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December 16, 2009 > Breathe Easier This Winter

Breathe Easier This Winter

Cold Winter Months Can Exacerbate Chronic Lung Conditions

If you have a chronic lung condition, chances are that the winter months can pose a particular challenge.

"The cold months are the time when seasonal flu is prevalent," says Dr. Carmencita Agcaoili, pulmonologist and ICU director for Washington Hospital. "Cold air has been known to exacerbate bronchial asthma and to some extent COPD with a bronchospastic (characterized by spasmodic constriction of the bronchial muscles) component."

Additionally, during the colder months there is increase in use fireplace and wood stoves for heating. If not properly ventilated, these heating methods can contribute to hazardous air quality and can potentially trigger exacerbation of lung diseases. Plus, when it's rainy and wet, there's a greater chance for mold growth, which can also trigger breathing problems, Dr. Agcaoili says.

The most common breathing problems Dr. Agcaoili sees include:
* Chronic obstructive pulmonary disease (COPD), a group of chronic lung diseases, including emphysema and chronic bronchitis, that block airflow and make it progressively more difficult to breathe;
* Bronchial asthma, a chronic inflammatory disease of the airways that causes recurring fits of coughing, wheezing, shortness of breath, and chest tightness;
* Interstitial lung disease (including pulmonary fibrosis), a group of disorders, most of which cause progressive scarring of lung tissue, that eventually affects the ability to breathe as well as the transfer of oxygen into the bloodstream;
* Bronchiectasis, destruction and widening of the airways often resulting from infection or inflammation of the airways.

For patients with chronic lung disease, Dr. Agcaoili says symptoms may be reduced by:
* Avoiding smoke from cigarettes, cigars, pipes and wood-burning fireplaces;
* Reducing exposure to smog from car exhaust and air pollutants on poor air quality days;
* Staying away from strong odors such as air fresheners, perfumes, mothballs and insect sprays;
* Reducing exposure to irritants and dust from dusting, sweeping and yard work;
* Avoiding animal dander, dust mites, pollen and molds.

While air pollutants and even cold air can impact lung function, infection remains a major contributor to respiratory complications, according to Dr. Agcaoili. With the seasonal flu in full swing and H1N1 a continuing threat, patients must safeguard against communicable diseases.

"Patients with chronic lung problems are of course more susceptible to any respiratory infection or attacks, because their system is already compromised to start with," she explains. "And influenza's main organ target is the respiratory system."

Additionally, she says, the H1N1virus has been linked to serious respiratory complications, including:
* Acute Respiratory Distress Syndrome (ARDS), leading to acute respiratory failure, mechanical ventilation and/or death;
* Community-acquired pneumonia;
* Exacerbation of COPD/asthma.

To minimize the chances of getting sick, those with chronic respiratory issues should:
* Get proper vaccinations as recommended by their physician;
* Use proper hand-washing hygiene;
* Avoid exposure to sick people.

"Simple colds can be longer and ultimately can turn into bronchitis or pneumonia in these patients due to lower respiratory resistance," Dr. Agcaoili notes. "These patients also use medications that can worsen or decrease immunity, including steroids and other anti-inflammatory agents. Some patients are on oxygen, which helps them breathe, but can dry up secretions and lining in the lungs.

"Some of these patients are also sedentary due to their dyspnea (shortness of breath) on exertion. They are more prone to develop infection due to opportunistic organism like MRSA (staph aureus), pseudomonas or gram negative infection."

It is important, Dr. Agcaoili says to recognize symptoms that require medical attention, including:
* Persistent fever for greater than three days;
* Unrelenting fever greater than 102 degrees;
* Persistent cough;
* Cough with colored sputum that increases in its amount;
* Chest pain on breathing, as well as shortness of breath, wheezing, change in mental status, sleeping all the time, no appetite.

"When there is infection and you have evidence of two or more of the above symptoms, this might become sepsis, which is uncontrolled widespread infection in the body," she warns. "This will need immediate attention by a health care provider."

What is Dr. Agcaoili's advice for patients with chronic lung disease? When in doubt about your symptoms, call the doctor.

Breathe better

If you have chronic lung disease, you might benefit from Washington Hospital's free Better Breathing for Life Club. Family members and loved ones are welcome.

The group meets the fourth Wednesday of each month from 1 to 2:45 p.m. in the Conrad E. Anderson, M.D. Auditorium, Rooms A and B, located at 2500 Mowry Avenue, across the street from the main hospital.

For more information, call (510) 494-7025.

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