November is COPD awareness month, so I thought I would do a simple blog article on COPD and ways one can try to improve their lung function. Chronic Obstructive Lung Disease, COPD, is a form of lung illness that causes difficulty for a person to get air into and out of their lungs. The term COPD is used for persons with chronic bronchitis and/or emphysema. It is a misconception that all persons with COPD were smokers and in fact nearly 26% of people with COPD were never smokers. COPD is graded based on lung function testing and symptoms. There are four stages of COPD: mild, moderate, severe and very severe. Many people with only mild COPD may not have daily symptoms and only need therapy on an as needed basis whereas people with more moderate and severe COPD often have daily symptoms requiring medications on a regular basis to control symptoms of dyspnea, chronic cough and wheezing.
If a person is smoking, then obviously the first required step to improving lung function and symptoms from COPD is to quit smoking. It is frustrating for many that were either not smokers previously or quit many years ago and symptoms persist despite avoidance of smoke exposure. Daily I hear from patients that they would like education on ways they can try to improve their lung function either with exercises or diet. With that in mind I give you...
Five Ways to Improve Your Lung Function:
1- Breathing exercises
While standing, bend at the waist and push the air from your lungs, then slowly return to an upright position while slowly inhaling filling your lungs with as much air as is possible. Hold your breath for 20 seconds while raising your arms over your head. At the end of 20 seconds, relax and then slowly exhale as you lower your arms. Complete this cycle 5 times. If 20 seconds is too long for you reduce that time until you can improve over time.
Try Abdominal Breathing: Lay in a comfortable position on your back, and rest one hand on top of your abdomen. Rest the other hand on your chest. Breathe in deeply and slowly from your mid-section. The hand on your stomach will rise higher than the one on your chest. Exhale slowly from the mouth and inhale slowly from the nose, holding your breath for seven seconds if possible. Then, when you exhale, breathe out for eight to ten seconds. Make sure to squeeze your abdominal muscles near the end, so you exhale all the air. Breathe this way for five cycles.
Pursed lip breathing exercises includes taking deep breaths in through your mouth over five to seven seconds and then slowly exhaling through pursed lips over seven to ten seconds. By blowing out slowly over several seconds it creates back pressure which thereby helps prevent collapsing of the proximal airways. A person with emphysema is prone to airway collapse which makes it difficult to get the air back out of the lungs and they can become hyperinflated over time which gives the appearance of barrel chest as is described in persons with significant emphysema.
Improve exercise tolerance. With exercise comes an increase in heart and breathing rate. On average a person can improved lung capacity by five to fifteen percent with frequent exercise. I recommend my patients do some form of exercise on a regular basis; that being three to five times per week. Something that will get their heart and respiratory rate up for about 20 to 30 minutes. In my more severe COPD patients I may prescribe pulmonary rehab which is a supervised exercise program offered at the hospital that slowly works a person up to a level of exercise over time. This is done under supervision of nursing staff and physical therapists. In more severe COPD patients this may include using supplemental oxygen with exercise.
3- Clean Home
Ensure a clean home and environment. Keeping a clean home environment is important to maintaining and improving lung function. Indoor airborne pollutants, dust and chemical fumes can flair symptoms and keeping a clean home can go a long way to preventing exacerbations of disease. Place your mattress and pillow case in a dust mite proof zippered case and wash sheets and bedding at high temperatures. Consider eliminating as much dust collecting items such as window treatments, carpet and curtains. When outdoor air quality is poor, keep windows closed and stay indoors using air conditioning which also helps with humidity. High humidity and air temperatures are a trigger for COPD symptoms in most people with COPD. Consider getting an indoor air purifier and HEPA filters. If you have trouble cleaning because of symptoms consider hiring someone to clean your home with non-toxic, fragrance-free cleaners.
4- Secretion clearance
Improve secretion clearance. Many people with COPD have significant chronic bronchitis symptoms which include productive cough of thick and often discolored sputum. A person with COPD has excessive mucous producing cells in their airways and produce more sputum than is normal. Often the little hair like cilia that is supposed to help move those secretions out have been damaged from smoking making clearance of these secretions problematic. In these cases, a device called a flutter valve or Acapella valve may help. It is a device one breaths through and a valve rotates with exhalation causing a vibration that travels through the airways to help break the excess mucous that is attached to the airway walls. Once the secretions are free from the airway wall, deep breathing and coughing can help clear the excess mucous and reduce symptoms of chronic bronchitis. Some people with very severe symptoms can have a process known as bronchiectasis, widening of the airways, which makes clearance even more difficult. In those persons, that still have significant symptoms despite use of a flutter device, more aggressive therapy may be needed in the form of a percussive vest they wear two to four times per day for 20 to 30 minutes at a time.
5- Improve nutrition and sleep
It seems we all do not get enough sleep these days but fatigue in people with COPD can be worse. Their metabolism is working harder to get the simple machinery of the cell to work correctly and low oxygen and poor gas exchange can make this more difficult leading to increased fatigue. Trying to optimize sleep by going to bed at the same time and awakening at the same time each day getting at least 7-8 hours of sleep each night can help. Some people with more severe COPD may benefit from supplemental oxygen with sleep as their saturations drop with the diminished respirations that come with sleep.
Nutrition is an important factor when it comes to everything in healthcare and COPD is no different. A person with severe COPD often gets winded when eating especially if a larger meal as the stomach expands and compresses the diaphragm up into the chest. Often rather than three large meals per day six to seven small meals throughout the day may reduce dyspnea symptoms. Focus on a balanced diet and beware of a diet which is high in carbohydrates. Food is broken down into small particles that can be absorbed and used as fuel and in the process of that breakdown there is the byproduct of CO2. Carbohydrates produce the most CO2 followed by protein, with fats producing the least amount of carbon dioxide. A person with COPD and emphysema has difficulty with gas exchange and in some severe COPD patients it is difficult to clear carbon dioxide leading to what is termed CO2 retention. This can significantly impact the quality of life and make symptoms of shortness of breath after eating more severe.
So, there you have it as promised. 5 simple steps you can try today to improve your lung function. Happy COPD awareness month.