I clapped and cheered with all of the other proud moms and dads who attended the opening weekend performance(s) of the Addams Family musical, staged by our high school technical and musical theater students. I was especially proud of one little ‘ancestor’ who, not many days ago, couldn’t breathe well enough to speak, let alone to sing. Her asthma is generally controlled with preventative medication, inhaled twice daily, but a combination of several missed doses and a hard afternoon workout resulted in a hurried trip to pick her up, several puffs of her rescue inhaler and a whole afternoon and evening of her feeling very poorly. We’re being very careful now, to remember her medication, after all, the Addams Family has two more showings, and she wants to sing and dance! Though triggers and some symptoms may differ from one individual to another, shortness of breath is a universal experience for kids with asthma. Shortness of breath is a common symptom of both restrictive and obstructive lung diseases. What’s the difference between obstructive and restrictive lung diseases? Restrictive lung diseases interfere with the ability to fully expand the lungs, making it difficult or impossible to fill the lungs with air. If tissue in the chest wall becomes stiff as sometimes happens when muscles are weakened or nerves are damaged, lung expansion is restricted. Interstitial lung disease, sarcoidosis, neuromuscular disease (such as amyotrophic lateral sclerosis aka ALS), pulmonary fibrosis, asbestosis and silicosis are all restrictive lung diseases. Obstructive lung diseases are those that hinder a person’s ability to exhale all the air from the lungs with every breath. Chronic obstructive pulmonary disease aka COPD (meaning emphysema), asthma, and Cystic Fibrosis are all obstructive lung related diseases. All negatively affect oxygenation during exertion; as lungs work harder but fresh air circulated into and spent air circulated out of the lungs decreases during a time when the body needs more, not less oxygen. Because the American Lung Association sponsors National COPD Awareness Month in November to raise awareness about COPD, let’s remember what usually causes it: Long-term exposure to lung irritants that damage the lungs and airways. In the USA the most common COPD-causing irritant is cigarette/pipe/cigar and other types of tobacco smoke, inhaled directly or second-hand. Individuals with a rare genetic condition (alpha-1 antitrypsin deficiency), may develop COPD more easily when exposed to irritants, as well as may people with asthma (learn more at nhlbi.nih.gov). Data indicates that vapor from e-cigarettes is just as irritating to the lungs of people with COPD as tobacco smoke (McNeill A, Brose L, Calder R, et al 2015). Always, it’s wise to use NEITHER traditional NOR electronic cigarettes. Let the singing and dancing continue! Be well.

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