What is COPD?
COPD stands for “Chronic Obstructive Pulmonary Disease”.
The word ‘Chronic’ means it won’t go away.
The word ‘Obstructive’ means partly blocked.
The word ‘Pulmonary’ means in the lungs.
The word ‘Disease’ means sickness.
Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by chronic obstruction of lung airflow that interferes with normal breathing and is not fully reversible.
The chronic airflow limitation characteristics of COPD is caused by a mixture small airway disease (obstructive bronchiolitis) and parenchymal destruction (emphysema)
Risk factors of the development of COPD
- Smoking is the cause in the vast majority of cases. Smoking >10 pack years (20 cigarettes/day for 1 year = 1 pack year) is the cause in 80-90% cases of people aged 40 years or more.
- Exposure to Bio-mass fuel burning: In Bangladesh biomass particularly wood stove smoke exposure is an important risk factor for COPD particularly for rural and sub urban house wives.
- A smoker is 10 times more likely than a non-smoker to die from COPD.
- Other risk factors include:
- Passive smoking
- Exposure to air pollution at work and in the environment
- A history of childhood respiratory infections
What are the symptoms of chronic obstructive pulmonary disease?
- Cough is usually the first symptom to develop. It is productive with sputum (phlegm). It tends to come and go at first, and then gradually becomes more persistent (chronic). You may think of your cough as a 'smokers cough' in the early stages of the disease. It is when the breathlessness begins that people often become concerned.
- Breathlessness (shortness of breath) and wheeze may occur only when you exert yourself at first. For example, when you climb stairs. These symptoms tend to become gradually worse over the years if you continue to smoke. Difficulty with breathing may eventually become quite distressing.
- Sputum - the damaged airways make a lot more mucus than normal. This forms sputum (phlegm). You tend to cough up a lot of sputum each day.
- Chest infections are more common if you have COPD. A sudden worsening of symptoms (such as when you have an infection) is called an exacerbation.
- Other symptoms of COPD can be vaguer. Examples are weight loss, tiredness and ankle swelling.
What to do:
- Stop smoking. It is the most important thing you can do to help your lungs.
- See your doctor. Take medicine the way the doctor says to take it.
- Go to the hospital or doctor right away if your breathing gets a lot worse.
- Keep the air clean at home. Stay away from smoke and fumes that make it hard to breathe.
- Keep your body strong. Learn breathing exercises. Walk and exercise regularly. Eat healthy food get a healthy weight.
- If your COPD is severe, get the most out of each breath. Make life as easy as possible at home.
Know your drug:
Management of COPD exacerbations involves increasing the dose and/or frequency of existing short acting bronchodilator therapy, preferably with a ß 2-agonist. If not already used, an ant cholinergic can be added until the symptoms improve.
Systemic glucocorticosteroids are beneficial in the management of exacerbations of COPD. they shorten recovery time, improve lung function (FEV1) and hypoxemia (PaO2), and may reduce the risk of early relapse, treatment failure, and length of hospital stay.
Antibiotic treatment in exacerbations of COPD
- Shoulder shrugging: Circle shoulder girdle forward, down, backwards and up. keep timing constant, allowing two full seconds per circle and relax throughout. Continue for 30 seconds. Repeat the exercise three times with short rest intervals between sets.
- Full arm circling: One arm at a time, pass arm as near as possible to the side forehead, circle arm in as large a circle as possible (10 seconds per circle). Repeat for forty seconds. Repeat the exercise three times with short rest intervals between. Repeat with other arm.
- Increasing arm circles: Hold the arm away from body at shoulder height. Progressively increase size of circle for a count of six circles in ten seconds then decrease for a further count of six. Repeat for forty seconds. Repeat with other arm.
- Abdominal exercise: Sitting in chair, tighten abdominal muscles, hold for a count of four and then release muscles over four second to starting position. Repeat continuously for thirty seconds. Perform the procedure three times with short rest periods in between.
- Wall press ups: Stand with feet a full arm length distance from the wall, place hands on wall and bend at elbow until nose touches the wall, push arms straight again allowing eight seconds from start to completion. Repeat for 40 seconds continuously to a total of five repetitions. Repeat procedure three times with a short rest in between.
- Sitting to standing: Using a dining chair, sit, stand, sit allowing ten seconds from start to completion. Repeat continuously for forty seconds to a total of five repetitions. Perform exercise three times with short rests between.
- Quadriceps exercise: Sitting on chair straighten right knee, tense thigh muscles, hold for count of four, then relax gradually over a further four seconds to a total of five repetitions over forty seconds. Repeat the exercise three times with short rest periods in between. Repeat with left leg.
- Calf exercises: Holding onto back of chair, go up on toes, return to floor taking 8 to 10 seconds to complete procedure. Repeat continuously for forty seconds.
- Walking on the spot: Holding onto the back of chair, allow one knee to bend, keeping toes on the ground. Bend other knee, whilst straightening first knee and allow four seconds for complete procedure. Repeat this bending/straightening of knees i.e. walking on the spot keeping toes on the ground continuously for 40 seconds to a total of ten repetitions. Repeat the exercise three times with short rest periods in between.
- Step ups: Step up with the right foot onto step then brings up left foot. Step down with right foot then left foot. Allow four seconds for the complete procedure and repeat continuously for 40 seconds. Repeat the exercise three times with short rest periods between.