Tips For Avoiding Acute Exacerbation Of COPD or Chronic Obstructive Pulmonary Disease

In this blog, we will review a few simple things that the patient and the patient’s family with chronic obstructive pulmonary disease (COPD), emphysema, and chronic asthma may use to prevent COPD exacerbations.

Many patients with COPD may have underlying chronic asthma and many are active or
former smoker.  Many may have associated emphysema in conjunction with intermittent symptoms of asthmatic bronchitis. Preventing a flare-up of COPD and/or underlying asthma may further help improve quality of life and may decrease use of acute care/hospitalization.

(1) Understanding severity of disease. One needs to understand underlying severity of COPD if underlying bronchial asthma or emphysema is present or not. There are no specific COPD cures, but controlling the symptoms helps improvement of respiratory symptoms and sense of wellbeing. One may consider pulmonary function test if not done to assess underlying severity.

(2) Understanding of acute or chronic COPD symptoms. Keeping a log of regular COPD symptoms and any changes may help to seek early medical treatment for control of COPD exacerbation in the early phase rather than later. The patient may get low-grade fever, increase in cough, quantity, change in the color, and/or increase shortness of breath.

(3) Home oxygen use. A few patients with COPD may need use of oxygen either at night or on exertion or continuously. This needs to be evaluated by their physician.

(4) Emergency plan. It would be good to have an emergency plan if there is worsening of the symptoms. If someone with severe asthma and/or COPD, it may be good to have a course of antibiotic and a tapering course of prednisone handy and start it with exacerbation of symptoms in conjunction with their primary care and/or pulmonologist. If there is worsening of COPD then it would be good to call 9-1-1 and go to the Emergency Room.

(5) Anxiety symptoms. Anxiety, COPD, asthma, emphysema symptoms go hand-in-hand.  With the change in respiratory symptoms and an increase in air hunger there may be fluctuation in anxiety and depression symptoms. Relaxation is the key. Slow deep breathing exercise may help.

(6) Exercise. Regular walking, breathing exercises and moderate strenuous exercise, depending on heart condition may be considered based on physician advice. This has been shown to decrease exacerbation of COPD, and clearing of respiratory secretions in the morning.

(7) Avoiding certain foods. Usually cold water, cold drinks, dairy products, ice cream, and chocolate may trigger underlying COPD/asthma. Bananas increase mucus formation.  This may be good to void. Many patients notice a change once they cut down the use or discontinue it.

(8) Medications. Use of inhalers, nebulizers, oxygen, its duration frequency and maximum dose, needs to be understood. The common mistake many COPD patients make is overuse of long-acting bronchodilators in place of short-acting inhalers or nebulizer treatment. This needs to be avoided. Correct inhaler technique is the key.

I hope this may help in understanding underlying symptoms of COPD and exacerbation factors and cut down any major flare-up.

Integrative Medical Treatment & Management Benefits in patients with Bronchial Asthma and Chronic Obstructive Pulmonary Disease

This is the first blog for the web site discussing the need for the integrative medical management and treatment approach for patients with bronchial asthma and chronic obstructive pulmonary disease (COPD).  In this blog, we will discuss the standard approach for bronchial asthma and chronic obstructive pulmonary disease, and the benefits of adding other modalities to further optimize medical treatment.

Bronchial asthma is a very common respiratory disorder. Almost everyone knows someone in his or her family, friend or co-worker who suffers from bronchial asthma. It has multiple facets and gets worse with time if remains untreated. If untreated, it leads to deterioration of health and increase in medical expenses.  Similarly, the outcome is the same for those with COPD, but it is generally seen in smokers mostly, for which they themselves are responsible. There are a few patients who have COPD as a result of second hand smoke exposure.

Inhalers are key in the treatment of disease control. There are different groups of inhalers used to treat asthma and COPD.  Many are common in its treatment as it is a similar disease but not completely the same either. Bronchial asthma is an airway reversible disease and has good response with bronchodilators but the same is not true in the case of COPD as the bronchodilator has less airway reversibility than asthma.

There are short-acting inhalers, long-acting inhalers, steroid inhalers and other medications, which are taken orally for control of the symptoms. These help to control the symptoms of asthma or COPD, but do not eliminate or decrease the need in the long run.  If the disease is not under control then this increases the cost of health care and dependence on medication.

Standard medial therapy is excellent in helping to control the symptoms of asthma or COPD, but when other alternative modalities are added to the current standard medical management then the chance of slowly improving the asthma and COPD is there. This may help to overall improve the symptoms and cut down the need for inhalers. This may happen in many patients but not all, and still may show some clinical improvement.  This may decrease the need for Emergency visits, urgent care visits or hospitalization.

The integrative medial treatment approach is an addition to other alternative modalities of treatment like Ayurveda, Yoga, Pranayama, exercise, special diet, etc., to the standard medical treatment that one is getting.  The goal is to use the multidisciplinary approach to control the disease of asthma and/or COPD, as it is simple, yet a complex disease that has multiple mechanisms of manifestation and exacerbation. A multi-modality treatment approach helps rather than just using the standard treatment of just inhalers or nebulizers alone. This is our observation in our practice in the group of patients who prefer the approach of integrative modalities of treatment verses the standard medication treatment alone protocol.

One may think, can such kind of integrative treatment approach help? Why does adding a regimen like exercise, special diet, Ayurvedic herbs, improvement of sleep through good sleep hygiene and lifestyle, etc., help?

There are no standard medical trials or any head-to-head medical trials involving the findings found in medical literature to prove or disprove it, but it is our experience that it helps patients with asthma and/or COPD from our observation of hundreds of patients having been followed over many years in our Pulmonary and Sleep Medicine Clinic.  We have taken many of the observations from the literature of Ayurveda and incorporated in current medical treatment.  We have tried to incorporate two different medical systems for overall improvement of asthma or COPD.  It is like using the parallel software of an Apple computer to connect two different operating systems of Microsoft and MAC to get the benefits of both software and operating systems.

We have seen that Ayurveda gets incorporated better with standard medical treatment and it helps the patient. Ayurveda is the oldest documented medical literature. Asthma is not a new disease it has existed for thousands of years so why not use that data and old observation of Ayurveda to help patients currently suffering from the disease and incorporate it with current medical science to further optimize the patient’s health?

By adding the basic principles of Ayurveda, the world’s oldest medical science, we have seen that gradually, over many months and in 2-3 years the body starts changing. One may say that toxins come out of the body or the airway reactivity decreases. Or it may be part of rejuvenation of the body. Thereby slowly the exacerbation of the asthma or COPD symptoms mayl decrease. One needs to improve the digestion, postnasal drip, heartburn symptoms, irritable bowel symptoms, excess gas or bloating sensation, irritability or lack of sleep or inadequate sleep one has with asthma and/or COPD.

Nature has pairs of opposites forces. As there is a disease in the body so exists a healing system in the body, also. We would like to tap into the second one.  The body has inherent properties of healing on its own, it just needs adequate condition and time, and if it happens then there is a high chance that the body can get better. Although there are so many variable factors, there are few known and most of are unknown to us but the body has a tendency to heal and get better.

A disciplinary approach is needed with clinical monitoring of asthma and COPD treatment and management by addressing every issue of the symptoms one has one by one and giving time for the body to change. This will subsequently bring improvement in breathing, decrease respiratory infection, decrease in need of rescue inhaler or nebulizer, sleep improvement, etc.

Because of this kind of need for medical management of asthma and COPD, we have designed the bronchial asthma and COPD integrative medical treatment protocol to help patients who are interested in this kind of medical approach.  The program is clinically monitored for underlying asthma and COPD disease progress.

The asthma and COPD program uses the best of eastern and the western medical science to optimize underlying bronchial asthma and chronic obstructive pulmonary disease.  We have used this approach on hundreds of patient with excellent results.