COPD: Cleansing the lungs

COPD (chronic obstructive pulmonary disease) causes difficulty in breathing, exacerbates cough and increases mucus production. The ability to clean the lungs, help to conserve energy and oxygen, and prevent lung infections.

Key points

To cleanse the lungs, you can take the following steps:

• 
  
  Cough management. A deep cough clears the lungs of mucus, removing it into the respiratory tract.
  
  


• 
  
  Postural drainage, by giving the patient a position in which fluid flows under the influence of gravity.
  
  


• 
  
  Thoracic percussion. Light shocks will weaken the mucus in the lungs.
  
  

The effect of mucus on the lungs and overall health?

Usually, the mucus in the body is liquid. It performs a protective function and moistens the lining of organs, such as the lungs, stomach, and intestines. It also helps to remove the bacteria. However, with COPD, mucus is produced more dense, which can lead to its accumulation in the lungs and airways. This makes breathing difficult and puts the patient at risk for infections.

Infections of the respiratory tract and cough cause wheezing and difficulty breathing. Infection can lead to greater production of mucus in the lungs, which becomes more dense. Slime can also change color.

[caption id="attachment_613" align="aligncenter" width="259"] COPD lungs[/caption]

Why is it necessary to control a cough, postural drainage and chest percussion to cleanse the lungs?

You can not restore the health of your lungs. But by controlling the cough, you can drain the mucus of their lungs. This will help:

• 
  
  Open the airways and facilitate breathing.
  
  


• 
  
  Prevent infections.
  
  


• 
  
  Treat the symptoms and improve well-being.
  
  

Cough management

Cough is the body's way of getting rid of mucus. The cough with which you clear the lungs must go deep from the lungs. This weakens the mucus by moving it into the airways. It is best to do this after using an inhaler or other medications. Follow the instructions:

• 
  
  Sit on the edge of the chair.
  
  


• 
  
  Slightly lean forward and relax.
  
  


• 
  
  Take a slow breath.
  
  


• 
  
  Cough 2-3 times.
  
  


• 
  
  Sniff again slowly. Do not make rapid or deep breaths with your mouth. This can block mucus from coming out of the lungs or cause an uncontrolled cough.
  
  


• 
  
  Relax and repeat all over again.
  
  

Postural drainage

Postural drainage occurs by giving the patient a position in which fluid flows under the action of gravity.

Take all positions for 5 minutes and approximately 30 minutes after using the inhaler. Make sure you have an empty stomach. If you started to cough, take a sitting position. Follow the instructions.

Lie down on the bed or the floor. Use pillows in different positions.

• 
  
  Cleansing the front of the lungs
  
  

Lie on your back. Make sure your breasts are below your hips. Place two pillows under the buttocks.

Follow the instructions: Put one hand on the stomach, the other on the chest, inhale. You should feel a shift of the hand on the abdomen, while the hand on the chest should remain motionless. This is called diaphragmatic breathing.

• 
  
  Cleansing of the side parts
  
  

Place a pillow under your hip, lying on your side, inhale. After 5-10 minutes, turn over to the other side.

• 
  
  Cleansing of the back of the lungs
  
  

Lie on your stomach.

Place two or three pillows under your hips. Breathe in your belly.

Thoracic percussion

Light shocks in the chest will weaken the mucus in the lungs.

Follow the instructions:

• 
  
  Fold your hand with a handful and hit it lightly on the chest.
  
  


• 
  
  Consult a physician about safe areas. Avoid jolting in the area of the spine and sternum.
  
  


• 
  
  You can ask someone to help you.
  
  

These three methods may not be effective for everyone, consult a doctor about alternative methods of lung cleansing.

It is very important to remain active and continue to exercise in COPD. Training will help:

• 
  
  Strengthen your muscles and develop endurance.
  
  


• 
  
  Reduce shortness of breath.
  
  

Always consult a doctor before starting any sports program.

COPD: Breathing is easier

Chronic obstructive pulmonary disease causes difficulty breathing. It is impossible to restore lung health, but one can prevent complications and improve well-being.

Key points

• 
  
  If you have COPD, you will notice that you are doing quick, shallow breathing.
  
  


• 
  
  It is important to avoid shortness of breath.
  
  


• 
  
  Teaching proper breathing will help get rid of shortness of breath and take deep breaths.
  
  


• 
  
  Practicing proper breathing is necessary regularly.
  
  

What is breathing training?

Quick, superficial breaths complicate the flow of air into the lungs.

You can try three basic ways to facilitate breathing:

• 
  
  Inhaling with closed lips helps to breathe more air.
  
  


• 
  
  The inhalation of the diaphragm helps the lungs open up to absorb more air. The diaphragm is a large muscle between the lungs and the stomach.
  
  


• 
  
  The inhalation in the forward slope facilitates an easier movement of the diaphragm.
  
  

[caption id="attachment_611" align="aligncenter" width="282"] COPD Breathing[/caption]

Why should you use these methods of breathing?

One of the main symptoms of COPD is shortness of breath, which is aggravated by physical exertion. Breathing takes a lot of energy, patients often lose weight and become weaker. Small superficial breaths make it difficult for air to enter the lungs. The study of new ways to control breathing in these cases will help improve well-being and get rid of the discomfort.

How to use these breathing techniques?

Use these methods when necessary and practice as often as possible.

Breathing with closed lips

Breathing with closed lips (meaning not tightly closed) helps to get more air into the lungs. This allows you to perform physical activities.

• 
  
  Breathe in with your nose and mouth, almost closing your lips.
  
  


• 
  
  Breathe for about 4 seconds, then make a slow exhalation for 6 to 8 seconds.
  
  

Diaphragm breathing

Breathing with a diaphragm expands the lungs and receives more air. The diaphragm is a large muscle between the lungs and the stomach.

• 
  
  Lie on your back.
  
  


• 
  
  Put one hand on your stomach, the other on your chest, inhale. You should feel the movement of the hand on your stomach, while the hand on your chest should remain motionless. Practice this method of breathing for 20 minutes, 2 - 3 times a day.
  
  

Breathing when tilted forward

Breathing in this way will reduce shortness of breath during exercise and rest. You can apply this method in a sitting or standing position.

The doctor's consultation

If you have any questions about breathing techniques, consult your doctor.

COPD: Regular exercise will improve well-being

Key points

Chronic obstructive pulmonary disease often makes breathing difficult, which in turn limits activity and physical activity. But staying in active physical form is very important, with COPD. Sports loads will help:

• 
  
  Strengthen your muscles and develop endurance.
  
  


• 
  
  Reduce shortness of breath.
  
  

Exercises in COPD can be part of a rehabilitation program for the lungs.

Always consult your doctor before starting any sports program. Heart problems, such as coronary artery disease and high blood pressure, are common among people with COPD, so they can limit exercise options. Perhaps you will need medical supervision.

The effect of COPD on your activity

COPD causes shortness of breath and worries you because of the inability to fully exercise? But, on the other hand, lack of activity means that the muscles, heart and lungs continue to weaken. This harmful cycle can lead to depression, isolation, loss of independence and a weakened immune system that can not fight infections.

Why is it necessary to exercise with COPD?

Although physical activity does not improve lung function, it improves the body's ability to use the existing lung function. Sport strengthens muscles, improves shortness of breath and helps to become more active. These activities include daily activities such as shopping or cooking. You will cease to worry because of your shortness of breath, feel tired and become more independent. All this contributes to improving the quality of life.

How to exercise with COPD?

Basically, the exercises consist of aerobic exercises that strengthen the oxygen flow to the muscles and strength training on the upper and lower muscle groups. Always consult a doctor before starting any sports training program. Heart problems, such as coronary artery disease and high blood pressure, are common among people with COPD, so they can limit exercise options. Perhaps you will need medical supervision.

Start the program with preparation:

• 
  
  Consult with your doctor. It will help determine the target direction, frequency and duration of the loads.
  
  


• 
  
  Start practicing slowly and gradually.
  
  


• 
  
  Choose exercises that bring you pleasure.
  
  


• 
  
  Always start from warm-up and cool down after intensive exercises.
  
  


• 
  
  Pay attention to your breathing. Try to breathe slowly. Breathe in with your nose and breathe out with your mouth.
  
  


• 
  
  Examples of exercises for people with COPD.
  
  

Aerobics classes

Aerobic exercises increase the amount of oxygen that will get to the muscles. Aerobic exercise strengthens the heart muscle, including walking, running, cycling and bicycling, swimming and water aerobics. The same effect at home has a shopping trip, cleaning (especially to music), an active game with children, walking with a dog. There is an easy way to determine if the heart rate is normal during aerobic exercise:

• 
  
  If you can not talk and train at the same time, you are doing too much exercise.
  
  


• 
  
  If you can talk during training, you are doing a good job.
  
  


• 
  
  If you can sing during a workout, you are performing insufficiently intensive workloads.
  
  

Consult your doctor before starting any sports training program. It will help determine the target direction, frequency and duration of the loads.

Strength exercises for the lower muscle group

Extension of the leg in the knee joint, lifting the legs, and lifting on the socks develop the lower muscle groups. Consult your doctor before starting these exercises.

• 
  
  Extension of the leg in the knee joint. In the sitting position, on the exhalation alternately unbend your legs.
  
  


• 
  
  Rise of legs. In the sitting position on the exhalation, alternately raise your legs to the level of the shoulders.
  
  


• 
  
  Rise on the toes. Step on the step so that the back of the foot hangs, holding onto the railing, go up on your toes. Hold in this position for a few seconds, then slowly sink to the foot.
  
  

Strength exercises on the upper muscle group

Strength exercises of the upper body are designed to strengthen the muscles of the arms and shoulders, which support the chest and improve breathing. Consult your doctor before starting these exercises.

• 
  
  Divorce the arms in the sides. Spread your arms out to the sides, exhale and raise your hands to shoulder level. Hold your hands in this position for a few seconds and slowly lower.
  
  


• 
  
  Circular ulnar movements. Touch your hands to your shoulders and slowly turn your hands. Repeat this exercise the other way.
  
  


• 
  
  Breathing with elbows. Raise your elbows to shoulder level and touch the fingertips with your fingertips. Take a breath, so that your fingers are separated from your chest, then slowly return to the starting position with a slow exhalation.
  
  

Contact your doctor if:

• 
  
  You have COPD and you want to start playing sports. It will help you choose the right program.
  
  


• 
  
  Despite regular sessions, you have problems with shortness of breath.
  
  


• 
  
  Want to practice more. A doctor can offer more exercises for self-fulfillment.
  
  

COPD: Causes

COPD is most often caused by smoking. Most patients with COPD are smokers with experience:

• 
  
  Approximately 10 to 15 smokers out of 100 have COPD.
  
  


• 
  
  Some studies show that half of smokers with experience older than 45 years suffer from COPD.
  
  


• 
  
  COPD is basically a combination of two diseases: chronic bronchitis and emphysema. Both diseases are caused by smoking.
  
  

Chronical bronchitis

Almost all patients with chronic bronchitis smoke. Over time, tobacco smoke and other irritants can lead to inflammation of airways (bronchioles). As a result, airways produce more mucus than normal. Inflammation and excessive cough cause excessive production of mucus and narrow the airways.

[caption id="attachment_607" align="aligncenter" width="310"] Causes of COPD[/caption]

Emphysema

With emphysema, tobacco smoke and other irritants can damage elastic fibers in the lungs. These elastic tissues are necessary for normal lung function. When elastic fibers are damaged, tiny air sacs (alveoli) are damaged at the end of the bronchioles. The alveoli are the place where the blood exchanges carbon dioxide (a byproduct of metabolism) for oxygen. With lesions, the walls of the alveoli become large and transmit less oxygen to the blood. Destroyed alveoli can not be replaced.

Other reasons

Other possible causes of COPD include:

• 
  
  Prolonged exposure to irritants (industrial dust, chemical vapors) on the lungs.
  
  


• 
  
  Low birth weight and repeated infections of the lungs.
  
  


• 
  
  Inherited factors (genes), including antitrypsin alpha 1 deficiency, are a rare disease in which the body can not produce a protein (antitrypsin alpha 1) that protects the lungs from damage. In smokers with this disease, the symptoms of emphysema appear by 30-40 years.
  
  

COPD: Symptoms

With COPD:

• 
  
  There is a constant cough.
  
  


• 
  
  Often coughing up mucus.
  
  


• 
  
  Appears shortness of breath.
  
  

Exacerbation of COPD

Many patients with COPD are prone to attacks and exacerbations of the disease, which are quite dangerous and can lead to hospitalization.

Symptoms include:

• 
  
  Expectoration of more mucus.
  
  


• 
  
  Change in color or density of mucus.
  
  


• 
  
  Appearance of shortness of breath.
  
  

[caption id="attachment_604" align="aligncenter" width="368"] COPD Symptoms[/caption]

These seizures are most often caused by infections - such as bronchitis and pneumonia, as well as contaminated air. The doctor will help to draw up a plan of action for sudden exacerbations of the disease. Such training will help control symptoms and avoid panic attacks.

Stages of COPD

The stages of COPD are often determined according to the symptoms. The leading analysis is the volume of forced expiration in 1 second, which is measured with a spirometer.

Easy COPD (stage 1)

• 
  
  Frequent, but not permanent cough, which raises mucus from the lungs
  
  


• 
  
  Function of light FEV1 (volume of forced expiration in 1 second) - 80%
  
  

Moderate COPD (2nd stage)

• 
  
  Chronic cough with a lot of mucus
  
  


• 
  
  Dyspnea, especially with exercise
  
  


• 
  
  Function of easy FEV1 50% - 79%
  
  

Severe COPD (stage 3)

• 
  
  Chronic cough with a lot of mucus
  
  


• 
  
  Dyspnea
  
  


• 
  
  Weight loss
  
  


• 
  
  Exacerbations of COPD
  
  


• 
  
  FEV1 lung function 30% - 49%
  
  

Very severe COPD (stage 4)

• 
  
  Chronic cough with a lot of mucus
  
  


• 
  
  Dyspnea
  
  


• 
  
  Weight loss
  
  


• 
  
  Blue skin, especially the skin of the lips, fingers and toes
  
  


• 
  
  The accumulation of fluid in the legs (edema)
  
  


• 
  
  Sensation of stomach overflow
  
  


• 
  
  Disorientation due to an overabundance of carbon dioxide and lack of oxygen in the blood
  
  


• 
  
  Life-threatening exacerbations of COPD
  
  


• 
  
  FEV1 lung function 30% - 49%
  
  

Diseases with similar symptoms

Diseases that cause such symptoms include:

• 
  
  Heart failure.
  
  


• 
  
  Disease of the coronary artery.
  
  


• 
  
  Asthma.
  
  


• 
  
  Cystic fibrosis.
  
  


• 
  
  Pulmonary fibrosis.
  
  


• 
  
  Expansion of the bronchi.
  
  

COPD: When to Call a Doctor

Call the emergency room if you experience:

• 
  
  Blocking of breathing.
  
  


• 
  
  Difficulty breathing.
  
  


• 
  
  Severe chest pain.
  
  

Call a doctor immediately if you have previously been diagnosed with COPD and you:

• 
  
  Expecting blood.
  
  


• 
  
  Have developed shortness of breath or wheezing, which is rapidly aggravated.
  
  


• 
  
  You experience chest pain.
  
  


• 
  
  Cough more often than usual and notice a change in the color of the expectorated mucus.
  
  


• 
  
  Have noticed swelling of the legs or abdomen.
  
  


• 
  
  Developed a high temperature.
  
  


• 
  
  Developed the symptoms of influenza.
  
  

If your symptoms (cough, mucus, and / or dyspnea) suddenly deteriorate, it can be an exacerbation of COPD.

[caption id="attachment_603" align="aligncenter" width="256"] COPD Doctor[/caption]

Call a doctor if:

• 
  
  Your medicine does not help you.
  
  


• 
  
  Symptoms gradually worsen.
  
  

You have a cold and:

• 
  
  Your fever lasts longer than 2 - 3 days.
  
  


• 
  
  Dyspnea became much worse.
  
  


• 
  
  Cough aggravated or lasts longer than 7 to 10 days.
  
  


• 
  
  You have not been diagnosed with COPD, but you have symptoms. Smoking increases the likelihood of COPD.
  
  


• 
  
  You're coughing up blood.
  
  

Consult your doctor

If you are diagnosed with COPD, ask your doctor for advice on:

• 
  
  Cessation of smoking.
  
  


• 
  
  Annual vaccination against influenza.
  
  


• 
  
  Vaccination against pneumonia.
  
  


• 
  
  Physical training and rehabilitation programs for the lungs.
  
  


• 
  
  Any renewal or substitution of medication or therapy.
  
  

Who to contact

To medical professionals who can diagnose and treat COPD, include:

• 
  
  Family doctors.
  
  


• 
  
  Therapists.
  
  


• 
  
  Nurses of the highest qualification.
  
  


• 
  
  Assistant physician.
  
  

You can also be referred to a pulmonologist if:

• 
  
  Your diagnosis of COPD is uncertain.
  
  


• 
  
  You have unusual symptoms.
  
  


• 
  
  You are under 50 and do not smoke.
  
  


• 
  
  You often go to the hospital because of sudden exacerbations of breathlessness.
  
  


• 
  
  You need long-term oxygen therapy or corticosteroid treatment.
  
  


• 
  
  You are thinking about surgery, for the purpose of a lung transplant or a reduction in lung volume.
  
  

COPD: Analyzes and Examinations

For the diagnosis of COPD, the doctor will perform the following:

• 
  
  Will study anamnesis and will conduct a physical examination.
  
  


• 
  
  Check lung function, using spirometry.
  
  


• 
  
  Will make a chest x-ray. This will help to rule out other diseases with similar symptoms.
  
  

Surveys that are prescribed if necessary

• 
  
  Arterial blood test for gases and acidity.
  
  


• 
  
  Oxymetry measures the oxygen saturation of the blood.
  
  


• 
  
  An electrocardiogram or an echocardiogram
  
  


• 
  
  Carbon dioxide transfer factor.
  
  

[caption id="attachment_601" align="aligncenter" width="246"] COPD Examinations[/caption]

Surveys that are prescribed in rare cases

• 
  
  Analysis of measurement of antitrypsin alpha level 1.
  
  


• 
  
  CT scan.
  
  

Regular checks

Since COPD is a disease that is aggravated, the doctor will prescribe regular examinations and tests:

• 
  
  Spirometry.
  
  


• 
  
  A blood test for gases and acidity.
  
  


• 
  
  X-ray and cardiogram.
  
  

It is important to inform the attending physician about any changes in symptoms and exacerbations, he can change the treatment plan and prescribe alternative drugs.

Early diagnosis

The earlier COPD is diagnosed, the sooner the patient can take steps to slow the progression of the disease and maintain a quality of life. The tests will help the doctor diagnose COPD before any symptoms appear.

Consult your doctor about testing if you:

• 
  
  You smoke.
  
  


• 
  
  Burn asthma for a long period of time.
  
  


• 
  
  Have a genetic predisposition to emphysema.
  
  


• 
  
  Work in a zone of high concentration of chemicals and dust.
  
  

COPD: An Overview of Treatment

Although COPD can not be cured, it can be controlled. 

Treatment objectives:

• 
  
  Slow down the disease, avoiding tobacco smoke and polluted air.
  
  


• 
  
  Limit symptoms such as shortness of breath.
  
  


• 
  
  Increase the level of activity.
  
  


• 
  
  Improve your health.
  
  


• 
  
  Prevent and treat sudden exacerbations of the disease.
  
  

Most people with COPD continue to live in their usual rhythm of life.

Initial treatment

COPD treatment in the initial stages facilitates breathing and slows down the disease. You need:

[caption id="attachment_599" align="aligncenter" width="275"] COPD Treatment[/caption]

• 
  
  Quit smoking. It's very important and it's never too late. No matter how long you live with COPD, quitting smoking will slow the illness and improve the quality of life. Today, there are many ways to quit smoking.
  
  


• 
  
  Active life position. If you remain active, you will be able to control shortness of breath and are less likely to feel depressed or isolated.
  
  


• 
  
  Take care of your health. Influenza, pneumonia, and other diseases that damage the lungs can exacerbate COPD. Do your best to avoid them:
  
  
  
  
  • 
    
    Wash your hands often.
    
    
  
  
  • 
    
    Avoid contact with sick people.
    
    
  
  
  • 
    
    Consult with your doctor about the annual vaccination of influenza and pneumonia.
    
    
  
  
  
  


• 
  
  Adhere to a balanced diet. Muscle weakness and weight loss are common in severe COPD, making it difficult for the body to fight the disease.
  
  


• 
  
  Avoid trigger factors. Avoid factors that can cause a sudden exacerbation of the disease, including polluted air, cold dry air and hot, humid air.
  
  


• 
  
  Learn how to breathe. Learn the methods of breathing to increase the flow of air into the lungs. Learn ways to cleanse the lungs to conserve energy and oxygen.
  
  


• 
  
  Rest more often. Give yourself time to rest in the breaks between household chores and other activities.
  
  

Oxygen treatment

Oxygen treatment is used mainly to prevent right-sided heart failure.

Medications

• 
  
  Bronchodilator funds. These drugs open the bronchial intubation tubes, which facilitates breathing and reduces symptoms.
  
  


• 
  
  Anti-inflammatory drugs, such as corticosteroids, can be in the form of pills or be used with an inhaler. If you use an inhaler, be sure to read the instructions to it.
  
  


• 
  
  Expectorants. These drugs will facilitate the expectoration of mucus.
  
  


• 
  
  Treatment of muscle weakness and weight loss. Many patients with COPD have a problem with weight that can be treated, paying attention to regular and balanced meals.
  
  


• 
  
  Rehabilitation program for the lungs. The doctor can offer this program for training breathing and proper selection of physical exertion.
  
  

Surgery as a form of COPD treatment is not very common, but there are several types of COPD:

• 
  
  Reducing the volume of the lung involves removing part of one or both of the lungs.
  
  


• 
  
  Transplantation of the lung.
  
  


• 
  
  Bullectomy removes bullae from the lungs.
  
  

Heart failure, which damages the right side of the heart and is called the pulmonary heart, is common in people with COPD. Treatment can consist of oxygen and a diuretic.

About what it is worth remembering

COPD treatment is applicable on an ongoing basis, but it is worth remembering that COPD is a disease that can be fatal. You and your doctor should discuss all treatment options, as well as an action plan in case of exacerbations.

COPD: Prevention

Do not smoke: the best way to protect yourself from COPD is to quit smoking. By refusing to smoke, you slow down the damage to your lungs. Today, there are many ways to quit smoking. Quitting smoking is especially important if you have a low level of antitrypsin alpha 1 protein.

Avoid contaminated air: other respiratory irritants (such as contaminated air, chemical vapor, and dust) can also exacerbate COPD symptoms.

[caption id="attachment_597" align="aligncenter" width="345"] COPD Prevention[/caption]

• 
  

  Prevention of other diseases

  
  

Influenza vaccination: if you have COPD, you need an annual flu vaccination. Patients with COPD are more prone to complications, such as pneumonia, so vaccination will reduce this risk. In addition, vaccination will reduce the risk of sudden exacerbations of COPD.

Vaccination of pneumonia: People with COPD often get pneumonia, so pneumococcal vaccine will reduce this risk.

COPD: Continuous treatment

Over time, COPD is aggravated. Dyspnea worsens along with other symptoms of COPD.

If the diagnosis is made in the early stages, you may be able to avoid serious lung damage.

It is very important to stop smoking

• 
  
  If you continue to smoke, the symptoms of COPD will worsen more quickly, and you will be more at risk of other serious illnesses.
  
  


• 
  
  Damage to the lung can not be cured and restored, but you can take control of the symptoms of the disease if you quit smoking.
  
  

Complications

[caption id="attachment_595" align="aligncenter" width="299"] COPD treatment[/caption]

The health problems caused by COPD include:

• 
  
  Sudden exacerbation of COPD, manifested in the form of sudden attacks of cough, wheezing, and / or the amount or color of mucus that you refract.
  
  


• 
  
  Increased lung infections, such as pneumonia.
  
  


• 
  
  Increased risk of osteoporosis, especially if you are taking corticosteroids.
  
  


• 
  
  Depression or anxiety. COPD can limit the ability to work and can reduce your independence, sexual activity, social activity, and self-esteem. This often causes depression, and difficulty breathing can cause a feeling of excitement.
  
  


• 
  
  Problems with weight. If chronic bronchitis is the basis of COPD, you will probably lose weight. With emphysema, you can gain weight and muscle mass.
  
  


• 
  
  Heart failure that damages the right side of the heart.
  
  


• 
  
  Pneumothorax. COPD can damage the structure of the lung, which will lead to the ingress of air into the chest cavity.
  
  


• 
  
  Problems with sleep due to lack of oxygen in the lungs.
  
  

COPD treatment is improved, which improves the quality of life of patients, but COPD can also be exacerbated and lead to fatal consequences.

It is important to talk with your doctor about these problems:

• 
  
  How do you see "your death"? Do you want to fight for life to the end? Do you want a peaceful, peaceful death?
  
  


• 
  
  If you experience sudden, life-threatening breathing problems, do you want artificial ventilation?
  
  


• 
  
  What other alternative treatments are you ready for?
  
  


• 
  
  Do you want to sign a document on transferring to another person the rights to make important medical decisions in case of loss of legal capacity?
  
  

COPD: Living with a disease

The main points in the treatment of COPD:

• 
  
  To give up smoking.
  
  


• 
  
  Work on shortness of breath.
  
  


• 
  
  A balanced diet and an active lifestyle.
  
  


• 
  
  Awareness.
  
  


• 
  
  Support for loved ones.
  
  

[caption id="attachment_593" align="aligncenter" width="259"] COPD[/caption]

It is very important to stop smoking

If you continue to smoke, the symptoms of COPD will worsen more quickly, and you will be more at risk of other serious illnesses. Damage to the lung cannot be cured and restored, but you can take control of the symptoms of the disease if you quit smoking.

 

COPD: Medications

Drugs used to treat COPD:

• 
  
  Reduce shortness of breath.
  
  


• 
  
  Help control coughing and wheezing.
  
  


• 
  
  Prevent sudden exacerbations of COPD.
  
  

Most people confirm that the drugs facilitate breathing. Some medicines should be used with inhalers or nebulizers.

Choice of drugs

Bronchodilator funds. These drugs open the bronchial intubation tubes, which facilitates breathing and reduces symptoms.

Broncholytic fast-acting agents relieve symptoms. These include:

• 
  
  Anticholinergics.
  
  


• 
  
  The agonists Beta 2 (albuterol, levalbuterol).
  
  


• 
  
  A combination of these two.
  
  

Bronchodilators with long-term action help prevent respiratory problems. They are intended for patients with chronic symptoms. These include:

• 
  
  Anticholinergics.
  
  


• 
  
  The beta 2. agonists ( salmeterol, formoterol , and arformoterol ).
  
  


• 
  
  Corticosteroids (prednisone) can be used as pills to treat sudden exacerbations of COPD or as an inhaler. They are also used for asthma.
  
  

Other drugs include:

• 
  
  Expectorants
  
  


• 
  
  Methylxanthines , which are used in severe COPD cases. They can have serious side effects.
  
  

About what it is worth remembering

Using a bronchodilator for the first time, you may not notice its effect. This does not always mean that the drug does not help. Try the same drug take a little later.

Dosing inhalers and nebulizers work equally well.

Most patients who use the inhaler do not know how to use it properly. Consult your doctor regarding instructions for use.

COPD: Alternative treatment and surgery

Surgery as a form of COPD treatment is not very common, but there are several types of COPD:

• 
  
  Reducing the volume of the lung involves removing part of one or both of the lungs.
  
  


• 
  
  Transplantation of the lung.
  
  


• 
  
  Bullectomy removes bullae from the lungs.
  
  

Alternative treatment

Alternative treatment involves:

• 
  
  A rehabilitation program that combines physical activity, respiratory therapy, emotional support, dietary advice and information. Such programs are required for patients after surgical reduction of lung volume or lung transplantation.
  
  


• 
  
  Oxygen treatment consists of supplying oxygen through a mask or tube, which helps to relieve dyspnea.
  
  


• 
  
  Artificial ventilation facilitates breathing, used in a hospital for sudden exacerbations of COPD.
  
  


• 
  
  Injections of antitrypsin Alpha1 (such as Aralast, Prolastin, or Zemaira). These drugs help patients with antitrypsin deficiency alpha 1.
  
  

COPD: symptoms, treatment

Chronic obstructive pulmonary disease (COPD) is a group of chronic respiratory diseases of adults, adolescents and children: emphysema, chronic obstructive bronchitis, bronchiolitis obliterans, severe bronchial asthma, bronchiectasis and cystic fibrosis. The main feature that combines the above-mentioned diseases in the COPD group is a progressive irreversible bronchial obstruction with increasing phenomena of chronic respiratory failure.

• Treatment


• Bronchodilators


• Corticosteroids


• Pronounced impaired sputum emptying


• Infusion therapy


• Prevention of venous thrombosis and embolism


• Non-invasive and invasive ventilation


• Pulmonary heart

 

For instrumental objectification of the severity of the process, measure the volume of forced expiration in 1 s (FEV1) - NICE Grading of Severity of Airflow Obstruction: severity of obstruction	Force of forced expiration,%
Moderate	50-80
Average	30-49
Heavy	<30

COPD develops mainly in people aged 40 and over, progressing at a slow pace. Severe and extremely severe course of the disease mainly falls on the age of 55 to 65 years. Usually, patients with such a diagnosis are under the supervision of doctors for many years, which gives a higher chance of delivering a correct and accurate diagnosis. When a person's condition becomes extremely serious, he falls into a coma, often there is a hospitalization in the ICU. But it is worth knowing that doctors can not radically help these patients.

Doctors should also remember: not all patients can be helped. And not all patients with severe COPD decompensation should be admitted to the intensive care unit. If the patient is still brought to the ICU, physicians should try to avoid invasive mechanical ventilation if the person has COPD decompensation. In most cases, the patient is brought to the department in the stage of decompensation, with severe respiratory failure and manifestations of the pulmonary heart.

Drowsiness of a person can talk about concomitant hypercapnia. Blood saturation is below 90-92%. In this phase of the disease, therapy with bronchodilators and corticosteroids often does not give the desired, expected effect. The treating doctor has to transfer the patient to controlled breathing. The condition of a person in such cases, as a rule, becomes better. But further to the doctors stands a much more complicated, often insoluble, task - how to disconnect the patient from the apparatus of artificial ventilation?

Monitoring

All patients should be given a radiograph of the lungs. Conduct blood pressure control, heart rate, ECG, blood gases, peak expiratory flow rate, blood electrolytes, hematocrit, glucose, creatinine, blood saturation.

Treatment

Treatment should be carried out in this order. First, oxygen therapy is started with nasal catheters at a rate of 1-2 liters per minute. A high rate of oxygenation, especially in patients with severe hypercapnia (drowsiness is a clinical manifestation of hypercapnia), can cause the development of apnea. Further, the oxygen delivery rate of the physicians is adjusted to provide an acceptable level of oxygenation (saturation of 88-92%). The patient takes a forced sitting or semi-sitting position. You can not put the patient lying in bed.

Provide venous access using peripheral venous catheters. If a person is in a coma, there are signs of severe respiratory failure, you must immediately intubate the trachea and begin ventilating.

Bronchodilators

Most people with COPD in a stage of decompensation respond moderately to bronchodilator therapy. If a person took beta-2-agonists or anticholinergics before entering the ICU, the best solution of the doctor will be to continue inhalation of that beta-2 agonist or anticholinergic that previously had a positive effect, this information should be found in the patient or relatives.

It is advisable to use a nebulizer powered by a compressor, not oxygen. Given the low sensitivity of patients to bronchodilators, in all severe cases, beta-2 agonists and anticholinergics are combined.

Preparations for nebulizer therapy in COPD :

• Salbutamol 2.5 mg (Berotek 1 mg = 20 drops) at intervals of 30 minutes to 4-6 hours;


• Ipratropium bromide (also marketed under the name Atrovent) 0.5 mg (40 drops) at intervals of 2 hours to 4-6 hours;


• Berodual 2.0 ml (40 drops), spacing 2-6 hours. Berodual is a combined bronchospasmolytic drug that contains 2 bronchodilators: fenoterol (beta-2 agonist) and ipratropium

In the absence of a nebulizer, short-acting metered-dose aerosol beta-2 agonists, terbutaline sulphate (analogue: Bricanyl®), salbutamol (analogue: Ventolin), Berodual (combination drug), fenoterol hydrobromide (Berotek), and / or anticholinergic drugs - ipratropium (atrovent), oxytropium bromide (analog: Oxyvent). Efficacy will be greater if the metered-dose inhaler is equipped with a spacer.

At the beginning of therapy, a person immediately inhales from 3 to 6 doses. If there is no effect, inhalation should be repeated after 20 minutes. In the future, inhalations are carried out in accordance with the instructions to the drug. When using these drugs, contraindications should be considered: severe hypertension, rhythm disturbances, etc. And monitor the concentration of potassium in the plasma, if the patient receives beta-2-agonists - possibly a rapid development of hypokalemia.

Introduction of euphyllinum

It is used in case of inefficiency of beta-2-agonists and anticholinergics or inability to use them. Do not administer eufillin if the patient was administered it regularly before admission. The loading dose of the drug is 2-4 mg per 1 kg of the patient's body for 20 minutes IV (10 ml 2.4% euphyllin).

Supportive therapy: 0.5 mg / kg per hour. With congestive heart failure, severe liver disease, pneumonia, this dosage should be used: 0.25 mg / kg / h. When using aminophylline, the indicated dosages are reduced by twenty percent. The introduction of euphyllin is recommended to continue until a marked improvement in the condition of a person - an average of 24 hours, sometimes even a longer period.

Corticosteroids

Inhaled corticosteroids are attributed only to patients with a proven clinical or spirometric response or with FEV1 less than 50% of that due or with repeated exacerbations. Long-term use of systemic corticosteroids can not. The effect of these drugs develops mainly in 2-4 hours from the beginning of admission (an average of 2-6 hours), the effectiveness is low.

In case of severe exacerbation, if a person is unable to take medications alone, prednisolone ( dexamethasone , hydrocortisone in appropriate dosages) at a dose of 0.5-1 mg / kg after 6 hours intravenously for 2 hours. Then, the daily dose of medics is reduced to 40-60 mg per day. In more mild cases, it is necessary to prescribe prednisone tableted for 5-10 mg 4 times a day. The duration of taking systemic corticosteroids is 10-14 days.

N-acetylcysteine

N-acetylcysteine, which is prescribed at a dose of 1200 mg per day during exacerbation, contributes to a faster improvement in the human condition.

Pronounced impaired sputum emptying

In the presence of viscous, difficult-to-cough phlegm, it is necessary to carry out measures that contribute to its dilution and enhance drainage. Initially, procedures can worsen a patient's condition by increasing the amount of sputum and increasing bronchospasm.

Physicians should explain to the patient the necessity of these procedures and to warn that at first his condition can become worse. Depending on the available drugs and the clinical situation, doctors prescribe:

• N-acetylcysteine (Fluimucil) nebulizer - nebula 3 ml 10% solution, 1-2 times a day;


• Inhalation of a solution of furosemide ( Lasix ) 0.5-1 mg per 1 kg of the patient's body. In a day to spend 2-3 sessions. This disease reduces the viscosity of phlegm, almost always well tolerated by patients;


• With a large amount of purulent viscous sputum in humans, it can be attributed to inhalation of 3-7.5% sodium chloride. This method is not well tolerated by everyone. Inhalation should be carried out using 5-10 ml of r-ra, after 3-4 hours. Before each inhalation of sodium chloride, inhalation is made with beta-2 agonists;


• Inhalation is recommended to alternate with sessions for 10-15 minutes VCIVL (intensifies sputum drainage);


• With a strong, painful cough, you can prescribe a patient inhaled lidocaine 1% - 5.0.

Infusion therapy

If you can take liquid and food, you usually enter the volume taken by the patient. If there are disturbances of consciousness, such a patient is given probe nutrition. In rare cases, patients need intravenous infusion therapy. The efficiency criteria are as follows: restoration of diuresis more than 60ml / hour, reduction of dry skin, thirst reduction, hematocrit within 0.35-0.40.

Hypervolaemia and large volumes of fluid are contraindicated. With CVP more than 12 cm of water. Art. Infusion therapy should be discontinued. Increased blood pressure decreases with the improvement of the patient's condition, usually, there is no need for medication. If the SBP is less than 90 mm Hg. st., it is necessary to apply the introduction of vasopressors (dopamine, epinephrine).

Prevention of venous thrombosis and embolism

Thromboembolism of the pulmonary artery (PE) is a common cause of decompensation in COPD. At autopsy PE patients are fixed in every 4 patients from those who were admitted to the hospital with a diagnosis of "exacerbation of COPD". For this reason, prophylaxis of deep vein thrombosis and PE is performed by physicians to virtually all patients with exacerbation of COPD, if no contraindications are found.

Low molecular weight heparins used in usual preventive doses cause fewer side effects and are more convenient to use. Therapy lasts on average from 7 to 14 days (until the patient's condition is improved and activated).

Antibiotics

Very often decompensation of COPD is associated with infectious processes - sinusitis, pneumonia, bronchitis and so on. Therefore, almost all patients need antibiotics. In chronic obstructive pulmonary disease, the most common pathogens provoking inflammation are: pneumococcus, hemophilic rod, various viral-bacterial associations. Accordingly, respiratory fluoroquinolones ( hemifloxacin , moxifloxacin), protected aminopenicillins (piperacillin / tazobactam, amoxicillin / clavulanate), modern macrolides are the drugs of choice.

If the patient was in the hospital for a long time before entering the intensive care unit, there is a high probability of joining the hospital gram-negative flora, mainly of Pseudomonas aeruginosa. This medicine should be considered when prescribing antibiotics (cefoperazone, ceftazidime).

Non-invasive and invasive ventilation

Noninvasive ventilation (NIVL) is considered to be the most important innovation in the conservative therapy of patients with COPD decompensation in recent years. The method allows to reduce nosocomial mortality and hospitalization of patients, reduces the need for invasive artificial ventilation (IVL). NIVL facilitates the transfer of a person to independent breathing after an invasive mechanical ventilation. But modern breathing apparatus and appropriate monitoring are needed.

Indications for non-invasive ventilation

NIVL is assigned if at least one of the following conditions exists:

• Respiratory acidosis (pH equal to or less than 7.35 and / or PaCO2 is equal to or greater than 6.0 kPa, or 45 mm Hg);


• Severe shortness of breath with clinical signs of fatigue of the respiratory muscles and / or increased load on the respiratory muscles (paradoxical movement of the abdomen, participation of auxiliary respiratory muscles or entraining intercostal spaces).

For these purposes, pressure-sensitive modes are available, of which there are only three: Pressure support; BiPAP; Proportional Assist. The use of a complete helmet mask is the most comfortable option for the patient.

Experienced doctors know that it is necessary to perform a certain selection of patients. A person should be in a clear consciousness, have stable indicators of hemodynamics, have a desire to cooperate with a doctor. If there is no improvement in the patient's condition (saturation, gases and blood pH, xymptoms) within 1-2 hours after the onset of NIVL, one should consider the need for mechanical ventilation.

Indications for invasive pulmonary ventilation

The presence of any of the following signs may serve as a basis for carrying out artificial ventilation:

• Inability to evacuate the bronchial secretion, increasing fatigue and exhaustion of a person;


• Stopping breathing or heart activity;


• Intolerance or ineffectiveness of NIVL;


• Appearance of coma harbingers;


• Bradycardia or arterial hypotension;


• Increasing hypercapnia more than 60 mm mercury column against the background of hypoxemia (PaO2 55-65 mm Hg, Sp02 less than 90%);


• Breathing pauses with loss of consciousness or sensation of suffocation.

Technology of ventilation

At the initial stage, mechanical ventilation is used similar approaches for those with exacerbation of bronchial asthma. Ventilation with pressure control (PCV) can be a method of choice in patients with severe hypoxemia and hypercapnia. It is recommended to try to keep the patient's respiratory activity, for which there are auxiliary ventilation modes (BIPAP, SIMV + PSV, etc.). And doctors need to try as soon as possible to transfer a person to independent breathing. The shorter the duration of invasive ventilation, the lower the mortality in these patients.

Pulmonary heart

Diagnosis of the pulmonary heart is established by such signs:

• enlargement of the shadow of the heart on the chest X-ray,


• swelling of the jugular veins,


• hypertrophy of the right ventricle,


• ECG signs,


• presence of peripheral edema.

Echocardiography can confirm the dysfunction of the right ventricle, since swelling is not always associated with right ventricular failure and pulmonary hypertension. To reduce fluid retention, intravenous furosemide is administered intravenously at a dose of 1 mg / kg.

Drugs that are better not to be prescribed for exacerbation of COPD

The appointment of cardiac glycosides and ACE inhibitors in the pulmonary heart is not recommended. The regulation of respiration in severe exacerbation of COPD is disturbed, and many drugs can aggravate these disorders. It is necessary to try without extreme necessity not to prescribe sedatives (especially from the group of benzodiazepines), antidepressants, narcotic analgesics, as during artificial ventilation of the lungs, and even more so without ventilator.

COPD: Avoid Trigger Factors

Key Points to COPD: Avoid Trigger Factors

You can reduce the risk of sudden exacerbations of the disease, avoiding trigger factors.

Key points

• 
  
  Study and avoid the main trigger factors for COPD.
  
  


• 
  
  Avoiding sudden exacerbations of the disease, you will feel better and can reduce the impact of COPD on your life.
  
  


• 
  
  Pay attention to the warning signs, regarding the sudden exacerbation of the disease. You may need to see a doctor.
  
  

The main trigger factors in COPD

The trigger factor is a circumstance that aggravates the symptoms and aggravates the disease. These include:

• 
  
  Such diseases as cold, flu, or pneumonia.
  
  


• 
  
  Contaminated air, smoke or smog.
  
  


• 
  
  Tobacco smoke.
  
  


• 
  
  Cool dry air, hot, humid air or high altitude.
  
  


• 
  
  Cleaning agents and other chemical components.
  
  


• 
  
  Pollen, dust and dust mite.
  
  


• 
  
  Wool, leather, or saliva of pets.
  
  


• 
  
  Gases and pairs of home heaters.
  
  


• 
  
  Refusal to take medication.
  
  

Not all patients have identical triggers. What can cause a sudden exacerbation of the disease in one person may not be a problem for another at all.

Why is it important to avoid trigger factors?

Sudden exacerbations of COPD can limit your activity. Sometimes, it can even lead to hospitalization. Avoiding sudden exacerbations, you can stay active and reduce the impact of COPD on your life.

That is why, it is important to pay attention to the symptoms. The exacerbation of the disease is due to:

• 
  
  The appearance of stridor and shortness of breath.
  
  


• 
  
  An intensified cough or discolouration of the coughing mucus.
  
  


• 
  
  The appearance of a fever, problems with sleep and a sense of fatigue.
  
  

How to avoid trigger factors?

To protect yourself from the impact of trigger factors:

• 
  
  Quit smoking. This is the main point from which treatment begins.
  
  


• 
  
  Use an air conditioner or an air filter in your home.
  
  


• 
  
  Prepare food near an open door or window, or turn on the fan.
  
  


• 
  
  If the streets are dusty or polluted air, stay at home and close the windows.
  
  

Protect your health

• 
  
  Go through the annual vaccination.
  
  


• 
  
  Consult with your doctor about the need for pneumococcal vaccination.
  
  


• 
  
  Wash your hands to avoid infections.
  
  


• 
  
  Adhere to a balanced diet, a healthy lifestyle and enough rest.
  
  


• 
  
  Do not forget to take medicines while traveling.
  
  

After you have read this information, you will be able to determine, and therefore avoid the triggers of COPD.

Consult your doctor

If you have any questions, contact your doctor.

COPD: avoid losing weight

Key points on COPD: avoid losing weight

Some people with the severe chronic obstructive pulmonary disease - especially those who have emphysema - can have a reduced body weight and inadequately eat.

Patients with COPD often lose weight, and when losing weight a person loses muscle mass, including the muscles involved in the process of breathing. This makes breathing difficult.

Approximately every 4 patients with COPD weigh less than normal.

To avoid weight loss, eat more foods that contain fat and protein. Because large amounts of fat can be hazardous to health, consult your doctor or dietitian.

Although the causes of weight loss in COPD are not fully understood, experts believe that this is due to a combination of factors, which include:

• 
  
  The need for more energy.
  
  


• 
  
  Consuming more energy with physical activity.
  
  


• 
  
  Dyspnea.
  
  


• 
  
  The use of corticosteroids, which accelerate the breakdown of muscle tissue in the body.
  
  


• 
  
  Side effects of some drugs include a decrease in appetite.
  
  


• 
  
  COPD can reduce the level of oxygen in the blood.
  
  

[caption id="attachment_578" align="aligncenter" width="356"] COPD: avoid losing weight[/caption]

Why weight loss is dangerous in COPD?

Weight loss is dangerous in COPD, due to loss of muscle tissue, which leads to a feeling of weakness and difficulty breathing. Weakness in turn leads to a greater risk of developing infections, such as pneumonia. Approximately every 4 patients with COPD weigh less than the norm and are at risk of death.

How to avoid weight loss in COPD?

If you start to lose weight, then you should eat more protein and get more calories. This means that you need to eat more foods that contain fat and protein. Since such food is a health hazard, consult a therapist or a nutritionist before starting a new diet.

High-calorie, nutritious snacks

Foods that contain many calories include:

• 
  
  Ice cream.
  
  


• 
  
  Pudding.
  
  


• 
  
  Cheese.
  
  


• 
  
  Bars of muesli.
  
  


• 
  
  Custard.
  
  


• 
  
  Corn chips with cheese.
  
  


• 
  
  Eggs.
  
  


• 
  
  Crackers with peanut butter.
  
  


• 
  
  Buns with peanut butter or cream cheese.
  
  


• 
  
  Pop corn with parmesan cheese.
  
  


• 
  
  High-calorie food additives.
  
  

Add calories to snacks

To add calories to snacks, try:

• 
  
  Add egg or egg yolk to meat, pasta, cheese and similar products.
  
  


• 
  
  Add the powdered milk to the soup, scrambled eggs, pudding, potatoes and yogurt.
  
  


• 
  
  Add cheese to sandwiches, crackers, casseroles, soups, toast and pasta.
  
  


• 
  
  Add an extra tablespoon of vegetable or olive oil, mayonnaise, butter, margarine or sour cream to sandwiches, bread, casseroles, soups, pasta, potatoes, rice and vegetables.
  
  


• 
  
  Add crushed nuts in pudding, sauce, mashed potatoes, casserole, salad and yogurt.
  
  

Add protein to your diet

Dairy and meat products contain a large number of proteins. Try to use more of these foods or:

• 
  
  Add the milk powder to the scrambled eggs, soup and meat.
  
  


• 
  
  Add cheese or butter to appetizers.
  
  


• 
  
  Choose desserts made with eggs - biscuit, custard and rice pudding.
  
  


• 
  
  Use food supplements that are high in protein.
  
  

If you have COPD and you are worried about weight loss, consult a therapist or a nutritionist. It will help you to create a balanced, high-calorie and high-protein diet. If you consume more calories, but continue to lose weight, consult a doctor.

This article explains about COPD - Chronic Obstructive Pulmonary Disease, causes of COPD, how COPD diagnosed, how to treat COPD and much more.

COPD (Chronic Obstructive Pulmonary Disease): Overview

COPD is a lung disease that causes difficulty breathing. This is caused by lung damage for many years, usually by smoking.

COPD is often a combination of two diseases:

• 
  
  Chronic bronchitis - inflammation of the respiratory tract and increased production of mucus. This can narrow or block the airways, making breathing difficult.
  
  


• 
  
  Emphysema - a disease of the respiratory tract, characterized by a pathological expansion of the air spaces of the terminal bronchioles, which is accompanied by destructive changes in the alveolar walls of COPD, is aggravated over time. Health can not be restored easily, but damage can be prevented.
  
  

Causes of COPD

COPD is almost always caused by smoking. Prolonged inhalation of tobacco smoke irritates the respiratory tract and destroys the elastic fibers in the lungs. Risk factors also include the inhalation of chemicals, dust and contaminated air for a long period of time.

Usually, lung damage does not occur at an early age, COPD symptoms begin to appear in people older than 60 years.

More susceptible COPD patients who suffered serious infections of the lungs in childhood. People who fall ill with emphysema at 30-40 years may have abnormalities called antitrypsin deficiency alpha 1. But this happens very rarely.

Symptoms of COPD

The main symptoms are:

• 
  
  Prolonged (chronic) cough.
  
  


• 
  
  Mucus when coughing.
  
  


• 
  
  Shortness of breath, which is aggravated by physical exertion.
  
  

Because COPD is aggravated, difficulty breathing can occur even when performing simple actions - eating or dressing. Patients often lose weight and become weaker. From time to time, the symptoms can become aggravated and aggravated.

How is COPD diagnosed?

For diagnosis of COPD, a physician:

• 
  
  Perform a survey and listen to the lungs.
  
  


• 
  
  Ask questions about past illnesses and smoking.
  
  


• 
  
  Spends spirometry.
  
  


• 
  
  Assign chest X-ray and other tests to exclude other problems that could cause symptoms.
  
  

How to treat COPD

The only way to slow the development of COPD is to quit smoking. This is the main point on which the course of the disease depends. Regardless of how long you smoke, giving up this habit will stop lung damage.

If it's difficult for you to stop smoking, consult a doctor. He will give the best advice and, if necessary, prescribe certain drugs.

The doctor will prescribe a treatment that will ease the symptoms and improve your health.

• 
  
  Medications can help ease breathing. If you are prescribed an inhaler, use it according to the instructions.
  
  


• 
  
  The program of rehabilitation of the lungs will help you in the future to avoid exacerbations.
  
  


• 
  
  Periodically you will use oxygen.
  
  

Patients with COPD are more susceptible to lung infections, so doctors strongly recommend that they undergo an annual vaccination against influenza and pneumonia.

At home, patients should:

• 
  
  Avoid exposure to irritants such as smoke, dust, or dry air.
  
  


• 
  
  Use air conditioner or air filter.
  
  


• 
  
  To have a rest during the day.
  
  


• 
  
  Perform regular physical activity.
  
  


• 
  
  It is good and balanced to eat. If you lose weight, consult a therapist or a nutritionist.
  
  

What you need to remember

• 
  
  Sudden exacerbations of the disease: As COPD aggravates, sudden exacerbations of the disease can occur. In such cases it is necessary to consult a doctor or, in severe cases, an emergency room.
  
  


• 
  
  Depression and anxiety: if you have a note of depression, see a doctor. Recommended medicine and support groups will help you cope with emotional disorders.
  
  

COPD - Health Tools

Health tools will help you make the right decision and the necessary measures to improve your health.

• 
  
  Powder inhaler
  
  


• 
  
  Dosing inhaler
  
  


• 
  
  Avoid losing weight
  
  


• 
  
  Avoid Trigger Factors
  
  


• 
  
  Cleansing the lungs
  
  


• 
  
  Compliance with a healthy diet
  
  


• 
  
  Training for easy breathing
  
  


• 
  
  Physical exercise to improve well-being
  
  


• 
  
  Oxygen therapy
  
  

How to identify asthma triggers

Asthma: How to identify asthma triggers

Asthma is a long-term (chronic) disease of the respiratory system. It causes inflammatory processes in the tubes, through which air enters the lungs (bronchial tubes). Inflammatory processes make bronchial tubes more sensitive to certain pathogens. Such a reaction can lead to impairment of respiratory activity, sudden deterioration of breathing and other symptoms of an asthma attack.

If you avoid contact with pathogens, you can:

• 
  
  Prevent an asthma attack.
  
  


• 
  
  Reduce the frequency and severity of certain seizures.
  
  

Contact with some agents of asthma you can not avoid or even do not want. And, nevertheless, you can identify the majority of pathogens that provoke an exacerbation of symptoms:

• 
  
  Watching the lungs work (measuring the maximum volumetric expiratory flow rate). The lungs will not work very well when you are among the pathogens of asthma.
  
  


• 
  
  Having passed allergy tests. If you are allergic, the substances that cause allergies can trigger asthma symptoms.
  
  

What are the causative agents of asthma?

The causative agent of asthma is a factor that worsens the performance of the lungs and leads to a sudden deterioration in breathing and other symptoms of an asthma attack. When you are surrounded by pathogens, the risk of a sudden asthma attack increases. A serious asthma attack can lead to an emergency call.

Some pathogens are substances to which you are allergic (allergens). Such pathogens include:

• 
  
  Home dust mites.
  
  


• 
  
  Cockroaches.
  
  


• 
  
  Wool of domestic animals.
  
  


• 
  
  Home mold.
  
  


• 
  
  Pollen.
  
  

Some pathogens are not allergens and do not cause an allergic reaction, they cause an exacerbation of symptoms. These include:

• 
  
  Cigarette smoke and contaminated air.
  
  


• 
  
  Infections of the upper respiratory tract, for example, colds, influenza and sinusitis.
  
  


• 
  
  Physical exercises. In most people, asthma symptoms worsen during exercise.
  
  


• 
  
  Dry, cold air.
  
  


• 
  
  Medications, for example, beta-blockers, aspirin and other non-steroidal anti-inflammatory drugs.
  
  


• 
  
  In adults, hormones, including pregnancy and periods of menstruation. Symptoms may occur before or during these periods.
  
  


• 
  
  Gastrointestinal reflux disease (GERD). Experts still can not come to a consensus on whether GERD worsens asthma symptoms or not. Studies have shown conflicting results as to whether GERD causes asthma or not.
  
  

Test your knowledge

The causative agent is what can lead to an attack of asthma.

• Yes - Correct answer


• No - Wrong answer

The causative agent is a substance that can trigger an attack of asthma. Pathogens are substances that are in the air, for which you are allergic, or other factors, for example, respiratory viruses, physical exercises, cold and dry air.

Why identify asthma triggers?

Knowing the pathogens of asthma, you can determine what causes the worsening of the symptoms. Avoiding contact with asthma triggers, you can:

• 
  
  Avoid an attack of asthma.
  
  


• 
  
  Reduce the duration and severity of asthma attacks.
  
  

Test your knowledge

Avoiding contact with asthma triggers helps prevent asthma attack or reduce its duration and severity.

• Yes - Correct answer


• No - Wrong answer

Avoiding contact with asthma triggers can help prevent asthma attack or reduce its duration and severity.

How to identify the causative agents of asthma?

1. 
   
   Identify possible pathogens of asthma. The causative agent is what can trigger an attack of asthma. Being close to a potential pathogen, carefully monitor your condition. This will help identify what can cause an asthma attack. Write down possible pathogens on a sheet of paper or in a special diary.
   
   


2. 
   
   Follow the work of the lungs. The causative agent does not always cause an exacerbation of symptoms. Nevertheless, they provoke narrowing of the bronchial tubes, making breathing more difficult. To identify pathogens that do not always cause the manifestation of obvious symptoms, you need to use a pneumotachometer to measure the maximum volumetric expiratory flow rate during the day. Indicators MOSV decreases when the bronchial tubes are narrowed, and accordingly, it occurs when the pathogen is nearby. Use a pneumatic tachometer when you are near a traditional pathogen, which is indicated in the relevant section. Record the results of the pneumotach in the diary.
   
   


3. 
   
   Take the allergy test. Skin tests or blood tests help in determining the allergy to certain substances. Skin tests are the application to the skin of the back or hands of one or more allergens in small doses. The degree of swelling and redness of the place where the contact with the allergen passed, shows the body's reaction to the allergen. If MOSV values decrease, when you are near a certain allergen, you need to pass a reaction test for it.
   
   


4. 
   
   Show records of pathogens to your doctor. After you have identified the pathogens of asthma, you and your doctor can make a program, how to deal with them.
   
   

Test your knowledge

Lung monitoring and allergy tests are two ways to help identify asthma triggers.

• Yes - Correct answer


• No - Wrong answer

Lung monitoring and allergy tests are two methods that help determine what triggers an exacerbation of asthma.

Where now?

Now that you have read this information, you can proceed to identify pathogens. Do not forget to report the results to your doctor.

If you have any questions about this information, ask your doctor at the next appointment.

Asthma during pregnancy

Asthma occurs in people very often, including pregnant women. Some women suffer from asthma during pregnancy, although before that there was never the slightest sign of the disease. But during pregnancy, asthma not only affects the body of a woman, but also limits the access of oxygen to a child. But this does not mean that asthma complicates or increases the danger to a woman and to a child during pregnancy. In women with asthma, with the proper control of the disease, pregnancy passes with minimal risk or at all risk for the woman herself and her fetus.

Most drugs that are used to treat asthma are safe for pregnant women. After years of research, experts can now say that it is much safer to continue to treat asthma than to stop treatment during pregnancy. Consult with your doctor about which treatment will be most safe for you.

Risks of refusing treatment during pregnancy

If previously you did not have the slightest signs of asthma, then you do not need to be so sure that dyspnea or wheezing during pregnancy is a sign of asthma. Very few women, who know for sure that they have asthma, draw attention to minor symptoms. But we must not forget that asthma affects not only your body, but the fetus, so you need to take preventive measures in time.

If the disease is out of control, then it threatens with the following:

• 
  
  High blood pressure during pregnancy.
  
  


• 
  
  Pre-eclampsia, a disease that increases blood pressure and can affect the placenta, kidneys, liver and brain.
  
  


• 
  
  Greater than usual toxicosis in the early stages of pregnancy (hyperemesis of pregnant women).
  
  


• 
  
  Births that occur unnaturally (the attending physician causes the onset of labor) or go through with complications.
  
  

Risks to the fetus:

• 
  
  Sudden death before or after birth (perinatal mortality).
  
  


• 
  
  Poor development of the fetus (retardation of intrauterine development). Small child weight at birth.
  
  


• 
  
  The onset of labor until 37 weeks of pregnancy (premature birth).
  
  


• 
  
  Low birth weight.
  
  

The higher the control over the disease, the less the risks.

Asthma and pregnancy

Management of asthma in pregnant women occurs in the same way as in non-pregnant women. Like any other asthmatic, a pregnant woman should follow prescribed treatment and adhere to a treatment program to control inflammation and prevent asthma attacks. Part of the treatment program for a pregnant woman should be reserved for monitoring the movements of the fetus. This can be done independently, recording each movement of the fetus. If you notice that during an attack of asthma the fetus became less moving, immediately contact your doctor or call an ambulance.

Overview of asthma treatment in a pregnant woman:

• 
  
  If more than one specialist participates in the treatment of a pregnant woman suffering from asthma, they
  [caption id="attachment_538" align="alignright" width="286"] Asthma during pregnancy[/caption]
  must work together and coordinate their actions. In the treatment of asthma, an obstetrician should also participate.
  
  


• 
  
  It is necessary to carefully monitor the lung function during the entire pregnancy - the child should receive a sufficient amount of oxygen. Since the severity of asthma may change in the second half of a woman's pregnancy, regular examination of symptoms and pulmonary function is necessary. For the examination of pulmonary function, the attending physician uses spirometry or a pneumotachometer.
  
  


• 
  
  After 28 weeks, it is necessary to observe the movements of the fetus.
  
  


• 
  
  In the case of poorly controlled or severe asthma after 32 weeks, an ultrasound examination of the fetus is necessary. Ultrasound examination also helps the doctor to examine the condition of the fetus after an asthma attack.
  
  


• 
  
  Try to do everything possible to avoid and control asthma triggers (for example, tobacco smoke or dust mites) and you can take smaller doses of the medicine. Most women have nasal symptoms, and there is a close connection between nasal symptoms and asthma attacks. Gastroesophageal reflux disease (GERD), especially common during pregnancy, can also exacerbate symptoms.
  
  


• 
  
  It is very important to protect yourself from the flu. It is necessary to get vaccinated against the flu before the season starts - sometimes from the beginning of October to the middle of November in the first, second or third trimester of pregnancy. The vaccine against influenza only lasts one season. It is absolutely safe during pregnancy and is recommended for all pregnant women.
  
  

Most pregnant women except for asthma have allergies, for example, allergic rhinitis. Therefore, the treatment of allergies is a very important part of the management and management of asthma.

• 
  
  Inhaled corticosteroids in the recommended doses are effective and safe for pregnant women.
  
  


• 
  
  Also recommended antihistamine, loratadine or cetirizine.
  
  


• 
  
  If immunotherapy is started before pregnancy, it can be continued, but it is not recommended to start during pregnancy.
  
  


• 
  
  Talk with your doctor about taking a decongestant (oral administration). Perhaps there are other, better options for treatment.
  
  

Preparations for asthma and pregnancy

The results of studies in animals and on people taking asthma medications during pregnancy found not many side effects to which a woman and her child are exposed. It is much safer to take asthma medications during pregnancy than to leave it as it is. Poor control of the disease brings more harm to the fetus than the drugs. Budesonide, approved by the Food and Drug Administration, is the safest inhaled corticosteroid for taking during pregnancy. One study showed that small doses of an inhaled corticosteroid are safe for the woman herself and for her fetus.

That's what is recommended for admission during pregnancy.

Recommendations for taking medication during pregnancy
Degree of severity	Medications for daily intake, necessary to maintain long-term control of the disease
Heavy permanent shape	Preferably: A large dose of an inhaled corticosteroid, preferably budesonide, AND An inhaled beta-2 long-acting agonist (eg, salmeterol or formoterol) OR Combination of drugs that contain a large dose of a corticosteroid and a long-acting beta-2 agonist (eg, Advair Diskus) AND IF NECESSARY Tablets or corticosteroid long-acting syrup (2 mg / kg / day, usually not more than 60 mg / day). (Try to reduce the number of pills taken and maintain control of the disease with large doses of an inhaled corticosteroid.) If you take oral corticosteroids for a long time, a specialist consultation is necessary. Alternative: A large dose of inhaled corticosteroids AND Theophylline with prolonged action, serum concentration from 5 to 12 mg / ml
Medium constant form	Preferably: OR a small dose of inhaled corticosteroids, preferably budesonide, and an inhaled beta-2 long-acting agonist OR The average dose of an inhaled corticosteroid IF NECESSARY for women with recurrent asthma attacks, the average dose of an inhaled corticosteroid and an inhaled beta-2 long-acting agonist Alternative: A small dose of an inhaled corticosteroid, preferably budesonide, or a modifier of leukotriene or theophylline (methylxanthine) The average dose of an inhaled corticosteroid and / or a leukotriene modifier, or theophylline, if necessary
Minor permanent form	Preferably: A small dose of inhaled corticosteroids, preferably budesonide Alternative: Mast cell stabilizer or leukotriene modifier OR Theophylline with prolonged action, serum concentration from 5 to 12 mg / ml
Periodic	The daily taking of medication is not necessary A fast-acting bronchodilator to relieve the symptoms that appear and pass: 2-4 strokes of an inhaled beta-2 fast acting agonist depending on the symptoms. For this, it is better to choose albuterol. If you take albuterol more than two days a week, the attending physician should prescribe treatment, as for a permanent form with minimal symptoms. More serious seizures may occur with greater interruptions without a single symptom or impairment of pulmonary function. For serious attacks it is recommended to take a course of taking tablets, syrup or injections of a corticosteroid.
Fast rescue:for all patients	A fast-acting bronchodilator: 2 to 4 strokes for an inhalation beta-2 fast acting agonist, depending on the symptoms. It is preferable to take albuterol. The intensity of treatment depends on the severity of the attack. It may be necessary to take a one-time treatment with aerosol or up to three approaches with interruptions of 20 minutes. In addition, it may be necessary to undergo a course of treatment with tablets, syrup or corticosteroid injections. Receiving a beta-2 fast-acting agonist more than two per week (except for stress asthma cases) suggests that treatment should be reviewed.

Never stop taking or lowering the dose of medication without the doctor's permission. Make any changes to the treatment you need only after the pregnancy.

The drugs that can cause potential harm to the fetus include epinephrine, alpha-adrenergic components (other than pseudoepinephrine), decongestants (other than pseudoepinephrine), antibiotics (tetracycline, sulfanilamide preparations, ciprofloxasin), immunotherapy (stimulation or dose increase), and iodides. Before you start taking the medicine, being pregnant or intending to become pregnant, you need to consult a specialist.