These days, the coronavirus (Covid 19) epidemic has affected our country and the whole world. It is certain that it will continue to be effective for a while. I hope that our country and the world will overcome this epidemic as soon as possible and with the least damage.
While coronavirus infection is overcome asymptomatically without any complaints in some people, it causes mild-moderate complaints in some people and causes severe pneumonia in a small number of people. The disease affects older people more severely and is more fatal, especially in those with additional cardiovascular or lung disease. Unfortunately, chronic lung diseases are common diseases in our society and our smoking rate is high. COPD, or chronic obstructive pulmonary disease, colloquially known as "chronic bronchitis" or "chronic bronchitis", is a chronic disease that causes a decrease in the flow of air during breathing due to the narrowing of the bronchial tract in the lungs. COPD is among the top causes of death. Smoking has an important place among the causes of COPD. Lung diseases such as cystic fibrosis, asthma and emphysema may also appear as COPD in the future. The main complaint of chronic lung diseases is exertional dyspnea, which occurs as a result of bronchial obstruction. In other words, respiratory distress occurs when the patient moves (walking, climbing stairs, sports). The reason for this is oxygen starvation, which occurs as a result of the insufficient amount of oxygen passing from the lungs to the blood and the tissues' increased oxygen needs due to exertion. The patient feels this as getting tired very quickly with simple movements. While this initially occurs in mild movements that only require effort, such as climbing stairs, it later occurs even in the simplest movements such as walking. These patients also experience frequent lung infections, which sometimes require hospitalization. These infections make the disease more chronic.
Coronavirus basically causes pneumonia in the lungs and seriously blocks the passage of oxygen to the blood. If the patient has a previous lung disease such as COPD, the patient enters the picture of acute respiratory failure. This requires intensive care and ventilator support and can be fatal. ir. In patients with severe coronavirus pneumonia, it may also cause some permanent damage to the lungs, which we call sequelae. These damages are likely to cause chronic respiratory problems in the future.
Once COPD develops, its effects remain limited even if medication is used continuously. Non-drug treatments have been applied to these patients for the last decade. These treatments are generally called respiratory rehabilitation (pulmonary rehabilitation). Pulmonary rehabilitation includes all non-drug treatments applied to maximize functional capacity in people with chronic lung disease. The purpose of this treatment is to correct respiratory distress and chronic weakness and fatigue caused by chronic restriction of the airway. For this purpose, it is necessary to increase the lung capacity and the strength and endurance of the body muscles.
Although those with chronic obstructive pulmonary disease (COPD) are often included in the pulmonary rehabilitation program, those with other common asthma, cystic fibrosis, bronchiectasis and many other chronic lung diseases can also be included in this program.
How is it done?
The patient is evaluated by a pulmonologist and pulmonary rehabilitation is deemed necessary. Initially, a respiratory function test and cardiopulmonary exercise test are performed. Various physical therapy methods are applied to the patient by the respiratory physiotherapist and some breathing techniques are taught to the patient. In addition, an exercise program that increases the patient's respiratory muscle strength and general body condition is given according to the level determined in the exercise test. Patients generally continue this program for 15-30 sessions, 3 days a week. When the patient is exercised, vital data such as heart rhythm, blood oxygen level and blood pressure are checked with special systems.
With pulmonary rehabilitation methods and newly developed devices such as VEST, lung capacity in COPD and other chronic lung patients can be increased significantly, and accordingly, there is a significant improvement in the patient's complaint of difficulty breathing (exertional dyspnea) that occurs with movement. Again, the frequency of infection and hospitalization in patients decreases significantly. of all this As a result, patients' quality of life increases and their addiction decreases. In order for these treatments to be more effective, they should be used in the early stages of COPD, not in its advanced stages.
It seems that coronavirus will continue to be a threat to everyone, especially COPD patients, in the near future. For this reason, respiratory rehabilitation is extremely important for patients with chronic lung disease, especially respiratory distress, to be better prepared. In this way, the devastating effects of possible corona infection can be reduced. Respiratory rehabilitation is extremely important to prevent chronic problems that may occur in the future due to lung damage in people who have severely recovered from the corona infection.
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