Chronic Obstructive Pulmonary disease now impacts over 5.5 crore Indians, leaving them gasping for air.
Dr Arjun Khanna, a chest physician associated with Yashoda Hospital, Kaushambi has answered your questions on chronic and common respiratory diseases.
Q. What is Chronic Obstructive Pulmonary Disease?
COPD or Chronic obstructive pulmonary disease, also known as chronic bronchitis, in Hindi we call it Kala Dama, happens when irritants, pollutants, cigarette smoke or biomass fuel enters your lungs and irritates them, and over a period of time as smoke accumulates inside your lungs, it damages the airways.
Q. How would we know if someone has COPD? What signs or symptoms should we look out for?
The most common presentation of COPD is when you see someone who has been smoking all their lives, usually males more than 50 years of age, come in with chronic cough, shortness of breath, dry hacking cough, excess phlegm in morning hours.
Unfortunately in India, women in rural areas have been exposed to chulha and angithi smoke, develop COPD as early as 40 years of age. And when you look at their X-Rays, it resembles that of someone who has smoked all their lives.
Q. Please explain which tests will be required for someone who isn't sure whether he has a chronic cough issue or COPD?
Because chronic cough is a symptom of COPD and if you have been a smoker and have lived in a polluted city like Delhi, if you have worked on a chulha, you need to be screened for COPD. There is a simple point of function test called Spirometry Test or a Lung Function Test you have to take. You have to blow on a tube and the technician will guide you on how to suck in the air. This will give your doctor a curve or a graph of your lungs and based on these figures we can easily diagnose whether you have COPD or not. Sometimes we also ask for a chest X Ray or sputum test to rule out other infections. But that one test to rule out or rule in COPD is the Lung Function Test or Spirometry test.
Q. My dad is suffering from COPD. What other issues will he face as he gets older? Breathing exercises don't help him much, is there any solution to increase his breathing capacity? Can walking be a good exercise for him?
COPD is a progressive disease. So over a period of time as the lung involvement becomes more severe, breathlessness is going to increase. Unfortunately we have now realised that COPD involves not just the lungs but also other organs. A lot of patients with COPD will also develop heart disease, diabetes, bone disease.
Can exercise help him? The answer is a big yes. International guidelines of COPD now highlight the importance of exercise. This is a specific tailored kind of exercise we call Pulmonary rehabilitation. This is not your simple walking or going to the gym. It’s a structured exercise that is designed by rehab specialists. They will examine him first, see how much muscle mass he has, the power of his lungs, exercise capacity and accordingly they will tailor a regimen for him. No matter how many drugs you give to the patients of COPD, unless they exercise their breathlessness will not go away.
Q. What is Oxygen Therapy and how can you do it at home?
Oxygen is a drug. You cannot start oxygen therapy at home. Oxygen therapy has to be prescribed by a doctor. If you have severe COPD your doctor will test if your oxygen saturation is low, and will prescribe you oxygen at a particular dose at specific hours or 24 hours depending upon how severely affected your lungs are. Do not start oxygen therapy on your own. Oxygen is available commercially and people buy it from chemists. But if you use oxygen without doctor’s prescription, it can make your COPD worse.
Q. What are the lifestyle changes I can make in my life to ease the symptoms of COPD?
If you already have COPD, your doctor will give you some medicines, drugs and inhalers. In India there is a myth that once you start using inhalers, you will get hooked to them. Patients don’t want to use the inhalers because they feel they’ll have to take them for life. It’s a myth. If your doctor prescribes the inhaler please use it. These are absolutely safe medicines. Apart from inhalation therapy the doctor will prescribe some exercises you have to do daily, you need to stop smoking, vaccinate yourself, eat a good well balanced diet.
Q. I have quit smoking after being a heavy smoker. Will I still get COPD?
It’s good you have quit smoking. Lung function you have lost because of being a chain smoker cannot be recovered, but it’s not necessary that you will get COPD. If you develop shortness of breath, if you find you can’t exercise enough, if you have any amount of cough, please get yourself tested. The doctor will do a spirometry test to check if you have COPD. COPD depends upon a number of factors – it will depend upon your genetic susptability, if you are living in a polluted environment, apart from smoking, have you been exposed to other pollutants for a long period of time. If you think you have COPD, your doctor will do a spirometry test and tell you know.
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FIT is running a month-long campaign to increase awareness around chronic lung diseases. If you have any questions on COPD, write in to us at FIT@thequint.com. We’ll get our experts to answer your queries for you. For more information on COPD, call 1800 208 2882.
(This article has been published in association with Philips Respironics as part of our #BreatheFIT campaign)