Common Breathing Issues Uncovered

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We don't breathe, we don't live. Millions of people live everyday with the uncomfortable sensation of not being able to get a full breath of air, due to illness or disease. Struggling to get air into the lungs is called dyspnea, shortness of breath, or labored respiration. Respiration is the act of breathing in and breathing out and the normal adult respiration count hovers around 12-20 breaths per minute, while a child's range is normal rate depends on their age:

  • Neonatal Period  30-60 breaths per minute

  • Early Childhood  20-40 breaths per minute

  • Late Childhood    15-25 breaths per minute

Infants and younger children breathe diaphragmatically, older children and adults with their chests. Because there is such a wide range of people that experience breathing difficulties, the medical community has not given a concrete analysis of what classifies breathing difficulties.

Common causes of dyspnea include: air passage blockages in the mouth, nose, or throat; heart disease because if your organs aren't getting enough oxygen pumped to them; and emotional distress. Pneumonia, brochiolitis, COPD, and pulmonary hypertension are indicative of lung problems, while choking, croup, and epiglottis are indicative of airway path difficulty.

BREATHING PROBLEMS

Pneumonia

Pneumonia occurs when the alveoli, or air sacs, in your lungs become inflamed, usually due to bacterial infection most commonly caused by pneumococcus bacteria, although viral infections are not uncommon. When infected mucus from your throat or nose settles into your lungs, they can act as a quagmire pulling in more bacteria and germs creating a breeding ground for infection and pus. Our bodies try to expel that infection by coughing. If you can expel some of the mucus, it is likely to be green or yellow, sometimes even bloody.

Symptoms of pneumonia include pain that worsens when you take a deep breath or cough. Many people complain of "hurting all the way into my back." You may have a low-grade or a high fever, chills that make you shake, and shortness of breath. Some people lose their appetite, and are very fatigued. Smoking will certainly exacerbate the difficulty you will have in breathing.

Treatment for pneumonia depends on if the pneumonia is bacterial or viral, and if you have another medical problem simultaneously, such as AIDS, diabetes, or Chronic Obstructive Pulmonary Disease, better known as COPD. You could be admitted to the hospital if you are elderly and live alone, or are very young, or if your symptoms are severe. Bacterial pneumonia is treated with antibiotics. Viral pneumonia, is treated with rest, lots of fluids, and palliative or symptomatic care; and occasionally, with specific antiviral agents.

  • Pneumonia Overview: Medline Plus' link page to pneumonia basics, issues, and research from the U.S. National Library of Medicine and the National Institutes of Health.

  • Pneumonia Basics: Tips to help you understand pneumonia.

Bronchitis

Viruses, bacteria, smoking, and chemical irritants can cause bronchitis. An inflammation of the cells lining the bronchial tubes creating pain, redness and swelling, make it difficult to breathe. Cilia, the tiny hairs in your lungs, trap irritants. In this case, the cilia stop working, causing air passages to become clogged.

Acute and chronic bronchitis are the two known types of bronchitis. The acute infection is most often viral and lasts just a few days. Chronic bronchitis is diagnosed if someone has cough and sputum present for at least six months out of a year, or if cough and sputum are present most days for three months, or for a minimum for at least two years. Chronic bronchitis is also known as a form of Chronic Obstructive Pulmonary Disease, or COPD. Most people over 40 don't realize that they have the disease. Smoking causes most chronic bronchitis cases and over 14 million Americans are reported to be diagnosed with it each year, most in the Southern part of the country, as well as women.

Symptoms include coughing, with or without yellow or green phlegm, chest pain, and shortness of breath. There are certain tests used to diagnose the chronic form of bronchitis, including the somewhat painful drawing of arterial blood gases to determine blood oxygen level. Treatment for bronchitis depends on if it is acute or chronic. To stop smoking is the first step for any respiratory disease. Bronchodilators can help open your airways to make breathing easier. Corticosteroids reduce inflammation and swelling, while expectorants make it easier to cough up phlegm to get it out of your lungs. Antibiotics are not given unless your doctor determines they are warranted for bacterial infection. Severe cases of chronic bronchitis will likely need oxygen therapy.

  • All About Bronchitis: Learn what it is, what its specific symptoms are, and how to treat it. Good sections on chronic bronchitis and how to manage its symptoms.

  • Acute Bronchitis in Children: Most often, acute bronchitis is caused by a virus in children; however, children over the age of six sometimes contract the bacterial form.

Bronchiolitis

Bronchiolitis is an inflammation of the lung's small airways. It generally strikes children under age two, usually around three to six months of age. Bronchiolitis and pneumonia are the most common consequences of respiratory syncytial virus, better known as RSV, a respiratory virus that most older children and adults recover from in just a week or two. However, when a baby or an infant has RSV and bronchiolitis, it can be very serious requiring hospitalization for 75,000 to 125,000 children each year.

Symptoms begin and are similar to other respiratory infections: coughing, sneezing, runny nose, fever, no appetite, and sporadic wheezing. Infants may become irritable, look very uncomfortable, and have a hard time breathing, their skin may retract or pull in under their ribs as they try to breathe. They may become cyanotic or get a blue tinge to their skin and around their mouths, and fever. If this is the case, call your pediatrician as your child may need to be hospitalized with oxygen for a few days. There is no one specific treatment for bronchiolitis. While in the hospital, your child will get all the necessary food and liquids through an IV if needed, a long tube will be used to suction out the nose, and oxygen or other breathing treatments will be used as needed to make your baby comfortable and able to breathe better.

  • Bronchiolitis: An explanation of the disease, its cause, and what to do if your child is hospitalized as well as what to expect when going home after a hospitalization.

  • RSV FAQs: Catch the symptoms before RSV advances into bronchiolitis or pneumonia.

Chronic Obstructive Pulmonary Disease (COPD)

COPD is a slow killer. Ranking fourth as the leading cause of U.S. Deaths, most people know it as emphysema or chronic bronchitis. Over time, breathing becomes quite difficult to the point that oxygen is needed. By that time, COPD has made the activities of daily living, such as getting dressed, doing light chores, or walking, harder to do without feeling severely short of breath. This can create long-term disability, meaning that it may be difficult or impossible to work. It is important to seek medical attention early on to prevent further complications brought on by COPD.

There have been many statistics published regarding COPD. For example, one person dies from COPD every four minutes. That means 120,000 Americans die from the disease every year. Doctors have diagnosed over 12 million people with COPD, and it is likely that another 12 million have the disease and just don't realize it. Symptoms of COPD include:

  • Constant coughing, what some people call a "smokers cough."

  • You experience shortness of breath while doing activities you've always done.

  • Your body produces excess sputum.

  • You have a feeling like you can't breathe or take a deep breath.

  • You begin to wheeze.

Smokers, those with long-term lung exposure to environmental factors such as chemicals, dust, or fumes, and those with the genetic condition, alpha-1 antitrypsin, are at significant risk for COPD. Smoking accounts for 90 percent of all COPD deaths. If you have COPD, you must take steps to manage it to ensure good health and minimal complications due to COPD:

  • Quit smoking.

  • Stay away from lung irritants.

  • See your physician regularly for COPD monitoring.

  • Get your pneumonia, seasonal and H1N1 flu shots.



Asthma

Asthma is a chronic inflammatory condition of a person's airways, or bronchial tubes. When the muscles surrounding the airways tighten and the airways become inflamed, it becomes extremely hard to breathe, wheezing may occur, your chest may become tight, and you cough. Asthma is usually triggered by an environmental allergen, stress, or exercise. Attacks can last just a few minutes or days. Most asthmatics carry an inhaler, usually called a "puffer", that they use to breathe in such drugs as albuterol, which greatly reduces asthma symptoms immediately in most cases.

There is no cure for asthma, but it can be managed so that the asthmatic can lead a normal life by avoiding what triggers an attack. Don't smoke. Don't be around others that smoke. Keep dust, pet hair and dander to a minimum in your home. Reduce stress. Avoid sudden cold air. Avoid breathing in airborne allergens such as pollen, chemicals, and mold.

  • AAFA: The Asthma and Allergy Foundation of America's educational program. Find educational materials to help you and your family coop with asthma in the healthiest way possible.

  • Asthma Control: Guidelines to help you manage your asthma and its symptoms.

Emphysema

Emphysema falls under the COPD umbrella. It is most known to be a consequence of smoking, chronic bronchitis, as well as the aged. The lungs lose their ability to expel air due to the permanent, physical destruction of lung tissue, resulting in obstruction and enlarged air sacs. It is a chronic disease with no cure that must be managed to maintain a good quality of life.

The disease commonly attacks those age 50 and over who have been heavy smokers. The most common symptom is shortness of breath. Later, a heavy cough and thick sputum develops. Breathing becomes strainful, and later heart or respiratory failure may occur. The end result of emphysema is eventual death. Treatment is management of the disease, what is called symptomatic or palliative care. Doctors work with patients to enhance their quality of lives through creating a regimen of better breathing through technique, medication, and oxygen therapy.

Pulmonary Embolism

A pulmonary embolism means there is an arterial blockage in the lungs. It is most often a blood clot that develops elsewhere in the body, travels to the lungs, and blocks an artery. Most clots are small and can damage the lung without causing death. Large clots can quickly lead to death. Many times these are caused by clots which happen in the legs caused by deep vein thrombosis (DVT), which suddenly break away and travel to the lungs. Symptoms include sudden shortness of breath, sharp chest pain, and coughing that brings up foamy, pink mucus. Any time that any symptom is sudden and severe, it is imperative to visit your emergency room. Pulmonary embolism symptoms often mimic heart attacks.

Treatment includes blood thinners, called anticoagulants. Reduce your risk of pulmonary embolism by avoiding sitting for long periods of time. Sedentary activities such as working all day at the computer, rehabbing from surgery, or flying long hours on a plane put you at higher risk for DPV, which can lead to a pulmonary embolism. If you are at high risk, often you must wear compression stockings, take blood tests or scanning images, as well as blood thinners such as Coumadin.

Pulmonary Hypertension

High blood pressure in the arteries that supply blood and oxygen to the lungs is called pulmonary arterial hypertension (PAH). The blood vessels in the arteries thicken and narrow causing backed-up pressure in the heart. Less blood circulates, less oxygen is picked up by the lungs. Shortness of breath, fatigue, and dizziness are the result.

PAH is lifelong, exacerbated by smoking and high altitudes. There is no cure, even if a primary condition causing the disease goes away. Oxygen, blood thinners, and medications and procedures to allow your heart to pump more efficiently can lower the hypertension and prevent further damage. Lung transplants are a last resort, usually done in congenital heart disease.

  • Pulmonary Arterial Hypertension: Covers an overview of the disease as well as how pre-existing conditions can cause or make symptoms worse.

  • PAH: An organization dedicated to pulmonary arterial hypertension and education.

Croup

This common childhood viral illness is also called laryngotracheobronchitis, and is considered an upper airway infection. It affects children ages six months up to five years usually during the fall, winter, and spring. Its onset is usually abrupt. Your child goes to bed feeling fine, then wakes up in the wee hours of the morning sounding like a barking seal, complaining of not being able to breathe well. Stridor usually accompanies croup. Stridor sounds like wheezing, but is caused by inflammation of the larger airways, not the lungs, and happens upon breathing in.

Symptoms usually get better during the day, but get worse at night. Most children have the mild form of croup, with mild or no trouble breathing. The stridor may develop only when agitated or if they are crying. Kids with moderate or severe croup may have their skin retract under their ribs, indicating much trouble breathing. Croup usually gets better in three to four days. It sounds terrible, but becoming upset about hearing the cough and stridor will only make your child upset and feel worse. If the croup worsens, call or see your pediatrician immediately or visit your ER.

  • Croup for Parents: How to recognize croup, when to call the doctor, and what to do about it at home.

  • Croup Scoring System: A somewhat technical, but easily read, article on croup. Written for doctors, it covers pathophysiology, epidemiology, causative organisms, and risk factors. Includes a scoring system for croup severity at the end.

Allergies

Allergies flare up when your immune systems overreacts to certain a allergen, whether it be pollen or peanuts. Seasonal and food allergies can make breathing difficult. Seasonal allergies affect the nose, sinuses, and throat, while food allergies can cause the serious, even deadly breathing problem known as anaphylaxis. Anaphylaxis occurs when someone has a severe reaction upon breathing in airborne particles of an allergen or by ingesting one. The throat tightens up and hives may occur, multi-systems of the body are affected. The only thing that will save a life is by using the Epipen. An epipen contains enough life-saving epinephrine to get you or your child to the hospital to be treated immediately.

Seasonal allergies are usually milder, more like a cold, but not caused by viruses. They are a histamine reaction to trees, grass, mites, and mold. Hay fever is one of the most common reactions to outdoor allergens, while pet dander, dust mites, and mold are the most prevalent indoor allergens to cause breathing troubles. Most seasonal allergy symptoms are alleviated by over-the-counter medications such as antihistamines.

  • Seasonal Allergies: Including a description of allergic rhinitis or hay fever.

  • The Food Allergy and Anaphylaxis Network: There is nothing more scary for a parent than worrying that your child's allergy is not properly under control. Learn about severe food allergies and how to use the epipen.

Hiatal Hernia

Some people describe having a hiatal hernia as a "rope tied around their middle." Hiatal hernias occur when the upper part of the stomach slides through an opening in the diaphram that usually is large enough only for the esophagus to fit. Sometimes the hernia slides in and out of the opening, sometimes it slides in permanently, mostly due to increased abdominal pressure. When the hiatal hernia is "acting up" it often causes indigestion, pain, and trouble breathing.

Obesity, slouching, frequent coughing, constipation, smoking, birth defects, and heredity are suspected to contribute to the condition. For the most part, hiatal hernias are asymptomatic, but can cause chest pain, pressure, heartburn, belching, coughing, and swallowing difficulties. Gastroesophageal reflux, better known as GERD, often accompanies a hiatal hernia. GERD weakens the sphincter muscle between the esophagus and the stomach, often allowing the hiatal hernia to occur. If the hiatal hernia is the fixed type, it occasionally can become strangulated, causing a medical emergency.

  • When the Stomach Slips Up: Everything you wanted to know about hiatal hernias, includes the usual overview, symptoms, tests and treatment options, including self-care from home.

  • Hiatal Hernia Diet: Generic guidelines and drawing of a hiatal hernia.

Panic Attacks

During a panic attack, a person is suddenly faced with intense fear. The chest tightens, a persona might begin to have trouble breathing, and feel like they might be dying. The heart feels like it is jumping around in your chest and you feel like you might hyperventilate. Panic, or anxiety, attacks affect about five percent of the total population; and, although quite frightening, usually has no long-lasting physical effect.

Psychiatrists define a panic attack as an abrupt, intense, discomforting fear that peaks within 10 minutes and has at least four of the 13 following symptoms:

  • Palpitations

  • Sweating

  • Shaking or trembling

  • Feeling short of breath of like you could smother

  • Feelings of choking

  • Chest pain and chest discomfort

  • Abdominal distress, including nausea

  • Feeling disoriented, dizzy, unsteady, faint

  • Feeling surreal, not living in the moment or being detached from oneself or reality

  • Fear of losing control or going insane

  • Fear of dying during the attack

  • Chills or hot flashes

  • Numbness and/or tingling sensations, called paresthesias

Respiratory symptoms seem to dominantly affect women more than men. Panic attack symptoms closely resemble heart attack symptoms, so if you are unsure, go to the ER immediately, especially if this is new to you. If you have had the symptoms before and are certain it is a panic attack, relax yourself, practice breathing techniques that you've learned in order to manage the attacks so that you can slow down your breathing, and know that it will pass. Do not treat any panic attack at home if you have underlying medical illness, such as heart disease.

  • Panic Disorder: Panic attacks accompany panic disorder. Usually the attacks are over in about 20 minutes, but occasionally last up to an hour.

  • Help Guide: Support to get you through panic attacks.

Obesity

Consuming more calories than you take in and not expending those calories during exercise can lead to obesity. Obesity is measured as having a body mass index (BMI) of 30 or above. Over 300,000 Americans die from obesity each year. Soon it will bypass smoking as the most preventable cause of death in the United States.

Obesity brings with it dangerous complications, such as sleep apnea, a problem causing someone to stop breathing over one hundred times each night, sometimes for a minute at a time. Obstructive sleep apnea causes a blockage of the airway as the soft tissue in the back of throat collapses and closes while you sleep. Most times, the brain signals you to awaken so that you can breathe, and often you find yourself gasping for breath. Obese people are affected frequently. The main treatment for breathing problem due to obesity is to lose the weight and exercise.

Most transient respiratory illnesses and breathing problems are preventable. Keeping your mental and physical health in shape by getting regular sleep, reducing anxiety, stopping smoking, reducing excess weight with diet and exercise, getting immunized against the flu and pneumonia, and washing your hands frequently will help keep many of these breathing problems at bay. Some respiratory problems are life-long and need management, such as asthma and certain food allergies. Talk to your physician about the treatment right for you.

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