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Chronic lung disease is the term for a wide variety of persistent lung disorders.

Emphysema and chronic bronchitis (referred to as Chronic Obstructive Pulmonary Disease or COPD), asthma, cystic fibrosis, and restrictive lung diseases are examples of serious lung conditions that can adversely affect the quality of a patient's life.


Some lung diseases, such as cystic fibrosis, are hereditary and show up early in life. A major known risk factor for emphysema is cigarette smoking, but there is one type that you can inherit.

Environmental factors such as second-hand smoke or long-term exposure to industrial pollutants can cause COPD. Other examples of environmentally caused diseases are asbestosis and coal miner's disease.

Restrictive lung disease

Restrictive lung disease (chest wall diseases) can result from different problems, including interstitial fibrosis, scoliosis (spine curvature), and sarcoidosis.

Some cause scarring in the lungs, while others compress the lungs. Some have no known cause; other causes include occupational exposure, chemotherapeutic agents or radiation, and connective tissue diseases such as lupus or rheumatoid arthritis.

A serious problem

COPD (emphysema and chronic bronchitis) affects 210,000,000 people worldwide. It is a leading cause of disability and death in the United States, taking its toll on some 24 million Americans.

COPD deaths are climbing. COPD is now the fourth leading cause of death, and experts predict that by 2030 it will be the third leading cause.

The direct and indirect annual cost of treating persons with COPD alone in this country is $38 billion. Another 23 million persons have asthma, which also adversely impacts lives and productivity.

Warning signs

Symptoms generally start out mild. You may notice an ongoing cough, shortness of breath, wheezing, or chest tightness. You may also experience frequent colds or flu. Your symptoms likely will worsen over time. Severe symptoms include:

  • Shortness of breath after little or no exertion, or that persists after brief rest following normal exercise
  • Labored breathing; difficulty in drawing air into your lungs or breathing out
  • A cough lasting more than a month, regardless of your age
  • Chronic mucus or sputum production lasting a month or more
  • Wheezing or noisy breathing due to blockage of airways of the lungs
  • Coughing up blood
  • Swelling in your ankles, feet, or legs
  • Bluish lips

If you are experiencing any of these symptoms, the American Lung Association recommends seeing a doctor immediately.

Quality of life

"Chronic lung disease not only affects the patient's quality of life, but the family's as well," says Lana Hilling, RCP, FAACVPR, coordinator for lung rehabilitation programs at John Muir Health.

"Imagine what it's like to be short of breath all the time. These persons are no longer able to enjoy their hobbies, work, or even go shopping without feeling as if they are suffocating,” she says.

“When patients receive optimal medical care, which includes attending a pulmonary rehabilitation program, they are able to become active participants in their lives again."

Team effort

In classes of four to six persons, the staff teaches breathing techniques, energy conservation, a graded exercise program, relaxation techniques, and panic control.

A team of health care professionals reviews medications and their most effective use, and examines each patient's nutritional status. The programs are under the supervision of two medical directors who are pulmonary specialists.

In addition, a clinical pharmacist, clinical social worker, registered dietitian, registered physical therapist, exercise specialists, and respiratory care practitioners are on the team. Group support is also an important component.

"It is so encouraging to me to hear our participants make comments about the great progress they are making," Hilling says.


"One patient stated that he has learned to pace himself and he can now play 18 holes of golf again. Another participant said that the program has saved him from having to go to the emergency room many times, as he now understands his breathing problems, and how to help himself when he becomes very short of breath."

Participants learn to reduce risk factors, pace themselves, and practice self-assessment techniques in order to recognize the signs of an infection and seek early treatment. They develop confidence and their quality of life increases.

All have different goals. Some want to be able to play with grandchildren, travel, climb stairs, and attend ball games and other activities that many of us may take for granted. "It's wonderful to see our participants getting back to doing things they want to do," Hilling concludes.

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