Lung Disease

WHY MIGHT OLDER ADULTS WITH HIV HAVE LUNG DISEASE?

Lung diseases are more common in people with HIV. They are more likely to have lung cancer, lung infections, and emphysema (difficulty breathing). Apart from common causes of lung disease such as smoking, HIV itself — and the chronic inflammation it causes — can also damage lung tissue over time.

WHAT HAPPENS WHEN YOU HAVE LUNG DISEASE?

Lung disease makes it hard to breathe and do the things you enjoy. It can cause pain or death, especially if lung cancer is the cause. Since the lungs work with the heart, people may also have heart damage if their lung disease is not controlled.


What you can do with your doctor

TELL YOUR DOCTOR IF YOU’RE SHORT OF BREATH

Shortness of breath can be serious. You should not just chalk it up to age. Tell your doctor, even if your shortness of breath goes away once you rest. If ignored, it may start to happen even when you are resting and may never get better again. You should deal with shortness of breath as early as possible to prevent lasting damage to your lungs.

ASK IF YOU NEED VACCINES

You should get a flu vaccine every year to protect yourself against the illness. Flu can cause serious complications in people with HIV or lung disease. A higher dose flu vaccine, Fluzone, is available for people over 65. It’s designed to create a stronger immune response – ask your doctor if it’s right for you. You should also get vaccinated against pneumonia. Severe pneumonia can cause decreased lung function and death. It is better to prevent pneumonia rather than to treat it after it happens. The CDC recommends that people over 65 and all people with HIV get both the Prevnar and Pneumovax vaccines to protect against pneumonia.


What you can do yourself

TAKE YOUR MEDS CORRECTLY

You should take the right number of pills at the right time of day, as prescribed. If you use an inhaler, show your doctor how you use it, to make sure you’re using it correctly. The right pills and inhalers can help relieve coughing and breathing problems.

EAT A HEALTHY DIET

Eating healthy food and keeping a healthy weight are important. Being overweight can make it harder to breathe, while being underweight might mean you’re not eating the right food to keep your lungs healthy. To plan a balanced diet, you should ask to see a nutritionist.

EXERCISE

Exercise expands and strengthens your lungs. Even a small amount of exercise helps, so any exercise is better than none. If you’re not sure where to start, ask to see an exercise trainer for older persons. Besides helping you develop an exercise regimen, a physical therapist can teach you breathing exercises that reduce shortness of breath and allow you to do more.

DON’T SMOKE!

Smoking causes lung problems and many other diseases. Don’t smoke and avoid secondhand smoke. If you plan to quit smoking, ask your doctor for help. You should also avoid other things that may affect your lungs, such as car exhaust and fumes from paint, cleaning supplies, and the like.

PROTECT YOURSELF AROUND SICK PEOPLE

Lung disease makes it harder to heal from lung infections. To protect yourself from other diseases, you should take extra care when around sick people, especially those who are coughing. You should also wash your hands often.

BACKGROUND

Lung Disease or COPD (Chronic Obstructive Pulmonary Disease) is quite common in older adults with HIV. The technical definition of COPD is: “a disease state characterized by airflow limitation that is not fully reversible.” COPD is a general term for a number of different lung problems. A common type of COPD is chronic bronchitis (recurrent cough with phlegm). This damages the upper air tubes and is accompanied by shortness of breath. The disease affects small sacs (alveoli) at the end of the breathing tube (trachea). As a result, not enough oxygen gets to the blood for normal functioning. Another lung disease called asthma is an allergic reaction and can be treated. Unfortunately, these lung conditions affect not only quality of life, but can also make you more prone to pneumonia and an increased risk of death.

CAUSES

Smoking is a major cause of COPD. Older adults with HIV are more likely to smoke than adults without HIV, leading to more lung disease. However, other causes are the recurring lung infections they may have experienced before effective HIV treatment became available. Less common causes of lung disease are occupational exposures to dusty conditions and mining. Finally, a high viral load or low CD4 count can increase risk of COPD.

DIAGNOSIS

You should tell your doctor if you are having recurrent bouts of shortness of breath, chronic cough with phlegm, or extreme tiredness. Your doctor can order a series of simple tests to determine the cause of your problem, including both lung and heart issues. A simple chest X-ray can reveal the condition of your lungs and heart, as well as rule out a tumor or growth.

A COPD diagnosis is made using a device called a spirometer. While breathing into a tube attached to the device, a sensor takes measurements. If you have a diagnosis of asthma, a bronchodilator will be administered and the test repeated. Your doctor will use measurements from the spirometer to diagnosis COPD.

WHAT CAN BE DONE

If you are diagnosed with COPD, what can be done? Even with early symptoms, it is never too late to quit smoking. The American Lung Association outlines an approach to quitting smoking at https://www.lung.org/stop-smoking.

Medications can increase the size of the bronchi and decrease the respiratory symptoms associated with COPD. However, some of these medications may interact with antiretroviral drugs. Your doctor and pharmacist can help resolve this problem.

In some cases, pulmonary rehabilitation can be helpful in building up the muscles that assist with breathing and increasing the efficiency of how the heart circulates oxygenated blood.

If you have been diagnosed with COPD, you may be vulnerable to infections. For this reason, you should take the seasonal flu vaccine annually, specifically the stronger version of the vaccine that is given to those 65 years of age and older who may have compromised immune function. You should also be vaccinated against bacterial pneumonia. To ensure the best protection against different strains, your healthcare provider may recommend two separate pneumonia vaccines.

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