When breathlessness can actually kill you?

 Increasing awareness of heart diseases makes their detection early and prompt. But the flip side of the story is that all breathlessness in thought to be coming from heart ailments. We tend to forget the 

5^th most killer disease of the world, COPD (Chronic Obstructive pulmonary disease).

Smoking, urban life, outdoor & indoor air pollution all contributes to fast ageing of lung. When fast pathological ageing of lung start i.e. rapid decline of FEV1 than normal detected in Lung Function Test, it is termed as COPD. It is a progressive life threatening lung disease. 

It kills 3 million people worldwide per year. It accounts for 5% of all death globally. More than 90% of COPD death occurs in low middle income countries. There is a steep rise in number of COPD cases. It has increased by a whopping 27% in last decade. It is the 5^th biggest killer disease and will become 3^rd most killer disease by 2020.

Chronic bronchitis or Emphysema are the day today conversation words used for COPD. Early detection may change the course of disease and significantly reduce the morbidity and death rates associated with it. The common symptoms of COPD – cough, sputum production, breathlessness, weakness, fatigue etc.

Prevention of COPD:

1.       Avoid tobacco smoke

2.       Avoidance of outdoor & indoor air pollution

3.       Early detection with Spirometry, which measures lung function. It is also called PFT test

 Treatment of COPD:

1.       Quit Smoking

2.       Bronchodilator

3.       Pulmonary rehabilitation comprising of

                  - Exercises

                  - Breathing maneuvers

                  - Nutrition

                  - Vaccination   Flu shot, Pneumococcal

                  - Disease Education

4.       Supplemental Oxygen if required

5.       Management of acute Exacerbation

“Knowledge is Prevention, Knowledge is Cure”

Let’s join hands to make our COPD patient live longer & healthier.

Lung problems in thyroid diseases

Thyroid diseases can lead to various chest problems. Both hypothyroidism and hyperthyroidism can cause respiratory muscle weakness and decrease lung functions. 

Thyroid is a gland in neck which produces thyroxine hormone. Thyroid hormone is very important for good health. It drives protein, fat & carbohydrate metabolism of body. It maintains basal metabolic rate (BMR). So a less of thyroid hormones (hypothyroid) leads to decrease BMR and thus weight gain and more of thyroid hormone (hyperthyroid) in body causes weight loss. Thyroid hormone levels in body has  to be in the range. The hormone levels below or above the normal range causes various problems.

Changes in thyroid state during pregnancy can impair fetus growth and maturation. thyroid state can be assessed by thyroid function tests. A high TSH means hypothyroid  and low TSH means increase in thyroid hormones. 

There are certain respiratory problems encountered in thyroid dysfunction.

HYPOTHROIDISM & RESPIRATORY PROBLEMS:

• Causes obesity leading to Obesity Hypoventilation Syndrome
• Decreases respiratory drive from brain
• Causes respiratory and diaphragmatic muscle weakness
• cause obstructive sleep apnea 
• 1/4 th of hypothyroid patients have pleural effusion.

HYPERTHROIDISM & RESPIRATORY PROBLEMS:

•  Hyperthyroidism increases respiratory drive and cause breathlessness on exertion or rest
• Respiratory muscle weakness
• Grave's Hyperthyroidism (a subtype of hyperthyroidism) may be associated with allergy (raised IgE levels & atopic background) which can precipitate life threatening asthma attack on starting beta blocker medicine for hyperthyroidism
• Pulmonary Hypertension

ENLARGEMENT OF THYROID OR GOITER;

• Compression of trachea can occur with nodular goiters and thyroid cancers
• This leads to whistling sound on inhalation phase (stridor), breathlessness or cough

So, if you are a thyroid patient and you experience cough, breathlessness, snoring or daytime sleepiness, immediately contact your doctor.

Sleep apnea in Thyroid disorders (Hypothyroidism)

OSA is common in diseased thyroid state when thyroid secretes less hormone which is known as hypothyroidism. Hypothyroidism is when your thyroid is not secreting enough thyroid hormones and treated by oral thyroid tablets taken every day empty stomach. In hypothyroidism TSH levels are high and that is how it is diagnosed. OSA in hypothyroid state is independent of obesity and improves significantly with treatment of hypothyroid state.

So, OSA patients should undergo thyroid function tests to rule out Hypothyroidism. Similarly, in hypothyroid patients, OSA symptoms should actively be looked for and sleep study should be performed if required. 

COPD & OSA: "A Deadly Duo"

COPD is making news with many designations like "Silent killer" or "Common Killer You Aren't Aware Of" or "The 3rd most killer disease" and many more. COPD is the cost our lungs pay for living in urban areas and smoking.

Obstructive sleep apnea (OSA) also holds reputation in causing a myriads of complications in all vital organs if untreated. Though the cause of OSA is not as well understood as COPD but treatment causes good response and prevention of complications.

COPD is breathing disorder while OSA is a sleep related breathing disorder. The presence of OSA in COPD patients not only makes the symptom worse but also increases the chance of death in COPD patients. COPD & OSA overlap has been aptly said to be a "A Deadly Duo".

Understanding of both the diseases and their co-existence is vital in treatment of such patients. Diagnostic tests for both the diseases are simple and widely available. Screening of OSA can be done with Epworth sleepiness score online by anyone while COPD can be diagnosed with Pulmonary function tests. Defeating the two devils together is difficult but not an impossible job.

Giving a chance to patients to breathe without difficulty is not an impossible feat. It can be achieved by patient  education, doctor's  attitude and proactivity to diagnose and treat both the diseases together.