by Martin Rosenberg, Scripps Memorial Hospital La Jolla
Between allergies, asthma, respiratory infections and other health problems, it’s no surprise that breathing difficulties are one of the most common problems for seeking medical care. Some of these are fairly easy to treat, while others may be more complicated. Whatever the cause of your breathing problem, getting effective treatment can make a huge difference in your quality of life. Let’s take a look at two of the most common causes of breathing trouble—and what to do about them.
One of the most common breathing problems we encounter is pneumonia, which is an infection of the lungs caused by viruses or bacteria that enter the lungs through several pathways. Pneumonia often follows a respiratory infection and can be more likely to affect young children or elderly people due to weaker immune systems. We also see pneumonia more often among patients with chronic obstructive pulmonary disease (COPD), a serious lung disease usually associated with emphysema or chronic bronchitis. Because their lungs are already working harder than normal, COPD patients may not be able to fight infection as well as patients with healthy lung function. As a result, COPD patients who get the common cold or flu may be more susceptible to developing pneumonia.
Pneumonia symptoms usually arise rather quickly and may include a deep, persistent cough (often coughing up mucus), fever, fatigue, and difficulty breathing or shortness of breath. Chest pain, especially upon inhaling or coughing, may also be present. If symptoms are mild, you may have “walking pneumonia”; in other words, you are not sick enough to have to remain in bed.
Your doctor most likely will order a chest X-ray and a sputum culture (saliva test) to determine if you have pneumonia. If caught and diagnosed early, many cases of pneumonia can be treated at home. Depending on the severity of the disease and whether you have other health problems, you may need to be treated in the hospital. Severe cases may require intensive hospital care. In general, though, pneumonia is treated with antibiotics to eliminate the infection. Bronchodilators, which are medicines that help open the bronchial tubes to let more air pass through to the lungs, may also be used to ease breathing. Most cases of mild pneumonia clear up in two to three weeks.
Because pneumonia is caused by bacteria or viruses, one of the best prevention techniques is to wash your hands frequently and avoid being around other people who are sick. This is especially important if you already have a health problem that affects your lungs, such as COPD or asthma. If you do catch a cold or flu, allow your body plenty of rest and time to recover and consult with your physician.
Asthma is a chronic disease that affects the airways of the lungs and interferes with normal breathing. An asthma “attack” happens when asthma triggers irritate the airways and cause them to overreact. During an attack, three things happen: the airways become inflamed and swollen; the muscles around them constrict and make the airways even smaller; and the mucous glands in the airways step up production, further blocking the opening. With all this going on, there’s not much room left for air to pass freely to and from the lungs.
Allergies are one of the most common asthma triggers, and may include dust, animal dander, mold, pollen, cigarette smoke, and fragrances such as perfume. “Exercise-induced” asthma can occur as a result of physical activity. Symptoms can range from a hacking cough, wheezing, rapid breathing, and trouble taking a full breath to a life-threatening inability to breathe at all.
Without treatment, severe asthma attacks can be fatal.
To diagnose asthma, your doctor may do a pulmonary function test known as a spirometry, in which you exhale forcefully into a mouthpiece connected to a spirometer. The spirometer measures the amount and force of air that you breathe out. Your doctor may then give you a medication to open your breathing passages and repeat the test; if there is a 15 percent or greater improvement in your breathing, you may be diagnosed with asthma. At this point, your doctor will begin looking at what may trigger your asthma; this may include allergy testing.
In addition to avoiding triggers, asthma can also be helped through medication. Bronchodilators may help air flow through to the lungs. Anti-inflammatories help keep airways from swelling. Leukotrine modifiers can help ward off the chemicals that cause airways to swell and tighten. For patients who require emergency care for asthma, new treatments include long-acting aerosol medications and heliox, a combination of helium and oxygen that helps to open the airways.
Martin Rosenberg is a respiratory therapist with Scripps Memorial Hospital La Jolla. Join Martin for a free seminar on healthy breathing tips at “Breathing Right” on Friday, July 16 from 10:15-11:45 a.m. at the Lawrence Family Jewish Community Center, Senior Activity Room. To register, call 1-800-SCRIPPS.