There are plenty of things that take my breath away – a fantastic sunset, great surf conditions, my wife (I’ll take any brownie points I can get!) – but for those of us with healthy hearts and lungs we struggle to understand the difficulties of those living with a chronic cardiopulmonary concerns. The condition known as Chronic Obstructive Pulmonary Disease (COPD) or emphysema, can be a debilitating illness that makes breathing incredibly difficult and the thought of physical tasks a cause for anxiety.
COPD arises from the deterioration of a crucial part of our airways where the vital gas exchange process takes place. At the same time sufferers also experience damage to the fine hairs that line the airways called cilia. The combination of these factors lead the airways to become a breeding ground for bacteria leading to frequent infections and heightened pneumonia risk. Coughing becomes a feature as the sufferer tries to clear their airways, however coughing in and of itself is an abrasive action and can cause the airways to become inflamed and for the cilia to become even more damaged. Whilst some medication may assist in managing inflammation and keeping airways open, and also in managing infections and antibiotics are a frontline defence against infection, there is no pharmaceutical approach that can comprehensively manage this process so as to meaningfully change the course of this disease.
Now, as grim a picture as this seems, there is actually a series of strategies that can be put in to place to help most sufferers control the rate of disease progression and reduce infection risk. A comprehensive management program must include 3 main features. The first is knowing how to keep your airways clear. The active cycle of breath techniques (ACBT) involves a ‘huffing’ manoeuvre instead of coughing which is far more effective in clearing the congestion that leads to coughing fits and an environment ripe for infection. The second is to undergo some basic breath training. It might sound silly but learning how to breath effectively is something that is often lost in the disease process and since the diaphragm is in fact a muscle it responds very well to exercise. Lastly, the most important strategy is exercise. This is usually a loaded term but in COPD its a non-negotiable. In as much as the airways are limited, the systemic gains still available through the application of appropriate exercise therapy is the difference between those who live well and those who don’t. Improvements in the vascular system’s capacity for oxygen transport and heart and muscle health can lead lead to reductions in shortness of breath, less time in hospital and less secondary health concerns.