Lung disease attacks our most basic need for living survival…the
ability to breathe. Diseases such as Chronic Obstructive Pulmonary
Disease and Sarcoidosis affect the lungs and the lucky patients, my
opinion, are those who desaturate enough to qualify for supplement
oxygen.
Following is one of the best explanations I have read explaining
what happens in our need for oxygen. Thanks to Mark Magnus
answering a patients question on EFFORTS, www.emphysema.net.
“With any and all lung diseases, there are two things we worry
about,
monitor and treat as they manifest. First, we are concerned about
the
adequacy of ventilation. When lung disease becomes severe enough
to
affect ventilation, we want to be prepared to support it if and
when
demand exceeds the capacity of the afflicted person. Next, we
are
concerned about adequate oxygenation. When that becomes
negatively
affected, we must be prepared to support it with appropriate
oxygen
therapy.
Symptoms associated with disturbances in these two functions are
for the
most part, the same, with shortness of breath, excess work to
breathe
and resultant anxiety all being the most frequent
symptoms/complaints.
What separates CRPD from COPD is the treatment approach to the
’causes’
of the symptom set.
In COPD, symptoms are most often the result of poor lung
mechanics, that
is, poor movement of air because of obstruction to exhalation.
The lungs have too much air in them and even normal breathing
doesn’t
‘dilute’ the air in those over-inflated lungs sufficiently to allow
a
return to normal gas levels within them and consequently also in
the
blood. So carbon dioxide is increasingly elevated which, until
compensated by the body, stimulates the person to try to breathe
more.
Eventually, oxygenation suffers and adds to the degree/severity
of
symptoms. Treatment is aimed to improve ventilation and oxygen,
as
indicated. That is done by administering oxygen, implementing
breathing
techniques to better control breathing and taking various
medications by
mouth as well as inhaled to help to better control or reduce
symptoms.
CRPD require more in the way of oxygen support, as moving air
tends to
be easier, though certainly requires more energy and work. It
usually
requires more directly, pharmacological intervention to better
control
and resolve the underlying problem. Anti-inflammatory medications
like
prednisone are most often a major part of treatment. And, in
turn,
symptoms of CRPD most often respond to treatment with
anti-inflammatory
medications.
Sarcoidosis is one of the CRPD’s that is most readily treated
and often
resolves or goes into remission. I’m curious to know how your COPD
was
diagnosed AND what your ‘other’ PFT numbers are. Simply removing
part
of a lung can mimic several values of PFT’s suggesting COPD.
http://www.nhlbi.nih.gov/health/dci/Diseases/sarc/sar_whatis.html
http://www.stopsarcoidosis.org/sarcoidosis/diseasefacts.htm?gclid=CN_g5a
KokJ4CFQhV2god4hY4oQ
http://www.medicinenet.com/sarcoidosis/article.htm
http://www.mayoclinic.com/health/sarcoidosis/DS00251
…
Mark W. Mangus, Sr., BSRC, RRT, RPFT, FAARC
Pulmonary Rehabilitation Coordinator
Christus Santa Rosa, Medical Center
San Antonio, TX
mark.mangus@christushealth.org
Responses reflect my positions and opinions alone and do not
necessarily
represent the positions or opinions of Christus Santa Rosa Health
Care.”
Thank you Mark and EFFORTS!
More later… Sharon O’Hara
