A WHO report reveals that respiratory diseases make up 5 of the 30 most common causes of death: chronic obstructive pulmonary disease(COPD) is third; lower respiratory tract infection is fourth; tracheal, bronchial and lung cancer is sixth; tuberculosis is twelfth and asthma is twenty-eighth.Altogether, more than 1 billion people suffer from either acute or chronic respiratory conditions. Also, asthma affects 235 million people worldwide, out of which 15–20 million people are from India. As per a recent report in 2021, more than 20 of the 30 most polluted cities of the world are in India.Also, interestingly, reports suggest that the sale of asthma medicines in India has grown by more than 40% in the past four years -thanks to increasing levels of pollution.
Anyone with chronic respiratory disease should consult a specialist and formulate a prevention and treatment plan.
This would include:
Adhering to the Regular Medicines – Inhalers – both metered dose(MDI) and dry powder (DPI), nebulisers and oral medicines.
The most often done mistake is stopping medicines on their own, without having a proper step-down plan. Many patients during this pandemic have stopped their regular medicines for their chronic conditions due to various reasons, and have reported very late to the hospital, thus ending up very sick. Remember “Absence of symptom is not the absence of disease.”, as sometimes our own body (read - lungs) has a way to compensate – (only to an extent) thanks to our lungs which are two in number and elastic in nature with multiple plexus of blood vessels!
Avoiding Possible Triggers Which Can Exacerbate - allergic diseases, asthma and COPD. This holds true for patients with chronic diseases and most often patients themselves can identify the possible triggers. There are also ways to identify the triggers by specific testing – which are only rarely necessary, most often a good clinical history would suffice.
Identifying patterns of triggers in allergic diseases and asthma is of utmost importance as this can prevent an acute episode and hospitalization. Commonly the pollutants – not only outdoor, but the indoor air pollutants and triggers should also be looked into. Patients should have clear dos and don’ts on their list, based on the nature of their illness after discussing with their physician.
Vaccination – This is most often overlooked. Most often vaccination is thought to be only for kids. The importance of adult vaccination has come to the forefront after this pandemic. There are adult vaccines other than the COVID vaccine – like the pneumococcal vaccine, influenza vaccine, etc. The annual flu vaccine is for all, from the age of 6 months and above. Speaking to your physician would help you understand adult vaccinations better. Persons with comorbidities, pregnant women and those above 50 years of age are the ones who are vulnerable.
This might be the most underestimated component in the management of respiratory diseases. This requires a tailored approach to suit a specific patient’s need and disease condition and at the same time involves understanding the limitations of the underlying problem. Pulmonary rehabilitation usually includes nutritional support, exercise and inspiratory muscle training, counselling and education about the underlying problem and understanding their prescribed drugs.
In any chronic respiratory problem being self-aware is really important as subtle changes in the breathing pattern are often realized first by the patients. Hence understanding the disease and having a realistic and practical approach with emphasis on prevention goes a long way in preserving lung function.