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What does copd feel like: 10 Signs of Chronic Obstructive Pulmonary Disease

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10 Signs of Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) includes one or more of three separate diseases:

They all make it harder to breathe and get worse over time.

The three key symptoms of COPD are:

  • Shortness of breath
  • A cough that doesn’t go away
  • Coughing up thick, often colored mucus (phlegm)

If you notice any combination of these symptoms, you should talk to your health care provider.

Early Symptoms

Many people don’t notice any symptoms of chronic obstructive pulmonary disease (COPD) in the early stages. In some cases, this may be because there aren’t any. In others, though, there are subtle early signs that you might notice if you pay attention.

For example, you might find that you simply can’t do the daily tasks of life as easily as you used to, like walking up the stairs, gardening, or bringing your groceries inside. This could be because you’ve gained weight, stopped exercising, or gotten the flu. But if there’s no obvious cause and the symptoms seem to stick around, it’s time to see your doctor for an evaluation.

They can do a series of tests on your breathing (spirometry) that could help rule out or diagnose COPD.

Other Symptoms

Symptoms typically get worse over time, and you may have serious lung damage before you even notice them, especially if you’re a smoker. Make an appointment if you have any of these other possible signs of COPD:

  • Wheezing
  • Blue lips or fingernails
  • Fatigue (extreme tiredness) most or all of the time
  • Frequent colds
  • Losing weight without trying
  • Swollen feet, ankles, or legs
  • Having to clear your throat a lot
  • Chest tightness

When to Call a Doctor

These symptoms can mean that you have an infection or your COPD is getting worse. Call your doctor within 24 hours if you notice:

  • You’re out of breath or coughing more than usual.
  • Being out of breath affects your daily routine.
  • You’re coughing up more gunk than normal.
  • The gunk is yellow, green, or rust-colored.
  • You have a fever over 101 F.
  • You feel dizzy or lightheaded.

Call 911 or go to the emergency room if you’re still out of breath after using the medicines your doctor has prescribed for your COPD.

7 Signs Your COPD Is Getting Worse

Frequent coughing or wheezing, excess mucus and shortness of breath are hallmark symptoms of chronic obstructive pulmonary disease (COPD), the third leading cause of death in the United States. A person’s particular symptoms and their severity can be signs that the condition is worsening.

According to the Centers for Disease Control and Prevention (CDC), almost 16 million people in America have COPD, a classification that includes emphysema and chronic bronchitis.

COPD can be early, moderate, severe, or very severe depending on your symptoms, the number of exacerbations you’ve had, and your lung function. In early COPD, a person may have chronic cough and phlegm but may not be aware they have reduced lung function; they sometimes dismiss their symptoms as a normal part of aging.

Symptoms are impossible to ignore in severe COPD. A person with severe COPD can get short of breath even while walking slowly or getting out of a chair.

Managing Symptoms, Exacerbations, and Progression

Even though there is no cure for COPD, there are treatments to improve symptoms. If you take steps to quit smoking, to exercise, and to improve your diet, you can increase your life expectancy and have a better quality of life.

Avoiding exacerbations, which is when symptoms flare up or get worse, is a major part of slowing the progression of COPD, says Meredith McCormack, MD, an associate professor of medicine at Johns Hopkins Medicine in Baltimore. Exacerbations can happen fast, within a matter of hours or days, according to the American Thoracic Society (ATS).

RELATED: What Your Loved Ones Need to Know About COPD

“Exacerbations are often triggered by respiratory infections which could be viral or bacterial,” says Dr. McCormack. “They can also be triggered by exposures, like if someone has an increased exposure to pollution or secondhand smoke,” she says.

In a review published in October 2017 in the International Journal of Chronic Obstructive Pulmonary Disease, the authors noted that severe exacerbations are associated with higher mortality, and the risk increases with each new exacerbation.

“COPD exacerbations is one of the most important predictors of the progression of COPD, and a history of exacerbations is one of the most important predictors of future exacerbations,” says McCormack. That’s part of why it’s so important to take steps to try to minimize the risk of exacerbations, she adds.

The following are signs that may indicate that a person’s COPD is getting worse.

1. Increased Shortness of Breath

“Worsening shortness of breath is a cardinal signal that your COPD is getting more severe,” says Robert A. Wise, MD, the director of research in pulmonary and critical care medicine at Johns Hopkins Medicine in Baltimore. If climbing the stairs or walking up a slight incline has become harder for you, that could indicate your condition is deteriorating, says Dr. Wise.

If the increase in shortness of breath is relatively mild, your symptoms could be managed by your doctor by increasing medication or adding medications, says McCormack. “In more severe cases it might require an emergency room visit or hospitalization,” she says.

2. Wheezing

The narrowing of the airway can cause wheezing, a high-pitched whistling sound that happens as you breathe. If your wheezing gets worse, it could be a sign of an exacerbation.

Wheezing that becomes much more pronounced very quickly or stays constant (doesn’t come and go) should get medical attention right away, according to the Merck Manual.

Not everyone who has COPD has wheezing. In a study from October 2015 in the International Journal of Chronic Obstructive Pulmonary Disease, researchers found that about 38 percent of people with COPD had wheezing as a symptom. In the study group, wheezing was associated with worse COPD symptoms, more exacerbations, and worse lung function.

3. Changes in Phlegm

Exacerbations could cause an increase in the amount of phlegm you produce, and the color of the phlegm might change from clear to yellow or green, says McCormack.

According to the ATS, a change in phlegm (also called mucus or sputum) is often one of the first signs that your COPD is getting worse. The color change may signal an infection in the lungs.

4. Worsening Cough

“If you develop a worsening cough or a new onset of cough and it’s persisted for several weeks, you should be checked by your doctor,” says Wise. A chest X-ray may be necessary. The X-ray images could indicate if there are physical signs that your COPD is getting worse or if the increased cough or chest pain could be due to another health issue, such as a problem with your heart.

5. Fatigue and Muscle Weakness

A lot of patients with COPD are tired all the time, says Amy Attaway, MD, a pulmonologist at the Cleveland Clinic in Ohio. This isn’t surprising considering that the condition by itself can cause a lot of fatigue, she says.

“It really comes down to the fact that your body has to work harder than someone’s who doesn’t have COPD. More of your energy is spent simply breathing,” says Dr. Attaway.

“Fatigue in COPD can also be caused by inflammation that leaks out to the rest of your body,” she says. “You can actually get muscle weakness from that,” she says.

6. Edema

In more severe COPD, edema can cause the ankles, legs, and feet to swell. The fluid retention can cause a weight gain of anywhere from 5 to 15 pounds, says Wise.

This swelling is due to what is known as cor pulmonale, or pulmonary hypertension. Those conditions are caused by a combination of not enough oxygen, inflammation, and high pressure on the lung vessels and right side of the heart that can happen as a result of emphysema.

A 2009 study published in the journal Chest suggests that pulmonary hypertension is associated with a decrease in life expectancy.

7. Feeling Groggy When You Wake Up

“Sometimes as COPD advances people start to have low oxygen at night,” says Attaway. “The way it manifests is that they just feel really tired or groggy when they first get up.”

This lack of oxygen can be a result of severe COPD, but it could also be a sign of obstructive sleep apnea, according to the American Thoracic Society. “Sleep apnea or sleep disordered breathing is a frequent comorbidity with COPD and should be treated to help avoid exacerbations,” says McCormack.

COPD Symptoms and Diagnosis | American Lung Association

What Are COPD Symptoms?

Many people don’t recognize the symptoms of COPD until later stages of the disease. Sometimes people think they are short of breath or less able to go about their normal activities because they are “just getting older.” Shortness of breath can be an important symptom of lung disease. If you experience any of these symptoms, or think you might be at risk for COPD, it is important to discuss this with your doctor.

  • Chronic cough
  • Shortness of breath while doing everyday activities (dyspnea)
  • Frequent respiratory infections
  • Blueness of the lips or fingernail beds (cyanosis)
  • Fatigue
  • Producing a lot of mucus (also called phlegm or sputum)
  • Wheezing

Remember: Don’t wait for symptoms to become severe because valuable treatment time could be lost. Early detection of COPD is key to successful treatment.

Diagnosing COPD

To diagnose chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema, your doctor will evaluate your symptoms, ask for your complete health history, conduct a health exam and examine test results.

Health History

Your doctor will want to know if you:

  • Smoke or have a history of smoking
  • Are exposed to secondhand smoke, air pollution, chemicals or dust
  • Have symptoms such as shortness of breath, chronic cough or lots of mucus
  • Have family members who have had COPD

Testing for COPD

Spirometry: If you are at risk for COPD or have symptoms of COPD, you should be tested through spirometry. Spirometry is a simple test of how well your lungs work. For this test, you blow air into a mouthpiece and tubing attached to a small machine. The machine measures the amount of air you blow out and how fast you can blow it.

Spirometry can detect COPD before symptoms develop. Your doctor also might use the test results to find out how severe your COPD is and to help set your treatment goals.

Other tests: Your doctor may also want you to have a chest X-ray and/or other tests, such as an arterial blood gas test, which measures the oxygen level in your blood. This test can show how well your lungs are able to move oxygen into your blood and remove carbon dioxide from your blood.

Living well with COPD

Breathe (Sheff). 2017 Jun; 13(2): 151–157.

Abstract

COPD is a group of conditions that includes chronic bronchitis and emphysema.

This factsheet aims to show people with chronic obstructive pulmonary disease (COPD), their friends and family how they can still live a full life with this condition.

What is COPD?

COPD is a group of conditions that includes chronic bronchitis and emphysema.

Chronic bronchitis (inflamed and narrow airways) prevents the lungs from emptying normally when you breathe out. You will have to make an extra effort to breathe, which can make you feel breathless.

Emphysema (damaged lung structure) occurs in the areas of gas exchange, known as the alveoli. Walls of the alveoli become less stretchy and so it is more difficult to empty air out of the lungs.

Symptoms, such as shortness of breath, coughing and fatigue (feeling really tired out), gradually worsen and can severely affect quality of life. However, there are many things you can do to help yourself feel better.

What causes COPD?

Many things can cause COPD. In Europe, the most common cause of COPD is cigarette smoking. Breathing in cigarette smoke irritates the airways so they become inflamed and make you cough.

If you smoke and have COPD, the first step you should make to help prevent your condition from getting worse is to stop smoking. However, not all smokers develop COPD and some people with COPD have never smoked. Other causes of COPD include: exposure to air pollution, both indoors and outdoors; inhaling certain gases at work over many years; or it can be hereditary. Research has also shown that having asthma as a child could increase a person’s risk of developing COPD.

How can I help my condition?

1. Stop smoking

It is never too late to give up! The benefits begin within a few days. Once you quit smoking, the rate at which your lungs age will be the same as a non-smoker.

2. Exercise and breathing

When you exercise or carry out daily activities you may feel breathless. This is not dangerous and the breathlessness disappears rapidly when you stop exercising.

Breathlessness can be very uncomfortable and scary but the worst thing you can do is avoid exercise. If you do, you will become unfit and eventually feel even more breathless during simple tasks.

Try to exercise as often as you can to improve your overall fitness and well-being; practise by walking up the stairs. Stop when you need to rest and you will feel the shortness of breath disappearing rapidly. Sometimes, breathing through ‘pursed lips’ may help you to catch your breath.

Another easy way to exercise is to walk for 20 minutes each day. It is advised that you take your reliever medication before you exercise. This medication will also help to relieve your symptoms when you exercise.

If your breathlessness suddenly becomes worse or does not disappear rapidly after exercise, you should see a doctor. If your breathlessness is becoming troublesome, it is very important that you follow a rehabilitation programme as advised by your doctor. It will help you exercise for longer before feeling breathless, improve your symptoms and enhance your quality of life.

3. Diet

It is important that healthy eating becomes part of your daily routine. You should try to eat lots of fruit and vegetables.

  • When you are feeling well, doctors recommend that you eat 3-4 meals a day

  • If you are feeling unwell, you should eat 5-6 smaller meals a day of soft foods. Food and drink rich in carbohydrates and proteins such as pasta, chicken and fish are preferable.

Being overweight will make your breathing even more difficult.

However, if you are underweight for your height you may need a special diet.

It is okay to drink alcohol with meals, as long as it is in moderation.

What should I do if my condition worsens?

A noticeable worsening of your condition is called an exacerbation. When this occurs, you will experience more symptoms than normal, which might be more severe than you are used to. This can be very distressing. Exacerbations are often triggered by a normal cold or during times of bad weather. They can last for different amounts of time but usually between 7 to 21 days. If they last longer, you may need extra treatment from your doctor.

What treatment will I be prescribed by my doctor?

Inhalers

Bronchodilators, e. g. beta agonists or anticholinergics
  • Make breathing easier.

  • They open the small airways, and reduce the uncomfortable overinflation of the lungs.

  • Effects can last between 4 and 24 hours.

  • Short-acting bronchodilators are used whenever symptoms are troublesome.

Inhaled corticosteroids
  • Reduce inflammation in the small airways.

  • Can prevent about a quarter of exacerbations.

  • Recommended for people with more severe COPD who have more than two exacerbations per year despite using bronchodilators.

  • Can be given in a combined inhaler with long-acting bronchodilators.

Please note:

There are several types of inhaler that can be used to deliver these drugs and they all work slightly differently. Make sure you know exactly how to use your inhaler as there may be a special way of putting it together or cleaning it to make sure it works effectively.

Oxygen

Oxygen
  • Given to those who do not have enough oxygen in their blood, not to those who feel breathless.

  • Should be used for at least 16 hours per day to notice the benefits.

  • Oxygen saturation (the amount of oxygen in your blood) can be checked by a nurse or doctor using an oximeter or by a blood test.

  • Best to use it during the night, after meals and during exercise.

  • How long the oxygen lasts depends on the size of the cylinder and the oxygen flow rate used.

Oxygen cylinder
Liquid oxygen
Portable oxygen concentrator

Tablets

Antibiotics
  • Fight off bacterial infection.

  • Prescribed if you cough up more phlegm than normal or if your phlegm changes colour.

  • Improves symptoms during an exacerbation.

  • Contact your nurse or doctor if you think you need them

Steroids e.g. prednisolone
  • Given to treat exacerbations.

  • Improve recovery.

  • Reduce length of hospital stay. Cylinders contain compressed oxygen and are usually used in emergencies.

Diuretics

General practical advice

Clothing

Wear suitable clothes for the time of year. Try to wear loose garments that are easy to put on.

Heating

Keep your home at a temperature between 19 and 21°C. Cold temperatures may make you feel worse.

Holidays

If you have COPD you can still go on holiday. If you are flying, you must check with the airline before you fly and give them as much notice as possible. Visit the air travel section on the ELF website for further details.

Housework

Avoid using strong chemical products such as polish and paints, as they may irritate your airways and worsen your symptoms.

Leisure

Visit your friends as often as you can. When you prefer to stayat home, keep yourself entertained by listening to music or simply just relax.

Sex

COPD symptoms and treatment may reduce your urge to have sex but this does not mean it is dangerous for you to do so. Slight increases in heart and breathing rate are normal.

Sleep

Establish a routine for going to bed, getting up and resting. Avoid sleeping too much during the day – or drinking too much alcohol or caffeine – or you will find it difficult to sleep at night.

Vaccinations

Infections, such as flu or pneumonia, can easily infect your lungs as they are more susceptible compared with healthy people. Doctors recommend that you have a flu vaccine each year and a pneumonia vaccine if you are over 65 years old.

How will my illness be monitored?

It is important that you regularly visit your doctor or nurse. They will ask how you are feeling and whether your treatment is working. This is your opportunity to talk to your healthcare professional about how you are feeling, your symptoms and your needs. They may listen to your breathing with a stethoscope and assess whether your treatment needs changing. Tests that your doctor might perform to check your condition include:

  • A spirometry test. This test is used to diagnose COPD and may help to show how your illness is progressing. The test involves taking in as deep a breath as possible to fill your lungs with air and breathing out as hard and fast as you can for at least 6 seconds into a machine.

  • Oximetry. This is a very simple and painless way to check whether you have enough oxygen in your blood. It detects the colour of the blood pulsating through the tip of your finger. If the reading is low you may be advised to have arterial blood gasometry. This measures exactly how much oxygen and carbon dioxide you have in your blood and will tell the doctor whether you need extra oxygen.

  • A quality of life questionnaire. This will include questions that ask how you are feeling and how you cope with certain activities. It will show whether your treatment is helping your condition.

  • An X-ray of your chest. This test will help to rule out any other possible causes of your symptoms, and will highlight any obvious obstructions.

  • A six-minute walk test. This shows the doctor how far you can walk in six minutes and how difficult you find it.

What will make me feel worse?

  1. Continuing to smoke.

  2. Not taking the recommended treatment.

  3. Using your inhaler incorrectly.

  4. Not dealing with other illnesses.

  5. Not keeping regular appointments with your doctor.

  6. Limited interaction with your friends and family.

  7. Not completing 20 minutes of daily exercise.

How will I know if my condition is worsening?

You feel more short of breath than usual.

If this happens:

  • Check your self-management programme and follow the advice.

  • Keep calm.

  • Take your rescue inhalers.

  • Start emergency treatment if you have it.

  • If you use oxygen, have it on all day but do not increase the amount that your doctor has prescribed.

  • Try doing the relaxation and breathing techniques demonstrated to you by your doctor.

  • Move around more slowly.

You may notice that you are producing more phlegm than normal.

It may change colour and become thicker, which is harder to cough up.

Your legs and feet may become swollen.

If this happens:

If you experience any of the following, please see your doctor:

  • Coughing up blood

  • Being more short of breath than normal

  • More phlegm and a change in its colour

  • Swollen legs and feet

  • Pain in the side of your chest when you take a breath

  • Drowsiness.

  • Mood swings

Exacerbations

If you regularly experience exacerbations, it may have a disabling effect on your overall well-being that can last for months. Your illness will progress and you may have a lower quality of life. You should speak to your doctor about how to avoid worsening symptoms and how to manage them if they do get worse.

Your doctor can work with you on a written action plan with goals that work for you.

Steroids and antibiotics may be given to control symptoms and fight off infection, as infections often cause exacerbations. If you have an annual flu vaccine along with your normal medication, you will greatly reduce the risk of catching flu.

If you experience a very serious exacerbation, you may go into hospital so that doctors can control your symptoms and give you more suitable treatment.

Further reading

European Lung Foundation website: www.europeanlung.org

  • Download more factsheets on topics related to COPD, including on quitting smoking when you have a lung condition, staying active and pulmonary rehabilitation

  • Find local patient organisations for people with COPD

The European Lung Foundation (ELF) was founded by the European Respiratory Society (ERS), with the aim of bringing together patients, the public and respiratory professionals to positively influence respiratory medicine. ELF is dedicated to lung health throughout Europe, and draws together the leading European medical experts to provide patient information and raise public awareness about lung disease.

The original version of this document was based on a publication by Respirar, a part of the Spanish pulmonary group (SEPAR) and on ‘Living with COPD’, written by Monica Fletcher, Chief Executive, Education for Health. It was reviewed and updated in 2017 by Professor Martijn Spruit, Dr Frits Franssen and Saskia Weldam PhD.

National Emphysema Foundation – Assessment of the Patient — Your Evaluation as a Possible COPD Patient

Here is a personal checklist that will enable you to determine whether you should consult your physician.

  1. Does COPD run in my family?

  2. Do I smoke?

  3. Am I short of breath more than others?

  4. Do I cough?

  5. When I cough, do I cough up yellow or green mucus?

History

A careful history, with a focus on cough, expectoration, shortness of breath, wheeze, and the duration of these symptoms is basic. A careful smoking history and an occupational history detailing possible dust and/or irritant exposures are also needed. Most patients have had some telltale symptoms for years before they come to a doctor for an evaluation. None of these symptoms is specific or diagnostic by itself. A careful family history in reference to close relatives with COPD is important because COPD runs in families. Some common questions often asked by doctors or nurses to help evaluate the patient are listed in Tables 1 and 2. It is important to talk about the patient’s duration of symptoms, lifestyle, work environment, and problems related to the illness.

 

Physical examination

A complete physical examination should be performed during your first visit to a doctor.

Table 1: Questions a doctor may ask:

  • How long have you had cough, shortness of breath, or wheeze?

  • Have you seen many doctors for it? What are you now doing to treat it?

  • How many days did you miss from work last year because of the lung problem?

  • Were you in the hospital for it? How long and how many times last year?

  • Describe your usual good day.

  • Do you have more good days than bad days in a week? What are you able to do when you are feeling your very best?

  • Who do you live with?

  • What recreation do you prefer?

 

Table 2: More Questions Your Doctor or Nurse May Ask:

  • How does the emphysema or chronic bronchitis bother you?

  • When does it bother you the most?

  • What have you learned to do that helps you to live with it?

  • Does it ever embarrass you to have lung trouble?

 

Your physician will thoroughly examine your chest, observe your breathing patterns, and perhaps monitor how hard you are working to breathe. He or she will note the degree of over-inflation by percussion (tapping over the lungs). He will listen to your chest with a stethoscope to hear the air flow in and out of your lungs. The intensity (loudness) of the sounds is helpful. Noises caused by mucus or inflammation are also noted.

 

The physician or nurse will also listen to your heart sounds to determine the rate and rhythm of your heart and any signs of heart strain that may accompany advanced stages of COPD. The examination itself is not very accurate in determining the severity of the abnormality, however. A physical examination may be normal even in the early stages of significant disease. This is because airflow abnormalities are usually moderately advanced before they can be detected with a stethoscope!

 

Chest X-ray

Chest x-rays are not very useful in assessing the patient with COPD. By the time the x-ray is clearly indicative of the disease, the neighbors usually know the diagnosis! However, the x-ray may show over-inflation of the lungs, which is common in emphysema. X-rays are also valuable in finding other abnormalities such as shadows which may indicate coexisting lung cancer. Lung cancer and COPD often occur together because both are caused by smoking. The heart and the large vessels to and from the heart can also be seen on a chest x-ray and give some indication about associated heart strain, but only in advanced stages of disease. However, the chest x-ray can be completely normal, even when the patient has a significant degree of COPD. The x-ray, though traditional, is not a good way of diagnosing or evaluating COPD.

 

Electrocardiogram (EKG)

The EKG also is not useful in evaluating patients with COPD. In very advanced disease, EKG abnormalities are usually evidence of strain in the right side of the heart, i.e., that portion of the pump that propels blood from the tissue back through the lungs to take on oxygen and get rid of carbon dioxide.

 

Sputum Examination

Culturing the sputum of patients with emphysema and/or chronic bronchitis is almost useless. The common bacteria are well-known, and today physicians properly prescribe antibiotics based on their knowledge of the most common organisms and will do so if sputum increases in volume and becomes colored. Yellow or greenish sputum is almost always infected and requires antibiotics.

 

Measuring Lung Capacity

A simple device called a spirometer measures your lung capacity. During this test you take a deep breath, as deeply as you can, and blow it out all at once into a machine that records airflow and capacity. The total amount of air blown out of fully inflated lungs is called the vital capacity. Since the air is forced out by your muscular effort, it is called forced vital capacity (FVC, newer term FEV6). This test measures the useful size of your lungs. The rate of airflow tells how open the air passages are and how well the lungs can empty, or how well their elasticity is functioning. The lungs empty somewhat like an inflated balloon. Remember how a flabby or overused balloon empties slowly and incompletely? This is a lot like the lung with emphysema. The airflow test is called the forced expiratory volume in one second, since this airflow is timed or measured over the first second of exhalation. The symbol for forced expiratory volume in one second is FEV1. These two tests, the FVC and FEV1, reveal all your doctor needs to know about your lung capacity and airflow. These two numbers are somewhat similar to systolic and diastolic numbers in blood pressure readings. We believe that knowledge of FVC and FEV1 is as valuable and important to health promotion as knowledge of blood pressure. These tests measure your lung power, which is essential to your continuation and enjoyment of life.

 

Normal values are based on age, sex, and height. Younger and taller individuals have greater airflow and air volume than shorter or older people. Men have slightly greater airflow and air volume compared with women of the same age and height.

 

Self-Testing- Try It Yourself

Normal lungs have large volume, and they empty quickly because airways are open and lungs are elastic. You can do a little checking yourself with a stopwatch. Take a full breath; hold if for one second. Then, with your mouth open, blow out as hard and fast as you can. Your lungs should be completely emptied – meaning that you can blow no more air out even though you try– in no more than 4 to 6 seconds.

 

If one takes longer to blow out all the air, it means that airflow is obstructed or limited. Today we use the term “limited” because this airflow reduction can be due to either a loss of lung elasticity (emphysema) or problems with airways (asthmatic or chronic bronchitis). See how simple it is!

 

Unfortunately, routine lung function tests have been accepted all too slowly. No person would go for a complete check-up if the physician did not examine the eyes, ears, nose, throat, listen to the heart and lungs, feel the abdomen for any abnormal masses, and examine the genital, rectal, and pelvic areas. All these are routine, and to supplement them, appropriate laboratory blood and urine tests are done, plus an electrocardiogram and, usually, a chest x-ray. Unfortunately, none of these examinations or tests identifies early COPD.

 

Only spirometric measurements of the kind we have just described can identify the patient who is just beginning to develop a lung abnormality.

 

When one considers that the disease process finally resulting in disability may go on for 20 to 30 years, doesn’t it make sense to identify the problem early and to take immediate corrective action? The answer must be yes if you are to a enjoy a long happy life.

 

Very simple devices for measuring lung capacity are becoming popular. One such device is called a peak flow meter, which measures the greatest airflow rate you can produce. A man’s normal figure is around 600 liters per minute, and a woman’s is 370 liters per minute. Both are normal. (The lower value for women is because of their shorter stature and female sex). Some physicians instruct their patients to use peak flow meters at home to study the response to treatments designed to open up their air passages. Another new device called a spirometer accurately measures forced vital capacity. These measurements of both volume capacity (forced vital capacity) and flow can give a good estimate of the mechanical function of the lungs. (Newer, less expensive pulmonary function testing equipment is now readily available for use in primary care physician offices).

 

Other tests are used in more advanced stages of disease to obtain additional knowledge about the lungs’ function. One such test is the blood gas measurement. A small amount of blood is drawn from an artery by a small needle and syringe. This blood is analyzed to measure the amount of oxygen and carbon dioxide it contains. This test is used to assess more advanced stages of emphysema and chronic bronchitis and is needed when the physician is considering prescribing oxygen and in cases of serious and emergency illness.

 

Another simple method of measuring blood oxygen is with an instrument called an oximeter which is widely used today. It is popular because it does not require arterial blood sampling. However, it is not as accurate as arterial blood measurement, and it tells nothing about the levels of carbon dioxide or acid (pH) in the blood. The pulse oximeter measures blood oxygen by reflected light. This test is easy and painless and will be much more widely used in the future.

 

Additional lung function tests such as the diffusion test also measure the integrity of the air-blood interface, or alveolar capillary membrane. Numerous additional tests are used for research purposes, but they do not have any practical value at the present time.

 

In summary, adequate evaluation of patients with all stages of COPD is within the reach of all doctors and their patients. The approach is simple and straightforward. All patients with shortness of breath, cough, wheeze – particularly those with family history of COPD and absolutely all smokers – should insist on this crucial evaluation.

Answers from Dr. Thomas Petty, Professor of Medicine, University of Colorado.

COPD: Wheezing and Chest Tightness

When you have COPD, wheezing, shortness of breath, and chest tightness are common symptoms. Wheezing is a whistling or squeaking sound when you breathe in or out. Chest tightness may feel like it is hard to take a deep breath or it’s painful to breathe. It can cause a feeling of shortness of breath.

How does COPD cause wheezing and chest tightness?

COPD is a condition that keeps your lungs from working as they should. The lungs’ job is to get air in and out of the body. Inside the lungs, air moves through tubes called airways. In healthy airways, air moves in and out easily. With COPD, lungs and airways become damaged. This damage causes the lining of airways to swell and become clogged with mucus. The airways can also collapse. Then air does not move in and out of the body normally. This can lead to wheezing and chest tightness.

COPD is a term for two main conditions. These are chronic bronchitis and emphysema. In both of these conditions, the airways and lungs become damaged. The damage is usually due to breathing in irritants over a long period of time. The main irritant that causes COPD is cigarette smoke. Other irritants are pollution, dust, fumes, and chemicals.

With chronic bronchitis, the damaged airways make more mucus than normal. Mucus is a thick, sticky fluid. It traps smoke and other harmful irritants breathed in. This helps protect the airways. But too much mucus can make the airways narrow. Bronchitis can also cause the airways to swell. The muscles that surround the airways may tighten. These problems cause the airways to narrow even more. This means less air moves in and out of the lungs.

Air contains oxygen. This is a gas the body needs to breathe. In healthy lungs, air moves to the air sacs (alveoli). These are bunches of round sacs at the end of the airways. Oxygen passes from the air sacs into the bloodstream. Then it is carried to the rest of the body. As the body uses oxygen, a gas called carbon dioxide is left over. This gas goes back to the air sacs. Then it is breathed out of the body. This process is called gas exchange.

With emphysema, gas exchange does not work well. This is because the air sacs become damaged. The airways are also damaged. They are not as stretchy as they should be. They become floppy and may collapse when you breathe out. This traps stale air in the air sacs. Then not as much fresh air can be breathed in. This makes it harder to take a deep breath.



Airway with chronic bronchitis.



Airway with emphysema.

Chronic Obstructive Pulmonary Disease (COPD) — Symptoms & Treatment

Treatment

If you are at risk for COPD, an early diagnosis is key. According to the AAFP, death from COPD is preventable with early diagnosis and treatment. Treatment includes:

Lifestyle changes: Stop smoking if you smoke cigarettes, cigars, or e-cigarettes. Don’t smoke anything.

Medicines: Your doctor may prescribe one or more medicines to ease your symptoms and help you breathe. These medicines may include:

  • Oral antibiotics – to treat infections.
  • Bronchodilators – inhaled medicine to relax the muscles around your airway.
  • Oral or inhaled steroids – to control the inflammation in your lungs and help you breathe.

Inhaled medicines involve a small, handheld canister that you carry with you. You can use the medicine as needed or as your doctor has advised. Ask your doctor if you should use a spacer. This is a small, hollow device that helps you inhale more of the medication into your lungs where it is needed.

Some inhaled medicine is given through a nebulizer. A nebulizer is a machine that turns liquid medicine into a vapor that you breathe in. It is commonly used to treat people who have more serious COPD. It also helps people who have trouble using handheld inhalers.

Vaccines: Certain vaccines can prevent dangerous respiratory infections, such as the flu and pneumonia. These infections can cause serious problems for people with COPD.

Oxygen therapy: You may have to use oxygen on a regular basis to help you breathe. This involves wearing a mask or nasal prongs and having the oxygen tank with you to use as you need or as your doctor has advised.

Pulmonary rehabilitation: This is a combination of therapies to help you manage your disease and improve your quality of life. A team of health professionals will help you create a plan to help you feel better. Your plan may include a diet and exercise program, breathing strategies, and ways to conserve energy.

Surgery: This is rare. This could involve a lung reduction operation or a lung transplant. This is usually a treatment of last resort.

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90,000 Why repeated appointments are needed for chronic diseases

What is a chronic disease?

A chronic illness is one that lasts a long time, and its symptoms may increase or decrease over time.If treatment is effective, symptoms may go away. As a rule, chronic diseases do not go away – if they exist, they accompany a person all his life. Periods of exacerbations and remissions, compensation and decompensation are possible. (Compensation is a mechanism aimed at adapting the body to risk factors and diseases, acting up to a certain point. Decompensation is a disruption in the work of an organ due to its exhausted possibilities for compensation. – Ed.). With the right treatment, compensation can be long-term.

Such diagnoses can be made by narrow specialists, but often a family doctor or therapist can constantly supervise the patient.

Top 5 chronic diseases with which people come to “Scandinavia”

  • Hypertonic disease;

  • chronic bronchitis and bronchial asthma;

  • dorsopathy;

  • chronic gastroduodenitis;

  • chronic tonsillitis.

Hypertension

Hypertension is a diagnosis related to diseases of the heart and blood vessels associated with high blood pressure for a long time.

What should be done to patients with essential hypertension?

Hypertension is a chronic disease that requires constant monitoring. The risks of complications from it are quite high and, moreover, dangerous – heart attack and stroke.You need to come at least twice a year, even if nothing bothers you.

If the head does not hurt, this does not mean that the disease is not progressing. The risk of heart attack and stroke may increase, and therapy may need to be adjusted.

What awaits a patient with essential hypertension at follow-up appointments?

On a follow-up visit, the condition and risk factors are assessed, and the achievement of target blood pressure values ​​is assessed.If necessary, the doctor adjusts the therapy. The doctor must draw up a plan for future observation and the frequency of subsequent appointments.

What is the prevention of hypertension?

There is a strong association between the presence of the disease and modifiable and non-modifiable risk factors. Non-modifiable are gender, age. Modified – smoking, obesity, alcohol, excessive consumption of table salt, low physical activity.

As a rule, it is difficult for the patient to follow all preventive prescriptions. Depending on what happens in his life, the course of the disease can change. We explain that if a patient restricts their diet with salt and foods containing hidden salt (such as sausages), then this will reduce the pressure to a certain level. With a decrease in body weight by one kilogram, blood pressure decreases by 2 mm. With proper motivation, in the future, you can refuse to take pills if blood pressure has returned to normal.

But only 3% of patients usually adhere to all recommendations for changing lifestyle, and only in them, in the future, the need for constant treatment may disappear. Even if the symptoms have passed, the need for observation remains, because the diagnosis has not gone anywhere, the risks remain and the symptoms may return.

Chronic lung diseases: chronic bronchitis, bronchial asthma, chronic obstructive pulmonary disease

Chronic bronchitis is inflammation or irritation of the airways accompanied by a cough with mucus / phlegm.Chronic bronchitis lasts three months or longer.

Bronchial asthma is a lung disorder in which the airways literally swell and narrow. Symptoms: a feeling of tightness in the chest, wheezing, coughing and shortness of breath.

Chronic obstructive pulmonary disease (COPD) is a disease in which the symptoms of chronic bronchitis and pulmonary emphysema are most often combined.

What should a patient with chronic lung disease do?

Smoking is one of the strongest factors in the development of chronic bronchitis and chronic obstructive pulmonary disease.If you abandon it, then the symptoms of chronic bronchitis will practically go away. COPD, in turn, will steadily develop further, but to a much lesser extent than if you continue to smoke. By the way, the situation with quitting smoking against the background of all five chronic diseases is much better than with the fight against other factors. One in ten quits smoking, according to my observations.

You need to see a doctor two to three times a year. In these repeated visits, the condition is monitored, the therapy is corrected.You may need to test the function of external respiration using spirometry (measurement of air flow and lung function). If the disease progresses due to a risk factor, then spirometry objectively shows a decrease in lung volumes in numbers. A person breathes into a special device connected to a computer. He makes special maneuvers, and then his performance is compared with normal, average values. A phonendoscope for such diseases is not enough: it cannot objectively assess lung function against the background of the same COPD.

In some cases, your doctor may order computed tomography or fluorography.

Dorsopathy

Dorsopathy is a group of syndromes associated in one way or another with pain in different parts of the back.

How often should I see a doctor if my back hurts?

First you need to achieve so that there is no pain. With an exacerbation of a chronic disease, the doctor prescribes anti-inflammatory drugs and physiotherapy exercises.The latter is called early activation.

Then you can sign up for rehabilitation treatment with specialists in physiotherapy exercises and a neurologist, for massage and other complex treatment.

Many people experience back and neck pain. Nowadays, people often develop a “tablet posture”, when, due to prolonged work at the computer, a deformation occurs in the cervical spine. This is a real scourge.

If your back hurts, you should also go to the family doctor twice a year – for dispensary observation.The doctor can assess the situation: track, for example, whether the patient has gained overweight, whether his lifestyle has changed. A person may have an exercise-related job when, for example, they bend or squat incorrectly.


What happens on repeated appointments with dorsopathy?

The most important thing is an examination; there is no need to repeat the X-ray examination without indications. An examination is required before scheduled rehabilitation treatment.In most cases, it is needed twice a year, because nobody does physical therapy at home. When it hurts, people do exercise, and when the pain goes away, they stop. Another visit is needed to adjust the therapy: some conditions may be a contraindication to some types of treatment.

Chronic gastroduodenitis

Chronic gastroduodenitis is a combination of prolonged inflammation of the mucous membrane of the stomach and duodenum.

Why is this diagnosis in the top five?

It is observed in almost everyone due to inaccuracies in nutrition, which, again, almost everyone has. You also need to go to the appointment twice a year.

What is the diagnosis?

Fibroesophagogastroduodenoscopy (FGDS), ultrasound of the abdominal organs (since problems may be due to problems of the biliary tract), a clinical blood test and some biochemical parameters, a study of feces.If the stomach lining is altered, a biopsy is advisable.

Chronic tonsillitis

Tonsillitis is an inflammation of the tonsils caused in most cases by a viral and sometimes bacterial infection. Chronic tonsillitis is accompanied by several symptoms: persistent sore throat, bad breath, tonsillolitis (yellowish lumps in the tonsils), enlarged and sensitive lymph nodes in the neck.


What should patients with chronic tonsillitis do?

For chronic tonsillitis, a doctor’s examination is needed twice a year to assess your overall health.The fact is that a person may have health problems if there is tonsillogenic intoxication. He can walk and be treated by other specialists, but his infection is actually in the tonsils.

Diagnosis of tonsillitis is an examination, bacteriological examination and a blood test.

Treatment and patient responsibility

What if the patient is using parascientific treatment?

There are strange things that people learn about from friends: they drink hydrogen peroxide, buy a nebulizer and breathe in propolis, mineral waters, put mustard in socks.These methods are not only ineffective but also dangerous.

How do you explain to patients not to do this?

It must be explained that this is an unproven method: at least it will be ineffective, and at the most, it will lead to other pathological conditions. It is worth telling the person that there is a proven cure.

The main thing is to talk to the patient about all the problems and mistakes, to explain in understandable words why he needs one treatment and does not need another.

Where is the line when a family doctor transfers a patient to a specialized doctor and vice versa?

It’s hard to feel it! We have to go to doctors not only because of chronic diseases. You need to find your family doctor so that he can perceive you as a whole, with all possible problems and diagnoses, take into account all factors. Typically, a person with essential hypertension may have back pain.

I do not in any way detract from the role of specialists.But often we have the following situation when a person is prescribed several drugs, first by a neurologist, then by a cardiologist, and then by a gastroenterologist. A man comes out with a dozen pills and does not understand what to do next. And here a general practitioner can help him: he prioritizes treatment so that drugs do not interact with each other. You need to understand what is paramount so that the treatment does not bring harm.

How can a person work in a team with a doctor? How to share responsibility for treatment?

There are two facts.One is legislative, the other is human. First, Federal Law No. 323 directly states that a person is responsible for his own health. He must take care of him! Second: health is the peak to which everyone must climb himself. I saw this phrase during my surgical practice on a poster in the surgeon’s office. The poster showed a ballerina standing on one leg, floating in the air.

The patient’s health, its maintenance and preservation is his personal responsibility.The most valuable thing we have is health and time. The doctor’s responsibility is observation, correct prescriptions, correct diagnosis, accessible, complete, understandable explanation. You can even draw pictures. Do you understand why give up salt? It seems that we understand everything, but we cannot tell right away. Or you can draw a blood vessel, the endothelium that lines it to the patient, tell about how small vessels create general resistance so that the blood pressure in the body is adequate.If the endothelium swells due to salt and blood flows more difficult through the vessels, then the load on the heart increases and the pressure becomes stronger. So blood pressure rises. And if the salt is eliminated, it will be much easier. And such explanations, pictures, handouts work well.

Coronavirus infects COPD patients and smokers more easily

“People with chronic obstructive pulmonary disease (COPD), as well as smokers, have a higher risk of contracting coronavirus,” VB said in an interview with .KG family doctor of FMC No. 15 Zhainagul Bokusheva.

“It has been established that the coronavirus enters the body primarily through a certain type of protein in the nasopharynx and bronchi. For some reason, the amount of this protein in the nasopharynx and bronchi is higher in smokers and COPD patients than in other people, so the virus is easier.” catch on “and begin self-production, gradually getting into the lungs and causing pneumonia. But, as found, if a person quits smoking, the amount of dangerous protein in the nasopharynx and bronchi is reduced, which reduces the risk of coronavirus infection,” she explained.

The surge of coronavirus pneumonia in our country can be associated with this factor?

– He certainly played his part. In general, the level of respiratory diseases in the country is quite high. And one of the leading places among them is chronic obstructive pulmonary disease (COPD). But most patients do not even suspect that they are suffering from it.

Zhainagul Arslanovna, what is the prevalence of COPD in our country in recent years?

– Kyrgyzstan, judging by the WHO data on the situation with lung diseases, for many years continues to occupy one of the first places among the countries of Europe and Asia both in terms of the number of patients and in terms of mortality from lung diseases.One in 10 people over the age of 40 has COPD. In just eight months of this year, 1,130 people died from lung disease, according to the National Statistics Committee. In terms of mortality, they occupy the fifth line after heart disease, cancer, diseases of the digestive system and external causes.

Where does it all start?

– It all starts with a chronic cough, often in the morning, with a small amount of sputum. A person, as a rule, does not pay attention to cough and phlegm and does not feel sick.Many people just don’t realize that these are very dangerous symptoms. Judging from conversations with patients during the reception, some generally think that coughing and phlegm in the morning is normal. They do not pay attention to the most formidable symptom – shortness of breath. Many hope that this will pass soon. Alas, it won’t go away by itself. And only when the patients can no longer even rise to the third or fifth floor without shortness of breath, they come, but the respiratory function is already significantly reduced.

The insidiousness of COPD lies precisely in the fact that the formation of irreversible changes in the bronchi and lungs begins long before the first symptoms of the disease appear.

Previously, chronic obstructive pulmonary disease was called chronic obstructive bronchitis, “smoker’s cough”, but now doctors have come to the conclusion that COPD is a slowly progressive airway disease that affects not only the bronchi, but also the lung tissue.

What are the causes of the disease?

– Our colleagues from the National Center for Cardiology and Therapy, headed by Professor Talant Sooronbaev, Doctor of Medicine, conducted a national study of pulmonary health with the support of the Ministry of Health and foreign experts in this field.They examined four thousand residents of twenty villages in the Naryn and Chui regions, and whole families. And, judging by the results, the main cause of the high morbidity and mortality from bronchopulmonary ailments, in particular COPD, is smoking. This is evidenced by studies in other countries where people smoke a lot. More than 30 percent of men in twenty villages surveyed by our specialists smoke.

But it has been established that not only active smokers suffer, but also passive ones. Here’s an example – a woman has never smoked, and she is diagnosed with COPD.The reason – the husband smoked all his life in the apartment. There are also two other big factors. This is simply catastrophic air pollution in the capital. And in the villages – inside the dwelling. As a rule, it is caused by the fact that people use dung, low-quality coal as fuel. The smoke from their combustion is very harmful to the lungs. A third cause of high morbidity and mortality from lung disease is acute respiratory viral infections. For some reason, our citizens have formed an opinion about them as frivolous diseases. But in vain.

In the families examined by fellow pulmonologists (and there were more than one thousand of them), they even had no idea what acute respiratory viral infections were. Meanwhile, it has already been proven: if you carry the flu on your feet, then the flu virus can cause complications from the heart, kidneys and other organs. That is why the seemingly harmless flu is so dangerous.

What changes occur in the lungs with COPD?

– Long-term exposure to tobacco smoke and other harmful factors leads to narrowing of the bronchi due to spasm of small muscles, thickening and edema of the mucous membrane, increased production of mucus, which blocks the lumen of the bronchi.As a result, irreversible changes in the bronchial wall develop, and the mechanisms of protection of the bronchi from infection are disrupted. The result is progressive respiratory failure, when the lungs can no longer cope with the supply of oxygen to the body.

When you talk to patients, what arguments do you give to convince them to quit smoking?

– The first argument is that quitting smoking will improve the condition in any case, even in the later stages. The second is to prolong life. And the third is the economic aspect.Today cigarettes are not cheap and will continue to rise in price. It is worth calculating how much money goes into the smoke and thinking that this money could be spent on something useful. Fortunately, the measures the government is taking to reduce smoking are yielding real results. And we must continue the fight against smoking even more actively.

By the way: the CHI fund reminds that patients with chronic obstructive pulmonary disease, if registered at the place of residence and indications, can receive a free basic package of medical services, which includes a general blood test, urine test, urinary sediment microscopy, sputum analysis, blood sugar determination and urine, blood cholesterol, EKG.

Reception and consultation with a doctor are free of charge.

A patient with the status of insured is given the right to purchase preferential drugs under the additional MHI program with a discount of up to 50% in pharmacies that have entered into an agreement with the MHI Fund, for example, for drugs such as salbutamol, beclomethasone and others.

Within the framework of the State Guarantee Program, upon admission to a hospital by a referral from a family doctor, patients with COPD, depending on their eligibility for benefits, make a co-payment.

For all questions, you can call 113 – the MHIF’s hotline from 9.00-18.00, except weekends.

How a sedentary lifestyle destroys the body

Hundreds of thousands of people around the world die prematurely every year due to sedentary lifestyles. Gazeta.Ru explains what dangers an office chair conceals and how to avoid them.

Every year, almost 70 thousand Britons die prematurely, because they sit at work or at home without getting up for six or more hours in a row, experts from the University of Queens in Belfast have found.They published the results of the study in the journal Journal of Epidemiology and Community Health .

As it turned out, 30% of British adults spend six or more hours on weekdays without getting up. And on weekends, when they move to cozy home sofas and armchairs, this figure rises to 37%.

Constant sitting affects the work of the brain, endocrine system and metabolism in general. Disruptions in the body’s work lead to premature death.

“You need to put some stress on your body to keep your heart healthy and your entire body to function,” explains lead author Leonie Heron.

Increased mortality and health problems from sedentary lifestyles are not just problems for the British. Most people in developed countries face them.

How the “seated man” appeared

The first preconditions for a sedentary lifestyle appeared in the 18th century, when the British weaver and carpenter James Hargreaves invented the mechanical spinning wheel.A device capable of producing six times more yarn than a hand-held machine became a symbol of the beginning of the industrial revolution. The leading states of the world over the next years massively switched from manual labor to machine labor, and from an agrarian society to an industrial one. If earlier one of the main qualities of a worker was physical strength, now he was required to perform monotonous actions at the machine.

The next step towards seclusion was the invention of steam engines, thanks to which steamships and steam locomotives appeared.Now the journey from one destination to another requires less physical effort. Later, elevators also contributed, saving people from the need to walk up stairs.

Primary education in many countries, meanwhile, had become compulsory – now children spent more time sitting in the classroom.

At the end of the 19th century, there was a boom in mechanical engineering – railway networks expanded, trams appeared on the streets, and mass production of cars began. The trucks took over some of the heavy lifting work.

The post-industrial revolution transferred labor to the intellectual field, tearing workers away from their machines and making them sit at tables. TV has become an affordable entertainment that allows you to spend whole days on the couch.

Today, smart technology, the Internet and computers have reduced physical activity in society to a minimum.

Now people mostly work in the office, sitting in a chair. Whereas earlier a person had to move or stand to earn their food, now the average Danish does not get up from a chair or car seat seven hours a day, and the average Chinese – 8.5 hours.

According to in 2018 study , office workers spend up to 85% of their day sitting.

Doctor, what will become of me?

The post-industrial revolution has created an epidemic of obesity and a number of other diseases caused by inactivity. In the United States, it is estimated that a sedentary lifestyle leads to 300 thousand deaths annually. At the same time, people who sit still for more than four hours a day have a 40% higher risk of premature death compared to those who sit less.

Lack of mobility provokes the development of metabolic syndrome, obesity, cancer and cardiovascular disease. Taken together, these diseases are responsible for for about 60% of deaths in developed countries.

A sedentary lifestyle leads to physical inactivity. Muscles weaken and atrophy, strength and endurance decrease. Bone mass decreases, the functions of the spine and joints suffer. Prolonged physical inactivity leads to cardiovascular diseases (coronary heart disease, arterial hypertension), respiratory disorders (chronic obstructive pulmonary disease) and digestion (intestinal dysfunction).

In addition, lack of activity affects the work of the brain – weakness develops, working capacity and mental activity decrease, insomnia and excessive fatigue appear.

The spine is not designed for prolonged inactivity. Those who sit for about eight hours a day run the risk of suffering from herniated discs, poor posture and other spinal problems.

Vessels also suffer. The blood through the veins is moved mainly by the muscle-venous pump of the lower leg, the work of which is interfered with by prolonged immobility.Blood stagnates in the lower parts of the venous bed, stagnation provokes an inflammatory process in the vein wall and can lead to varicose veins and venous insufficiency. The first symptoms of disorders: pain, a feeling of heaviness in the legs by the end of the day. It is no less harmful, however, to work while standing – the constant load on the legs also increases the risk of developing varicose veins.

A sedentary lifestyle contributes to the development of anxiety disorders – A meta-analysis of scientists showed that the more time a person spends sitting, the higher the likelihood of suffering from anxiety.

In addition, lack of physical activity alone increases the risk of breast and bowel cancer by 21-25% , diabetes by 27% and cardiovascular disease by 30%.

How to protect yourself?

To prevent health problems, experts advise getting up every half hour at work, going to the cooler to drink water or discussing work issues with colleagues, walking along the corridor, and not in correspondence. You should also pay attention to your workplace – the angle between the back and the seat of the chair should be ninety degrees or a little more, and the back itself should have a curved shape to support the back and lower back.Ideally, it can be adjusted in height and tilt, the length and height of the armrests and the distance between them.

When working on a computer, the top of the monitor should be 5-8 cm above eye level. The monitor should be at arm’s length.

It will not be possible to compensate for “long-term” hours by going to the gym: even with regular visits to the gym or pool, those who spend most of the day at the monitor have physiological indicators worse than than those of people whose work does not require endless sitting on one location.

Moreover, this applies to both basic health indicators and associated with the changes in the brain inherent in different types of sitting, for example, an increase in the risk of developing depression. In other words, exercising and sitting in one place affect us independently, and a person who exercises regularly and does not spend days in a chair will be healthier than their gym partner who works in the office.

A study by Columbia University experts also shows that people who do not move while sitting have a higher mortality rate than those who constantly dilute their sedentary lifestyle.

So, increasing the level of physical activity does not make sense without reducing the duration of sitting. Therefore, it is necessary to control the time spent in a seated position and try to shorten it – to eat while standing or to get from the metro to work on foot, and not by bus.

90,000 Why is it hard to breathe, there is not enough air

When you need to call an ambulance

Without air, people can live only a few minutes. Therefore, in case of sudden respiratory failure, you need to dial 103 or 112 as soon as possible.Otherwise, acute respiratory failure will develop, due to which brain cells will begin to die off. It is indicated by the following additional signs :

  • the person becomes lethargic or loses consciousness;
  • he began to choke while eating;
  • cough that gets worse, and the person cannot move or lie down;
  • Foam or blood from the mouth due to cough;
  • the skin of the face turns blue;
  • hurts in the chest so that it is impossible to inhale;
  • colic appeared in the abdomen;
  • the joints are red and swollen;
  • Swollen lips, eyelids, forehead and scalp.

Why it’s hard to breathe

Breathing problems can be gradual, worse with exertion or excitement, and often have relatively harmless causes. We have already talked about them.

But sometimes a person cannot make a normal inhalation or exhalation due to dangerous conditions that require help as quickly as possible.

Severe allergy

Certain foods, drugs or chemicals cause allergies . Moreover, at the first contact, a person will not have symptoms, and upon repeated contact, a complex cascade of immune reactions is triggered, due to which a rapid edema of the subcutaneous tissue develops.In mild forms of allergy, watery eyes, a rash on the body or hives appear. But in severe cases, Quincke’s edema or anaphylactic shock develops. At the same time, the tissues of the larynx swell, so breathing is suddenly disturbed, and the voice becomes hoarse.

What to do

Severe allergies can lead to rapid death. Therefore, you need to urgently call an ambulance . You cannot take any medications without consulting a doctor.

When the condition improves, the allergist will order an examination.It is necessary to find a substance that causes such a reaction.

Foreign body

In adults, foreign objects enter the respiratory tract much less frequently than in children . But sometimes it happens during meals or careless handling of small parts. For example, when making repairs, some people like to hold nails with their lips, and when sewing – pins. Awkward movement can cause metal objects to be swallowed or into the larynx.

Foreign bodies, be it food or small things, create a mechanical obstacle to the entry of air.Sometimes, if batteries are swallowed, a chemical burn of the mucous membrane develops. Therefore, in response to irritation of the tissues of the respiratory tract, edema appears, it is difficult to inhale or exhale.

What to do

If a child or an adult has swallowed a small object, it is difficult for him to breathe and he cannot speak, but is conscious, he urgently needs help. You can free the airways using the Heimlich technique. Proceed as follows:

  • stand behind the victim and wrap your arms around him;
  • squeeze one hand into a fist and place it in the middle between the navel and the ribs, and place the other on top;
  • make 6–10 sharp thrusts in the abdomen in an upward direction, as if squeezing air out of the stomach.

Evolution and evolvability / Wikimedia Commons

Please note: this method cannot be used for children under one year old and for pregnant women. The women are pushed into the chest area and the baby is held head down and pounded on the back.

Even if after the first aid the person cleared his throat or vomited, you still need to call an ambulance.

Panic attack

A feeling of tightness in the throat, lack of air may appear during a panic attack .However, there are some of the additional symptoms:

  • heart palpitations;
  • feeling of fear;
  • sweating;
  • trembling and chills;
  • abdominal cramps or nausea;
  • headache;
  • dizziness;
  • violation of orientation in space.
What to do

Panic attacks are not life threatening, but they do not allow you to go about your business or work. Therefore, when the first symptoms appear, you need to call an ambulance, and after the condition improves, contact a psychotherapist or psychiatrist.

Chemical irritation

Severe respiratory distress can occur after inhalation of hot smoke or fumes from various chemicals. This condition is associated with chemical and sometimes thermal burns of the mucous membrane. Coughing, feeling short of breath, dizziness, confusion may appear within minutes or hours after contact with an irritating substance.

What to do

A person needs to call an ambulance as soon as possible.The doctors will give him a breath of oxygen. If the laryngeal edema worsens, a special tube will be installed to improve ventilation of the lungs and medications will be prescribed to reduce bronchospasm.

Laryngeal papillomatosis

If breathing problems develop gradually over several years, it is possible that it is laryngeal papillomatosis . It is a benign growth on the mucous membrane that causes human papillomavirus (HPV) type 6, 11, 16 and 18.

Breathing problems do not appear immediately.At first, a person notices that his voice becomes hoarse, and his breathing is noisy and sibilant. Then comes a chronic cough, pain when swallowing, often worried about pneumonia or colds. Sometimes, by mistake, the doctor may diagnose chronic laryngitis or bronchitis.

What to do

If breathing becomes difficult, you need to see a therapist. He will conduct an examination and, if necessary, refer you to a pulmonologist. The specialist will do a bronchoscopy – examine the airways using a flexible tube with a video camera.This will help confirm or disprove laryngeal papillomatosis.

To get rid of the disease, an operation is performed. Otherwise, the growths can spread below, to the trachea, completely close the throat lumen, and you will have to insert a hard tube from the outside. This is called a tracheostomy. The device will remain in the throat until surgical treatment is possible.

Cancer of the larynx or lungs

If difficulty in breathing develops over several years, accompanied by chest pain, coughing up blood, severe weight loss, it is possible that it is lung cancer or larynx .The disease often occurs in people who smoke, but sometimes the tumor is found in those who have never held a cigarette in their hands.

What to do

If the listed symptoms appear, you need to make an appointment with a therapist. He will send for a chest x-ray. If the suspicions are confirmed, you will be prescribed treatment depending on the stage and type of cancer.

Pneumonia, including those caused by the coronavirus

Pneumonia , or pneumonia, is provoked by bacteria and viruses, including coronavirus.The symptoms of everyone are expressed in different ways – sometimes it is a mild malaise or, conversely, a serious condition in which urgent help is needed. The signs of pneumonia are as follows:

  • increased body temperature, but in the elderly it may be lower than normal;
  • chills, sweating;
  • weakness and fatigue;
  • cough, with or without phlegm;
  • shortness of breath and chest pain – it is difficult to breathe in and out.
What to do

If symptoms of pneumonia appear, call a doctor at your home.He will prescribe treatment, which includes antibiotics, expectorant drugs. If the condition worsens, the patient will be referred to a hospital.

Heart disease

With heart failure , a person has a circulatory disorder, due to which fluid accumulates in the lungs and edema appears. This condition leads to the development of cardiac asthma. It is characterized by:

  • cough;
  • shortness of breath;
  • wheezing in the lungs.

Respiratory distress manifests itself gradually, over several hours or days.

What to do

At the first signs of pathology, you need to call an ambulance. In the meantime, the doctors are going – to make the victim sit in a comfortable position, to unfasten tight clothes. If a person is aware of their illness and carries emergency medications with them, you need to help him find them.

Bronchial asthma

This is a chronic disease , in which a lot of mucus is produced in the lungs in response to the action of an allergen or other irritant, which narrows the lumen of the bronchi.Therefore, a person develops shortness of breath – he inhales with a whistle and exhales heavily. At the same time, coughing with a large amount of sputum worries.

The disease proceeds with periods of exacerbation, therefore patients carry an inhaler and other medications with them. But sometimes the asthma attack of is very strong and does not disappear after using the necessary drugs, but becomes more and more intense. This condition can lead to respiratory arrest and death.

What to do

Call an ambulance urgently if symptoms occur for the first time or a person with diagnosed asthma has an attack that does not go away after taking medication.

Chronic obstructive pulmonary disease

In people who smoke for many years, the elasticity of the lung tissue decreases and it cannot perform its function. This is how chronic obstructive pulmonary disease (COPD) occurs. She has the following symptoms:

  • shortness of breath, which develops gradually, increases with physical exertion;
  • feeling of tightness in the chest;
  • wheezing;
  • chronic cough with phlegm;
  • weight loss in advanced stages.
What to do

If signs of COPD appear, you need to see a physician. He will recommend quitting smoking and prescribing medication to dilate the bronchi.

Pulmonary thromboembolism

Blood clots can form in humans with varicose veins. If they break off, they can enter the pulmonary artery and block its lumen. In this case, blood flow in the lungs stops and suddenly there is a violation of breathing, chest pain and coughing.sometimes there is sputum with blood. This condition can lead to death.

What to do

When these symptoms appear, call an ambulance. After improving the condition, the phlebologist will prescribe treatment for varicose veins to prevent recurrence of pulmonary embolism.

Pulmonary hypertension

Increased pressure in the arteries of the lungs and the right chamber of the heart is called pulmonary hypertension . This condition develops slowly over several years.It is caused by congenital and acquired heart defects, COPD, pulmonary embolism and some diseases of internal organs, for example, tumors that compress the vessels in the chest, inflammatory pathologies of the vessels or heart, or kidney diseases.

Pulmonary hypertension is characterized by shortness of breath, which first appears with physical exertion, and then without. Then the pain in the chest, dizziness, swelling in the legs, blue lips and skin, rapid pulse are disturbed.

What to do

If symptoms appear, you need to make an appointment with a therapist.He will prescribe an examination, find the cause of pulmonary hypertension and select a treatment. If you do not pay attention to your condition, the work of the heart will be disrupted and you will die.

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Life without alcohol and drugs – to the health of young people! – GAUZ GKB 2

Health is a state of complete well-being, which allows a person to live happily and achieve goals that correspond to his capabilities.The main indicators of health are:

– the ability to maintain and strengthen their own health and build their behavior without prejudice to the health and well-being of other people;

– high efficiency and disease resistance;

– self-confidence, the ability to control and manage your actions, feelings and thoughts.

Human health depends on many conditions, but the main one among them is a healthy lifestyle. Basic conditions for healthy lifestyle:

1.The mood for a healthy lifestyle.

2. Sufficient physical activity.

3. Ability to regulate your mental state.

4. Proper nutrition.

5. Hardening and training of immunity.

6. Clear mode of life

7. Compliance with hygienic requirements.

8. Ability to prevent dangerous situations and behave correctly when they arise.

9. Refusal from bad habits.

10. The need to learn more about your body, about the means and methods of maintaining and ensuring your health.

What types of mental addiction exist? The types of mental dependence include:

1) Group mental dependence on psychoactive substances. It is typical for adolescents and manifests itself in the need to use psychoactive substances, which arises when they get into a group of significant peers (“their company”). Outside of the group in which the group use of the psychoactive substance occurred, the need for use disappears. The existence of this dependence indicates the presence of a certain situational predisposition to the formation of the disease and the greater likelihood of its occurrence.If at this stage preventive measures allow you to stop contact with “your company”, then, as a rule, the teenager stops using the psychoactive substance.

2) Individual mental dependence. This is a pathological need for the use of a psychoactive substance in order to achieve mental comfort in a state of intoxication. Psychological dependence on a psychoactive substance is manifested in a constant desire to use psychoactive substances. A break in the use of a psychoactive substance causes a feeling of anxiety, tension, depressed mood.

How to learn to say “no” if psychoactive substances or drugs are offered? Saying “no” is a whole science, which, by the way, is not always fully comprehended even by adults. When rejecting, it is important to look the other person in the eye. The voice must be firm and confident. Any schoolchild and student has the right to make decisions, say “no” and not feel guilty. Some examples or scenarios of refusal:

1. “No, I do not use drugs.” This is an answer that does not require explanation, and may sound after the proposal of any type of surfactant or drugs.

2. “No thanks. I have to go to practice. ” Rational justification of refusal will not surprise those people who offer to try It also will not cause them any special fears – they will make sure that you are not their victim and very quickly lose interest.

3. To the question “Are you weak?” you can answer like this: “I am weak to sit on the needle for the rest of my life.”

4. “Thank you, no. It’s not my style. ”

5. “Leave me alone!”

6. “Why do you keep pressing on me if I already said NO?”

7.”Surfactants (drugs) do not interest me.”

8. If the interlocutor begins to make fun of the refusal, you need to support the “joking” form of conversation.

9. If the pressure becomes more persistent, you need to remember that you can always just leave.

10. Choose an ally: look for someone in the company who agrees with you.

11. Translate the arrows: say that you are not forcing any of them to do something, then why are they so annoying.

12. “Crush” intellect: if they convince that it is harmless, point out where they lie or simply do not know the consequences (for this you need to know what tobacco, alcohol, drugs are harmful) or scare: describe any terrible consequences if they use (for example, delirium tremens occur, AIDS can be contracted, teeth will rot, etc.)).

13. Avoid: if there is a suspicion that drugs may be offered in a campaign at a certain time, simply bypass it. 5

.

What are drugs and drug addiction? Drugs are chemical substances that alter a person’s consciousness and cause mental and physiological dependence. Addiction is a fatal disease in which the craving for the drug is so strong that it is impossible to stop without treatment. Drug addiction is a special mental illness in which it is not so much the consciousness and thinking of a person that suffer, as in other mental illnesses, but the sphere of needs.Under the influence of taking this or that narcotic substance, the need for its repeated receptions is formed in order to, if possible, constantly be in a state of intoxication caused by it (intoxication). If this substance is alcohol, the disease is called alcoholism . If this substance is nicotine, the disease is called nicotine addiction. If this is any other drug substance, the disease is called respectively drug addiction or toxic addiction .

What are psychoactive substances? Psychoactive substances (surfactants) – chemical and pharmacological agents affecting the physical and mental state, causing painful addiction . A surfactant is any substance that, when introduced into the human body, can change the perception of the environment, mood, cognition, behavior and motor functions. In everyday life, psychoactive substances are commonly referred to as drugs. However, psychoactive substances include not only drugs, but also alcohol, tobacco (nicotine), caffeine, volatile solvents, medicinal psychotropic drugs , etc.

How do alcohol and nicotine differ from drugs? Drug addiction develops much faster than alcohol and faster than nicotine. And it is much more durable: quitting using drugs is many times more difficult than quitting smoking or drinking alcohol. In addition, drugs are much more toxic substances: their doses are measured in milligrams, and only in some cases, grams, while alcohol is “measured” in glasses, and tobacco nicotine – in packs. Due to the special danger of drugs, they are prohibited for use, and their distribution is punishable by law.Drug addiction is a phenomenon associated with the consumption of any substances that alter the mental state of a person and cause addiction. Consumption of alcohol, smoking, consumption of drugs and toxic substances are manifestations of drug addiction, different in severity and social danger. Some of them have to be fought with all the forces of society, including law enforcement agencies (drug addiction), with others – by methods of anti-alcohol and anti-nicotine education.

Is the use of surfactants a personal matter for each person? No, the use of psychoactive substances and drug addiction is not everyone’s personal business, although a person himself decides whether to start using drugs or, relying on the received education and knowledge about drug addiction, to stop using drugs.There is no “right” to use drugs, and there cannot be, and drug addiction has nothing to do with the problem of “human rights”.

Do drug addicts have a weak will? The will of the addict is not weak, but incorrectly oriented towards a need that is destructive for the psyche and the body and is dangerous for others.

Why do teenagers start trying surfactants, drugs? The reasons for the use are different:

– out of curiosity; – for the sake of pleasure, the desire to experience joy, delight, pleasure;

– as a protest against parents: “I myself know how to manage my health, my life”;

– to relieve stress.

How to avoid negative peer pressure? To overcome the pressure, you must know:

– who you are and what are your values;

– how to make a decision on your own;

– how to act in different situations.

Algorithm of action:

1. Understand what is really happening: where are you; Who are you with; what are they doing; how they behave; how do you feel about what is happening?

2. Think about the consequences: how you will treat yourself tomorrow; whether this could lead to problems; whether it could harm your health; whether your parents will be disappointed with you; what are the consequences?

3.Make your decision.

4. Tell others about your decision.

5. What happens after I have made a decision? By saying no, you can:

– treat yourself well; – make others respect yourself for being a person;

– to maintain relations with parents;

– keep health;

– to protect yourself from misfortune.

Common myths among young people

1. Is alcohol a stimulant, does its use raise spirits?

No .Alcohol is a depressant, it inhibits the activity of the brain and spinal cord.

2. Drug addiction is just a state of mind.

No . Drug addiction is real, it can be both physical and emotional.

3. If it is not safe to drive after drinking, then it is quite possible to drive after smoking marijuana.

No. Studies show that driving skills deteriorate for a period of 4-6 hours after smoking one marijuana cigarette, and there are authors who argue that the peak of the violation occurs at the moment when the first signs of “addiction” disappear.

4. If you want to sober up, a cup of hot fresh coffee, fresh air or a cold shower will help you.

No . The feeling that you have sober up really does arise, but the amount of alcohol in the blood does not change, and, therefore, the speed of reaction, attention and behavior will be like that of a drunk person.

5. Beer drunkenness is lighter than vodka drunkenness.

No. Beer, wine and spirits all contain alcohol, and therefore the effect is the same.

6. People do not die from alcohol poisoning.

No. People die from drinking too much.

7. Traces from the use of marijuana (if you smoked just one single portion) in the human body are completely invisible, ie. absent.

No . Traces from the use of even one serving of marijuana are found in the human body within one week after smoking.

8. In order to keep warm, you can take a glass of alcohol.

No . Drinking a glass of alcohol causes the blood vessels near the surface of the skin to dilate, although this creates a feeling of warmth. The body actually loses heat quickly, thereby causing hypothermia in the body. Where can you go for help? There are many people who can give you good advice: – trusted friends; – parents – try to talk to them, they were teenagers too, ask them how they resisted peer pressure when they were young; – specialists of the psychological and psychotherapeutic service of MAUZ GKB No.