1. Chronic Obstructive Pulmonary Diseases (COPD)

2. COPD
Definition: Chronic Obstructive Pulmonary Disease (COPD) is not one single disease but an umbrella term used to describe chronic lung diseases that cause limitations in lung airflow (World Health Organization)
Types of COPD:
Asthma
Emphysema
Chronic Bronchitis

3. Symptoms of COPD Dyspnea Shortness of Breath (SOB) Fatigue Coughing
Difficulty breathing
Shortness of Breath
(SOB)
Fatigue
Coughing
Sputum (phlegm)
Production

4. COPD Diagnosis The main test for COPD is Spirometry
During the test, a technician will ask you to take a deep breath and then blow as hard as you can into a tube connected to a small machine

5. Facts About COPD
According to the American Lung Association, COPD is the 4th leading cause of death in the United States
Behind heart disease, cancer, and strokes
Cigarette smoking is the primary cause of COPD
Long-term exposure to secondhand smoke can also increase a person's risk for COPD
Industrial exposures, such as toxic fumes or dust, can increase a person's risk of COPD as well

6. What Is Asthma A chronic disease that causes:
Bronchial constriction and spasm (tightening of the muscles around the airways)
Inflammation of the bronchioles
Airways that are overly sensitive to allergen and irritant triggers
Excessive mucus production in the bronchioles
There may be periods when there are no symptoms but the airways are swollen and sensitive to some degree all of the time

7. Symptoms of Asthma Breathlessness Nighttime or early morning coughing
Coughing or wheezing after physical activity
Breathing problems during particular seasons
Coughing, wheezing, or chest tightness after allergen exposure
Colds that last more than 10 days
Relief when medication is used

8. What Is Asthma Video

10. Risk Factors for Developing Asthma
Smoking
Environmental Pollutants
Allergies
Family History
African Americans are more likely than Caucasians to be hospitalized for asthma attacks and to die from asthma
It often starts in childhood. More boys have asthma than girls, but in adulthood, more women have asthma than men.

11. Asthma Triggers Dust Mites (tiny insects that eat dead skin)
Exercise
Viral Illness
Weather Changes
Exposures to Airborne Chemicals
Dust
Tobacco Smoke
Animal Dander (cats more of a problem)
Cockroaches
Dust Mites (tiny insects that eat dead skin)
Grass, Mold, and Pollens
Stuffed Animals

12. Additional Asthma Triggers
Wood Fires
Charcoal Grills
Perfume and Scented Soaps
Household Sprays
Paint
Gasoline
Expressing strong emotions like anger, fear, or excitement
When a person with asthma laughs, yells, or cries hard, natural airway changes may cause wheezing or other asthma symptoms 

13. Exercise Induced Asthma (EIA)
Tightening of the muscles around the airways
Distinct from other types of asthma because it only happens with exercise
Can be prevented by taking pre-exercise medication and by warming up/cooling down
About 10% of the general population without asthma, have EIA when they exercise

14. Symptoms of Exercise Induced Asthma
Coughing, wheezing, chest tightness and shortness of breath
Coughing is the most common symptom of EIA and may be the only symptom
The symptoms of EIA may begin during exercise and will usually be worse 5 to 10 minutes after stopping exercise

15. Symptoms of Exercise Induced Asthma
Symptoms range from mild to severe and often resolve in min
Occasionally some individuals will experience "late phase" symptoms four to twelve hours after stopping exercise
Late-phase symptoms are frequently less severe and can take up to 24 hours to do away

16. Causes of Exercise Induced Asthma
When you exercise you breathe faster due to the increased oxygen demands of your body.
Usually during exercise you inhale through your mouth, causing the air to be dryer and cooler than when you breathe through your nasal passages. This decrease in warmth and humidity are both causes of bronchospasm
Exercise that exposes you to cold air such as skiing or ice hockey is therefore more likely to cause symptoms than exercise involving warm and humid air such as swimming

17. Preventing Exercise Induced Asthma
Proper warm up for 6 to 10 minutes before exercise
Proper cool down
Carefully monitor respiratory status before, during and after exercise
Use medication (Albuterol) minutes before exercise begins
Check outdoor ozone/air quality levels
If your client is complaining of breathing difficulty- BELIEVE IT and take action
Never encourage your client “tough it out” when having asthma symptoms

18. Training Considerations
Clients with asthma can participate in exercise/sports without restrictions
If your client is having trouble exercising, their asthma may not be in good control
If clients are having symptoms with activity, encourage them to use their rescue inhalers

19. Training Considerations
Aerobic exercise should be guided by the client’s shortness of breath
Intermittent exercise with frequent rest breaks at a ratio of two parts exercise to one part recovery
A circuit training format is recommended emphasizing breathing control and rest as needed between sets
If a client is experiencing unusual dyspnea during exercise, stop exercise
Upper extremity exercises cause increased dyspnea and must be monitored

20. Training Considerations
Good
Activities that involve only short bursts of exercise or intermittent periods of activity are usually better tolerated
Walking, volleyball, gymnastics or baseball
Swimming that involves breathing warm and moist air, is often well tolerated
Bad
Aerobic sports are more likely to cause symptoms
Distance running, soccer or basketball
Cold air sports such as ice hockey or ice-skating may not be tolerated as well

21. Exercise Guidelines Mode:
Treadmill walking, cycling, elliptical trainers
Frequency:
3-5 days per week
Intensity: 40-60%
Duration: minutes
Resistance Training:
1 set of 8-15 repetitions
2-3 days per week
Allow for sufficient rest between exercise

22. Asthma Medications Two categories of medications:
Controller Medications
Taken every day to prevent swelling in the lungs
Examples may be Inhaled Corticosteroids such as Azmacort, Pulmicort, Flovent, Advair
These medications must be taken every day, regardless if there are symptoms or not
Reliever or Rescue Medications
Taken only when needed to relieve symptoms
Taken before strenuous exercise to prevent exercise induced asthma (EIA) from developing

23. Reliever or Rescue Medications
Examples: Albuterol, Proventil, Ventolin, Maxair
Should be taken minutes before strenuous or aerobic activity begins
Taken when needed to relieve symptoms
Should be immediately and easily accessible
You should be aware that your client is using this medication

24. What is an Asthma Attack?
Occurs when a person is exposed to a trigger and their asthma symptoms start to appear
This can occur suddenly without warning, or develop for days before the symptoms begin
Attacks are preventable by avoiding exposure to triggers and taking medications

25. Handling an Asthma Attack
Remain calm and reassure the person
If the person has an inhaler with them, they
should take it
Have the person sit up and breathe slowly- in through the nose, out through pursed lips slowly
Have the person sip room temperature water/ fluids
If the person is a minor, contact the parent or guardian as necessary
Do not leave the person unattended

26. Call 911 If… Lips or nail beds are bluish
Person has difficulty talking, walking or drinking
Quick relief or “rescue” meds (albuterol) is ineffective or not available
Neck, throat, or chest muscles are pulling in (retracting).
Nostrils flare out when trying to breathe
Obvious distress
Altered level of consciousness/confusion
Rapidly deteriorating condition.

27. What is Emphysema?
Damage to the lungs that is Permanent and Irreversible
Destruction of the alveoli
The lungs become less efficient at gas exchange
The lungs also lose their elasticity and the person experiences difficulty exhaling
Loss of elasticity results in lung enlargement. The enlarged areas are ineffective in eliminating CO2 and in transferring O2 from the air into the blood stream

28. What is Emphysema
Damage to the alveoli not only results in difficulty breathing, but the heart also has to work harder to circulate blood through the lungs.
All these changes make less O2 available to the body

29. Symptoms of Emphysema Shortness of Breath (SOB) Cough with Phlegm
Dyspnea-difficulty breathing
Coughing
Wheezing
Excess Mucus
Cyanosis-bluish color of the skin

30. Causes of Emphysema
Cigarette smoking is the most common cause of emphysema 
Smoking is responsible for approximately 80-90% of deaths due to COPD
Environmental Conditions
Pollution
Work Environment (miners)

31. Complications of Emphysema
People with emphysema eventually die from it, or from complications resulting from:
Recurring chest infections, pneumonia, the flu, colds
Pulmonary Hypertension: Abnormally high blood pressure in the arteries of the lungs
Cor Pulmonale: Enlargement and strain on the right side of the heart

32. Emphysema Treatment
Two surgical procedures can be done to help people with emphysema:
Lung-Volume Reduction Surgery: The most severely diseased parts of the lung are removed allowing the remaining lung tissue and muscles to work better
Lung Transplantation: Last resort for people with emphysema

33. Emphysema Treatment Quit smoking
The single most important factor for maintaining healthy lungs
Bronchodilator
Antibiotics/Steroids
Exercise

34. What’s In a Cigarette Video

36. What is Chronic Bronchitis?
Inflammation of the trachea, bronchi, and bronchioles causing excessive mucous production and inflammation of the bronchial walls

37. Symptoms of Chronic Bronchitis
Persistent cough that produces mucus, which may be blood streaked
Shortness of breath aggravated by exertion or mild activity
Frequent respiratory infections that worsen symptoms
Wheezing
Fatigue
Ankle/foot and leg swelling
Headaches

38. Causes of Chronic Bronchitis
Cigarette Smoking
The longer and heavier a person smokes, the more likely it becomes that the person will get chronic bronchitis
Secondhand Smoke
Viruses
Air Pollution
Infection
Allergies

39. Chronic Bronchitis Treatment
Quit Smoking!
Drinking Water-lung secretions will be thinner and easier to clear when the person is well hydrated
Bronchodilator Medications
Vaccines-annual flu shot
Humidifier
Corticosteroids
Exercise