HEALTH MATTERS: Learning to live with lung disease

Most lung disease is chronic, with more than 35 million Americans currently living with the condition.

By Kenneth H. Goldblatt, M.D. Princeton HealthCare System
    We often take for granted our ability to breathe, counting on our lungs to do their job without us even having to think. That is, until we become winded after walking just a few blocks or are left gasping for air after climbing a normal set of stairs.
    It’s then that we start to pay attention to our lungs, which provide our body with a constant supply of oxygen to keep our cells and organs working properly. When our lungs stop working properly, so do a lot of other functions, and our health and quality of life begin to suffer.
    Every year, more than 400,000 Americans die of lung disease. Lung disease is America’s No. 3 killer, responsible for 1 in 6 deaths, according to the American Lung Association. Most lung disease, however, is chronic, with more than 35 million Americans currently living with the condition.
    With the help of medication, lifestyle changes and pulmonary rehabilitation, many patients with lung disease can improve their quality of life and resume activities they once enjoyed with little effort.
    The week of March 15 to March 21 is National Pulmonary Rehabilitation Week, an effort initiated by the American Association of Cardiovascular and Pulmonary Rehabilitation to focus national attention on pulmonary rehabilitation’s contribution to the enhancement of the life of the person with Chronic Obstructive Pulmonary Disease (COPD).
    COPD includes emphysema, chronic bronchitis and asthma. Severity can range from mild shortness of breath during normal activity to the complete inability to perform even basic tasks of daily living. For patients with asthma, shortness of breath may be episodic, triggered by exercise or certain allergies. At the same time, COPD can be aggravated by dust, viruses, bacteria, animal dander, pollution and tobacco smoke.
    If you have been recently diagnosed with COPD, there are several actions you can take to improve your ability to breathe and live a normal life.
    First and foremost, if you are a smoker, quit now. If you don’t smoke, don’t start. Smoking is the leading cause of COPD. The more a person smokes, the more likely that person will develop severe chronic bronchitis or emphysema. Secondhand smoke may also cause chronic bronchitis.
    Secondly, there are several effective medications available to help improve your ability to breathe and help prevent COPD from progressing. These medications generally fall into two categories — bronchodilators that relax the muscles around the bronchi to allow easier breathing and corticosteroids that are inhaled to decrease inflammation of the airways. In addition, your health care provider may prescribe antibiotics to treat any infection and may recommend vaccines to prevent pneumococcal pneumonia and the flu. Some patients with severe chronic obstructive pulmonary disorder may require oxygen treatment.
    Nutrition also plays a role in treating COPD. If you are overweight or obese, your diaphragm tends to push up and put pressure on your lungs, impacting their ability to work properly. Conversely, if you are underweight, your body may not be getting enough calories to function well, especially when the act of breathing takes extra energy. Eat a balanced diet rich in fruits and vegetables and low in salt.
    Regular exercise, beginning with a pulmonary rehabilitation program, is also key to treating COPD. When you become short of breath, you compensate by doing less. This in turn causes your muscles to become deconditioned, which puts a heavier burden on your lungs to power your body. When you exercise regularly, you build up your muscles, making them more efficient in their use of oxygen and relieving the stress on your lungs.
    The Pulmonary Rehabilitation Program at University Medical Center at Princeton — the first in Central Jersey to earn national certification by the American Association of Cardiovascular and Pulmonary Rehabilitation — is generally a 12-week program consisting of three hour-long sessions each week. Sessions are supervised by a team of pulmonary therapists, advanced cardiac life support certified nurses, licensed registered respiratory therapists, exercise physiologists and registered dietitians.
    The program uses a variety of equipment, including treadmills, stationary bikes and weights, combined with educational sessions to help patients:
    • Reduce shortness of breath;
    • Increase the ability to perform daily activities;
    • Master breathing techniques;
    • Improve stamina and strength;
    • Decrease anxiety and depression; and
    • Improve overall physical and mental well-being.
    After completing a pulmonary rehabilitation program, patients realize that they now can do much more than they could do previously. Learning how to live with COPD gives patients better control over their lives and helps them enjoy living again.
    Pulmonary rehabilitation is available at University Medical Center at Princeton’s main campus and UMCP’s Monroe unit in Monroe Township and requires physician authorization. For more information about UMCP’s Pulmonary Rehabilitation Program or to find a pulmonologist on staff at Princeton HealthCare System, call 888-742-7496 or visit www.princetonhcs.org.
Dr. Kenneth Goldblatt is chairman of the Department of Medicine and chief of Pulmonary/Critical Care at University Medical Center at Princeton. He also is the medical director of UMCP’s Pulmonary Rehabilitation Program.