Intense Training for Breathing Problems

Research has shown high-intensity training is an effective way to treat patients with breathing problems. However, this intense training is often too difficult for the patient to do for long periods of time. Now, new research shows high-intensity training in short intervals is also effective and much easier for the patient.

Chronic obstructive pulmonary disease is the fourth leading cause of death in the United States. COPD is a lung disease characterized by difficultly breathing. Often the respiratory muscle strength and endurance is reduced in these patients. Increasing this strength and endurance can help the patient’s breathing. Researchers from the University of Western Australia in Perth conducted a study to see if short, high-intensity training sessions could help COPD patients.

The study included nine individuals with COPD. The participants completed eight weeks of respiratory muscle training combined with a general exercise program. The training included 20-minute sessions, three times a week, where the participant did intense bouts of breathing into a machine. The respiratory strength and endurance were measured during the training period.

The study found that in week one of training, the participants breathing pressures were 68 percent of the maximum. By the eighth week of training, the breathing pressures had increased to 95 percent of the maximum. The study also reports the respiratory endurance of the participants improved.

Researchers say this study shows high-intensity, interval-based training is feasible and effective for patients with COPD. The patients in the study showed significant improvements in respiratory muscle strength and endurance when the training was done just three times a week for eight weeks.

Could You Have Whooping Cough?

Whooping cough. The term conjures up images of poor, sick children making the characteristic whoop as they struggle to bring air into their sick lungs. While this image may once have been accurate, the whooping cough of today is more cough and less whoop.

The two populations who suffer most from pertussis (as it is officially known) are infants and adults. Those less than six months have not yet been fully vaccinated and can die before they even have the lung capacity to make the characteristic whoop. Adults will likely experience pertussis as a persistent cough (without any telltale whoop) that can last weeks and months.

Children are vaccinated against pertussis beginning at two months of age when they are given the DTaP vaccine — diptheria, tetanus and acellular pertussis. Unfortunately, protection against the disease is generally not long lasting, and these vaccinated children become vulnerable to the disease as they graduate from high school. The result is a population of adults who are susceptible to pertussis, catch pertussis, and are capable of transmitting it to the very young and vulnerable.

While pediatricians are sensitive to the presence of coughs in their patients, general practitioners frequently misdiagnose pertussis as bronchitis, allergies or asthma. Dr. James Cherry, chief of pediatric infectious disease at UCLA Children’s Hospital, found that 26 percent of college students reporting a cough that lasted six days or more actually suffered from pertussis. Unfortunately, very few of those individuals were actually diagnosed with pertussis and prescribed the recommended antibiotic — erythromycin for 14 days.

Jim explains what it is like to suffer from a persistent cough: “It is very frustrating to think that I went to doctors repeatedly and did not have pertussis come up as a possible diagnosis.”

The frustration that Jim feels while suffering from a persistent and irritating cough is nothing compared to the suffering an unprotected infant would experience if it contracted the disease from him or from another adult.

Dr. describes the effect of pertussis on adults, “Usually no serious harm comes to the individual, but rather a lot of discomfort and frustration due to the 100 day cough. The spread to others is the main concern, especially to children under six months of age, as they can on rare occasion die from it and are often hospitalized.”

The DTaP vaccine used in children is not recommended for adolescents or children, and there is currently no pertussis vaccine available for adults. So, what should you do if you suspect you have pertussis? Unfortunately, all you can do is go to your physician, insist that pertussis be considered as a possible diagnosis, take the complete course of any antibiotics that are prescribed, and avoid close contact with infants.

Obstructive Lung Disease and Death

A long-term study shows people with chronic lung disease are at a higher risk for early death.

Chronic obstructive pulmonary disease is an umbrella term used to describe airflow obstruction that is associated mainly with emphysema and chronic bronchitis. Experts from the American Lung Association say the exact prevalence of COPD is not well defined, but it affects tens of millions of Americans and is a serious health problem in the United Sates. Experts also say the extent to which obstructive and restrictive lung disease kills may be underreported.

Long-term smoking is the most frequent cause of COPD. It accounts for 80 percent to 90 percent of all cases. A smoker is 10-times more likely than a non-smoker to die of COPD. Some symptoms of COPD include chronic cough, chest tightness, shortness of breath, an increased effort to breathe, increased mucous production, and frequent clearing of the throat. In a new study, researchers found people with severe or moderate chronic obstructive pulmonary disease or restrictive lung disease were more likely to die early than those without lung disease. Smoking tobacco is the primary cause of emphysema and COPD, but other factors, including asthma, genetics, and occupational exposure to dust and irritants are also important.

Researchers also found the disease is often not listed as the primary cause of death even among people who had severe COPD. Of the 66 people in the study who died with severe COPD, only 23 percent had it listed on the death certificate as the primary cause of death. Among people with moderate COPD, only 4.4 percent had it listed as the primary cause of death.

“COPD is definitely a killer, but this study shows that we may be underestimating its truly negative impact,” says Udaya B.S. Prakash, M.D., president of the American College of Chest Physicians. He continues, “Accurate data on how many Americans die of this disease is crucial to educating the public of the dangers of tobacco use.”

Low Weight and Lung Disease

Does severe lung disease cause you to lose weight or is low weight a risk factor for developing the lung disease? Doctors around the United States recently set out to understand the connection between body mass index and chronic obstructive pulmonary disease (COPD).

COPD is the term used to describe any lung condition that restricts airflow in and out of the lungs. This includes emphysema and chronic bronchitis. The American Lung Association reports 16 million patients have been diagnosed with some form of COPD. As many as 16 million more are undiagnosed.

Anywhere from 24 percent to 35 percent of COPD patients have low body mass and malnutrition. That is defined as less than 90 percent of their ideal weight or weight loss of 5 percent to 10 percent of their initial weight. In a study of 458 men, researchers found middle-aged and older men with low body weight were at a “substantially higher risk of COPD.” The doctors also studied women, but were unable to come to a conclusion on their findings.

“A somewhat surprising result of this study is our finding that men with high body baseline body mass had a lower risk of getting COPD,” write the researchers. While they are pleased at their findings, they admit they do not understand them. The source of the connection remains unclear, although they speculate that low birth weight babies might maintain low body mass index throughout life and be at higher risk for lung problems in adult life. The doctors say early nutritional intervention may perhaps avert later lung problems.

Removing Lung Clots

Doctors say nearly 600,000 lung clots are diagnosed each year in patients. The symptoms include shortness of breath and leg swelling. Many patients go untreated, but a new procedure can help turn their lives around.

Jack is 49. His sunken cheeks and dark eyes are a result of his 20-year struggle with lung problems. “It just got harder and harder and harder to breathe,” says Jack.

Dozens of doctors told him it was pneumonia. Finally, one physician determined Jack had lung clots. Blood clots break off from the leg and travel to the lungs. If large enough, they can disturb blood circulation.

Doctor saw Jack when his condition was at its worst. “His legs were tremendously swollen, at least 12 to 15 inches in diameter below the knee,” says Dr. Mulligan.

Blood thinners did not dissolve the clots. So Dr. Mulligan used a procedure called a pulmonary thromboendarterectomy, or PTE. He used a tiny device to remove the clots.

“The tip is fine enough so that you can see those small little vessels and dissect them clean,” says Dr. Mulligan.

Eight weeks after surgery, he’s up and around – without oxygen. “I feel so damn good. It sometimes just brings tears to my eyes,” says Jack.

Dr. Mulligan says, “It’s a tremendously underdiagnosed and definitely an undertreated problem.” Patients often live with symptoms like shortness of breath, leg swelling and fatigue for years.

“I hope that by doing these interviews and trying to reach out a little bit that we can trigger a diagnosis for somebody,” says Dr. Mulligan.

And with treatment, he says Jack can soon regain an active lifestyle.