Around 500 million microscopic air sacs called alveoli are found in your lungs. These alveoli are reservoirs of the air you breathe and draw oxygen from the air you breathe and expel carbon dioxide. Smoking kills the cells that line these air sacs, which causes them to collapse. This hampers the process of breathing and air exchange and leads to insufficient oxygenat

Alveoli damage deteriorates over time as well. Additionally, as lung tissue deteriorates, it gets more fibrous, making it more difficult for people to fully expand their lungs upon inhalation. Less lung tissue and lung expansion result in less oxygen reaching all the necessary locations. Due to this, many individuals do not realize there is an issue until they begin to experience shortness of breath.

Your lungs and airways undergo major modifications due to smoking. Some changes happen quickly and suddenly. These include things like pneumonia and colds. Emphysema is one example of another, more chronic alteration that occurs gradually and can last a lifetime.

Here are a few detrimental modifications that smoking makes to your lungs and airways.

Your lungs and airways’ mucus-producing cells enlarge and multiply when you smoke. As a result, mucus production rises and thickens.

This extra mucus cannot be removed by your lungs in an efficient manner. As a result, the mucus continues to obstruct your airways and causes you to cough. This extra mucus is also prone to infection.

Smoking speeds up the aging process of your lungs and interferes with their ability to defend you against infection.

The lungs get inflamed and itchy after smoking. Even one or two smokes might irritate the throat and make you cough. Additionally, smoking can damage the lungs and lung tissue. Less oxygen reaches your body’s vital organs because of the reduction in air gaps and blood arteries in your lungs.

The cilia, or broom-like hairs, that border the lungs clean and help keep the airways clean are damaged by smoking. After lighting a cigarette, cilia start to move more slowly. Even one cigarette can cause your cilia to function more slowly for several hours. The number of cilia in your lungs decreases as a result of smoking, leaving fewer cilia to effectively clean the breathing apparatus leading to greater chance of infection and injury.

Inflammation occurs in the tissues and tiny airways of smokers’ lungs. This could make your chest feel constricted, make you wheeze, or make you feel out of breath. Chronic inflammation causes the formation of scar tissue, which alters the structure of your lungs and airways and can make breathing difficult. A chronic cough with mucus might be caused by lung inflammation over many years.

Smoking damages the alveoli, or tiny air sacs, in the lungs that facilitate oxygen exchange. Some of those air sacs are harmed when you smoke. Because alveoli do not regenerate, when you destroy them, you permanently damage a portion of your lungs. Emphysema manifests itself when enough alveoli are lost. Emphysema causes severe shortness of breath and can lead to death.

Your airways are lined with cilia, which are small brush like hairs. The cilia remove debris and mucus, keeping your lungs clear. Cilia are killed or temporarily rendered paralyzed by smoking. You become more vulnerable to infection as a result. Smokers experience more respiratory infections and colds than non-smokers.

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The use of a metered-dose inhaler’s (MDI) commonly known as an inhaler appears easy. However, a lot of people end up not using them properly. This leads to less effective treatment and less than optimal relief of symptoms.  When you use your inhaler or MDI incorrectly, less medication enters your lungs and more of it stays in your mouth. Use a spacer if you have one. More medication enters your airways with its assistance and makes use easier.

You might need to prime the inhaler if you have not used it in a while. For details on when and how to do this, refer to the instructions that come with your inhaler. Below are some of the instructions in a simplified format.
1. Remove the cap.
2. Check the inside of the mouthpiece to make sure nothing is within it so nothing will accidently enter your breathing passages.
3. Before each usage, shake the inhaler thoroughly 10 to 15 times.
4. Let all your breath out. Try to exhale as much air as you can.

5. Keep the mouthpiece firmly into the inhaler. To create a tight seal, place your lips all the way around the mouthpiece.
6. Press the inhaler down once as you begin to inhale slowly through your mouth.
7. Continue to inhale slowly and as deeply as you can.

   8. Remove your inhaler from your mouth. Hold your breath as you slowly count to 10, if you can. This enables the medication to penetrate your lungs deeply.

8. Pucker your lips and slowly exhale through your mouth.
9. Wait one to two minutes before taking your next breath if you are utilizing a beta-agonist, an inhalation medication that provides fast relief. For some medications, there is no need to wait in between breaths.
10. Reinstall the mouthpiece’s cap and make sure it is tightly closed.
11. After using your inhaler you should gargle, spit, and then rinse your mouth with water. Do not ingest the water. This lessens the negative effects of your medication.

    It is important to keep your inhaler clean. Try and look at the inhaler’s medicine spraying hole. Clean your inhaler if you notice powder in or around the hole.

Remove the plastic L-shaped mouthpiece from the metal canister.

Only the mouthpiece and cap should be washed in warm water. Do not wash the actual container of the medicine with water. Overnight air drying is advised if the cap or mouthpiece has been washed. Re-install the canister inside in the morning. Put on the cap. Never rinse any other parts.

On the canister of many inhalers are counters. Before you run out of medicine, keep an eye on the counter and refill the inhaler. Never submerge your canister to see if it is empty. This does not work. When you visit the clinic, bring your inhaler. Your service provider can ensure that you are utilizing it properly.

Your inhaler should be kept at room temperature. If it is too chilly, it might not function correctly. There is pressure on the medication in the canister. Therefore, be careful not to overheat it or puncture it. Having your inhaler in good working condition with an appropriate amount of medication and understanding how to use it accurately and appropriately is important to your ability to breathe well.

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The likelihood that you may get asthma can also depend on whether you are a boy or a girl and also your age. Before puberty, boys have a twofold increased risk of developing asthma compared to girls. However, girls are more likely to develop asthma after puberty.

Due to the complexity of triggers that cause asthma, we still cannot anticipate likelihood of developing disease based on family history alone.

Asthma may not be inherited in one of these ways and a person may develop asthma without any family history. In other words, neither the mother nor the father nor both directly contribute to the development of asthma. Your children will be more likely to develop asthma, eczema, or allergies if either parent has a history of any of these disorders. One must keep in mind that a number of genes have been linked to a higher risk of developing asthma. It must also be kept in mind a child’s exposure to specific environmental factors will also be a factored into the likelihood of developing disease. Because of this, some individuals who do not have any genetic risk factors for developing asthma may still develop ot in the future.

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Breathing pauses or interruptions are brought on by obstructive sleep apnea (OSA), frequently because of a temporary obstruction or collapse of the throat or airways.

While you sleep, a CPAP machine continuously blows compressed air into your mouth and nose. This helps you breathe correctly by keeping your airways open.

How does a CPAP machine work? 

The compressor or motor of a CPAP machine produces a steady stream of pressured air that passes through an air filter and into a flexible tube. Purified air is delivered through this tube into a mask that is sealed over your mouth or nose.

The CPAP machine’s airstream forces any obstructions open as you sleep, allowing your lungs to get plenty of oxygen and assisting in the uninterrupted delivery of oxygen. As a result, your breathing does not slow down because there is nothing blocking this oxygen flow. You do not have to wake up constantly to start breathing again as a result.

What are the pros and cons of using a CPAP machine?

The usage of a CPAP machine has advantages and disadvantages, much like many other forms of therapy. Here are a handful of the well-known pros and cons.

It is commonly known that utilizing a CPAP machine has several advantages. As you sleep, these devices give your body an ongoing flow of oxygen. They contribute to avoiding the small breathing pauses that characterize sleep apnea by doing this. As a result you manage better oxygen saturation and a far better quality of sleep

Longer-term CPAP use often results in an increase in benefits. It is extremely important to recognize that usage of a CPAP machine when it is medically advised by your pulmonologist or chest specialist reduces your likelihood of suffering a heart attack, stroke, or other cardiovascular event. Use of a CPAP machine with appropriate settings as advised by your doctor and his team enhances your capacity for uninterrupted sleep which in many cases helps with better cognition and commonly helps lower your blood pressure. Management of sleep apnea is known to help lower cholesterol and blood sugar levels leading to overall optimization of health.

Some patients experience some discomfort and difficulty falling asleep, especially in the beginning while using a CPAP machine. Occasionally they may experience a feeling of anxiety or mild claustrophobia. These can easily be overcome. Some patients experience nasal congestion, dry mouth, occasional mild nose bleeds. Most of these issues can be easily overcome by ensuring a well-fitting mask.

The management of sleep apnea is gaining extreme importance as evidence points to the worsening of many diseases in all parts of the body because of it. Sleep apnea is diagnosed by way of a sleep study which can be carried out in your own home or in the hospital and its analysis along with a consultation with a Board Certified chest specialist and pulmonologist who is specially trained and certified in the area of sleep medicine.

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Your doctor might arrange for Pulmonary Function tests (PFT) to evaluate how well your lungs are functioning. These are not blood tests but rather tests that are done by a trained technician in the clinic.  You will be explained and demonstrated on how to perform the test.  If you already have a lung-related underlying medical problem, your doctor may recommend this test to see how the disease has progressed or to see how the condition is responding to the treatment he has prescribed for you. Pulmonary function tests are not painful in any way and there is no special preparation that is needed ahead of time, such as use of extra medication or fasting to do them.

Pulmonary function tests may be ordered for you by your chest specialist or pulmonologist in the following common conditions:

1. If you are experiencing symptoms of cough or shortness of breath

2. If you have symptoms or history of Asthma, COPD or Lung fibrosis

3. For monitoring the progression of chronic lung diseases such as chronic obstructive pulmonary disease also known as COPD, asthma or lung fibrosis

4. To monitor the condition and function of your lungs, especially if you are regularly exposed to certain toxic substances in the workplace or your environment

5. Pulmonary function tests are also used to determine your safety and suitability for before surgery to ensure that anesthesia as well as recovery from anesthesia is safe and uncomplicated.

The following conditions can be diagnosed with the aid of pulmonary function tests

• Asthma
• Chronic Bronchitis
• Lung fibrosis
• Asbestosis, a disease brought on by asbestos exposure.
• Pulmonary tumor
• Bronchiectasis, a disease that causes the lungs’ airways to enlarge and extend making them less functional
• Sarcoidosis, a disease that results in inflammation of the liver, skin, eyes, lymph nodes, lungs, and other tissues
• Scleroderma, which is a condition that affects the body’s connective tissues and can also affect the lungs
• Weakness in the chest wall’s muscle as in Neuromuscular diseases and muscular dystrophy

Please inform your doctor:

If you recently suffered a heart attack or underwent chest surgery

If eye surgery was recently performed

If you recently underwent major abdominal surgery

If you have a history of cardiac arrythmias

Most patients are generally thought to be safe for pulmonary function tests. However, you may feel slightly dizziness during or after the test. This is not unexpected and improves in a few minutes. You should alert the technician performing the test or the physician. Difficulty in doing the test is extremely unusual and very easily manageable.

The post Why do I need a Pulmonary Function Test ( PFT)? appeared first on The Chest Clinic Karachi.

An allergic response occurs when the body’s immune system proteins also called antibodies mistakenly identify a harmless substance, such as tree pollen or animal dander, and considers it as an invader (allergen). This misrecognition causes an allergic reaction to result. Antibodies formed by the body bind to the allergen in an effort to shield your body from the chemical.

Your immune system’s production of chemicals causes allergy symptoms and signs like runny nose, itchy eyes, and skin rashes. Individuals may experience a similar reaction in their lungs and breathing channels or airways, which causes inflammation and tightening of the airways resulting in symptoms of asthma. These symptoms include cough, chest tightness, wheezing and shortness of breath.

What are common Allergens causing Asthma?

The common allergens found in the environment that causes symptoms of allergies and asthma include Pollen, Animal dander, Dust mite, Smoke and pollution amongst others. Certain foods ( e.g Peanuts, shell fish etc.) can trigger an allergic response in a person ranging from mild rash to a severe allergic reaction called “Anaphylaxis”

The post Can Allergies Cause Asthma? appeared first on The Chest Clinic Karachi.

Most treatments are designed to treat either asthma or allergic rhinitis. But a few treatments help with both conditions. The main treatment modalities include

Antihistamine: They are a class of drugs that are commonly used to treat the symptoms of allergies including sneezing, itchy eyes and nose, rhinorrhea (runny nose) and skin rash like urticaria. They control these symptoms by inhibiting “Histamine”, a chemical that is released by the body in response to an Allergen.

Inhaled Steroids: Steroids improve the symptoms of asthma by controlling inflammation, swelling and mucus production in the airways. Inhaled steroids are the mainstay of treatment of asthma. Regular use of steroid inhalers results in better control of asthma, reduces the risks of an asthma attack and hospital admissions. The side effects of inhale steroids are uncommon. Oral thrush            ( fungal infection) and hoarseness may be seen with regular usage and can be managed by antifungal drops or lozenges and thorough gargling after the use of inhalers

Modifier for Leukotrienes (Montelukast) The symptoms of allergic rhinitis and asthma can both be reduced by this kind of treatment. This daily medication, known as a leukotriene modulator, aids in regulating the immune system and the chemicals released through its biological pathways after an allergic reaction. The leukotriene modulators can control the symptoms of allergic rhinitis as well as asthma.

Bronchodilators: These are medications that relax the smooth muscle bands that tighten around the airways in asthma and COPD. This opens up the breathing channels making it easier to breathe and clear the mucus. They are 2 main categories of bronchodilators. Beta 2 agonists and anticholinergics. They are either long acting bronchodilators which are used as “controllers” that maintain the effect for an extended period making it easier to breathe throughout the day or short acting bronchodilators that have a rapid and more potent action. These short acting bronchodilators are used for symptom relief in an acute episode of shortness of breath.

Allergy shots (immunotherapy). By progressively lowering your immune system’s response to some allergy triggers, allergy injections can help cure asthma. Immunotherapy entails getting a small amount of the allergens injected in your body on a regular basis. This is almost like receiving a vaccination that can be protective against a disease.

Over time, your immune system develops a tolerance to the allergens, and your allergic symptoms lessen. As a result, asthmatic symptoms also get better. Typically, this course of treatment calls for repeated injections or controlled exposures over time.

Anti-immunoglobulin E (IgE) therapy. When you have an allergy, your immune system misinterprets a certain substance as harmful and secretes IgE antibodies against the offending allergen.

The IgE antibodies detect that allergen the next time you come into contact with it, alerting your immune system to release histamine and other chemicals into your bloodstream. Medicines can blocks IgE in the body to help prevent allergic reactions that cause asthma symptoms. Although it may also benefit allergic rhinitis, this medication is recommended for more severe allergic asthma.
To manage allergies or asthma, you might need additional medicines, particularly if your symptoms occasionally get severe. However, one of the most crucial actions you can take is to identify and stay away from the things that make your symptoms worse. This is one of the primary ways to protect yourself and reduce your need for medication.

Who is at risk of allergic asthma?

A significant risk factor for allergic asthma is a family history of allergies. Your risk of developing asthma is also increased if you yourself suffer from seasonal allergies or other allergies.

Is all asthma caused by allergies?

Even though allergic asthma is relatively common, there are other types of asthma with various triggers that can cause similar symptoms. Exercise, illnesses, cold air, gastro esophageal reflux disease or even stress itself can all be asthma triggers for certain people. People have multiple asthma triggers.

If you have symptoms of asthma, it is important you are appropriately evaluated by your chest specialist/ pulmonologist. This helps you to receive the most up to date treatment regimen to control your symptoms and minimize their side effects as well as potential un-expected problems for the future.

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What are common monkeypox symptoms?

According to the CDC, monkeypox infections often last two to four weeks and start with flu like symptoms. Symptoms common in monkey pox are fever, headaches, muscle pains, and fatigue. Over time, fluid-filled pimples, sometimes known as “pox,” blisters or vesicles appear all over the skin. Health officials have observed that the most recent instances of monkeypox frequently accompany genital rashes that can be mistaken for herpes or syphilis.

Although monkeypox can be fatal, there are two main viral types that carry differing levels of danger. According to the WHO, a strain from the Congo Basin kills around 1 in 10 of those who contract it, whereas a strain from West Africa seems to be less severe, killing about 1 in 100 of those who contract it.

People appear to be contracting the less severe strain right now all around the world, including in Europe and the United States. On July 29 and July 30, two deaths from monkeypox in Spain and one in Brazil were reported as the first known cases of the current outbreak outside of Africa. Five individuals have died in Africa, according to the WHO.

How is monkeypox transmitted?

The major way that human-to-human transmission of monkeypox occurs is by direct contact with infected lesions, scabs, or bodily fluids. During prolonged face-to-face contact or during close physical contact, such as kissing, snuggling, or sex can spread the virus as can through respiratory secretions. According to the CDC, people can contract an infection by coming into contact with clothing or bedding that has been used by an infectious person. The virus can infect a pregnant woman’s foetus or unborn baby.

A 2003 U.S. outbreak was caused by diseased animals being trafficked from Ghana to Texas, but it is not how the virus is presently spreading in the United States and Europe. People can also contract monkeypox via infected rodents or primates, as happened during that outbreak.

Is there a monkeypox vaccine or treatment?

Since smallpox and monkeypox are caused by the same virus family, antiviral medications and vaccines created and stored for smallpox, which has been completely eradicated, can also be used to treat monkeypox.

The White House in the United States is working to increase access to testing, vaccine doses, and treatments, but many people still have trouble getting access to these medications. According to some experts, monkeypox runs the potential of becoming another public health failure due to the same testing delays and vaccine shortages that the coronavirus had in its early stages. This is a frightening situation and requires individuals to be aware of modes and means of transmission and knowledge on how to best protect themselves.

How can I protect myself and others from monkeypox?

Health officials are warning people to exercise caution in crowded settings like family gatherings where it may be impossible to avoid bumping against individuals who may be infected and have active skin rashes or blisters because the virus transmits from skin to skin.

The CDC advises against kissing or hugging somebody who has a rash that resembles monkeypox or other potential symptoms, as well as refraining from sharing utensils. Along with not touching the clothing, bedding, or towels of someone who has monkeypox, refraining from sexual contact with them and maintaining proper hand hygiene are all appropriate approaches to prevent or minimize the risk of infections.

Infected people are advised to keep themselves away from other people and animals, and to cover any sores with long clothing and a mask.

In summary Monkeypox symptoms

• Swollen lymph nodes.
• Muscle aches and backache.
• Respiratory symptoms (e.g. Sore throat, nasal congestion, or cough)

Complications of monkeypox can include secondary infections which includes lung infections such as bronchopneumonia, widespread infection in blood called sepsis, infection and inflammation in the brain or spinal cord called encephalitis, and infection of structures within the eye such as the cornea with resulting in loss of vision. The extent to which infection can occur without a patient experiencing any outward symptoms or signs known also as asymptomatic infection is as yet unknown.

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In order for cells to function normally, oxygen is needed. On the other hand, abnormally high quantities of oxygen can cause oxygen toxicity, which can cause lung damage and respiratory failure. In particular when smoking, higher oxygen concentrations can raise the danger of airway fires. Without humidification, oxygen therapy can also cause the nasal mucosa to become dry. In most circumstances, an oxygen saturation of 94–96% is sufficient, although 88–92% saturations are desirable in situations when carbon dioxide retention is a possibility. Saturations should be as high as possible in cases of cardiac arrest or carbon monoxide intoxication.  Normal air contains 21% oxygen by volume; however, oxygen therapy can be used to raise this number to 100%.

People with respiratory disorders like COPD, COVID-19, emphysema, sleep apnea, and others can benefit from supplemental oxygen therapy to help them obtain enough oxygen to work and stay healthy. Hypoxemia, or low blood oxygen levels, can kill you and harm your organs. Oxygen therapy may be required permanently or only sometimes. You feel and sleep better when your blood oxygen levels are healthy.

Every organ in the body, but particularly the brain, heart, and kidneys, can suffer from a lack of oxygen. These organs, along with many others, are kept healthy by wearing supplemental oxygen. There is proof that giving hypoxemic people extra oxygen enhances their quality of life, their ability to exercise, and even their chance of survival.

Additional oxygen may also help you feel better. Breathing difficulties, weariness, vertigo, and sadness may disappear. You might sleep better, be more alert, and have better mood. You might be able to engage in additional activities, such traveling and ascending to high elevations.

Other factors besides a shortage of oxygen may be to blame for symptoms like shortness of breath. In some situations, extra oxygen might not be able to relieve the condition. However, it is still crucial to wear your oxygen if tests reveal you are not getting enough.

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A general term for illnesses that damage the heart or blood vessels is cardiovascular disease (CVD).

Since CVD includes any condition affecting the heart or blood vessels, most of the heart-related smoking-related problems fall under this heading. However, it is important to recognize that smoking related disease not only fall under the category of CVD, it is often a cause and major factor that aggravates the disease itself and leads to worse and earlier complications.

Smoking can cause the following effects on heart health such as arrythmias.

Arrhythmia is an irregular heartbeat. It is also called an abnormal heart rhythm. Cardiovascular fibrosis, or the scarring of heart muscle, is brought on by smoking. This may result in tachycardia, also referred to as a fast or irregular heartbeat. Cigarette nicotine known to speed up the heart rate can be a cause for tachycardia

Smoking also causes coronary artery disease. When the coronary arteries in the heart are unable to supply enough blood to the heart, coronary heart disease (CHD) occurs. It is also known as coronary artery disease or ischemic heart disease. Through atherosclerosis and increased blood pressure, smoking can lead to CHD.

Plaques accumulate in the coronary arteries due to atherosclerosis over time, obstructing blood flow and leading to inadequate blood flow or ischemia. The coronary arteries are harmed by high blood pressure, which causes them to become even narrower. Furthermore, the chemicals in cigarette smoke can thicken blood, forming clots that may block coronary arteries.

Smoking can also lead to a heart attack if it restricts blood flow to the heart. Another name for this is myocardial infarction. The muscle of the heart that helps pump blood through the body called the cardiac muscle begins to deteriorate in the absence of sufficient oxygen-rich blood.

Smoking can also lead to heart failure. Once the heart cannot pump enough blood to the body, heart failure follows. Heart failure can be caused by numerous conditions. Smoking raises the risk of heart failure because it causes damage to the blood vessels, the muscle of the heart as well as the electrical signaling process or the rhythm through which the heart synchronizes its pumping activity.

It is important to realize that one out of every five smoking-related deaths is caused by heart disease

Smoking and using birth control pills increase the risk of heart disease or stroke in women over 35.

Smokers have a 2–4 times higher risk of developing heart disease than nonsmokers.

Smoking increases a person’s risk of stroke by twice the risk over non-smokers.

Please protect yourself from cardiovascular disease by quitting smoking. Your pulmonologist can guide you on means and medications that help you to quit smoking.

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