Chronic respiratory disease

Chronic respiratory disease is not a geriatric disease that “will become terminal if it cannot be cured.” Current clinical studies have proven that as long as trigger avoidance and standardized layered intervention are done, more than 80% of patients can maintain normal lung function for a long time, and their quality of life will hardly be affected. There is no need to panic.

I went downstairs to pick up a package a few days ago and met Uncle Wang who lives on the first floor. He has been suffering from COPD for almost 12 years. In the past few years, he had to bundle up tightly and squat at home in the winter. He coughed and breathless when the slightest breeze blew. He had to be hospitalized at least twice a year. This year, he actually carried a fishing rod and went fishing with his old friend to a reservoir in the suburbs. I was still amused. "Aren't you afraid of being out of breath?" He waved his hand and said that in the past two years, he had listened to the doctor's advice and did not stop inhaled hormones on his own. He usually practiced abdominal breathing for 15 minutes every day at home.

At present, there are actually two sets of parallel ideas for clinical intervention for slow breathing. There is no absolute right or wrong, only the adaptability. One is the "standardized use of medication to control inflammation" led by Western medicine. It advocates using inhaled hormones and bronchodilators according to the severity of the disease after diagnosis. Even if there are no symptoms, the medication cannot be stopped without permission. This can suppress the chronic inflammation of the airway at a low level and avoid repeated damage to the lung function. This program is recognized as the first choice during acute attacks. It can quickly suppress the symptoms of asthma and reduce acute lung damage. The other is the traditional Chinese medicine system of "strengthening the body and adjusting the constitution", which places more emphasis on conditioning during the remission period, such as Sanfu Tie, moxibustion, and Baduanjin. By improving their own respiratory resistance, they can reduce the frequency of attacks. After two or three years of persistence, many elderly patients can reduce the number of attacks per year by more than half. When I was following up in the respiratory department, I met a 72-year-old chronic bronchitis patient. After combining the two plans, he used to be admitted to the hospital three or four times a year. Now he has not been to the emergency room for almost two years.

It’s a pity to say that in clinical practice, most of the patients with chronic breathing become aggravated because they have stepped on cognitive pitfalls. The most common mistake people make is "if you don't have asthma, you don't need to take medicine." I was particularly impressed by a 42-year-old asthmatic patient who works in sales. He usually throws away medicine when he has no symptoms. Sometimes he doesn't even go for a physical examination when he is busy. The last severe cold triggered a severe asthma attack. He was unconscious when he was sent here. He stayed in the ICU for a week before being rescued. His lung function dropped by 30%. Afterwards, no matter how he adjusted, he could not return to the previous state. He had to take two breaks to climb the third floor. Some people think that chronic breathing is only caused by smokers. This is not the case. Last month, I treated a 38-year-old female patient who had never smoked or drank. She was diagnosed with COPD. I spent a long time to find out the reason. Her family owned a small restaurant. She cooked in the kitchen every day, and the range hood did not work. She had smoked oil fumes for almost ten years and suffered from the problem. There are also decoration workers and stone processing practitioners who have been exposed to dust for a long time. Even if they do not smoke, the disease rate is three to four times higher than that of ordinary people.

By the way, there are still many people who ask whether they should take lung-clearing health products that cost thousands of yuan. To be honest, among the patients I have contacted, some have taken a lot of lung-clearing pills and lung-moistening tea, but the effect is not as effective as wearing a mask when going out every day and turning on the range hood when cooking. If you really need to moisten your throat and eat more fresh pears and white fungus, it is much more reliable than those messy health products.

There is another question that has been debated for many years: Can I exercise if I have slow breathing? Some doctors say that you must rest quietly, as any movement will increase the burden on the airways and make your breathing worse; some doctors say that you must move and practice to improve lung function. In fact, both statements are correct, but the applicable stage is not clearly stated. If you are in the acute attack stage and are panting even when lying down, you must rest and don't mess around; when you enter the remission stage and there are no obvious symptoms, you have to start moving slowly. Start by walking slowly for ten minutes every day, and practice pursed-lip breathing and abdominal breathing, and gradually increase the amount. I used to have a 60-year-old COPD patient who was out of breath after walking 200 meters at first. After practicing for 8 months, he can now walk two kilometers a day, and can go to the vegetable market with his wife.

In fact, chronic respiratory diseases are just like high blood pressure and diabetes. They are typical chronic diseases. There is nothing to be afraid of. What is most scary is that you either don’t take it seriously or you just believe in some “radical cure”. I have come into contact with so many patients, and those who live well are those who are willing to put some thought into their own rules. For example, some people get sick when they come into contact with cat hair, so don’t keep small animals. Some people cough when it comes to smog days, so wear N95 masks when going out to avoid these triggering minefields. Follow the doctor’s instructions and take medicine well. It is not difficult to coexist peacefully with it for decades. Oh, by the way, if your cough persists for more than two weeks and it still doesn't go away, don't force yourself to take cold medicine. Go to the hospital to take a X-ray and do a lung function test. Early detection and early intervention are better than anything else.