out (like an air filled balloon)- Make sure your chest does not move while breathing.- Once you have breathed in maximum, slowly breath out only through your mouth (as you blow a whistle) and feel your abdomen going inside.- Repeat this 10 time x 3 times a day2) Collateral Breathing: - Sit upright with back support - Look straight- Place your hands on the side of your chest wall (one hand on either sides)- Now take a deep breath in through your nose and feel the walls of your chest (rib cage) moving outwards as your chest expands.- No upper chest movement to be performed.- Now blow out the air through your mouth (as you blow a whistle) and feel the chest wall coming inside.- Repeat it 10 times x 3 times a day3) Apical Breathing:- Sit upright with a back support- Look straight, chin up- Place your palm across your upper chest (as the tips of your finger touch the collar bone).- Breath in through nose and feel the upper chest moving up.- Now once you have completely breathed in, slowly blow out through your mouth (as you blow a whistle) and feel your chest coming down to normal.- Repeat it 10 times x 3 times a day• Chest Expansion Techniques:1) Sit straight on a chair with back support (can also be done in lying).- Keep both the arms stretched out in front of the chest.- Now take your arms to the side and breath in through nose.- Slowly bring back the arms back in front of the chest and breath out through mouth.- Repeat 10 times 3 times a day.2) Sit on a chair with back support.- Keep both the arms stretched over head.- Bring both the arms to your shoulder level and breath in through nose.- Now gently take the hand back over head and breath out through mouth.- Repeat 10 times x 3 times a day.STAY HEATH WITH REGULAR EXERCISE!! GOOD LUCK!!

Like TB,This Lung Disease Is Not Communicable-COPD

Dr. Neelam Nath Bhatia, General Physician
Pollution after festivals has crossed Limits. Some areas of Delhi have recorded Suspended particles>1000(normal is 60+).COPD is one of the illnesses caused by pollution & low levels of oxygen in the blood.Simply put COPD is narrowing of passages and baloons (bronchi &alveoli) within lungs. Breathing becomes measured and Difficult as these fibrosed elements carry oxygen we breathe in,resulting in coughing and breathlessness.COPD is Not Reversible like Asthma. It progresses slowly. Both of these respiratory illnesses can be Controlled but Not Cured Permanently.COPD-Chronic Obstructive Pulmonary Disease can be deadly if associated with Heart illness as-Both heart and lung is One Unit and cause Breathlessness ,confusing the Treating doctors.Before an open heart surgery getting clearance from Lung doctor is a Must.Heart function is Measured by Echo and Lung Function is measured by Spirometry machines.Both machines are expensive and every GP cannot have them in Routine GP Clinics.Health Ministry will soon release "New Delhi declaration on mitigating effects of air pollution" and it has decided to declare COPD in Non Communicable disease (NCD) programme.We as Doctors can keep a Breathometer in our clinics to measure Lung Capacity of every person suspected to be at Risk, like we check BP as a Routine.Yes it is that simple. Cost of 'machine' is just 300/-(three hundred) only. One has to breathe in and breathe out with full force.Calibrations are on equipment,which is of the size of a baby feeding bottle.It gives a reading about functions of lung in a similar way the mother knows about milliliters of milk drunk by baby !This Breathometer is easily available and it is worth keeping in clinics as Some among others can have good lung functions too.WHY SEND EVERY Person for expensive lung tests? (So that Doubts can be Put to rest or treatment started on time so that illness does not progress to next dangerous level) Disease Grows Slowly like Cancer.We do have a choice to FIGHT pollution, learn to Live with it till the time some measures are taken up by Government and Individuals.This Means that our government is serious and want to screen people like other NCD diseases like Diabetes, Hypertension,Cancer and others.Reason to make COPD as NCD.Assistance will be provided to have Spirometers ,Nebulizers, Bronchodilators and Relevant medicines Available.This type of programme was launched to eradicate Polio and Small Pox and was Successful in Eradication of these 2 illnesses.Despite Awareness and programmes,there is No Reduction in TB cases but an Awareness has been Generated.Our Patients themselves ask for TB tests in Private Charitable Clinics if they have no time for government hospitalsRemember Non Smoking women are as Vulnerable to get COPD. Stress aggravates. Medicines to carry out MTP at advanced stage has COPD and low grade fever as side effects. If given once, the effect wanes, if given every year, the effect stays for life.And Women Too Breathe the Same Polluted Air as Men

Does Asthma Control You or Have You Controlled Your Asthma?

Dr. Rajesh Swarnakar, Pulmonologist
Asthma is a chronic disease which is affecting all age groups. It’s a hyper responsiveness of the airway to certain stimulus such as allergens, stress etc. It starts early in childhood and has symptoms of cough, breathlessness and chest tightness. Most important investigation being spirometry that guides for diagnosis as well as treatment.There is rise in the incidence of asthma in school going children which is of concern as its symptoms leads to absentees in school. This affects the social and psychological development of the child. Lack of awareness in parents let the symptoms to get worsen. The best available treatment is inhalation therapy which is safe as needed in micrograms and almost devoid of any long term side effects. Because of lack of awareness about availability of a very effective treatment in asthma people continue to suffer blaming their fate. While truth is that by controlling your asthma one can lead a normal active life.But how to find out whether your child’s asthma is under control? Well, take the following Asthma Control Test and find out now:How to take the test?Step 1:  Let the child respond to the first four questions (1 to 4). If your child needs help reading or understanding the question, you may help but let your child select the response. Complete the remaining three questions (5 to 7) on your own and without letting your child’s response influence your answers.Step 2:   Do scoring of the responses.Step 3:  The total score is to be added.Step 4: The score is to be discussed with the concerned doctor.Childhood Asthma Control Test (For children 4 to 11 years old)How is your asthma today?Very Bad - 0Bad - 1Good - 2Very good - 3How much of a problem is your asthma when you run, exercise or play sports?It’s a big problem; I can’t do what I want to do - 0It’s a problem and I don’t like it. - 1It’s a little problem but it’s ok. - 2It’s not a problem.          Do you cough because of your asthma?Yes, all the time – 0Yes, most of the time – 1Yes, some of the time – 2No, none of the time – 3Do you wake up during night because of Asthma?Yes, all of the time – 0Yes, most of the time – 1Yes, some of the time – 2No, none of the time – 3During the last 4 weeks, how many days did your child have any daytime asthma symptoms?Not at all – 51-3 days – 44-10 days – 311-18 days – 219-24 days – 1Everyday – 0During the last 4 weeks, how many days did your child wheeze during the day because of asthma?Not at all – 51-3 days – 44-10 days – 311-18 days – 219-24 days – 1Everyday – 0During the last 4 weeks, how many did your child wake up during the night because of asthma?Not at all – 51-3 days – 44-10 days – 311-18 days – 219-24 days – 1Everyday – 0Interpretation of score:19 or less:If your child’s score is 19 or less, it may be a sign that your child’s asthma is not controlled as well as it could be. Make an appointment to discuss the results obtained on this Childhood Asthma Control Test with your child’s doctor and ask if your child’s asthma treatment plan should be changed. Ask your child’s doctor about daily long term medications that can help control airway inflammation and constriction, the two main causes of asthma symptoms. Many children may need to treat both of these on a daily basis for the best asthma control.20 or more:If your child’s score is 20 or more, your child’s asthma may be under control. There are other factors that your child’s doctor may consider when assessing your child’s asthma control. Asthma is unpredictible.Your asthma symptoms may seem mild or nonexistent but they can flare up at any time. Have your child take the Childhood Asthma Control Test periodically no matter how good your child feels. Continue to have your child see the doctor on a regular basis to make sure your child’s asthma is treated as we as it can be.Every child has right to effective asthma treatment that can control their asthma. If not the treatment your child is receiving needs to be changed. You should go and talk to your doctor about this. If not contact an asthma specialist.With the help of above test one can know the status of the child. As of today many recent medications are available to keep asthma under control.  It’s important “to have your asthma under control than to have your asthma control you.”                          

Smoking and Coping With Copd

Dr. Vandana D.Prabhu, Pulmonologist
Mr. X was a smoker and knew it was bad for his lungs. But he was more scared about having a heart attack. So he took an ECG every year but it was always normal, and his chest x-rays were clear. Even though he was getting breathless and coughing a lot, he thought it was a normal smoker’s cough. He ignored it till he reached a stage where he couldn’t walk far without breathing difficulty.Now he has given up smoking, and is on treatment for COPD. It was tough to quit smoking, but with will power he succeeded. He now feels much happier and goes for his morning walk comfortably.COPD is the short form for Chronic Obstructive Pulmonary Disease. “Chronic” means that it will not go away. “Obstructive” means partly blocked. “Pulmonary” means in the lungs. This means that you need long-term treatment for a disease that is causing some blockage in your lungs. The air tubes which carry air in and out of the lungs become narrower, so the amount of air that goes in is much less. Also, air cannot get out of the lungs properly. Because of this, the patient feels breathless, his lungs feel very full, and his chest feels tight. These are the symptoms of COPD.Smoking is the most commoncause of COPD. People who get COPD are usually smokers over 40 years of age. Theymay be ex-smokers who have quit, but already have lung damage. Even non-smokerscan get COPD if they keep breathing in second-hand smoke. Constant exposure tofumes from burning firewood or charcoal is a risk factor. That is how women inrural India get COPD from their cooking stoves {“chula”} or room heaters[“sigri”]. Asthmatics can get COPD if their asthma is not properly controlled.Occupational exposure to dusty or smoky air like coal mines; or otherindustries like cement, textiles and chemicals may also cause COPD.The patient is asked to doa breathing test called spirometry; by which the doctor grades COPD as mild, moderateor severe; and decides on the treatment plan accordingly. Newer inhaledmedications are safe and effective for long-term treatment. The most importantadvice is to stop smoking and take the prescribed medicines regularly.The patient’s condition canget worse even if he smokes just two cigarettes a day. Cigarette smoke reducesthe lungs’ immunity against infections. It irritates the airways which getnarrower and produce excess mucus that blocks them. If the patient’s willpowerto quit smoking is not enough, the doctor may recommend a nicotine patch/chewing gum. This nicotine substitute reduces withdrawal symptoms like anxiety,restlessness and craving for tobacco smoke.To QUIT Smoking:Set a definite date when you will stop smokingcompletely.Tell your friends and family that you are tryingto stop. They will support and motivate you.Take one day at a time. Mark off each successfulday on a calendar.Avoid people who smoke and places that make youwant to smoke.Remove all ashtrays, cigarette packs andlighters from your home.Keep your hands busy. Whenever you feel likepicking up a cigarette, pick up a pencil instead.If you feel an urge to smoke, chew some nicotinegum instead.If you start smoking again, don’t give up onyour goal. On an average, people make 3-4 attempts to quit before they stopsmoking permanently.Keep the air clean in your home. Avoid smoke,fumes, and strong smells. If your house is being painted or pest-controlled,stay away.If you are cooking, keep the kitchen windowsopen and use an exhaust fan.On days when there is lot of pollution and dustoutside, stay at home and keep the windows closed.If you are overweight, it is harder to breathe.Try to lose weight.If you become breathless while eating, eatslowly and talk less.Eat fresh fruits and vegetables; in smallamounts but more frequently.Drink lots of water. This helps make the mucusin your lungs thinner, so that you can cough it out easily.Do breathing exercises. Walk slowly for 20 mindaily. If you feel breathless, stop and rest.If your COPD is very bad and you have beenhospitalised, the doctor may advise you to take oxygen at home. You will have toarrange for an oxygen cylinder or an oxygen concentrator.If breathing becomes very difficult, and it ishard to walk and talk, it may be an emergency. Go to the hospital right away.

5 Important Asthma Care Tips This Diwali

Ms. Swati Kapoor, Dietitian/Nutritionist
Asthma leads to coughing, shortness of breath, chest tightness and wheezing.It affects almost all the people of age but it generally starts in childhood.Moreover when it comes to festival such as Diwali, there are more chances of asthma to get worse if not taken precautions on time.This time of the year, India shows spikes in its statistics with respiratory problems due to the combination of various factors such as change in weather, allergy etc.For those who have respiratory disorders, are the sufferers.So if you really want to enjoy this period of celebration, try to implement these guidelines in your routineAvoid places where there is lot of smoke and crackers burning.If you really want to go, then cover your face with handkerchief.Eat four to six times a day, but smaller meals. Consume home cooked meals, this will not worsen your problem.Don't forget to take medication on time. Also keep your inhalers handy if travelling.Throughout the day, keep on sipping lukewarm water. This will help in clearing pollutants from the body.Avoid alcohol and smoking. They are bad for asthmatic people and it is more dangerous during festive season like Diwali.The most important tip for this festive season is to be happy and joyous. If your mind is happy and occupied, you will forget about asthma. So have a great time in Diwali, enjoy colours, lights and always remember prevention is better than cure. So stay fit and healthy.

Chronic Kidney Disease - Silent Killer

Dr. Ajay Goyal, Nephrologist
Chronic kidney disease (CKD) is a condition in which kidneys are damaged and their ability to keep a person healthy is decreased. The main role of the kidneys is to filter waste products from the blood before converting them into urine. The kidneys also:Help maintain blood pressureMaintain the correct levels of chemicals in your body which, in turn, will help heart and muscles function properlyProduce the active form of vitamin D that keeps bones healthyProduce a substance called erythropoietin, which stimulates production of red blood cellsCKD is the reduced ability of the kidney to carry out these functions in the long-term. This is most often caused by damage to the kidneys from other conditions, most commonly diabetes and high blood pressure. If kidney disease gets worse, wastes can build to high levels in your blood and make you feel sick. You may develop complications like high blood pressure, anemia, weak bones, poor nutritional health and nerve damage. People with CKD are known to have an increased risk of a heart attack because of changes that occur to the circulation. These problems may happen slowly over a long period of time. Early detection and treatment can often keep chronic kidney disease from getting worse.Talk to your doctor about your kidneys if you:Have diabetesHave high blood pressureAre obeseSmokeAre over 50years of ageHave a family history of kidney disease, diabetes or high blood pressureHave swelling over feetThree simple tests to check for kidney disease are Blood Pressure, Urine analysis and serum creatinine. Early kidney disease can and should be treated to keep it from getting worse.

Colds and Coughs in Children

Dr. Murali Gopal, Pulmonologist
This is one of the most common issues in kids of preschool age. Almost all toddlers would have had at least one episode of common cold (runny nose) and cough before they turn 2. It is commonly caused by viruses and mostly seen in winter months or during weather changes.  These viral infections are self limiting illness, where the child will get better by two weeks from onset of symptoms.It is usual to have fever when kids develop these respiratory tract infections. Some children especially preschool children can develop wheezing following viral upper respiratory tract infections. These can repeat with further infections. Most of these preschool wheezers out grow their symptoms by the time they reach 6-8 years of age. Some of them may require inhaler therapy during episodes. Few children with allergic symptoms may develop asthma as they get older. There is advancement of inhaler therapy over the last few years both for children and adults. There is misconception that inhalers are ‘addictive’. It is best way to give the medicine directly into the lungs as it is breathed in to where it is needed and it reduces the chance of side effect from oral medicines given for wheezing. These medications when given by mouth as syrup or tablets can cause undesired side effects compared to inhalers.Cough is a worrying symptom for most parents. Cough is a natural, protective reflex we have to expel the irritant,phlegm in the breathing tubes and lungs. Cough lasting for more than 3 weeks needs attention especially if it sounds moist. Cough medications may reduce the cough and makes the secretions thicker making it harder to cough up. Some cough medicines available in the market can lead to serious side effects and some are not licensed to be used in children. When do we worry about child’s respiratory symptoms? Cough in newborn baby and unvaccinated babies in the first 4 months of age.Child has persistent cough for more than 3 weeks which sounds moist.Sudden onset of cough following choking and breathing difficulties.Child has breathing difficulty like breathing faster, working hard to breath.Coughing up greenish sputum or blood.Do not self medicate children as their symptoms may vary with episodes. Always consult your child’s doctor before giving medicine to your child, even if medicines are prescribed for similar symptoms in the past.

Bronchial Asthma & How to Boost Your Child's Immunity

Dr. Loknath Kumar, General Physician
Bronchial Asthma is a chronic inflammatory disorder of the airways characterized by an obstruction of air flow.The inflammation of the airways makes them very sensitive resulting in spasm of the airways that tend to narrow, particularly when the lungs are exposed to allergens, cold air, viral infections, smoke and exercise. The reduced airways result in a reduction in the amount of air going into the lungs making it hard for the child to breathe.How Asthma affects children:The tendency to develop Asthma is often inherited. It has also been suggested that there is an association between day care environment and wheezing. Those who started day care early were twice as likely to develop wheezing in their first year of life as those who did not attend day care. Many children with Asthma can breathe normally for a few weeks or months between flares. When flares do occur, they often seem to happen without warning.Bronchial Asthma was found more often in children born during August to October, possibly due to more viral infections during their first six months of life.Children younger than 18 years of age account for a large portion of emergency department visits and hospitalizations due to asthma exacerbation. Asthma causes children and adolescents to miss school and causes parents to miss days at work.Signs and Symptoms:1) Wheezing: A musical high pitched whistling sound produced by airflow turbulence is one of the most common symptoms of Asthma.2) Cough3) Nocturnal/ Exercise induced cough: Children usually tend to cough after midnight, during early hours of morning or after exercise.4) Shortness of BreathDiagnosis:1) Pulmonary function test2) Allergy Test3) RadiographyManagement of Asthma and is it possible to boost the child’s Immunity:Although Inhalers and medications do provide relief, but considering their side effects and the repeated intervention that is needed,parents prefer Natural therapies like Salt Room Therapy that provide a very potent alternative to heavy medications. Kids have a natural aversion to medicines. A few Salt room therapy sessions under the playful environment provided within the Salt room helps the child build up immunity and steer clear of repeated Asthma and Wheezing attacks.Dr.Vanikala VenugopalRespiCare Whitefield

Water Vapor, chill in the air, dust, & fumes of Vehicles is a Deadly Combination.

Dr. Neelam Nath Bhatia, General Physician
29th October is World Stroke Day. Low levels of Oxygen in air does Trigger an attack of Stroke/ Heart attack & causes for both of these deadly and debilitating illnesses is same- blockages within blood vessels supplying blood to vital organs like brain and heart.What is Smog? Smoke + Fog. During winters the air quality is Very bad, low temperatures do not allow suspended particles to go up towards the sky.There is lots of construction work going on Left-Right & Center in all cities creating Dust Particles.Vehicles are running on road neck to neck and back to back with no place to walk/ cycle to go to work leading to fumes.Every living being is feeling the Effects of POLLUTION.Why are Birds dying? Every death in a bird is Not Due to Swine Flu.Why do we Not See as many Flowers in our gardens? The Oxygen Generating leaves have got dust on them. Plants cannot breathe,the plants do feel like us & we have difficulty in breathing.What is the solution? To stay indoors !! To get Air purifiers in cities & in our homes ! Is it practical? I feel guilty telling my pregnant patient to Not Go for a walk as Pollution can cause premature Births.I feel guilty telling little kids about Not to Play in garden. Cycling is risky as it is due to heavy traffic.Pollution carries risk of Arthritis Also.Pollution does not only Trigger an attack of COPD & Asthma. It can cause-Skin allergiesRed eyesRough skinLoss of hairPremature greying of hair and, Low Levels of Oxygen in blood.Keep homes clean, do not be an Animal lover as animals are Not meant for Apartments to be confined to narrow spaces . Do keep pets only if you can maintain Mansions with large gardens. It is Torture to Species of animals also. Pets feel pollution and they cause Pollution too.Grow as many indoor plants as possible within apartments but do keep the oxygen breathing out leaves Free from Dust.Exercise indoors till the time outside air gets cleaner and worth breathing. ( Wishful Thinking !)Do Wear a Mask when going outdoors.Remember that Pollution is everywhere, in newspapers, on TV news, within our homes and every living being is Affected by Pollution.We can remember it daily, use caution & avoid triggers so that disease(s) are Prevented.