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Managing Lung Disease

By  Cheryl Ellis, RPFT, CRT, Staff Writer

 

The lungs oversee the body’s oxygen needs by taking in air deep into their corridors (called bronchi), allowing for oxygen and carbon dioxide to filter in and out of the blood. The dance of oxygen exchange becomes more complicated with inhaled pollutants of different kinds, such as tobacco smoke, pollution and congestion from infections.

Our lungs also help the body’s metabolic process, releasing more carbon dioxide in situations where the kidneys need help keeping the body’s acid and alkaline quantities balanced. They can release more or less carbon dioxide if needed in a given situation.

Each body system works with the other to keep the body in a state of health. Illness can be acute (short term) or chronic (recurrent). Each disease has its own definition of acute or chronic. Lung disease can be caused by restrictive conditions such as spinal curvature, or obstructive conditions like emphysema. Lung disease is often a mixture of more than one condition, and both restrictive and obstructive conditions can occur at the same time.

UNDERSTANDING COPD

The National Institute of Health estimates that 12 million people have been diagnosed with Chronic Obstructive Pulmonary Disease (COPD).The term COPD is a general designation for a group of lung diseases that includes asthma, chronic bronchitis, emphysema and bronchiectasis.

COPD causes shortness of breath, and problems with mucus clearing and oxygen exchange from the lungs to the blood vessels. Each of the diseases that fall under the COPD classification creates different changes in the lung tissue, but essentially similar symptoms and challenges. Air flow is not only obstructed from going deep into the lungs. The ability to exhale properly hampers the next breath coming in.

The airways can collapse because the smaller airways “flop” closed when exhaling. The closed airway may need medication to open them up, or an altered breathing pattern that lets the air flow out more smoothly. Ideally, a combination of the two provides consistent help. The trapping of air prevents easy exchange of oxygen and carbon dioxide, and the “dance” that occurs when a new breath carries in fresh air causes “old” air to block the entry of “new” air. It’s similar to people needing to exit an elevator before others can get in.

DIAGNOSIS IS A BEGINNING

Individuals diagnosed in early stages of COPD may have an easier time adapting to lifestyle changes to assist with management of the disease. Eliminating smoking is a first course of action; and the earlier one starts, the simpler it may be.

Therapies like pulmonary rehabilitation are designed to adapt to the current state of health, and provide great benefits at any stage of diagnosis. Pulmonary rehabilitation by competent professionals includes breathing exercises, education on energy conservation and supervised exercise to improve stamina.

In all cases, COPD increases the amount of work it takes to breathe. Conserving energy, especially in later stages, improves breathing and the body’s ability to transfer oxygen. By supplying the body’s oxygen needs adequately, everything from digestion to sleep is positively affected.

ADJUSTING TO CHANGES

Family members and loved ones can have a difficult time with COPD diagnosis, treatment and day-to-day activities. Meals and medication schedules may have to be changed to assist the loved one with maintaining their health. Where meds and meals could be delayed or possibly skipped until a “convenient” time, a stricter schedule may have to be adhered to, delaying family activities.

Friends may not understand a progressive intolerance to certain odors from cleaning solutions, pets or colognes. The COPD patient may have adapted to exposure to some environments, but once diagnosed and advised on making changes, it may be less tolerable.

Mrs. Valorie Bender has been diagnosed with COPD, specifically emphysema, for fifteen years. She and her husband Michael had a number of adaptations to make during the first few years after her diagnosis.“Michael is a lot taller than me. If he sprayed air freshener or any kind of spray, I knew to stay out of the room until he was done.” Any spray releasing aerosol will have droplets that can be breathed in. Mrs. Bender learned to stay away from the area until the droplets had settled to avoid the mist penetrating her lungs.

She goes on to explain that adapting to COPD comes over time, and requires some creative thinking. With over a foot difference in height between the Benders, they are able to spot smokers to steer both of them away from second-hand smoke.“You have to be careful of people’s feelings” she indicates. Smokers, with or without a cigarette, carry the odor on their breath or clothing. The second- hand smoke can irritate lungs and trigger the need to use an inhaler. Preceding that would be a “coughing fit.”

Smokers may be used to strangers “commenting” on smoking by faking an intense cough. Mrs. Bender has chosen the middle path of dealing with this by avoiding the situation as much as possible. Family members may forget from time to time, or a new individual may be brought into their circle, requiring fancy footwork in being direct but kind. As her husband and caregiver, Michael Bender’s biggest adjustment was identifying what actions might be needed.“Michael had to learn not to panic when I went into a coughing attack.”

CAREGIVERS LEARN TO SAY “WHEN”

Loved ones with COPD may dig their heels in when it comes to adapting. Caregivers may feel obliged to push the situation. To eliminate stress on both parties, a middle ground is a better path.

When Valorie Bender’s “coughing fits” started, Michael learned to stay as calm as possible and just observe Valorie’s actions. If her handheld inhaler was needed, he could help by getting it for her, or help her to a chair to sit down until the coughing spasm passed. As they began to accept their roles in coping with COPD, caregiver and care receiver panic diminished. Michael learned the general “flow” of her coughing spasm, and that not all episodes are an emergency. Valorie, as the COPD patient, has adapted to letting herself get through the cough experience at her own rate, rather than push herself to “hurry up and get better so as not to panic Michael.”

The Benders have developed a lifestyle that may have limitations they didn’t have before Mrs. Bender’s diagnosis. Their changed lifestyle takes their mutual mental, emotional and physical well-being into the spotlight. Developing coping skills and creative management of activities has improved their relationship and mutual health.

 

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