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Vicious versus Virtuous Circle in COPD

Posted Jul 16 2013 11:58am

Yin and Yan

There is always an opposite side. The opposite side doesn’t need to be negative. It is just different. Some days people walk in the opposite sidewalk because of the intense sun heat that hits the other side. At a different time of the day, the opposite sidewalk works the better.

The Vicious Circle in COPD

Once the condition is established, breathlessness (also called dyspnea) becomes a common symptom. Breathlessness drives toward anxiety and even panic. The psychological situation of anxiety brings fear toward physical efforts. The avoidance of exercise makes patients to lose their fitness. When they are more unfit to physical efforts, the breathlessness will show up at any physical activity. This will then lead to anxiety …

The mirror image

If we know that breathlessness, anxiety, sedentary lifestyle, loss of fitness play a big role in the COPD story, we can then look for counterparts. Breathlessnes should be confronted with better breathing due to better treatment.  Anxiety with calmness and confidence through education and good patient-physician interaction. Sedentary lifestyle with being active due to encouragement. Loss of fitness with physical training through pulmonary rehabilitation.

The Virtuous Circle in COPD

Better airflow and reduced air trapping will lead to less dyspnea. Less dyspnea will create more confidence. More confidence keeps patients active. Being active makes patients to have better physical response. Better physical response will then reduce unconditioned lung airflow that will lead to less breathlessness during physical exertion.

The future

COPD is clearly better understood these days thanks to the efforts of multiple investigators in the world. Finding ways to approach components of the basic vicious circle will bring changes in the experience of the patient. Each effort is a seed to advance in a positive direction. Any advancement in a positive direction represents a stride when we all talk about COPD. Measures that address dyspnea, anxiety and fear, sendentarism, loss of fitness, will mean that a virtuous circle is being initiated. Patients with COPD will find light in the dark path of their condition and the whole quality of life might end improving.

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