I’ve read a couple of articles this past month that have piqued my interest. The first concerns proof of something that I am sure many patients with chronic obstructive pulmonary disease (COPD) and other breathing problems already know.
However, sometimes it’s just as important to raise awareness of things that, although apparently obvious, may not be well known. Johnston ( from Canada) and colleagues decided to investigate whether the common cold was associated with an increased risk of exacerbation (a severe chest infection) in people with COPD. As well as looking at the risk of an exacerbation they measured whether rhinovirus (a virus that commonly causes colds) was present or not. Having a cold was strongly associated with the risk of an exacerbation in patients with COPD, but interestingly the risk remained high even if rhinovirus was not detected.
The study was carried out by means of symptom reporting cards, daily diaries where patients reported on levels of breathlessness, temperature, sore throat, cough and change in phlegm. The benefit of daily symptom reporting is that you and your health professional can see at a glance if you are running the risk of an exacerbation (and possibly a hospitalisation). If you have breathing problems, daily recording of your symptoms may help you identify when prompt action is needed, and encourage your health professional to recognise the importance of common colds (with or without virus detection) in the worsening of COPD.
Monitoring helps you stay on top of your condition, and that in turn helps improve outcomes. The other study concerns the long-term cardiovascular limitations associated with pulmonary embolism (PE). Pulmonary emboli are blood clots in the lung, often caused by a clot in the leg that has travelled to the lungs. In the study 100 patients who had successfully been treated for and recovered from a PE were followed up a year later. Almost half of these scored less than 80 per cent of what would be expected for their age and gender on a fitness test that measured peak oxygen uptake.
Being male, overweight, a smoker or younger age seemed to increase your risk of lower fitness one year after treatment. The authors suggested that these patients could benefit from a cardio-pulmonary rehabilitation approach with a focus on improving fitness, as there is no evidence to suggest the lack of fitness is irreversible.
So, if you don’t feel yourself one year after a PE, why not approach your doctor or physiotherapist about some additional exercise training?
Rachel Garrod PhD MSc is a physiotherapy lecturer and stop smoking counsellor