May 25, 2018
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What you can do to breathe better

By Dr. Paul Shapero, Special to the BDN

Chronic obstructive pulmonary disease, or COPD, can make it hard to breathe. But there are steps you can take to breathe easier and improve your quality of life.

The more one knows about his or her type of COPD, the more opportunities there are to improve one’s breathing.

Each person with COPD has a combination of chronic bronchitis, emphysema and asthma to varying degrees. All forms of COPD decrease the delivery of oxygen to the heart, brain and the rest of the body. This impairs one’s quality of life.

When the lungs are subjected to years of cigarette smoke, the lungs make more mucus glands that produce more mucus to protect the lung tissue from the harmful effects of smoke. The lungs become twitchy (asthma), fill with mucus and scar (bronchitis), and the alveoli are destroyed (emphysema). The lungs may or may not be beyond repair.

A car driver needs to know how much gas is in the tank. Similarly, a patient needs to know his or her lung function as measured by a spirometer. This breath test measures lung size and the amount of air one blows out in one second. When the ratio of these two measures is less than 0.70, the diagnosis may be COPD. Often, one will inhale albuterol and repeat the breath test.

The result of this simple breath test, which takes no more than 10 minutes, enables a doctor to prescribe the best medications. Without it, it is an educated guess as to the best treatment. Since the medications are expensive, health care providers try to choose the most cost-effective and safe medication for each patient. Each medication helps to varying degrees. Often, the patient is in the best position to make the final decision.

As we study the medications for COPD, it has become apparent that drugs cannot do all the healing, and the power of medicine varies from patient to patient. Fortunately, the body itself has great recuperative and healing properties. Except for the brain and teeth, the body normally replaces all old cells with new cells every three to four months. Therefore, there is usually an opportunity to improve one’s COPD with appropriate treatment.

The body seems to work as a single unit, with each system affecting another system. For example, acid reflux can trigger an asthma attack. Being overweight means more work for the lungs and heart. No exercise decreases the efficiency of the lungs. An unbalanced diet limits the building blocks needed for normal tissue repair and healing. A poor night’s sleep, stress and no exercise impair the immune system, which protects us from infection.

Each of these items provides an opportunity to improve one’s breathing, decrease shortness of breath, increase one’s ability to walk and exercise, and improve quality of life.

These ultimately decrease the chance for bronchitis, pneumonia and worsening COPD.

We are slowly learning which medicine or combination of medicines is best for each patient. The hope is to match the proper medicine to the patient to yield the best results.

Our office is currently offering drug trials of new medicines and delivery devices to patients with COPD and asthma.

To help people who have smoked, our office is planning several sessions of free spirometry breath tests for people so they can know how much gas is in the tank. This information helps smokers and nonsmokers receive proper medications that are likely to help them breathe better.

Two sessions are scheduled for 5-7 p.m. Oct. 9 and Oct. 23, at our office in Evergreen Woods, 700 Mt. Hope Ave., Suite 430, in Bangor.

Call 947-8658 if you plan to come, but it is not necessary to call ahead.

Dr. Paul Shapero is an allergist whose practice is located in Bangor.

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