Cystic fibrosis (CF) is a common genetic disease that is inherited from your biological parents and occurs because of abnormalities in our genes. The CF gene is the instructions on how to build a channel (or pore) in our cells that allows salt to move into and out of the cell. This salt channel is called CFTR, thecysticfibrosistransmembraneregulator. A mutation in this gene means that this salt channel does not work properly.
The lungs are the most commonly affected organ in patients with cystic fibrosis. As a result, patients with CF can have a chronic cough, phlegm production, shortness of breath, chest tightness, sinus problems and occasionally cough up blood.
A standard treatment regimen includes:
airway clearance and exercise,
supplemental oxygen, and
Nearly half of CF sufferers report poor sleep quality. Your oxygen levels may lower during an exacerbation and this is most noticeable during sleep. In some people these changes in breathing and oxygen during sleep can affect their performance during the day. They may have difficulties with concentration, memory and feeling tired during the day. People who have low oxygen levels while awake will usually also have low oxygen levels during sleep. In some cases, patients who may not require oxygen while awake may need extra oxygen while sleeping.
Individuals with CF can have low levels of oxygen in their bodies and some need to use supplemental oxygen to bring their oxygen levels up to a healthier level. Supplemental oxygen protects the body from the effects of low oxygen levels. It also helps your body to function better and allows you to stay more active. Some individuals only need oxygen when they are active or while sleeping, however, in most cases, oxygen should be used 24 hours a day.
Will yoga exercises help COPD patients manage breathlessness better?
Many people who suffer from a lung disease find it very hard to exercise. Often even the thought of physical activity makes them feel breathless. But there is a way to overcome these fears that only lead to a downward spiral of both physical and mental decline, practising yoga. This low impact form of exercise will not only help raising your energy levels, it also clears your mind from worry. Being good for everybody, it is also more and more recommended especially for people with lung diseases, like emphysema, chronic bronchitis, and other lung diseases commonly known as COPD.
Why can yoga exercises be especially beneficial for COPD patients?
In yoga practice there are two essential parts that complement each other in a synergistic way. One part is the Asanas, physical posture that improve range of motion, balance, flexibility and strength of the body. The other part is the Pranayamas, breathing techniques that teach you how to control your breathing and keep your lungs more fully. It also strengthens your respiratory muscles. The two combined will help you improve your general fitness and make breathing easier and more efficient. Additional meditation helps relieve stress and anxiety, which allows you to extend the benefits of the pranayamas and asanas.
Pranayamas, breathing techniques, that can be beneficial for COPD patients are:
This is an exercise especially suitable to learn control your breathlessness. While leaning slightly forward you slowly breath out with your lips pursed, imagine you are blowing a kiss or cooling your soup. This slows down the exhalation and stimulates the abdominal muscles to contract and forces the diaphragm upwards, so the lungs will empty themselves better. Instead of long inhalations and short exhalations, which is a common reaction to breathlessness, you learn to do it the other way around, with an ideal rhythm being to make the exhalation twice as long as the inhalation. Not only will this calm you down and relieve the breathlessness, it also help to strengthen the breathing muscles.
Abdominal or Belly Breathing
COPD patient can benefit especially from the abdominal breathing technique, as it stimulates the diaphragm moving upward and downward, so more oxygen can be taken into the lower lobes of the lungs and spread through the body. At the same time the abdominal organs are massaged by the moving diaphragm, thus improving their intake of oxygen and functioning. By doing the belly breath your body relaxes and becomes re-energized at the same time.
Ujjayi Breathing or Ocean Breath
This is a special form of breath, typically used while practicing asanas. It is used to slow down the breath and make an audible sound by creating a constriction in the base of your throat, like you do when blowing out to create a fog on a mirror. It helps you to stay calm during the practice while focusing on the sound and avoiding breathlessness. It also is said to create heat in your body, which helps to keep up your energy levels throughout the practice. The diaphragm controls the length and the speed of your breath and will become stronger in doing so.
Correct breathing is an essential part of yoga; as the blood will be provided with more oxygen, which makes it possible to control energy levels and this will help you relax and calm your mind. Once you have controlled your breath by practicing pranayamas, you will feel more comfortable and confident to start practicing asanas.
Asanas, physical postures, recommended for COPD patients are:
Standing Mountain Pose
This is a straightforward pose, from which all other standing poses are performed. It requires you to stand tall, either with your arms raised or left hanging loosely at your sides. It teaches you to align your spine and balance the weight of your body, while focusing on your inner self. Your chest will open up and breathing will become easier.
Standing Back Bend
This pose is performed from the Standing Mountain Pose by placing your hands on your lower back with the fingers pointing down and arching your spine back. It helps to release tension in your neck and shoulders and opens up the respiratory system.
Standing Side Bends
These bends not only improve your posture by standing taller, it also regulates your breathing. The basic standing side bend is easily performed from the Standing Mountain pose. By exhaling with each bend, you stretch alternately to the left and to the right. This calming pose improves the flexibility of your rib cage and helps to strengthen your diaphragm to make breathing easier.
Seated Forward Bends
There are several seated forward bends, performed from either a chair or the floor. These poses calm the brain, stimulate the organs and stretch the spine and the shoulders to give more room to your lungs and help you to relax.
These are only a few examples of pranayamas and asanas that you can practice to help improve your lung condition. If reading this story triggered your enthusiasm to give it a try, do take some precautions before you begin. Things to consider are for example:
– Consult with your doctor or respiratory therapist about what is possible in your condition
– Always join a recognized yoga school, don´t go practicing by yourself without any coaching
– Be sure the yoga teacher of your choice is qualified, also for training special groups like COPD patients
– During class, always keep your inhaler or oxygen supply at hand
– Don´t overexert yourself, take a rest if you get exhausted or experience shortness of breath
With these precautions in mind and a good yoga teacher, you will surely be able to experience the benefits that can yoga give you, a fitter body and a mind more at ease.
Websites consulted: http://www.healthline.com/health/copd/yoga#1 http://yogachicago.com/2014/03/yoga-for-chronic-obstructive-pulmonary-disease-copd/ https://www.doyogawithme.com/yoga_breathing
Rheumatoid arthritis is a well-known disease for causing damage to joints, however the disease can also affect your lungs. It can cause damage to the tissue around the joints as well as your eyes, heart and lungs.
“We call it rheumatoid arthritis, but we should really call it rheumatoid disease,” says Elinor Mody, MD, director of the Brigham and Women’s Hospital Women’s Orthopaedic and Joint Disease Centre in Boston. Besides the joints, the “heart and lungs are the most commonly affected,” Mody says. Doctors aren’t sure how or why rheumatoid arthritis causes other organs to suffer, but lung complications of rheumatoid arthritis can be serious and even cause death.
Interstitial Lung Disease
Rheumatoid arthritis-associated interstitial lung disease, or RA-ILD, is the most serious lung complication for people with rheumatoid arthritis. This illness can be hard to detect, but occurs when lung tissue becomes inflamed and eventually scarred.
* Smoking increases the risk of developing it but non-smokers do develop RA-ILD.
* It causes breathlessness and a dry cough, but in many cases it is symptomless making it difficult to be able to detect it early enough to try and treat it.
* There are trials going on at the moment trialling new drugs to try and treat it but nothing has been very successful so far making the disease difficult to treat, other than treating the symptoms.
The inflammation and scarring caused by RA-ILD can lead to pulmonary fibrosis and permanent scarring of the lung tissues. The air sacs are gradually replaced by scar tissue reducing the respiratory capability of the lungs and resulting in shortness of breath.
* Supplemental oxygen can be used to help make breathing easier but it cannot reverse the dame done by pulmonary fibrosis.
* Methotrexate is a drug commonly used to treat rheumatoid arthritis, however this drug also causes pulmonary fibrosis. If you are on this drug then your
respiratory status needs to be carefully monitored.
Rheumatoid arthritis can also cause nodules to form in the throat and on the vocal cords, causing complications like hoarseness and other changes. Nodules can develop in the lungs as well, but usually don’t cause symptoms and patients may never notice them.
Prevention of Respiratory Issues
Because of the high risk of complications due to rheumatoid arthritis-associated lung disease and the fact that there is little treatment available, prevention is key. To help reduce your risk:
* Don’t smoke. If you do, ask your doctor for suggestions about how to quit smoking immediately. Chemicals found in cigarettes can irritate already delicate lung tissue, leading to further complications.
* Have regular check-ups. Your doctor should listen to your lungs and monitor your breathing at each visit as lung problems that are detected early can be easier to treat. Talk to your doctor about any shortness of breath you’re experiencing and ask about changing medications or starting supplemental oxygen therapy to help ease symptoms.
A team of researchers in America have developed and are currently testing out a table that may be able to help patients that suffer from the effects of COPD.
The team consists of people from all disciplines that have come together to pool their knowledge of COPD and patient’s pulmonary care and treatment to help these patients to improve their breathing.
The table is based on a gravity-powered approach to improve ventilation as well as helping to clear mucus. The table appears stable but in fact rocks forward and backwards with weight. The person on the exercise table lifts and pulls a bar while rocking the table forward
As the person pushes away the table then rocks backward resulting in the person’s feet being higher than their head. This movement forces air out of the lungs, which is normally difficult for a COPD patient to do and therefore reduces the difficulty of breathing for the patient. This approach also uses gravity to help the tiny hairs in the lungs to move the mucus along the trachea as well as the gravity also helping to move the lymphatic fluid out of the lungs. The movement of the abdominal viscera also moves the diaphragm which also reduces the effort of breathing.
The table not only aids the lungs and breathing but also benefits the rest of the body. The gravity effect on the body results in the drainage of lymphatic fluid from the arms and legs, improving circulation and reducing swelling.
One of the founders of the company is himself a COPD sufferer and says that the table has alleviated his symptoms greatly but the table is currently being vigorously tested in trials.
Researchers have found that the key to an inherited genetic deficiency that causes COPD could originate from the Vikings. Archaeological excavations of Viking pits in Denmark have shown that the Vikings used to suffer from massive work infestations. For populations living in these areas their genes developed in such a way as to protect their vital organs from diseases caused by the worms and this same trait can now lead to lung disease in our time.
COPD affects nearly 5% of the global population and the only inherited risk factor is alpha-1-antitrypsin (A1AT), which is compounded if the individual smokes.
A1AT protects the lungs and other organs like the liver from enzymes called proteases. These enzymes are produced by our immune system but also by parasitic worms. If you are deficient in A1AT then these enzymes are then allowed to break down lung tissue, which can lead to COPD.
A1AT deficiency means that you have an altered form or deviant of A1AT and are very common in Scandinavia, where they evolved in Viking populations more than two thousand years ago.
Professor Richard Pleass said: “Vikings would have eaten contaminated food and parasites would have migrated to various organs, including lungs and liver, where the proteases they released would cause disease.”
The deviant forms of A1AT bind to an antibody called Immunoglobulin E (IgE) that prevents the antibody molecule from being broken down by the proteases from the worms. Therefore Viking populations became protected by the deviant forms of A1AT which protected them for the worms.
“Thus these deviant forms of A1AT would have protected Viking populations, who neither smoked tobacco nor lived long lives, from worms.” Continued Professor Pleass, “it is only in the last century that modern medicine has allowed human populations to be treated for disease causing worms. Consequently these deviant forms of A1AT, that once protected people from parasites, are now at liberty to cause emphysema and COPD.”
It has often been wondered how and why A1AT deficiency has occurred and now it seems there are some pieces to the puzzle found among the Vikings. Therefore if you have Viking descendants it could be more possible that you have inherited the trait and have a higher risk of developing COPD. Now that we live longer and some of us smoke this now means that something which developed over generations to protect people from death by worm is now the same factor that causes COPD.
A machine has been developed that can recondition a set of lungs outside of the body in order for them to improve and make them healthier ready for transplant into a recipient. The machine is known as ‘the box’ and it ventilates lungs after their removal from the donor. It also infuses them with a mix of fluid, drugs and steroids which allows the lungs to dry out and get them into a better shape before being transplanted.
“It allows the lungs to stay alive… and allows us as providers to assess the function of the organ in a unique, well-controlled environment,” said Dr. Varun Puri.
The machine is made up of a ventilator to help simulate breathing and a bypass machine to perfuse the lungs with drugs and fluid In order to improve their function and generally helps to mimic the body with one major helpful difference. The lungs normally undergo a lot of stress in the body constantly exchanging gases with every breath, however in this box that stress factor is removed and gives the lungs a chance to heal.
This machine will hopefully help to improve lung transplant statistics and aid in improving the long-term survival rates of those that suffer from respiratory diseases like COPD. Currently fewer than 20% of donor lungs are considered suitable for transplant and 25% of candidates dies whilst waiting for a transplant. Even the survival rate post-transplant is 50% to survive 5 years. This device could aid in increasing the donor pool as the machine can take lungs that were previously deemed as unsuitable and give them a chance to heal and improve, making them then viable lungs for transplantation. With more lungs available for transplant fewer patients will die waiting and if the lungs are healthier when transplanted then hopefully the survival rates for lung transplants will also improve with further research.
“I am sure in the future we will be able to do things like gene therapy to the lungs in a controlled environment or utilizing specific anti-inflammatory agents to prevent short term and long term rejection of organs.” said Dr. Varun Puri.
Michele Coleman, 63, credits ‘the box’ with saving her life. A former smoker, she was diagnosed with chronic obstructive pulmonary disease and doctors asked if she would participate in a clinical trial.
“You don’t want to, but you kind of lose hope because when you are sick like that you know how fast you are going downhill,” Coleman said. “It’s scary, but anything that they could give me was going to be better than I had, and actually I figured I wouldn’t make it to the end of the year,” she said. The transplant for her was a huge success and she is still doing well with her ‘reconditioned’ lungs.
There is also hope of being able to do the same with other organs to improve transplantation survival rates across the board. Hopefully ‘the box’ brings a little light to those with severe respiratory diseases where their lungs are failing them.
References: http://www.foxnews.com and http://www.trunews.com
A team of experts in Brazil have demonstrated how their recently designed DNA-loaded nanoparticles are capable of passing through the mucus barrier in the lungs.
They believe that this can potentially lead to the development of therapeutic genes that can be delivered directly to the lungs using the nanoparticles to help treat CF, COPD and asthma.
“To our knowledge, this is the first biodegradable gene delivery system that efficiently penetrates the human airway mucus barrier of lung tissue,” said study author Jung Soo Suk.
The lung’s mucus barrier is important to keep lungs healthy as it is responsible for protecting the lungs from being infected by bacteria and foreign agents. The inhaled particles are trapped in the mucus and swept away from the lungs via beating cilia and goes to the stomach to be degraded. In many respiratory conditions this mucus barrier is a lot thicker and drugs cannot penetrate the barrier to get to the damaged cells underneath it and blocks treatment.
The team worked to demonstrate that by placing replacement or corrective genes or drug agents inside a biodegradable nanoparticle ‘wrapper’ that these can be inhaled by the patient and are able to pass through the barrier and work to correct defective genes within lung tissue cells in order to correct these cells so that they work more efficiently and significantly improve respiratory conditions. This would be excellent treatment for severe lung diseases as it would be efficient, a unique dose could work for many months and there would be less adverse side effects and no lung inflammation.
Previous studies have shown that non-viral, DNA-loaded nanoparticles have a positive charge which causes the gene to become attracted to and stick to the negatively charged mucus within the lungs. This has prevented traditional nanoparticles from effectively making it to their targets as they keep sticking to other unwanted targets during the journey through the lungs and also tend to aggregate and clump together making them too large to penetrate the mucus.
The new nanoparticles have a dense coat of a polymer called PEG, which neutralises the charge and prevents the sticky exterior problem. The study showed that these newly designed nanoparticles keep their size and rapidly penetrate the mucus layer. They are also biodegradable containing a protein which breaks down the delivery system once it has delivered its contents to the lung tissue cells.
They are now planning to move on to studies with humans and hopefully this potentially highly effective treatment wont be too many years away. It also demonstrates how wide-ranging the nanoparticle delivery system could potentially be and that by tweaking the system depending on the environment, the method could be used to effectively administer drug treatments to all areas of the body that previously had been considered difficult to reach or with barriers preventing drug access.
Researchers from a University in Utah have developed a model that can anticipate the deterioration of asthma in children. Asthma is a chronic inflammatory disease where the airways narrow and become swollen due to mucus accumulation in the lungs. Patients experience difficulty in breathing, coughing, frequent respiratory infections and tightness of the chest. It is believed that asthma is caused by a combination of genetic and environmental factors such as pollution, dust and smoking. There is no cure for asthma, for those with mild cases it can be handled by avoiding triggers such as pollution and certain foods but for those with more severe cases medications are needed to try and treat the symptoms however many patients suffer more frequent exacerbations and asthma attacks. Oxygen therapy and more severe medications are also sometimes needed for those that suffer from it badly.
Millions of people suffer from asthma and children are affected more than adults. Asthma attacks can be terrifying for both the child and their parents and it is difficult for a child to communicate their health status. Sometimes the parent has no idea the child is unwell until they cant breath and are in the middle of an asthma attack. This also results in huge cost to the NHS with children being admitted to hospital after visiting the A and E department for an attack. It would be helpful if the child or parents could anticipate that an attack may occur so that they can be prepared and maybe put into action a plan to prevent an exacerbation or reduce the frequency or severity of them.
The researchers have developed a machine learning model that is able to predict signs of asthma deterioration in children one week prior to an exacerbation. The Asthma Symptom Tracker is a self-monitoring tool that has been trialed on children with asthma over a 2 year period. The data has been collected and allowances made for temperature, humidity, tree pollen count etc and the results suggested that the mode; was 71% accurate, 74% sensitive and 71% specific in predicting an exacerbation a week later.
This model can now be integrated into an electronic device, which can be worn by the user. The device can take constant readings and warn the user of a potential case of deterioration in their health. The overall success rate is around 75% so would be extremely useful in helping those that suffer from asthma, as hopefully in the future a model can be developed for adults too. This could reduce exacerbations, improve the well-being of the patients and decrease the burden on the health care system.
Many people would not volunteer to spend a day living their life in the shoes of a COPD patient, however TV presenter Nadia Sawalha did take on the challenge. She spent a day as a COPD patient with a very tight corset around her waist and a mask over her mouth in order to simulate the constrained breathing conditions of a COPD sufferer and having oxygen equipment to take around with her. She then tried to go about her normal daily activities such as shopping and cooking.
She found it difficult even doing the little things such as walking up stairs and manoeuvring around the kitchen. She found it difficult to reach up and down for things, constantly stopping to pause for breath or to hold onto a wall. She had great difficulty getting around as the wheezing and gasping for breath always seemed to get in the way.
“It’s as if, when your airways narrow, so does your very life,” says Nadia. When asked about how she found the experience, she said that it was “truly horrific.” She recounts the feeling of “trying so hard to open your lungs” and being unable to have a conversation “because all you can think about is your next breath.”
Part of the reason that she undertook the challenge was because her nan suffered from COPD and she feels like she’s become a bit closer to her nan as she understands a bit more now the daily challenges that she went through. It has also made her understand the challenges COPD patients go through everyday and that she is fortunate to still have normally functioning lungs. Being a former smoker, she is now a strong advocate of early COPD diagnosis, especially after knowing how it feels like to lose a percentage of your breathing capacity. She realises now why patients need to be on supplemental oxygen just to get around but also how having the equipment attached to you all day can infringe on your mobility. She encourages people to get checked immediately if they think they may have COPD, saying that “it is not something you always get tested for, so it’s good to ask your doctor.”
Even though there are many challenges to overcome, exercising and keeping active is one of the best things COPD patients can do, other than quitting smoking. Keeping active will pay off and prevent the disease from worsening quickly and improve your mental well-being and quality of life.
An understanding of COPD is much needed in today’s society, especially where we see patients walking around with portable oxygen equipment. Becoming more aware of this condition helps us be more considerate toward our involvement in producing pollutants like cigarette and exhaust smoke or in the use of chemical irritants like cleaning solutions.
At the end of the challenge when Nadia could remove the corset she breathed a huge sigh of relief and it made her realise how lucky she was. Though people with COPD cannot do the same and just take off any virtual corset to feel better, with the right treatment and proper daily habits, there is hope to feeling much better and being able to breathe more easily. Hopefully Nadia has helped raise awareness of COPD and the daily struggles that patients go through and hopefully will encourage people to stop smoking and polluting the atmosphere so that fewer people suffer in the future. References: https://lovegoservice.wordpress.com
Fibre is already well known for its benefits in preventing heart attacks, diabetes and some cancers but also recent research has shown that it may also help to ward off lung disease, even if you are still smoking and regardless of BMI.
“While it’s impossible to say if eating more fiber will offset the effect of smoking on your lungs, it does improve lung function, both in smokers and in non-smokers as well,” explains nutrition expert Corrine Hanson.
As the nation ages, the number of people with COPD is projected to grow, creating a major national health problem for which the only preventative strategy is to give up smoking.
“Many people can’t give up smoking, which is one of the reasons why we are so excited about this study,” says Hanson, an associate professor at the University of Nebraska Medical Center.
In the study those who ate a high fibre diet had significantly improved lung function, exhaled more air and had less airway restriction compared to those that did not follow the diet.
Although, at its highest level, the effects of dietary fibre did not quite offset smoking, it still showed benefits equivalent to using an inhaler, Hanson says. He believes this may be due to its anti-inflammatory benefits, which may also explain why it helps to prevent cardiovascular disease, diabetes, and other ailments as well. Fibre has been shown to exhibit both anti-inflammatory and anti-oxidant properties, which have been implicated in both the development and progression of lung disease. Fibre also plays a key role in the formation of beneficial gut bacteria which has increasingly been found to be involved in good overall health.
Here are tips on boosting the fibre content of your diet:
Wash but don’t peel fruits and vegetables. Eating the skin and membranes ensures that you get every bit of A baked potato with the skin has twice the fibre of a potato without the skin.
Eat raw vegetables. Cooking them may reduce fibre content by breaking fibre down into its carbohydrate components. To avoid this effect, cook, microwave, or steam vegetables only until they are ‘al dente’ – tender, but still firm to the bite.
Choose whole fruits, vegetables. Juice does not contain as much fibre from the skin and membranes of whole fruits and veggies, and can also contain added sugar.
Add bran or wheat germ to casseroles, meatloaf, and cooked cereal. Each tablespoon of bran adds more than 1 gram of fibre and can barely be detected when blended with some cereal or a casserole.
Add vegetables to casseroles, soups, salads, sandwiches, pasta, and rice dishes. For example, simply add a cup of broccoli to a pasta dish for an extra 2 grams of
Hansen also says “there are very few interventional strategies for the prevention of COPD, with the exception of smoking cessation. This is a non-invasive, very inexpensive strategy that may be good for your lungs.”
If you do decide to alter your diet and increase your fibre intake then ensure you consult your doctor and ensure you maintain your usage of medication and oxygen therapy.
References: http://www.newsmax.com and http://www.medpagetoday.com