Out of breath,

but not outl

d far my /angs. Bat
the thing is that I was mare scared abaat my heart, abaat haring
a heart attack. Sa I taak an ECG erery year bat it was a/ways
narma/, and my chest X-rays were c/ear. And eren thaagh I was
getting breath/ess and caaghing a /at, I thaaght this is
`
narma/
` `
far smakers anti/ I reached a stage where I caa/dn`t wa/k far
withaat breathing traab/e.
Naw I`re giren ap smaking (thaagh that was taagh!),
I am an effectire treatment, and I hare /earned haw ta take care
af myse/f. I can ga far my marning wa/k, I am eating better, and
I am fee/ing mach happier!
The mast impartant thing I can te// yaa is that same days yaa
wi// fee/ better, same days nat sa gaad, bat if yaa hare a pasitire
attitade, yaa wi// be ab/e ta adjast and hare mare gaad days.
ing wa/k
What exaotly does COPD mean?
COPD is the short form for
Chronic Obstructive Pulmonary Disease.
NormaI air tubes
The word Chronic means that it will not go away.
The word Obstructive means partly blocked.
The word Pulmonary means in the lungs.
The word Disease means illness.
Air tubes of COPD patient
1
This means that you need long-term treatment for a disease
which is causing some blockage in your lungs.
This blockage is in the air tubes which carry air in and out of
your lungs. Your air tubes have become narrower, so the amount
of air that can go in is much less. Also, air cannot get out of your
lungs properly. Because of this your lungs feel very full, your
chest feels tight, and you feel short of breath.
s anyone else, speoially ohildren,
in danger beoause have COPD?
OPD is not an infectious
ease. That means it is not
used by germs. So other people
nnot "catch" COPD from you.
ildren do not get COPD.
ople who get COPD are usually
er 40. But you can also get it
en you are younger than 40,
pecially if you are a smoker.
Smoking is definitely the most common cause of COPD. Most
people who have COPD are smokers. Or they used to smoke but
even though they have stopped, they may have already damaged
their lungs. Even people who do not smoke can suffer if they keep
breathing in someone else's smoke.
Sometimes even people who do not smoke can get COPD if they are
exposed to things that damage their lungs. For example, constant
exposure to fumes from cooking stoves ("chula") or room heaters
("sigri") can cause it. That is how many women get COPD.
Also, those who have worked for many years in places where the air
is very dusty, smoky or polluted like coal mines and industries such
as cement, textiles, chemicals and electro-plating of jewellery.
People who have asthma can get COPD if their asthma is not treated
properly.
s COPD only a smoker's disease? s COPD only a sm
2
my
asthma attacks. I ased ta take injectians and tab/ets which
gare me re/ief far same time. Bat I kept getting attacks ff
again and again. Naw I am gaing ta anather dactar wha
says that if my asthma had been praper/y cantra//ed, my
/angs waa/d hare been in better canditian.
-
What has happened in my lungs?
You will understand your condition better if you know how your
lungs work.
4
When you get COPD, the
airways in your lungs become
narrower. The amount of air
that can pass through is much
less, so it cannot come out of
your lungs properly. Because of
the trapped air, your lungs feel
very full. Your whole chest
feels tight and you feel short of
breath. These are called the
symptoms of COPD.
When you breathe, air goes
into your lungs through the
airways which are like tubes.
These tubes carry air from
your nose and mouth into
your lungs.
How do End out how muoh
am affeoted?
Even if you have started feeling these symptoms only recently,
don't ignore them. The earlier you start treatment, the better you
can control COPD.
The doctor will examine you and ask about your breathing
problem and your general health, also about your home and the
places where you have worked.
You may have to do some breathing tests with the help of an
instrument called a spirometer. These tests are useful for
knowing whether your COPD is mild, moderate or severe.
Mild means that your COPD is not too bad.
Moderate means that your COPD is getting bad.
Se very bad.
Mild COPD
You may cough a lot. Sometimes you cough out mucus.
You feel a little out of breath if you work hard or walk fast.
Moderate COPD
You may cough more, and you cough out mucus.
You often feel out of breath if you work hard or walk fast.
You may have trouble doing physical work or housework. You may
have to do these things slower than other people.
You may take several weeks to recover from a cold or chest infection.
Severe COPD
You may cough even more, and you cough out a lot of mucus.
You have trouble breathing during the day and at night.
You may take several weeks to recover from a cold or chest infection.
You can no longer go to work or do housework.
You cannot climb stairs or even walk across a room very well.
You get tired with even the smallest effort, or even when you are
resting.
How muoh will treatment be
able to help me?
With the latest treatment which is very effective, you will feel
better and be able to do more:
You will able to breathe more comfortably.
You will cough less.
You will sleep better, feel more fit, and you will be able to
move around more easily.
You will be in a better mood, and you will feel more confident
about making adjustments in your daily life.
6
When my grand-daaghter
wants me ta p/ay with her,
I`m happy that I can!
V. Kaashik (age 52)
What oan do to win against
COPD?
Many things! First of all, your attitude of winning against COPD
will help you even at those times when you don't feel so good.
Now here are some specific t
If you are a smoker, sttop
smoking. It is the mostt
important thing you can do
to help your lungs.
Your condition will get wo
faster if you smoke even j
cigarettes a day. Cigarette
irritates your lungs and m
airways get narrower and
excess mucus which blocks them u
Smoking also interferes with the a
oxygen which is vital for your body.
You can stop smoking even if you have been smoking for a
long time.
If you feel that your willpower is not enough, you can ask
your doctor for advice. Your doctor may recommend pills to
help you stop smoking.
Set a definite date when you will stop. Tell your family and
friends in advance that you are trying to stop. Keep cigarettes
out of your house. Do not permit smoking in your home.
Remove all ashtrays. Stay away from the places and people
that make you want to smoke.
Keep yourself busy. Keep your hands busy. Whenever you
feel like picking up a cigarette, pick up a pencil or something
else instead.
1
8
If you feel an urge to smoke, chew some chewing gum.
Eat fresh fruits or vegetables. Drink a lot of water
every day.
If you start smoking again, don't give up on your goal!
Try to stop again. Some people have to try stopping many
times before they stop permanently
Take medicine exactly the
way your doctor says you
should take it.
Go for your medical check-ups on
dates your doctor tells you. Go to s
your doctor at least twice a year, ev
if you are feeling OK.
You should write down the name o
each medicine, how much to take,
when to take it. You can use the tab
below to write the details, and then
doctor to confirm that you have go
When I should How I should d Name of the
medicine take it take it
2
Medicines that make the airways wider are called
bronchodilators. These medicines act by preventing and
reversing the tightening of the small muscles around the air
tubes in your lungs. That is how they relieve your symptoms
and help you to breathe more easily.
9
Every time you go to your doctor for a check-up, take your list
of medicines, or the actual medicines, with you.
Talk to your doctor about how your medicines make you feel.
The doctor may adjust your treatment accordingly.
Talk to your family about your treatment and how you feel.
Keep your medicines and your instructions for how to use
them where everyone can find them easily.
The best reason to be regular with your treatment and keep
your COPD under control is that you can avoid expensive
hospitalisation.
Bronchodilator medicines come in many forms such as pills,
syrups, and inhalers. Some of the latest medicines for COPD
are given by inhalers.
There are various types of inhalers. The two most widely used
types are: the Rotahaler and the Metered Dose Inhaler
which is also called Spray Inhaler. If your doctor tells you to
use inhaled medicines, he will prescribe the type of inhaler
which is most suitable for you. Learning how to use an
inhaler is not difficult. In fact, with a little practice you can
use the inhaler as simply as taking pills or syrups.
The instructions on pages 18-20 will help you.
Rotoholer & Cplo Rotocops metered Dose nholer
10
At ane paint I gat rery frastrated
abaat taking medicines erery day.
Then I rea/ised that after a// it`s the
medicine an/y which has made me better.
H. Swaminathan (age 50)
Try to keep the air clean in your home. Stay away from
smoke and any kind of fumes and strong smells.
S
If your house is being pest-controlled or
painted, try to stay away.
If you do the cooking for your family,
keep the kitchen door or window open.
This allows fumes and strong smells e.g.
masala, to get out easily. An exhaust fan
will help to keep the air clean.
If you have a stove or "chula" which uses
wood or kerosene fuel, keep a door or
window open to let the fumes go out.
On days where there is a lot of pollution
or dust outside, stay at home and keep
the windows closed.
Keep your body as healthy and as strong as possible. as strong as possible. g p 4
12
Eat healthy food. Maintain the
right weight. Eat lots of fruit and
vegetables. Eat protein-rich foods.
Some examples of vegetarian
protein-rich foods are milk, soya,
dal and pulses. Some examples of
non-vegetarian protein-rich foods a
If you become breathless while eating, eat slowly. Talk less
while you are eating.
If the usual meals make you feel too full, eat smaller amounts
but more frequently.
If you are heavy, try to lose weight. It is harder to breathe and
move around if you are overweight.
If you are too thin, take extra food or nourishing drinks to
help you gain weight and stay healthy.
Drink lots of fluids such as water and juice. This helps to
make the mucus (balgam, kuff) in your lungs thinner, so
that you can cough it out easily.
Do breathing exercises. The instructions on page 21 will
help you.
Ask your doctor which breathing exercises can help you. The
exercises shown on page 21 will help to make your chest
muscles stronger so that you can breathe more easily.
Take some light exercise regularly. Walking is good for you.
Try to walk for at least 20 minutes every day. Start slowly. If
you feel breathless, stop and rest.
You can ask your doctor to recommend other exercises for
you. Find exercises which you like to do. Ask a family
member or a friend to join you. Having good company makes
everything go better!
ur daily life as easy as
Avoid physical and
rain.
you should do as
u can on your own. But
lowly, and do things
wn if possible. If your
bad, you should ask
o are close to you
chen, bathroom and
put things which you
n in a place that is easy
to reach.
13
I am rery partica/ar abaat maintaining
my haase. These days I hare ta da things
s/aw/y. Bat I can da them myse/f.
Mrs. Lee/a Jashi (age 50)
Find simpler ways to cook, clean and do other housework. If you
need to get something which is at a height, ask someone to get it
down for you.
Wear loose clothes so you can breathe freely. Choose clothes and
shoes that are easy to put on and take off.
If you have been hospitalised for COPD, you may have been
given oxygen in the hospital to help your lungs to breathe better.
If your doctor prescribes oxygen for you to take at home, you
will need to make arrangements for an oxygen cylinder or an
oxygen concentrator. Your doctor will advise you how to go
about this.
If your COPD is very bad, your doctor may advise
you to take oxygen at home, as part of the treatment.
5
15
Ramesh and I were /aaking farward ta a qaiet /ife
after aar serrice. Bat retirement has nat been at a//
peacefa/ far paar Ramesh. He has been haspita/ised
3-4 times far his COPD and each time his haspita/ bi//
is massire, thirty ta sixty thaasand. Sarry ta say bat
a/thaagh Ramesh was a `faaji` he has nat been rery
y y y y
discip/ined with himse/f. If he had fa//awed his
dactar`s arders, he waa/d nat be sitting here with an
p f f f
axygen cy/inder taday.
Ca/ane/ V.C. Singh
ta/ks abaat his friend
Ca/ane/ Ramesh Narain
wha has COPD
Get emergency help if you notice any of these danger signs:
It is hard to talk.
It is hard to walk.
Lips or fingernails turn grey or blue.
The heartbeat or pulse is very fast or irregular.
The medicine does not help for very long, or it does not help
at all, and even after taking it, breathing is still fast and hard.
Always keep handy the phone numbers of the doctor and
hospital, and people who can take you there. Write those
numbers here so that other people can find them easily.
If breathing becomes very difficult, it could be an
emergency. Go to your doctor or a hospital straight
away.
S
EMERGENCY PHONE NUMBERS
17
How to use the
Rotwhwfez wth Cgfw ff Rotwcwgs
S
2
1

How to use the

etezed Dose fnhwfez
[Spray nhaler]
1
2
S
4
19
1
2
S
4
20
Breathing Exeroises
Suggested websites for patients to know more about COPD:
www.|ung.ca/cop/tofc.htm|
www.freebreath.com/msn/programs_cop.asp
www.cop-internationa|.com/COPDAvocate/copsurviva|.htm|
Inhale slowly through
your nose until your lungs
are full of air.
Purse your lips as if you are
going to whistle. Now
exhale slowly.
Sit comfortably and relax
your shoulders.
Put one hand on your
abdomen. Now inhale
slowly through your mouth.
(Push your abdomen out
while you breathe in.)
Then push in your
abdominal muscle and
breathe out using the
pursed lip technique.
(You should feel your
abdomen go down.)
PURSED-LIP BREATHING
DIAPHRAGMATIC BREATHING
1
1 2 S
2
Breathing out should take twice as long as breathing in.
Do not force your lungs to become empty.
Repeat the above procedure three times and then take a little rest.
This exercise can be done many times a day.
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Cipla Ltd. Mumbai Contral Mumbai 400 008