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Chronic obstructive pulmonary disease
Pulmonary emphysema, chronic bronchitis and severe asthma are three diseases that are becoming more and more common in the United States. Typically, they produce a long-term illness that is frequently accompanied by physical disability. They are commonly referred to as Chronic obstructive pulmonary disease (COPD) or chronic obstructive lung disease (COLD), simply because each of the three diseases causes an obstruction to the air as it tries to leave the chest, making breathing difficult.
Bronchitis is a disease that affects the bronchial tubes. The tubes become inflamed and produce a great amount of mucous. The combination of the swelling and the excess mucus interferes with the air flowing in and out of the lungs.
Emphysema is a disease that results from the destruction of the alveoli, the air cells of the lungs. The alveoli lose their shape and eventually rup-ture. When this happens, the exchange of oxygen and carbon dioxide is compromised.
A chronic recurring productive cough (moist and wheezing) is the first symptom of emphysema, but it is often ignored. Emphysema usually develops gradually over a long period of time. Often, the patient cannot recall the time of onset. Factors such as cigarette smoking, air pollution, chronic infection, allergies, dusty environ-ments, and inherited factors may contribute. As the disease progresses and irreversible changes occur within the lung's alveoli, symptoms become severe and debilitating.
Symptoms of emphysema include difficulty in breathing; anxious and strained facial expression; puffing out of cheeks during exhalation; barrel-shaped chest; and bluing or dusty color to skin (lips, fingers, and toes are most notable).
Daily routine tasks such as dressing oneself or walking from bedroom to kitchen may prove extremely difficult and overwhelming physically for a patient with COPD.
COPD also affects a person's arterial blood gases (ABGs). A healthy person's blood gases stay balanced at a ph value of between 7.35 and 7.45. If the blood has too much acid, the ph value decreases. The lungs are the organ primarily responsible for maintaining the proper amount of acid in the blood, and for eliminating the carbon dioxide (CO2), which is an acid waste product. Also, the alveoli in the lungs of a person with COPD are not able to efficiently transport oxygen and carbon dioxide.
A person with COPD breathes more slowly or "shallowly". Because of this, the amount of CO2 in a COPD patient increases, since he or she is not "blowing off" the CO2. A blood test to determine ABGs indicates the level of oxygen and CO2 in the blood. ABGs are important in the diagnosis and treatment of disturbances of acid-base balance. In COPD cases, ABGs can indicate the need for oxygen therapy.
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