WHAT IS PULMONARY HYPERTENSION (PH) ?!
Pulmonary hypertension (PH) is a condition where the blood pressure in the pulmonary arteries (the blood vessels carrying blood to your lungs) is high. This increased pressure causes progressive damage to the heart and lungs.
When you exercise the heart beats more quickly to get more oxygen to the muscles. At the same time the pulmonary arteries expand to allow more blood through so that more oxygen can be carried to the muscles. They expand by stretching outwards slightly to create a larger inner area. In a person with PH, the walls of the pulmonary arteries are thicker, so are less able to stretch. Because of this the heart has to work harder to pump blood to the lungs, especially during exercise. If the heart has to work harder than usual over a long period of time then it begins to work less effectively and damage occurs.
PH affects many different types of people. In most people with PH, it is associated with another medical condition:
• portal hypertension
• connective tissue disease, eg systemic sclerosis
• HIV infection
• congenital heart disease
• sickle cell anaemia.
Some people develop PH with no known cause which is referred to as idiopathic PH and in some rare cases it can be inherited.
Your stage of PH is classified as shown in the table below, depending upon when your symptoms occur.
WHO classification of PH:
Class Description
1 No symptoms of any kind. Physical activity does not cause any symptoms
2 Comfortable at rest, but symptoms occur with ordinary physical activity
3 Comfortable at rest, but symptoms occur with less-than-ordinary effort (eg lifting the arms)
4 Symptoms while resting
Treatment for PH can be split into three categories:
• Conventional therapy (often called background therapy), which can include the following:
• Oxygen
• Warfarin
• Diuretics
• Targeted therapy
• Calcium channel blockers
• Endothelin receptor antagonists
• Phosphodiesterase 5 inhibitors
• Prostaglandins
• Surgery
• Pulmonary endarterectomy
• Atrial septostomy
• Transplant surgery
Most patients will have a regime involving a combination of background and targeted treatment which varies from person to person depending upon the cause of the PH and what stage they are at.
Many patients will need oxygen therapy, although some only need it at night. Oxygen therapy increases the amount of oxygen in the blood and it can also help to relax the arteries in the lungs which leads to reducing the pressure in the pulmonary arteries. Oxygen therapy can reduce tiredness and breathlessness in some people with PH and it can improve concentration and the ability to do everyday tasks.
Having PH can make you tired and lethargic. This may make it more difficult to do ‘normal’, everyday things. Here are some tips from the PHA website from patients to help make life a little easier.
Housework
• Where possible, avoid bending, lifting or over-stretching when doing housework.
• Use a lighter vacuum cleaner and iron.
• Do jobs sitting down where possible – a kitchen stool can really help.
In bed
• If your duvet is heavy, consider buying a lighter one.
• Use extra pillows to raise your head and make it easier to breathe.
• If you use an oxygen concentrator, consider putting it outside the bedroom to avoid the noise disturbing you.
Allgemeines
• After a bath, open windows before the house becomes too humid.
• Have chairs ready for places where you stand (eg, shaving or applying make-up).
• Slightly larger clothes can be less tiring to put on and take off.
• Put on a bathrobe straight after a bath or shower to avoid having to towel yourself dry.
• If bending down to put your shoes on is difficult, use a long-handled shoehorn.
Out and about
• Plan ahead to avoid having to rush.
• Consider asking for a wheelchair.
• If you drive, carry spare medication in the car.
References: http://www.phassociation.uk.com and www.who.int
Our Health Revolves Around Oxygen
Oxygen is fundamental to our health but many of us do not realise just how crucial it is. Oxygen deficiency can affect every aspect of our health and be a root cause of almost every medical ailment.
Oxygen deficiency can generically cause:
• overall body weakness
• fatigue
• circulation problems
• poor digestion
• muscle aches and pains
• dizziness
• depression
• memory loss
• irrational behaviour
• irritability
• lung problems
• increased unhealthy bacteria, germs, viruses and parasites
• Any chronic/long term disease
A shortage of oxygen has been linked to every illness from heart conditions, cancer, digestion and respiratory conditions to inflamed, swollen and aching joints, sinus problems, yeast infections and sexual dysfunction. When our cells lack oxygen they weaken and die, therefore without oxygen, nothing works very well or at all.
It is the main energy source for our brains to function properly and it calms the mind and stabilizes the nervous system. Without oxygen we cannot absorb important vitamins, minerals, and other nutrients our body needs. Oxygen depletion also weakens our immune system, which leads to viral infections, damaged cells, growths, inflamed joints, serious heart and circulatory problems, toxic build-up in the blood and premature aging. Low oxygen levels allow damaged cells to multiply incorrectly or unnecessarily and form growths in our bodies.
Oxygen aids in converting nutrients into energy, which also helps eliminate toxins and waste.
Your lungs will deteriorate 9-25% per decade (Framingham study) unless you do something to maintain them, which is why exercise is so important. However excessive stress in exercising can actually cause breathing blocks that results in inadequate levels of oxygen due to a build-up of waste products in the alveoli.
As our cells grow older they lose their ability to carry oxygen. As the liver ages it robs increasing amounts of oxygen reserves for detoxification which often leaves the other body systems with an oxygen shortage. Our brains need oxygen the most so when the body is in short supply our brains suffer the consequences.
The greatest contributor to oxygen deficiency is the deterioration of our breathing system. The next threat is a lack of exercise and nutrition, and then the environment.
Oxygen is involved in almost every bodily process so without it these processes fail and lead to problems with our health. Keeping our lungs healthy, eating the right food, exercising to keep our bodily systems functioning optimally and not breathing in pollution all helps to maintain the maximum oxygen levels.
It has also been discovered that "insufficient oxygen in our cells causes pain to be experienced more acutely than when oxygen supplies are ample" Dr. Samuel C. West.
There are multiple benefits of home oxygen therapy. Not only will it ease respiratory problems but it will help to ease the pain suffered by many and also help to keep your body working more efficiently and healthily, which can aid in improving your medical condition.
References: www.breathing.com
Common Causes of COPD
The 5 most common causes of developing COPD are below:
1. Cigarette smoke. This is by the far the most common reason people get COPD. You can get it from any tobacco products, like cigar and pipe smoke, especially if you breathe in the smoke. Smoking is the main cause of COPD and is thought to be responsible for around 90% of cases. The lining of the airways becomes inflamed and permanently damaged by smoking and this damage cannot be reversed. Up to 25% of smokers develop COPD.
2. Passive smoking. Even if you don't smoke yourself, just by breathing in second-hand smoke can cause damage to your lungs.
3. Air pollution. You can get COPD from breathing in chemical fumes, dust, air pollution or toxic substances at work.
4. Your genes. About 3 in 100 people with COPD have a defect in their DNA. This defect is called alpha-1 antitrypsin deficiency or AAT deficiency. Your lungs don't have enough of a protein needed to protect them from damage, which can lead to severe COPD. The symptoms normally show before you’re 35 years old. A research study has shown that smokers who have brothers and sisters with severe COPD are at greater risk of developing the condition than smokers who do not.
5. Asthma. If you don't treat your asthma, over time you can get lifetime damage and it can develop into COPD.
Some of these risk factors can be avoided by quitting smoking, reducing the amount of pollution we breathe and if we have respiratory problems ensure we medicate and treat them properly. These steps will help to prevent damage to our lungs and help to prevent the development of COPD. Obviously the genetic factor cannot be avoided but only 1% of COPD sufferers have the genetic defect.
References: www.webmd.com and /www.nhs.uk
Would You Like Your Very Own Robot?!
Home Oxygen Therapy is a medical treatment for patients suffering from chronic lung diseases. It involves the use of an oxygen concentrator to deliver oxygen via a nasal cannula or face mask to the patient and some may require being tethered to the machine on a constant basis. COPD is an umbrella term for these conditions and patients have restricted airflow through the lungs and experience coughing, wheezing and shortness of breath. The effect on quality of life can be significant and some are unable to participate in physical activities and require help to move. Home oxygen therapy aims to improve the patient’s freedom, health and quality of life by allowing treatment at home. Patients are encouraged to try and maintain a certain level of activity as research has shown that if exercise and mobility are retained then lung capacity and respiration improves.
However some patients find this difficult as they are tethered to a pressurized oxygen container via tubing and the weight, which is typically 4kg, can make transporting and lifting awkward especially for the more elderly patients. Some patients use a small hand cart to transport their equipment around or use a portable unit which they can carry over their shoulder. Despite the huge benefits of H.O.T it still imposes restrictions on the user’s movements, mobility, ability to participate in certain activities and quality of life.
A Follower Robot has been devised to help improve these patient’s lives. The robot can carry the equipment thereby reducing the physical burden and increasing freedom of movement. It is capable of following the patient’s movements and can follow behind the patient. It is simple to use, low weight, compact and at a low cost.
They have started testing these robots on H.O.T users to see if they are indeed beneficial and can aid them in their daily activities efficiently. Most users have found the robot easy to use and to manoeuvre with. It is hoped that after more trials are completed it can be manufactured and sold commercially for COPD patients. These robots could drastically improve patient’s lives allowing them to easily move around and enjoy more out of life which could have a positive effect on their health also. More importantly, how amazing would it be to have your own robot?!
References: www.robomechjournal.com and http://link.springer.com
Respiratory Breakthrough!?!
Scientists claim to have found the root cause of asthma which could also aid in the treatment of other respiratory diseases like COPD. This breakthrough could mean that there could be a new treatment within 5 years.
They have found a protein within the airways which they believe triggers an asthma attack. Asthmatics seem to have higher levels of this protein and when they breathe in a trigger such as dust or pollen these protein molecules cause a rapid increase of calcium within lung tissue cells. High levels of calcium within these cells make them contract and cause the airway spasms which trigger an asthma attack.
The presence of this protein makes cells more sensitive to any asthma triggers, which then makes an attack much more likely.
A drug already exists which can deactivate the protein and clinical trials could start within 2 years, raising hope that a treatment could be available within 5 years.
It is hoped that a few courses of treatment would be enough to stop asthma attacks. Not only this but there is hope that it may have a role in tackling COPD and chronic bronchitis for which there is currently no treatment. Hopefully at a minimum it may prevent flare-ups for these patients and make them less susceptible to the triggers such as dust, smoke and pollen, which can stimulate a severe respiratory event. This could help COPD sufferers enjoy fewer flare-ups and less respiratory distress improving their ability to lead more normal lives.
References: www.dailymail.co.uk/health
Apple Watches Could Measure Your Blood Oxygen Levels
When the people at iFixit took the new Apple Watch apart they found something strange, there wasn’t the expected optical module you usually find to measure your blood flow rate but there is a pulse-oximeter which can measure your oxygen levels.
It works by shining a light through your skin and it measures changes in your blood flow. As your pulse increases it changes the light transmission through the skin which a sensor measures. Additionally it can test how oxygen levels affect the way your blood interacts with light. The more oxygen in your blood, the brighter the red of the blood and the more infrared light it absorbs.
This component is currently disabled in the Apple Watch for unknown reasons but it looks as if Apple hope in the future to allow their customers to be able to monitor their own blood oxygen levels.
Being able to do this would be incredibly useful for a lot of people. If you’re hiking you can get a better sense of how you’re adapting to high altitudes, an athlete can monitor their performance and those with medical conditions such as asthma can instantly see if their oxygen levels are dropping. For those using oxygen at home you could simultaneously see if the oxygen that you are breathing in is improving your oxygen levels. A record of your data would be stored as your activities alter throughout the day and your doctor could use these results to help improve your treatment.
There is a danger that people may use the device as a self-diagnostic tool with regards to their health. This may be one of the reasons that Apple has left it disabled for now. Also perhaps there are issues with the accuracy of the measurements. It may be that arm hair, sweat and dirt could prevent the infrared light sensors from being accurate enough.
The possibility that very soon in the future we may have yet another helpful device to help monitor our health at home is exciting and good news for many suffering chronic respiratory diseases. It would be a helpful way for many to understand how their disease affects their respiration throughout the day and enable them, with their doctor’s help, to react quickly to changes in their blood oxygen levels to improve their health and quality of life.
References: http://thenextweb.com and http://venturebeat.com
The dangers of summer
Whatever stage your respiratory disease may be at, preventing flare-ups is highly important to ensure you stay as healthy as possible and to keep your breathing as easy as possible. This means you need to be aware of the triggers and eliminating any exposure to cigarette smoke, fire smoke, dust, chemicals, excessive wind and pollution. Breathing can also be difficult at temperatures around or below freezing, above 90 degrees F, or on days with high humidity, ozone levels or pollen counts.
Many patients have a component of asthma and some prefer warm, dry climates whereas others may prefer more humid environments.
Extreme hot or cold conditions can put stress on the entire body. In order to maintain a constant body temperature, you exert additional energy to warm or cool it down. This additional energy requirement also increases the amount of oxygen that your body is using. Breathing hot or cold air can also have a drying or irritating effect on the airway causing bronchospasm (contraction of the smooth muscle that surrounds the airway). This decreases the size of the airway and makes it more difficult to get the air in and out of the lung, increasing shortness of breath.
In general most patients find that they prefer minimal humidity levels of about 40%. This is also true of indoor humidity levels which can be difficult to maintain throughout the year, if it is a hot summer or a cold winter with the heating on. You can purchase a humidifier that works with your heating system or independent units for single rooms. De-humidifiers can also be purchased to help lower the humidity in certain rooms.
High indoor humidity is often also the source of mould growth in the home which is another trigger, as well as an increase in common indoor air pollutants like dust mites, cockroaches, bacteria and viruses. Also as humidity increases, the density of the air increases. This more dense air creates more resistance to airflow in the airway, resulting in an increased work of breathing (i.e. more shortness of breath).
Look out for common signs of high humidity:
• flooding or rainwater leaks from the roof or basement/crawl space
• poorly connected pipes or leaky pipes under sinks or in showers
• carpet that remains damp
• poorly ventilated bathrooms and kitchens
• condensation build-up from humidifiers and dehumidifiers, air conditioners, and drip pans under refrigerators/freezers
Here are some helpful pointers for when it is hot, although many are applicable to other weather conditions as well:
1. Drink plenty of fluids, fairly obvious for Australians, but please take into account if you have a fluid restriction.
2. Wear appropriate clothing and sunscreen.
3. Plan your activities carefully. Try to organise your activities or exercise for the coolest times of the day - early in the morning, or in the evening. When driving, park in shady areas if possible, and choose places to go that are air conditioned. Place sun protectors in your car when it is parked.
4. Keep cool, indoors. Use your air-conditioner if you have one and remember you do not need it to be freezing cold. A second benefit of the air conditioner is that it removes a great deal of humidity from the air as it cools it. If an air conditioner is not available, use fans and open windows to circulate the air during hot days. Special programmes are available in many places.
5. Use the buddy system. This means making sure that someone contacts you at least twice a day to check that you are OK.
6. Avoid rigorous exercise or excess activity.
7. Take your medications as directed.
8. Pay attention to weather reports.
References: www.healthline.com and http://lungfoundation.com and https://rotech.com
OXYGEN ALSO NEEDS NITRIC OXIDE FOR US TO BREATHE!
A new study conducted by Jonathan Stamler, a professor of medicine at Case Western Reserve University School of Medicine in Cleveland, OH, and colleagues has shown that the respiratory cycle involves three gases and not just two. He says their findings will transform our understanding of the respiratory cycle and could save lives as it will alter our treatments of various associated diseases linked to the respiratory system and also affect blood banks.
The current understanding is that the respiratory cycle uses blood to transport two gases - oxygen and carbon dioxide. Red blood cells pick up freshly inhaled oxygen from the lungs and carry it to cells in the tissues of the body; and then they bring back carbon dioxide as a waste product to be exhaled from the lungs.
However their study has proven that without the presence of Nitric Oxide it doesn’t matter how high the oxygen level is, the cells cannot accept the oxygen without it. The researchers show how nitric oxide controls the blood flow in small blood vessels inside tissue in a process known as "blood flow auto regulation.” It is the Nitric Oxide that controls the release of oxygen from red blood cells into the tissues that need it. Haemaglobin in the Red Blood Cells needs to be also carrying Nitric Oxide to enable blood vessels to open and to supply the oxygen it is carrying to the tissues.
Prof Stamler says "Within the tissues, the tiny vessels and the red blood cells together make up the critical entity controlling blood flow. Red blood cell dysfunction is likely a hidden contributor to diseases of the heart, lung and blood such as heart attack, heart failure, stroke and ischemic injury to kidneys."
If you suffer from a condition where there is a lack of oxygen uptake to your cells, it may not be the answer just to increase the oxygen supply, but to also look at whether your Red Blood Cells are functioning correctly and if there is an adequate Nitric Oxide supply. Then if necessary treat the Red Blood Cell problem in conjunction with oxygen therapy.
The study also has implications for blood transfusions. Recent evidence shows that blood transfusions lacking nitric oxide have been linked to higher risk of heart attacks, disease and death. It’s not enough to just increase oxygen content of the blood via a blood transfusion. If the Nitric Oxide mechanism is failing then the oxygen will not be able to make it to its destination. Blood in blood banks are known to be deficient in Nitric Oxide and transfusing this blood may actually make things worse by plugging up blood vessels in tissues and to solve this the nation’s blood should be replenished with Nitric Oxide.
It may be the case that many sufferers on oxygen therapy in the future could be helped and treated even more by investigating their Nitric Oxide levels, as there could be additional failings in their respiratory system that could be investigated and more successfully treated.
References: www.medicalnewstoday.com and www.sciencedaily.com
Home exchanges can make holidaying so much easier!
Holidays can be the experience of a lifetime but they can also be expensive and stressful to organise. If you are older, suffer a disability or chronic disease then you may have the additional expense of insurance, organising medical equipment or oxygen and perhaps having to pay more in order to have suitable accommodation. Swapping homes with another person in the country you want to vacate in could be the answer.
If they have similar circumstances then their home will be already adapted or suitable for your needs. It will feel more homely than a hotel room or apartment. The owner will have contacts for reliable services you may need whilst on your stay and have local knowledge and suggestions for places to visit. Most of all, you will save a lot of money on accommodation and can either save that money or spend it to do extra special things on your holiday that you may otherwise be ill-afford to have done.
Because you're both swapping homes then both parties are in the same boat when it comes to safety and ensuring that your home is looked after. You can exchange concerns and wishes prior to the exchange and only confirm the exchange once you are happy to do so. There is also the support from the company that you do it through.
Some people swap for just a week or two, or some go on longer holidays for a few months and live in a different home in different countries and travel around the world. You may stay 2 weeks in Dubai, 2 weeks in Croatia a week in Spain and another in France, the world is you oyster. All you need to do is find a home exchange partner in each country that is available around the time of your holiday. There are members that have second homes or holiday homes with a lot of availability.
All you need to do is join, list your property, search for members' homes that you're interested in staying in, communicate all your needs and arrangements and then enjoy a fabulous holiday!
If you're worried about arranging medical equipment or oxygen if you wish to travel from place to place then don't be, there are global companies that can provide you continuous support for the whole duration of your holiday even across different countries.
Home Exchanges are becoming increasingly popular as the cheapest and best way to enjoy your holiday!
References: www.homeexchange.com and www.guardianhomeexchange.co.uk and www.oxygenworldwide.com
Can swimming and a need for oxygen therapy mix?
The summer and holiday season is only round the corner, looking forward to swimming in the villa pool or in the sea. For those suffering with lung disorders requiring oxygen therapy this may seem like a fantasy, but it doesn't have to be.
If you have lung problems swimming could be the perfect exercise for you. As your body is floating it's less strenuous on your breathing and can help to improve your fitness and breathing. It's so beneficial that it even helps people who suffer from chronic obstructive pulmonary disease (COPD). People with COPD have a decreased lung capacity and get less oxygen with every breath than healthy people; therefore they tire out more quickly with just regular activities like walking or vacuuming. But those who exercise in a pool or swim lightly often end up with less breathlessness and can walk longer on land because of their lungs becoming stronger. It is a form of exercise that you can control, you can stop and start when you wish and go at a speed that suits you.
If you swim regularly at a private pool to improve your confidence and fitness then swimming on holiday won’t be an issue and you can enjoy your holiday more.
You may think that it is impossible to combine oxygen therapy and swimming but there are those that have managed it with some handy hints to share:
• Go to the swimming pool at a quiet time or when there is a slow lane available. Sometimes the swimming pool offers lessons or times for disabled or poor swimmers.
• You can have your POC at the side of the pool ready to use if you feel short of breath.
• Start off slow and don't push yourself too hard or fast. It will take time to build up your lung strength and fitness.
• You can get extra tubing to use with your cylinder and ask someone to walk alongside you in the pool to carry your cylinder as you do laps. You can ask your provider for spare tubing and cannula that you can use as a spare 'swimming set'. Check with the pool staff first to ensure they don’t mind you doing this.
• You can walk to and from the pool to increase your exercise and use your oxygen on the way there and on the way home and have it by the pool, so if necessary you can use it after each lap. As your fitness improves you will hopefully use it less and less.
• You can get an inflatable cushion and have your oxygen machine floating alongside you as you swim if you need oxygen constantly. Many find they can still use it in shallow and calm sea water too so you can swim in the sea on your holiday.
• If you're worried about the warmth and humidity of an indoor pool severely affecting your breathing you can go and visit and sit by the poolside with your oxygen to 'test the waters' first.
• There may be an option for you to use your rehab pool at the hospital for a while so that you can get used to swimming in a more controlled environment which will help with your confidence before venturing to a public pool, ask your doctor about options.
• There are water-proof cases that you can buy for your oxygen cylinder so that you can have it in the water with you.
• Start off slowly with just floating, walking around and exercises before moving onto short bursts of swimming and then onto laps. Do what you're comfortable with doing and progress at your own speed.
• Please note: Some indoor pools with water that contain a high level of chlorine and have bad ventilation might do you lungs more harm than good.
Obviously it depends upon the stage and severity of your lung condition and your reliability upon your oxygen and which equipment you use but there are options and ways around it. For most people they are able to take up swimming using these handy hints and find that after a period of time their fitness improves both in the water and on land and they become less reliant upon their oxygen. Also it means that you can then swim on holiday and enjoy the sun, sea and sand more!
If you require oxygen still on holiday whilst swimming or just want to have a back-up POC nearby on the shore or by the pool side then there are global oxygen supply companies that can supply these for you whilst you are on holiday in whichever country you’d like to visit.
References: www.healthunlocked.com and http://copdathlete.com
