Management of Copd during pregnancy


By Suryalakshmi Paleri

New Delhi, Nov 10 (IANSlife): COPD also known as chronic obstructive pulmonary disorders is a group of lung diseases that blocks airflow and makes it difficult to breathe. The most common of these diseases are emphysema and chronic bronchitis. Many people with COPD have both of these conditions. Emphysema slowly destroys air sacs in your lungs, which interferes with outward airflow. Bronchitis causes inflammation of the bronchi. COPD is a condition in which the disease worsens over time and it makes it difficult even to breathe. Asthma or Bronchitis is a very dangerous condition during pregnancy which causes fatigue, resulting in energy being diverted from the growing foetus.

DIAGNOSIS

Asthma can be hard to diagnose. To find out if you have asthma, your doctor takes your health history, does a physical exam and listens to your breathing.. You also may get a lung function test called spirometry. This is a test that checks how well your lungs work. During the test, you take a deep breath and exhale (blow) into a machine called a spirometer. This machine measures the amount of air you breathe in and out. It also measures how fast you can breathe. When you're pregnant, normal changes in your body can make you short of breath. This test can help your doctor know if shortness of breath is a common complication of pregnancy or if it's caused by asthma.

Treatment: Breathing Exercises with COPD

Pursed lip breathing

Coordinated breathing

Deep breathing

Huffing

Diaphragmatic breathing

Pursed Lip Breathing

Pursed lip breathing has a range of benefits:

It's been shown to reduce how hard you have to work to breathe.

It helps release the air trapped in the lungs.

It promotes relaxation.

It reduces shortness of breath.

Practising this technique 4 to 5 times daily can help. Here's how to practice pursed-lip breathing:

While keeping your mouth closed, take a deep breath in through your nose, count to 2. Follow this pattern by repeating in your head "inhale, 1, 2." The breath doesn't have to be deep. A typical inhale will do. Put your lips together as if you're starting to whistle or blow out candles on a birthday cake. This is known as "pursing" your lips. While continuing to keep your lips pursed, slowly breathe out by counting to 4. Don't try to force the air out, but instead breathe out slowly through your mouth.

Tip: Pursed lip breathing is best for performing strenuous activities, such as climbing stairs.

Coordinated Breathing

Feeling short of breath can cause anxiety that makes you hold your breath. To prevent this from occurring, you can practice coordinated breathing using these two steps:

Inhale through your nose before beginning an exercise.

While pursuing your lips, breathe out through your mouth during the most strenuous part of the exercise. An example could be when curling upward on a bicep curl.

Tip: Coordinated breathing can be performed when you're exercising or feeling anxious.

Deep Breathing

Deep breathing prevents air from getting trapped in your lungs, which can cause you to feel short of breath. As a result, you can breathe in the more fresh air.

Here's how to practice deep breathing:

Sit or stand with your elbows slightly back. This allows your chest to expand more fully.

Inhale deeply through your nose.

Hold your breath as you count to 5.

Release the air via a slow, deep exhale, through your nose, until you feel your inhaled air has been released.

Exercise tip: It's best to do this exercise with other daily breathing exercises that can be performed for 10 minutes at a time, 3 to 4 times per day.

Huffing

When you have COPD, mucus can build up more easily in your lungs. The huffing is a breathing exercise designed to help you cough up mucus effectively without making you feel too tired.

Here's how to practice the huffing:

Place yourself in a comfortable seated position. Inhale through your mouth, slightly deeper than you would when taking a normal breath.

Activate your stomach muscles to blow the air out in three even breaths while making the sounds "ha, ha, ha." Imagine you're blowing onto a mirror to cause it to steam.

Exercise tip: A huff should be less tiring than a traditional cough, and it can keep you from feeling worn out when coughing up mucus.

Diaphragmatic Breathing

The diaphragm is an important muscle involved in the work of breathing.

People with COPD tend to rely more on the accessory muscles of the neck, shoulders, and back to breathe, rather than on the diaphragm. Diaphragmatic or abdominal breathing helps to retrain this muscle to work more effectively. Here's how to do it:

While sitting or lying down with your shoulders relaxed, put a hand on your chest and place the other hand on your stomach.

Take a breath in through your nose for 2 seconds, feeling your stomach move outward. You're doing the activity correctly if your stomach moves more than your chest.

Purse your lips and breathe out slowly through your mouth, pressing lightly on your stomach. This will enhance your diaphragm's ability to release air.

Repeat the exercise as you are able to.

Protect Your Lungs during Pregnancy

Since you're essentially breathing for two, take these steps to protect your lung health and your infant's health:

Tell your doctor about any shortness of breath. There can be many reasons for shortness of breath in pregnancy. Pregnant women are no strangers to shortness of breath. Early pregnancy hormone surges and, later, the weight and bulk of your expanding womb restrict your breathing. If you're feeling short of breath, and you're worried about it for any reason, let your doctor know.

Ask for a lung function test. While the parameters for the test might change as your pregnancy progresses, the simple, noninvasive lung test called spirometry can help your doctor check on your breathing.

Manage asthma. Uncontrolled asthma during pregnancy puts both babies and you at risk. If you've been lax about your asthma medications, it's time to update your routine for pregnancy and then stick to it.

Avoid cigarette smoke. Don't smoke, ban smoking at home, and avoid all environments where you are exposed to cigarette smoke.

(Suryalakshmi Paleri, Executive Physiotherapist, Cloudnine Group Of Hospitals, Bengaluru (Malleshwaram))

 

  

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