The two most important things to talk about COPD is lifestyle modification and breaking the myth about inhaler therapy. COPD is a controllable disease. To keep it under control, it is important to take proper medicine at proper time via proper method. Medicine needs to be continued. It is a kind of disease that does not take too much of time to recur or to worsen. Seasonal changes, subtle temperature change in AC rooms are some of the reasons which can cause exacerbation of the disease. So, it should be kept in mind that you cannot stop taking the medicines or the inhaler without doctor’s consultation. Another important thing related to the inhaler is that, steroids are used in some inhaler which is extremely important to combat inflammation during COPD exacerbation. Since many people have some preconceived notion about steroid, it is important to know that steroid is a kind of medicine which is, if taken into proper dose, proper way and in proper technique, works as life savior. We just need to keep in mind that after taking inhaler if we gargle properly then the minimum side effects of steroid inhalation can also be avoided. So there is no reason to be unnecessarily scared of steroid.
Inhaler therapy is the cornerstone of COPD treatment. For example, do you wear specs elsewhere than your eyes ? Just like that when COPD or any lungs related problems set in, it is more effective to deliver the medicine directly in the air passage. If it is a metered dose inhaler then it has to be taken with spacer. In the present time some new breath actuated inhaler are also available in the market which delivers the drug only when you inhale. There are dry powder inhaler as well which are available in the capsule form and it is used with the help of a machine. There are different type of inhalers which delivers the drug i.e. the bronchodilator properly in the airway. These drugs works on the receptors and that provide bronchodilation and it eventually help to breathe properly. So therefore inhaler is a very important part and parcel of this treatment of this disease.
The second point of discussion is lifestyle modification in COPD. The cornerstone of treatment of COPD is smoking cessation. Another important cause apart from smoking is automobile emission, smog, air pollution. In Delhi those who doesn’t smoke but is inhaling the smog( happening currently) is equal to inhaling 20 cigarettes per day. In Kolkata also the inhalation of smog is equal to 7 to 10 cigarettes per day. So, beside smoking cessation, it is important to cut down on automobile emission.
Third most important thing is vaccination. Alongside COVID vaccines it is very important to take influenza and pneumonia vaccines. Those who have COPD or other lungs related problems, those who have crossed the age of 50 and the healthcare workers, influenza and pneumonia vaccinations are of utmost importance to them. The vaccines should be taken according to the schedule suggested by the doctor. Vaccine reduces the severity of pneumonia along with stay in hospital.
Some other important things that should be kept in mind are to not have refrigerated food, warm water while taking shower and it is also necessary to properly dry up after taking the shower. Those who go out for morning walk or evening walk they should keep in mind that the particulate matters in air are maximum during the early morning and evening, especially during the winter. So it is advised to walk after sunlight comes out. Another important thing that should be kept in mind during the COVID time is to maintain social distancing, proper use of mask and sanitization. So these things should be kept in mind to keep yourself fit and healthy.
-Dr. Angshuman Mukherjee, consultant pulmonologist, Fortis Hospital, Anandapur, Kolkata
