WHAT IS PULMONARY HYPERTENSION (PH) ?!

Pulmonary hypertension (PH) is a condition where the blood pressure in the pulmonary arteries (the blood vessels carrying blood to your lungs) is high. This increased pressure causes progressive damage to the heart and lungs.

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When you exercise the heart beats more quickly to get more oxygen to the muscles. At the same time the pulmonary arteries expand to allow more blood through so that more oxygen can be carried to the muscles. They expand by stretching outwards slightly to create a larger inner area. In a person with PH, the walls of the pulmonary arteries are thicker, so are less able to stretch. Because of this the heart has to work harder to pump blood to the lungs, especially during exercise. If the heart has to work harder than usual over a long period of time then it begins to work less effectively and damage occurs.

PH affects many different types of people. In most people with PH, it is associated with another medical condition:
•    portal hypertension
•    connective tissue disease, eg systemic sclerosis
•    HIV infection
•    congenital heart disease
•    sickle cell anaemia.
Some people develop PH with no known cause which is referred to as idiopathic PH and in some rare cases it can be inherited.

Your stage of PH is classified as shown in the table below, depending upon when your symptoms occur.

WHO classification of PH:
Class    Description
1    No symptoms of any kind. Physical activity does not cause any symptoms
2    Comfortable at rest, but symptoms occur with ordinary physical activity
3    Comfortable at rest, but symptoms occur with less-than-ordinary effort (eg lifting the arms)
4    Symptoms while resting

Treatment for PH can be split into three categories:
•    Conventional therapy (often called background therapy), which can include the following:
•    Oxygen
•    Warfarin
•    Diuretics
•    Targeted therapy
•    Calcium channel blockers
•    Endothelin receptor antagonists
•    Phosphodiesterase 5 inhibitors
•    Prostaglandins
•    Surgery
•    Pulmonary endarterectomy
•    Atrial septostomy
•    Transplant surgery

Most patients will have a regime involving a combination of background and targeted treatment which varies from person to person depending upon the cause of the PH and what stage they are at.

Many patients will need oxygen therapy, although some only need it at night. Oxygen therapy increases the amount of oxygen in the blood and it can also help to relax the arteries in the lungs which leads to reducing the pressure in the pulmonary arteries. Oxygen therapy can reduce tiredness and breathlessness in some people with PH and it can improve concentration and the ability to do everyday tasks.

Having PH can make you tired and lethargic. This may make it more difficult to do ‘normal’, everyday things. Here are some tips from the PHA website from patients to help make life a little easier.

Housework
•    Where possible, avoid bending, lifting or over-stretching when doing housework.
•    Use a lighter vacuum cleaner and iron.
•    Do jobs sitting down where possible – a kitchen stool can really help.

In bed
•    If your duvet is heavy, consider buying a lighter one.
•    Use extra pillows to raise your head and make it easier to breathe.
•    If you use an oxygen concentrator, consider putting it outside the bedroom to avoid the noise disturbing you.

General
•    After a bath, open windows before the house becomes too humid.
•    Have chairs ready for places where you stand (eg, shaving or applying make-up).
•    Slightly larger clothes can be less tiring to put on and take off.
•    Put on a bathrobe straight after a bath or shower to avoid having to towel yourself dry.
•    If bending down to put your shoes on is difficult, use a long-handled shoehorn.

Out and about
•    Plan ahead to avoid having to rush.
•    Consider asking for a wheelchair.
•    If you drive, carry spare medication in the car.

References: http://www.phassociation.uk.com and http://www.who.int

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Our Health Revolves Around Oxygen

Oxygen is fundamental to our health but many of us do not realise just how crucial it is. Oxygen deficiency can affect every aspect of our health and be a root cause of almost every medical ailment.

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Oxygen deficiency can generically cause:
•    overall body weakness
•    fatigue
•    circulation problems
•    poor digestion
•    muscle aches and pains
•    dizziness
•    depression
•    memory loss
•    irrational behaviour
•    irritability
•    lung problems
•    increased unhealthy bacteria, germs, viruses and parasites
•    Any chronic/long term disease
A shortage of oxygen has been linked to every illness from heart conditions, cancer, digestion and respiratory conditions to inflamed, swollen and aching joints, sinus problems, yeast infections and sexual dysfunction. When our cells lack oxygen they weaken and die, therefore without oxygen, nothing works very well or at all.
It is the main energy source for our brains to function properly and it calms the mind and stabilizes the nervous system. Without oxygen we cannot absorb important vitamins, minerals, and other nutrients our body needs. Oxygen depletion also weakens our immune system, which leads to viral infections, damaged cells, growths, inflamed joints, serious heart and circulatory problems, toxic build-up in the blood and premature aging. Low oxygen levels allow damaged cells to multiply incorrectly or unnecessarily and form growths in our bodies. Oxygen aids in converting nutrients into energy, which also helps eliminate toxins and waste.
Your lungs will deteriorate 9-25% per decade (Framingham study) unless you do something to maintain them, which is why exercise is so important. However excessive stress in exercising can actually cause breathing blocks that results in inadequate levels of oxygen due to a build-up of waste products in the alveoli.
As our cells grow older they lose their ability to carry oxygen. As the liver ages it robs increasing amounts of oxygen reserves for detoxification which often leaves the other body systems with an oxygen shortage. Our brains need oxygen the most so when the body is in short supply our brains suffer the consequences.
The greatest contributor to oxygen deficiency is the deterioration of our breathing system. The next threat is a lack of exercise and nutrition, and then the environment.
Oxygen is involved in almost every bodily process so without it these processes fail and lead to problems with our health. Keeping our lungs healthy, eating the right food, exercising to keep our bodily systems functioning optimally and not breathing in pollution all helps to maintain the maximum oxygen levels.
It has also been discovered that “insufficient oxygen in our cells causes pain to be experienced more acutely than when oxygen supplies are ample”  Dr. Samuel C. West.
There are multiple benefits of home oxygen therapy. Not only will it ease respiratory problems but it will help to ease the pain suffered by many and also help to keep your body working more efficiently and healthily, which can aid in improving your medical condition.

References: http://www.breathing.com

Common Causes of COPD

The 5 most common causes of developing COPD are below:

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1.    Cigarette smoke. This is by the far the most common reason people get COPD. You can get it from any tobacco products, like cigar and pipe smoke, especially if you breathe in the smoke.  Smoking is the main cause of COPD and is thought to be responsible for around 90% of cases. The lining of the airways becomes inflamed and permanently damaged by smoking and this damage cannot be reversed. Up to 25% of smokers develop COPD.

2.    Passive smoking. Even if you don’t smoke yourself, just by breathing in second-hand smoke can cause damage to your lungs.

3.    Air pollution. You can get COPD from breathing in chemical fumes, dust, air pollution or toxic substances at work.

4.    Your genes. About 3 in 100 people with COPD have a defect in their DNA. This defect is called alpha-1 antitrypsin deficiency or AAT deficiency. Your lungs don’t have enough of a protein needed to protect them from damage, which can lead to severe COPD. The symptoms normally show before you’re 35 years old. A research study has shown that smokers who have brothers and sisters with severe COPD are at greater risk of developing the condition than smokers who do not.

5.    Asthma. If you don’t treat your asthma, over time you can get lifetime damage and it can develop into COPD.

Some of these risk factors can be avoided by quitting smoking, reducing the amount of pollution we breathe and if we have respiratory problems ensure we medicate and treat them properly. These steps will help to prevent damage to our lungs and help to prevent the development of COPD. Obviously the genetic factor cannot be avoided but only 1% of COPD sufferers have the genetic defect.

References: http://www.webmd.com and /www.nhs.uk

Would You Like Your Very Own Robot?!

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Home Oxygen Therapy is a medical treatment for patients suffering from chronic lung diseases. It involves the use of an oxygen concentrator to deliver oxygen via a nasal cannula or face mask to the patient and some may require being tethered to the machine on a constant basis. COPD is an umbrella term for these conditions and patients have restricted airflow through the lungs and experience coughing, wheezing and shortness of breath. The effect on quality of life can be significant and some are unable to participate in physical activities and require help to move. Home oxygen therapy aims to improve the patient’s freedom, health and quality of life by allowing treatment at home. Patients are encouraged to try and maintain a certain level of activity as research has shown that if exercise and mobility are retained then lung capacity and respiration improves.

However some patients find this difficult as they are tethered to a pressurized oxygen container via tubing and the weight, which is typically 4kg, can make transporting and lifting awkward especially for the more elderly patients. Some patients use a small hand cart to transport their equipment around or use a portable unit which they can carry over their shoulder.  Despite the huge benefits of H.O.T it still imposes restrictions on the user’s movements, mobility, ability to participate in certain activities and quality of life.

A Follower Robot has been devised to help improve these patient’s lives. The robot can carry the equipment thereby reducing the physical burden and increasing freedom of movement. It is capable of following the patient’s movements and can follow behind the patient. It is simple to use, low weight, compact and at a low cost.

They have started testing these robots on H.O.T users to see if they are indeed beneficial and can aid them in their daily activities efficiently. Most users have found the robot easy to use and to manoeuvre with. It is hoped that after more trials are completed it can be manufactured and sold commercially for COPD patients. These robots could drastically improve patient’s lives allowing them to easily move around and enjoy more out of life which could have a positive effect on their health also. More importantly, how amazing would it be to have your own robot?!

References:  http://www.robomechjournal.com and http://link.springer.com

Respiratory Breakthrough!?!

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Scientists claim to have found the root cause of asthma which could also aid in the treatment of other respiratory diseases like COPD. This breakthrough could mean that there could be a new treatment within 5 years.

They have found a protein within the airways which they believe triggers an asthma attack. Asthmatics seem to have higher levels of this protein and when they breathe in a trigger such as dust or pollen these protein molecules cause a rapid increase of calcium within lung tissue cells. High levels of calcium within these cells make them contract and cause the airway spasms which trigger an asthma attack.
The presence of this protein makes cells more sensitive to any asthma triggers, which then makes an attack much more likely.

A drug already exists which can deactivate the protein and clinical trials could start within 2 years, raising hope that a treatment could be available within 5 years.

It is hoped that a few courses of treatment would be enough to stop asthma attacks. Not only this but there is hope that it may have a role in tackling COPD and chronic bronchitis for which there is currently no treatment. Hopefully at a minimum it may prevent flare-ups for these patients and make them less susceptible to the triggers such as dust, smoke and pollen, which can stimulate a severe respiratory event. This could help COPD sufferers enjoy fewer flare-ups and less respiratory distress improving their ability to lead more normal lives.

References: http://www.dailymail.co.uk/health

Apple Watches Could Measure Your Blood Oxygen Levels

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When the people at iFixit took the new Apple Watch apart they found something strange, there wasn’t the expected optical module you usually find to measure your blood flow rate but there is a pulse-oximeter which can measure your oxygen levels.

It works by shining a light through your skin and it measures changes in your blood flow. As your pulse increases it changes the light transmission through the skin which a sensor measures. Additionally it can test how oxygen levels affect the way your blood interacts with light. The more oxygen in your blood, the brighter the red of the blood and the more infrared light it absorbs.

This component is currently disabled in the Apple Watch for unknown reasons but it looks as if Apple hope in the future to allow their customers to be able to monitor their own blood oxygen levels.

Being able to do this would be incredibly useful for a lot of people. If you’re hiking you can get a better sense of how you’re adapting to high altitudes, an athlete can monitor their performance and those with medical conditions such as asthma can instantly see if their oxygen levels are dropping. For those using oxygen at home you could simultaneously see if the oxygen that you are breathing in is improving your oxygen levels. A record of your data would be stored as your activities alter throughout the day and your doctor could use these results to help improve your treatment.

There is a danger that people may use the device as a self-diagnostic tool with regards to their health. This may be one of the reasons that Apple has left it disabled for now. Also perhaps there are issues with the accuracy of the measurements. It may be that arm hair, sweat and dirt could prevent the infrared light sensors from being accurate enough.

The possibility that very soon in the future we may have yet another helpful device to help monitor our health at home is exciting and good news for many suffering chronic respiratory diseases. It would be a helpful way for many to understand how their disease affects their respiration throughout the day and enable them, with their doctor’s help, to react quickly to changes in their blood oxygen levels to improve their health and quality of life.

References:  http://thenextweb.com and http://venturebeat.com

OXYGEN ALSO NEEDS NITRIC OXIDE FOR US TO BREATHE!

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A new study conducted by Jonathan Stamler, a professor of medicine at Case Western Reserve University School of Medicine in Cleveland, OH, and colleagues has shown that the respiratory cycle involves three gases and not just two. He says their findings will transform our understanding of the respiratory cycle and could save lives as it will alter our treatments of various associated diseases linked to the respiratory system and also affect blood banks.
The current understanding is that the respiratory cycle uses blood to transport two gases – oxygen and carbon dioxide. Red blood cells pick up freshly inhaled oxygen from the lungs and carry it to cells in the tissues of the body; and then they bring back carbon dioxide as a waste product to be exhaled from the lungs.
However their study has proven that without the presence of Nitric Oxide it doesn’t matter how high the oxygen level is, the cells cannot accept the oxygen without it. The researchers show how nitric oxide controls the blood flow in small blood vessels inside tissue in a process known as “blood flow auto regulation.” It is the Nitric Oxide that controls the release of oxygen from red blood cells into the tissues that need it. Haemaglobin in the Red Blood Cells needs to be also carrying Nitric Oxide to enable blood vessels to open and to supply the oxygen it is carrying to the tissues.
Prof Stamler says “Within the tissues, the tiny vessels and the red blood cells together make up the critical entity controlling blood flow. Red blood cell dysfunction is likely a hidden contributor to diseases of the heart, lung and blood such as heart attack, heart failure, stroke and ischemic injury to kidneys.”
If you suffer from a condition where there is a lack of oxygen uptake to your cells, it may not be the answer just to increase the oxygen supply, but to also look at whether your Red Blood Cells are functioning correctly and if there is an adequate Nitric Oxide supply. Then if necessary treat the Red Blood Cell problem in conjunction with oxygen therapy.

The study also has implications for blood transfusions. Recent evidence shows that blood transfusions lacking nitric oxide have been linked to higher risk of heart attacks, disease and death. It’s not enough to just increase oxygen content of the blood via a blood transfusion. If the Nitric Oxide mechanism is failing then the oxygen will not be able to make it to its destination. Blood in blood banks are known to be deficient in Nitric Oxide and transfusing this blood may actually make things worse by plugging up blood vessels in tissues and to solve this the nation’s blood should be replenished with Nitric Oxide.
It may be the case that many sufferers on oxygen therapy in the future could be helped and treated even more by investigating their Nitric Oxide levels, as there could be additional failings in their respiratory system that could be investigated and more successfully treated.

References: http://www.medicalnewstoday.com and http://www.sciencedaily.com