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Like wardrobe shopping, patients should have regular checkups

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SN: Do pulmonologists deal with lung diseases only
Pulmonologists deal with diseases related to the respiratory system; the chest and the respiratory tract. This includes lungs and chest problems and certain types of allergies. Moreover, we also look into diseases of other organs that involve the lungs as well. For instance, scleroderma (a skin disease), ulcerative bowel disease, rheumatoid arthritis, etcetera.

SN: Lung diseases are rapidly increasing now; why
Environmental changes, more exposure to dust, fog and smog and industrialization have led to increase in respiratory diseases. Certain governmental projects such as coal-power projects have doubled our exposure to chemicals and smoke. These issues tend to increase the risk of respiratory problems in people who are prone to them. COPD (Chronic Obstructive Pulmonary Disease) is the third leading cause of death worldwide. And it becomes difficult to treat patients effectively in a country like Pakistan, where there is lack of awareness and proper treatment and exposure to smoking.

SN: Are there enough specialists to cater to the population
Unfortunately, the number of pulmonologists in Pakistan is too low. Under these conditions, chest patients are usually treated by general physicians. This can either delay treatment or complicate certain diseases.

SN: What can one do to minimize the effects of environmental pollution
Allergies, infections and respiratory diseases have increased due to smog. If it is necessary to go outside, especially during smog or fog, strictly use helmet when on bikes or cover your face with a mask. Adopt a healthy lifestyle so you have a better immune system. If you know about your problem, take precautionary measures beforehand. Similarly, timely and early treatment in case of chest infections saves one from a lot of problems further. Besides, the industry owners should also fulfill their corporate responsibility so that serious affects can be minimized among the population.

SN: What role can the government play in this regard
Government and private sectors both should play a responsible role in this regard. They should have awareness campaigns everywhere particularly in schools, so people can be educated about respiratory diseases. It is because persistent disease can be fatal especially among children and elderly after 60. These extremes of ages have a higher risk of death even with common infection and flu. The risk increases up to 30 percent particularly during the winter, smog and fog seasons.

SN: What are common chest problems in our country

Allergies are highly common here. When allergy does not get treated it converts into asthma, which is yet another growing problem. Other than this, COPD (form of asthma caused due to smoking cigarette, hookah and sheesha), pneumonia, flu, lung cancer, pulmonary hypertension (lung vessels get hardened) and respiratory failure are also some serious problems.

SN: Are respiratory diseases seasonal

Lung diseases continue throughout the year but seasons can also influence them. For instance, lung infections and allergies increase during the smog season; while allergies increase in wheat harvesting and pollen season. Similarly, those living in the industrial areas get exposed to a different environment. Therefore, individuals with sensitive respiratory tract have more chances of catching diseases like asthma, COPD, etcetera during peak times.

SN: When is the right time to consult a doctor

The early the better; particularly in the extremes of ages. Adults between 15 to 50 years, normally cope well with diseases. Individuals with serious issues such as COPD, asthma and tuberculosis should also check with a doctor immediately. Patients who know their problem aggravates seasonally, should consult their doctor before the season starts to get medicine dose adjusted and to help prevent the disease from occurring or its severity.

SN: Some patients have chronic issues such as post-nasal drip, sneezing etcetera. What would you recommend them
Post-nasal drip, blocked nose, sneezing and eye itching is a sign of allergic rhinitis. If left untreated, 70 percent patients can develop scleroderma later. Bloody mucus, excess of mucus production or change of its color is a sign of chest infection. Its mortality rate is 10 percent at home and 30 to 40 percent in hospital setting. Chest infections are major killers in hospitals. Sarc and swine flu are respiratory problems that have a high mortality rate. People with common respiratory problems have a higher risk of catching these diseases.

SN: How complicated can post-nasal drip get
The breathing tract starts from nose and goes all the way to the end of the lungs. This can cause both allergic and non-allergic rhinitis. When the allergic reaction continues till the lower respiratory tract, it causes asthma. Post-nasal drip is a seasonal disease initially which can occur due to an allergy, infection, pollens, dust, smog, cockroaches or due to one’s nature of job. There are 70 percent chances it leads to asthma if left untreated for more than a year. This complicates treatment. Home remedy for this can be taking honey, green tea or flu vaccine and avoiding the allergen.

SN: Can nasal sprays help in this regard
With exposure to allergen, it becomes difficult for nasal sprays to prevent the problem. It is important therefore, to try to prevent exposure. Medicines need to be given for it. Using masks is also very helpful as they help prevent entry of allergens and cold air in the nose.

SN: Do chest infections occur during winters
Chest infections are likely to increase in the cold weather in people who already suffer from some respiratory problem. This occurs because we are usually not in the habit of being prepared beforehand for the changing weather. Chest problems can occur throughout the year but our population is more vulnerable during winters. Also, patients with asthma, pneumonia, COPD or TB should get flu vaccination annually. So, their immunity can be boosted and disease can be prevented.

SN: For some, asthma gets triggered in the cold season. What can be done to control it
Yes, it does. Some people are simply allergic to the cold air. Triggers vary individually. Any allergen can cause an allergic reaction and complicate the underlying cause. Therefore, it is essential to first control your allergy. Like we do wardrobe shopping every season, patients should have regular pre-season checkups as well. People need to prioritize their health.

SN: What about exercise-induced asthma
Such patients are also advised to check with a doctor first for complete and proper treatment as it affects their quality of life. He would diagnose the underlying problem and see if exercise is the culprit or not. However, patients are recommended to start doing exercise slowly and increase pace gradually.

SN: People usually practice different home remedies like gargling, drinking lukewarm water, adding honey in warm water or drinking herbal teas to prevent respiratory problems. Are they really effective
If a patient feels better with any such home remedy he can take it. Home remedies are however, not recommended treatment therefore, patients should definitely follow the physician’s guideline as well.

SN: Treatment of respiratory problems sometimes requires the help of steroid medicine. What side effects can they have
Not all medicines contain steroids. Steroids in inhalers, both taken as puff or capsule form and nebulization have a minimal amount, which affects the breathing tract not entire body. Oral steroids on the other hand, can affect the whole body. Steroid medicine should not be taken without the doctor’s prescription. Always ask your doctor about its use, time period, and continuity. Doctors should also inform about their side effects. Rinse your mouth after taking inhalers as the medicine gets deposited and can cause a bad taste in the mouth and also cause infections. When taking oral steroids, a patient’s immunity gets lowered, chances of high blood pressure, infection, hormonal imbalances and weight gain increases. Doctors and patients should hence be careful when prescribing and using them.

SN: Is there anything left that you would like to add at the end
Do not take any disease for granted. Consult a doctor immediately if you have a persistent problem that is not settling. Avoid habits like smoking. TB is completely curable. Get treated for it at an early stage. Get vaccinated for flu on time. And never start, change or stop using any inhaler or medicine without consulting your doctor.

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