Can you hear me?

This week I will talk about how to diagnose the two types of bronchitis.  First of all, let's think about the following questions:

1)  Are you having a fever?
2)  Are you having a cough?
3)  If yes, how long have you been coughing?
4)  Are you having any nasal congestion?
5)  Are you having a runny nose?
6)  Do you feel heavy at your lungs when you breathe?
7)  Do you have a history of asthma?
8)  Do you have trouble breathing?
9)  Are you wheezing when you breathe?
10)  Are you a current smoker?
11)  If yes, how long have you been smoking?
12)  When you cough, do you cough up any phlegm or mucous?
13)  What is the color of your sputum?
14)  Are you having any shortness of breath?
15)  How often were you diagnosed with bronchitis in the past two years?

According to the nurse practitioner journal, cough is the primary symptom of bronchitis.  If you have been coughing for less than three weeks, you are having acute bronchitis.  You may also experience cold-like symptoms, such as nasal congestion, sore throat, fever, and possibly wheezing if you have a history of asthma.  If you experienced repeated bouts of bronchitis, you might be having chronic bronchitis.  

Your doctor may ask you to get a chest X-ray, to see whether it is bronchitis or other respiratory diseases such as pneumonia.  He/she may have a culture of your sputum to see if it's other type of respiratory illnesses and what antibiotic he/she can treat you with.  Lastly, you may need to have a pulmonary function test where you will blow into a spirometer to check how much air your lungs can hold and how quickly you can blow air out.  This device is used to check for asthma or emphysema.

Reference:

Bronchitis. (n.d.). Retrieved February 1, 2015, from http://www.mayoclinic.org/diseases-conditions/bronchitis/basics/tests-diagnosis/con-20014956

Hart, A., Nurse Practitioner: 18 September 2014 - Volume 39 - Issue 9 - p 32–39

doi: 10.1097/01.NPR.0000452978.99676.2b

To breathe or not to breathe?!

Welcome back!  This week I will talk about the causes (etiology) and the physiological processes (progression) of acute and chronic BRONCHITIS!!  Let's check out the following video to refresh our memory:

In other words, acute bronchitis is like having a cold in your lungs.  It is caused by either a bacteria or virus.  It can be triggered by air pollution, asthma, dust exposure, having contact with someone who's ill and not washing your hands with soap and water. The inflammation of the linings of the airway makes it very difficult for you to breathe.  Let's picture two swollen branches (bronchi) of your windpipe filled with thick mucous  in your lungs.  You try to breathe, but the air cannot get through. The friction and thick mucous from the swollen branches (bronchi) are preventing the air to go into your lungs.  This leads you to shortness of breath. You try to cough up the thick mucous to clear the airway, but it doesn't work.  However the good news is, it should go away in one to two weeks following proper medical treatment. Take a look at the following picture:

What about chronic bronchitis?  It actually has similar triggers, but SMOKING is the primary cause.  The inflammation of the linings of the airway is the same, but it is a chronic condition.  A person with chronic bronchitis will have the thick mucous cough for most days in a month and for at least three months a year for two years.  Now picture yourself coughing and having shortness of breath almost everyday in a month.  And you experience it for three months in a year for two consecutive years.  Do you still want to smoke?

Unlike acute bronchitis, chronic bronchitis will not go away in one to two weeks.  It is a life-long illness.  People with chronic bronchitis usually develop emphysema (bursting of the air bubbles in your lungs).   When they combine, it will become Chronic Obstructive Pulmonary Disease (COPD).  Chronic bronchitis can lead to other serious respiratory problems and possibly heart failure.  Let's think twice before you pick up your cigarettes.


Reference:
Understanding Chronic Bronchitis - American Lung Association. (n.d.). Retrieved January 25, 2015, from http://www.lung.org/lung-disease/bronchitis-chronic/understanding-chronic-bronchitis.html

The impact of chronic bronchitis in the U.S.

Last week, we learned about what bronchitis is.  This week, I will discuss the impact of chronic bronchitis: chronic obstructive pulmonary disease (COPD)  around the world especially the United States.  According to World Health Organization (WHO), COPD affects 65 million of people.  In 2005, 3 million of people died of this disease, which is equivalent to 5% of total death globally.  Although accurate epidemiology data is difficult and expensive to collect, it is a fact that 90% of COPD deaths occurs in low- and middle-income countries.  By 2030, COPD will become the third leading cause of death worldwide (WHO).  Up to this point, you might be convinced that COPD is not a concern in the United States, since we are a high-income country.  We have a world class health care system, we have various campaigns to educate people the consequences of tobacco smoking, which is the primary cause of COPD.  Americans would be more concerned about heart disease and lung cancer.  However, according to the American Lung Association (ALA), COPD is the third leading cause of death in the U.S.  In 2011, 10.1 millions of Americans have diagnosed with chronic bronchitis, which affects people of all ages.  Age 65 and older is the at risk population.  The prevalence of COPD is less than 4% in Washington (Hurry for Washingtonians) and Minnesota, and more than 9% in Alabama and Kentucky.  More women than men died because of COPD.  More than 70,000 women died of COPD in 2011 (ALA).

Besides looking at the general population, I also researched on how chronic bronchitis affects the U.S. military who are active in continuous combat operations.  According to the U.S. Army Medical Department Journal, in a thirteen-year period (2001-2013), the trend in rates of bronchitis was high and then it decreased slightly.  Among the 482,670 incidents of chronic obstructive disease, 57% of it were diagnosis of bronchitis.  However, between 2009 to 2013, the incidence of chronic bronchitis declined 23.6%.  The article did not explain what caused the decline; however, it is a good news.  Based on CDC's data, each American with COPD pay $6000 more for their medical treatment than someone who does not have COPD.

     

Reference:
Abraham, J. H., Clark, L. L., Sharkey, J. M., & Baird, C. P. (2014). Trends in Rates of Chronic Obstructive Respiratory Conditions Among US Military Personnel, 2001-2013. U.S. Army Medical Department Journal, 33-43.

Burden of COPD. (n.d.). Retrieved January 18, 2015, from http://www.who.int/respiratory/copd/burden/en/

Chronic Obstructive Pulmonary Disease (COPD) Fact Sheet - American Lung Association. (n.d.). Retrieved January 18, 2015, from http://www.lung.org/lung-disease/copd/resources/facts-figures/COPD-Fact-Sheet.html

Increase Expected in Medical Care Costs for COPD. (2014, July 29). Retrieved January 18, 2015, from http://www.cdc.gov/features/ds-copd-costs/

Bronchitis is...

After I babysat my friend's three boys for a week, I caught the bug that they had.  I started with a sore throat and muscle ache all over my body.  Since I had the flu shot, I thought drinking honey with lemon, taking some Vitamin C, and getting some sleep would be enough.  However, two days had gone by, my symptoms became worse.  My sore throat got worse, my nose was runny, my body ache lingered on, and I started coughing.  It’s the week of Christmas and my doctor was on vacation.  Again, I believed my flu shot and my immune system would help me conquer the battle; therefore, I didn’t bother to schedule an appointment with the on-call doctor.  I took some over the counter medicine to alleviate my symptoms.  I took it for three days per medication instruction, my nose stopped running, my sore throat felt a little bit better, and I stopped coughing.  I discontinued the medication thinking I should get better on my own because I had the flu shot.  Three days before the end of winter break, I started to feel warm all over the body.  Nevertheless, my hands and feet were cold like ice.  The next day, I lost my voice, I had a headache, I started wheezing at night, I couldn’t sleep, my nose and ears were stuffed up, I had tightness at my chest, and I coughed up yellow phlegm (mucous).  What do you think I have?  Let’s watch the video!    

https://www.youtube.com/watch?v=8BHxqndnPug

As you can tell by now, I was diagnosed with acute bronchitis at the doctor's office.  I was prescribed with some antibiotics and a cough syrup for ten days.  In order to fully recover, I must finish all the medications as prescribed.  Please call your doctor's office, if you are experiencing any of the symptoms described above.  Next week, I will talk about the patterns and causes of acute and chronic bronchitis.  Stay tuned!