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Showing posts with label Lung Health. Show all posts
Showing posts with label Lung Health. Show all posts

Saturday, 26 March 2022

Non-smoker’s lung cancer and the hidden link

How does one contract the so-called non-smoker’s lung cancer? The answer, one might say, is blowing in the wind.

The link between cigarette smoking and lung cancer is widely acknowledged. But not everyone who smokes gets lung cancer and not everyone who gets lung cancer is a smoker. How does one contract the so-called non-smoker’s lung cancer? The answer, one might say, is blowing in the wind. And that wind may be blowing a gas called radon.     

Radon is a naturally occurring colourless and odourless radioactive gas that according to the World Health Organization (WHO) is responsible for up to 14% of all cases of lung cancer.  The source of radon is uranium, a radioactive element found in soil and rocks.  

The term “radioactive” alarms many people. Justifiably so. Atoms of radioactive elements are unstable and spontaneously disintegrate into other elements, in the process giving off rays of energetic particles that can damage tissues and cause disease. When uranium undergoes radioactive decay, one of the products it forms is radon, which is itself radioactive and gives off dangerous high-energy rays. The gas can seep into basements and crawl spaces wherever uranium is present in the soil. Whether it does, depends on how fissures are structured in the ground underneath homes. It is possible for the basement of one house to be contaminated with radon while an adjacent home is unaffected. Granite, a stone that is composed mostly of silicon dioxide (quartz) can harbour trace amounts of uranium compounds and can therefore also be a source of radon.  

Uranium was first discovered by the German chemist Martin Henrich Klaproth in 1789, but its radioactive property was not identified until 1896 by French physicist Henri Becquerel. Polish-French physicist/chemist Marie Curie subsequently coined the term “radioactivity” after discovering two additional elements, radium and polonium, that like uranium fragmented into other elements accompanied by the emission of “rays” of energy.  

Every element has a nucleus composed of positively charged particles called protons, and neutral particles termed neutrons. Like charges repel each other, but proton-proton repulsion is reduced by neutrons squeezing in-between the protons. Negatively charged electrons roam about the nucleus in different shells, with the outer-most shell referred to as the valence shell.   

Elements with large nuclei, such as uranium, tend to be unstable. To achieve stability, they undergo spontaneous radioactive decay. Uranium-238, so-called because it has 92 protons and 146 neutrons in its nucleus, undergoes radioactive decay through 14 steps, eventually yielding lead-206, a stable nucleus. One of the nuclei produced in this lengthy chain is that of radon. As soon as radon forms, it begins to undergo radioactive decay into lighter elements by giving off alpha particles that are composed of two protons and two neutrons. When radon is inhaled, alpha particles become trapped in lung tissues and can damage DNA. Such damage can result in cancer over time.  

How does this happen? Alpha particles are a type of “ionizing radiation,” defined as radiation that is energetic enough to break chemical bonds in molecules. When water, which makes up 70% of human cells, is the target if such radiation, one of the breakdown products formed is a hydroxyl radical. This species is “electron hungry” and can steal electrons from other molecules such as DNA. Since electrons are the “glue” holding atoms together in molecules, their loss leads to molecular damage such as a change in a DNA sequence. Such a “mutation,” if uncorrected by the body’s DNA repair processes, can be passed on to generations of daughter cells which over time can transform into cancer cells. Mutations can also occur without the involvement of water. Radioactive emissions can attack DNA directly and disrupt its structure.   

Radioactivity is measured in picocuries per litre of air (pCi/L). On average, in North America, outdoor levels are around 0.4 pCi/L whereas indoor levels are higher, at roughly 1.3 pCi/L. It is recommended that protective measures be taken if indoor radon levels are above 4 pCi/L.  Smokers and former smokers are at greater risk than non-smokers. 

Various types of radon tests are available. The simplest ones, readily available at a reasonable cost, feature a canister filled with activated charcoal that absorbs radon as air passes through it. The canister is then sent to a laboratory where instruments detect and count the radioactive particles emitted. Another type of device contains a plastic film that is etched by alpha particles leaving tracks that can be visualized and counted in a lab. Also available are electronic detectors that require installation but can monitor radon levels continuously.  

Health Canada recommends a kit that collects radon for three months as the most accurate way of testing for the gas. As a general rule, the longer the time during which air is sampled, the more accurate the results. Detailed information on radon is available from Health Canada at https://www.canada.ca/en/health-canada/services/health-risks-safety/radiation/radon.html as well as the Environmental Protection Agency (EPA) website, or by calling 1-800-SOS-RADON.  

Takeaway: Measure your household radon levels and fix if needed. As for that beautifully polished granite countertop in your kitchen, no worries, as the traces of radon gas emitted are negligible relative to ambient amounts in the air, especially in properly ventilated homes. Bon Appétit and Happy Holidays!


Dr. Nancy Liu-Sullivan holds a Ph.D. in biology and served as a senior research scientist at Memorial Sloan Kettering Cancer Center. She currently teaches biology at the College of Staten Island, City University of New York.

https://www.mcgill.ca/oss/article/health-and-nutrition/non-smokers-lung-cancer-and-hidden-link


Thursday, 23 December 2021

Have Your Lungs Checked If You Notice This on Your Fingers or Toes

THIS SURPRISING SYMPTOM COULD SIGNAL A SERIOUS PROBLEM WITH YOUR LUNGS.

Lauren Gray

July 25, 2021


Amid the pandemic, millions of Americans have seen firsthand the devastating effects of serious lung conditions. And while the CDC says that the COVID crisis alone has caused over 2.3 million hospitalizations in the U.S. to date, an additional 37 million Americans live with a chronic lung condition, according to the American Lung Association.

Kick Turf Toe to the Curb









However, experts say that some of the worst lung conditions, including lung cancer, can be notoriously difficult to diagnose during the stages at which they're still curable. One study published in the journal Primary Health Care Research and Development found that due to complex presentations, up to 20 percent of lung cancer cases are initially overlooked, even after X-rays. That said, those same researchers suggested that "greater vigilance for patients presenting with atypical symptoms" would aid in prompt diagnosis.

One symptom in particular, which presents in the fingers or toes, can clue you into a serious lung condition. Read on to find out what to look for, and to learn more about the underlying cause.

RELATED: If You Feel This at Night, You Need to Get Your Liver Checked, Doctors Say.

Digital clubbing can indicate a serious lung condition.

Lung x-ray
Shutterstock

While many lung conditions are often difficult to diagnose and may go untreated for prolonged periods of time, there's one sign that should tip you off to a serious problem: clubbing of the fingers or toes. According to the Mayo Clinic, this is known as digital clubbing, and it's common among patients with lung cancer and pulmonary fibrosis, a chronic lung condition in which the tissue surrounding the lungs becomes scarred. It can also indicate lung abscesses, cystic fibrosis, chronic obstructive pulmonary disease (COPD), or a chronic lung infection.

While medical professionals are still working to understand the underlying causes of digital clubbing, they do know that it occurs when the body struggles to get enough oxygen into the bloodstream. As a result, fluid concentrates within the extremities, creating a swelling or rounding effect.

RELATED: If Your Breath Smells Like This, Get Your Liver Checked, Experts Say.

Here's what to look out for.

Digital Clubbing
Shutterstock

According to Pulmonary Fibrosis News, digital clubbing "typically occurs in stages, with the fingernails lifting from the nail bed first." From there, the fingertips become bulbous and begin bulging. A report from Mount Sinai's health library says that the nail beds may also soften, and the nails "may seem to 'float' instead of being firmly attached." They often "form a sharper angle with the cuticle," and they may also curve sharply downward in a convex fashion.

While other symptoms of lung conditions may develop slowly over time, digital clubbing tends to develop over a matter of just weeks.

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Digital clubbing can also indicate a range of other conditions.

Middle-aged man being examined by a female doctor in a doctor's office. Patient complains to the doctor of pancreas pain.
iStock

While lung cancer is the most common cause of digital clubbing, and 65 percent of people with pulmonary fibrosis also present with this symptom, there are cases in which the clubbing is the result of another underlying condition. Most often, these are conditions related to the heart, including congenital heart defects, and infections in the lining of the heart chambers or valves, among others.

Mount Sinai points out that in other, rarer cases, digital clubbing may suggest any of the following conditions: celiac disease, liver disease, dysentery, Graves' disease, a thyroid disorder, or one of several types of cancer.

Here's what to do if you're experiencing digital clubbing.

iStock

Most of the illnesses that cause digital clubbing are serious and require immediate medical care, so you should contact your doctor immediately if you notice this symptom. While there is no treatment for digital clubbing specifically, it may go away as you treat the underlying cause.

Treatment may include a combination of chemotherapy, surgery, and radiation to treat cancer, a combination of medication and therapies to treat various other lung conditions, or a combination of surgery and medication to treat various heart conditions, depending on the condition causing the clubbing.

https://bestlifeonline.com/news-lungs-clubbing/

Saturday, 3 October 2020

9 Warning Signs of Lung Cancer You Might Ignore

 Most lung cancers do not cause any symptoms until the disease has advanced. However, some people do have early lung cancer symptoms. 

If you visit your doctor when you notice these early symptoms, your cancer can be diagnosed at an earlier stage, when the treatment is more likely to be effective. The most common symptoms of lung cancer are:


1. A lingering cough

The majority of people with lung cancer have a cough, sometimes with blood. If you have a dry cough, and it lasts for over a month, you'd better get it checked out.

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2. Chronic infections

Most of the time, viruses are to blame for lung infections like chronic bronchitis. However, if you are getting sick repeatedly, and the sickness seems to go straight to your chest, it could be an early sign of cancer.

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3. Shortness of breath

Shortness of breath is common for people with lung cancer. You may feel like you can't get enough air into your lungs and It can be a scary sensation. It's important to tell your doctor if you are having difficulty breathing.

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4. Weight loss

A more advanced tumor may make proteins that tell your body to lose weight. If you are dropping pounds without a change in your diet or workout, you'd better go to the doctor.

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5. Bone pain

If the cancer has spread to other organs in your body, you may feel an ache deep down in your bones or joints. The back and hips are common sore spots.

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6. Swelling in your neck and face

If a lung tumor begins pressing against your vena cava, you may notice swelling in your neck and face. Your arms and upper chest can also be affected.

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7.  Overwhelming fatigue

80% of people with cancer note "excessive tiredness" as a sign. But It is different than feeling tired. It is a feeling so worn out that you can't wait to climb into bed.

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8. Muscle weakness

Lung cancer affects your muscles as well as other organs. One of the first areas to be impacted is your hips. You may find it hard to even get out of a chair. Weakness can also be in the shoulders, arms, legs.

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9. High calcium levels

Some lung cancers make hormone-like substances that upset the balance of minerals in your body. In some instances, excess calcium gets released into the bloodstream and this can cause: frequent urination, constipation, excessive thirst, belly pain and dizziness. If you notice any number of these symptoms, you need to visit your doctor.

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How Common is Lung Cancer?

Lung cancer is one of the most common causes of death throughout the world. Statistics from the American Cancer Society estimated that there will be about 244,000 new cases of lung cancer in the United States and about 154000 death were due to the disease.

Lung cancer is predominantly found in older people; almost 70% of people diagnosed with lung cancer are over 65 years of age.

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What are the causes and risk factors for lung cancer?

Research has shown that the chief cause of lung cancer is cigarette smoking. It is said that around 90% of lung cancers can be attributed to tobacco use.

Passive smoking is also an established risk factor for the development of lung cancer. It is said that a nonsmoker who resides with a smoker has a 24% increase in their risk of developing lung cancer. It is estimated that more than 7,000 lung cancer deaths occur each year in the United States that are attributable to passive smoking.

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https://www.buzzaura.com/9-warning-signs-of-lung-cancer-you-might-ignore/

Monday, 27 April 2020

Fighting Coronavirus - What to Eat and Three Pre-existing Conditions That Can Make it Harder to Fight it

Three Pre-existing Conditions That Can Make it Harder to Fight Coronavirus, and What to Eat


About Dr. William Li

William W. Li, MD, is a world-renowned physician, scientist, speaker, and author of EAT TO BEAT DISEASE – The New Science of How Your Body Can Heal Itself. He is best known for leading the Angiogenesis Foundation. His groundbreaking work has impacted more than 70 diseases including cancer, diabetes, blindness, heart disease, and obesity. His TED Talk, “Can We Eat to Starve Cancer?” has garnered more than 11 million views, and he has appeared on: Good Morning America, CNN, MSNBC, NPR, Voice of America; and in The Atlantic, TIME, and The New York Times. An author of over 100 scientific publications in leading journals such as Science, the New England Journal of Medicine, and The Lancet, Dr. Li has served on the faculties of Harvard Medical School, Tufts University, and Dartmouth Medical School.


You’ve heard what to look out for for symptoms of the novel coronavirus, and by now you have likely heard firsthand accounts of what it’s like from friends or family that are experiencing it themselves. For many people, COVID-19 causes mild to moderate symptoms that do not require hospitalization. In certain high-risk populations, like people over 60, people who are immunocompromised, and people with pre existing conditions, the virus can be severe or even fatal.
Here are three pre-existing chronic conditions that may make it harder for an otherwise healthy person to fight off the new coronavirus:
Heart disease
Heart disease is part of a group of conditions known as cardiovascular disease, in which the blood vessels in your body are damaged or unable to function normally. COVID-19 causes fever and increased inflammation, which can increase the stress on the heart and blood vessels. COVID-19 has been shown to cause pneumonia, which makes it harder for your lungs to oxygenate the blood, which puts further stress on your heart.
Heart disease also tends to accompany other underlying conditions that can increase risk, such as high blood pressure, high cholesterol, type 2 diabetes, lung disease, and liver disease. These all weaken your body’s defense against infection.
Chronic lung conditions
People with chronic lung conditions like chronic obstructive pulmonary disease (COPD), asthma, or pulmonary hypertension are at higher risk of developing severe symptoms from the pneumonia that can accompany COVID-19. Your lungs are crucial for bringing oxygen to your body. When this is compromised, it can be lethal.
Diabetes
Diabetes is a condition where your body either stops responding properly to insulin or doesn’t make enough insulin. This results in high blood sugar if it’s not managed properly. Diabetes can also cause a number of secondary issues, including a compromised immune system. Because the immune system is compromised in diabetes, it can be harder for your body to fight off COVID-19. High blood sugar may even help the virus survive longer.
Now more than ever it is important to maintain a healthy diet, especially if you are dealing with a chronic condition. A healthy diet not only helps to manage the chronic condition, it can help keep your body and immune system in fighting shape to reduce your risk of contracting COVID-19.
In addition to following an overall healthy diet, adding certain immune-boosting foods can help boost your immune system to better ward off or fight viruses.

  • Broccoli stems and florets contain a bioactive compound called sulforaphane that stimulates the immune system to increase natural killer cells, which may help in fighting viruses. Broccoli sprouts contain even higher amounts. In a study in people given a nasal flu vaccine, those who consumed 1 cup of broccoli sprouts in a smoothie had less flu virus remaining compared to a control group.

  • Mushrooms can stimulate the immune system in a different way. A study found that 1 ⅓ cups of mushrooms could increase IgA by 55%. IgA (immunoglobulin A) is a natural antibody that exists in the mucous membrane of the gastrointestinal tract, and is an important factor for preventing viral infections.

  • Aged garlic is another useful addition. Like broccoli, aged garlic extract can increase levels of natural killer cells. Even more important — in a clinical trial people taking aged garlic had fewer cold and flu symptoms and reported 58% fewer missed days of work due to illness. Aged garlic extract can be found as a supplement, or you can make it at home.



Friday, 24 April 2020

Life After Ventilators Can Be Hell for Coronavirus Survivors

Some never fully recover, and those who do often must relearn basic skills such as walking and swallowing.


Diana Aguilar, 55, spent 10 days on a ventilator fighting for her life in Somerset hospital, New Jersey.
Diana Aguilar, 55, spent 10 days on a ventilator fighting for her life in Somerset hospital, New Jersey.Source: Aguilar family






Her fever hit 105 degrees. In her delirium, Diana Aguilar was sure the strangers hovering over her, in their masks and gowns, were angels before they morphed into menacing aliens. As a doctor prepared to slide a ventilator tube down her throat, all she remembers thinking was: “I cannot breathe. I have no air. I give up, I give up.”


Aguilar, in the throes of Covid-19, was starting her 10-day descent into ventilator limbo. The mechanical device to which her tube was attached is coveted for its ability to push life-saving oxygen deep into damaged lungs. Yet it also is feared and reviled for the damage it inflicts — and for the slim odds of survival it affords. Aguilar wasn’t aware of any of that, yet she sensed this could be the end. She whispered her goodbyes to her husband, son and daughter, none of whom were anywhere nearby, and then she prayed to God in her native Spanish.


“You’re going to be fine,” a voice reassured her. “Start counting now; one, two…”


The voice belonged to an anesthesiologist, the last she heard before drifting off. Diana was diagnosed with Covid-19 on March 18, the day she arrived in the emergency room at Robert Wood Johnson University Hospital Somerset in Somerville, New Jersey. The virus had already been ravaging her body for weeks, infecting the tiny cells in her lungs that deliver oxygen to her blood.

She was struggling to breathe, and every inch of her body ached as she felt it failing. And then came the intubation, a last-resort intervention to save her life. It’s an awful moment for each of the many thousands of patients who are estimated to have undergone the procedure.







As the cases of Covid-19 infection soar, already approaching 900,000 Americans, more and more patients are going through the same dreaded treatment. The lucky ones pull through, but their journey back to health is long and perilous. Doctors are only now learning about the challenges ahead for people who arrive at the hospital so breathless and low on oxygen that a ventilator, many believe, is all that’s standing between them and death.

“Mechanical ventilation is a life-saving intervention,” says Hassan Khouli, chair of critical care at the Cleveland Clinic in Ohio. Yet even when patients survive, “some of them will continue to be profoundly weak,” he says. “It can get to the point where they can’t perform daily activities — shaving, taking a bath, preparing a meal — to the point they could be bedridden.’’


Some people never fully recover, says Michael Rodricks, medical director of Somerset’s intensive-care unit. And those who do often must relearn basic skills such as walking, talking and swallowing.

Just a few weeks ago, when the success of social-distancing strategies was far from assured, various models estimated that the U.S., with about 63,000 of the devices available across the country, would fall dramatically and tragically short of the numbers needed. At one point, it was estimated that New York City alone may need 40,000 ventilators. Auto manufacturers agreed to work with medical-device makers to ramp up emergency production. And as makeshift hospitals sprang up in New York’s Central Park and in conference centers and gymnasiums across the country, plans were hatched to put two patients on a single ventilator to double capacity.

Now there’s good news: It appears that U.S. hospitals will need fewer than 17,000 devices to treat Covid-19 patients, according to one widely used model. What the final numbers will look like as the virus continues its march across the country is anyone’s guess. But there’s little doubt there will be thousands of ventilator survivors once the pandemic is over. And the quality of their lives is still an open question.






When Aguilar, 55, woke up in intensive care at the end of March, she found her wrists tied to the bed frame. That, she later learned, was to stop her from tearing out the tube that ran down her throat all the way to her lungs. It was connected to a mechanical ventilator that had been breathing for her for 10 days as she lay in a medically induced coma.

A nurse slowly peeled the tape off her face and, with a flick of her wrist, yanked out the tube. Aguilar had made it through the most harrowing phase of her Covid-19 gantlet.


Nurses and doctors lined the hallway outside her room in the 361-bed regional medical center, located halfway between Trenton, New Jersey, and New York City. When she looked up through the glass window, they started cheering and chanting. “Yay, Diana! You made it!” she remembers hearing.

“They were jumping and clapping, and everybody was so happy,” she says. “I didn’t know I had all these people waiting for me, waiting to see how I’d do.”

She hadn’t yet fully grasped how close she had come to death and the long odds she had just beaten. The cheers were also because many of the patients with whom she shared the ICU eventually were rolled out in body bags. Here’s why: The lungs are dynamic, delivering inhaled oxygen into the blood supply in seconds. If they aren’t working, the damage is swift. A person can go from healthy to dead in fewer than six minutes.


She also didn’t know that her husband, Carlos Aguilar, was in the room next to her. While Diana was sedated as the machine helped her breathe, Carlos had grown ill with the same virus. A few days earlier, he’d been admitted to the hospital. And hours after Diana regained consciousness, Carlos, 64, was sedated so doctors could slide a tube down his throat as his breathing worsened.





Carlos Aguilar
When Diana Aguilar was extubated and wheeled out of intensive care, she snapped a photo of her husband, Carlos Aguilar, intubated in the room beside her own.
Source: Aguilar family
When a person inhales, oxygen flows through the trachea, down branches that divide again and again, to end in 600 million tiny buds of air sacs known as alveoli. The oxygen passes easily through their walls, just one cell thick, and into the blood stream, where it fuels the rest of the body. 

Coronavirus and the inflammation it causes is like slime, clogging up the intricate system. One of the most troubling aspects is the virus’s ability to penetrate deep within the lungs, burrowing into cells and churning out viral particles. The issue isn’t just losing those cells in the lungs that are supposed to help oxygenate the body. The problem is the lungs then become the battleground for the fight, where the human immune system takes on the foreign invader. The tightly packed cells become so swollen from fluid and inflammation they stop functioning. Survivors have likened it to the sensation of drowning. 

Because SARS-CoV-2 is new to the human body, the infection can trigger a massive immune response, says Christopher Petrilli, an assistant professor at NYU Langone Health in New York.

“If you have an infection, your body tries to recruit as many immune cells as it can to fight that infection,’’ he says. “While it is effective at destroying the cells that have the virus, it has the potential to damage the surrounding tissue as well.’’


The interplay between the respiratory and circulatory systems, which run oxygen-enriched blood through the body, is delicate. In Covid-19 patients, the lungs don’t move enough oxygen. This restricts the amount that makes it into the blood, where it is supposed to fuel the body, repair and replace damaged cells and support the immune system.
That’s where a ventilator comes in.

It can be adjusted to boost oxygen, pressure and volume, pushing the air more forcefully into the lungs. But even when a patient is severely ill, some alveoli still function well. The goal is to take the pressure off the sick regions while supporting those that are still working, making sure they have the ideal amounts of oxygen and pressure so they can enrich the blood as efficiently as possible.


“I call this the Goldilocks approach,’’ says J. Brady Scott, an associate professor of cardiopulmonary sciences at Rush University Medical Center in Chicago. “When we put people on ventilators, one of my goals is to give a person the oxygen they need but not cause damage to the parts of the lungs that are still healthy. You don’t want to get too little, not too much. You want to give just what’s right.’’

Though weak, Diana felt a wave of euphoria when she was free of the ventilator. But her sense of joy was short-lived. A doctor informed her that her husband was on life support in the ICU room next to hers. Diana was crushed. Had she made it this far, only to see her husband of 35 years taken away from her? The couple had been together since Diana was just 17 years old. She wasn’t about to say goodbye to him now. The following day, as she was wheeled out of intensive care, her nurse pulled her bed up beside his room to let her peer through the glass window so she could catch a glimpse of Carlos, who was now on a ventilator, too.

“I don’t know how I pulled my body to sit up, but I wanted to see him,” she says. Her cell phone felt like a brick in her weak hand, but Aguilar managed to lift it above the bed frame to snap a photo of Carlos. She blessed him before she was whisked away, exhausted.





Somerset Hospital handout
Health-care workers celebrate as Carlos Aguilar, 64, is discharged, with 'Here Comes the Sun' blasting over the speaker system.
Source: Somerset hospital
With both parents in intensive care, the Aguilar’s grown children were distraught. Carlos Aguilar Jr., 32, lives with his parents in New Jersey and had watched them both rapidly deteriorate from Covid-19 at home. “I felt helpless,’’ he says, especially after dropping his dad off at the hospital, waiting in the silent house for a phone call. “Not knowing what’s next is so hard.”

For years, the main focus of critical-care doctors who intubate patients has been keeping them alive, fine-tuning the treatments in an effort to improve survival rates. The machines, first introduced in 1928, were initially called iron lungs and used to help polio patients breathe. Only recently have researchers learned that the biological responses to the breathing machines that kick in almost immediately often have lasting harm.


“There are a lot of other dangers when we use mechanical ventilation,’’ says Richard Lee, interim chief of pulmonary diseases and critical-care medicine at the University of California at Irvine. “We have to sedate patients for them to tolerate a mechanical breathing tube in their lungs, and the longer you are in an ICU on sedation requiring a machine, all those other things — like decreased muscle tone and strength and the risk of hospital-acquired infections — increase.’’


When a person goes on a ventilator, the muscles that typically handle their breathing start to atrophy within hours. Many patients are put on sedatives to make it easier for the machine to take over. But this immobilizes other parts of their body and leads to widespread weakness.

The risk of dying remains higher than average for at least a year after getting off a ventilator, a risk tied to both the number of days spent on the machine and other health conditions the patient had before falling sick.





Somerset Hospital handout
Carlos Aguilar Jr., right, picks up his father, Carlos Aguilar, left, after he was discharged from Somerset hospital on April 14. Ten days earlier he picked up his mother, Diana, from the same hospital.
Source: Somerset hospital
Diana didn’t have the best health track record going in. She is a two-time colon-cancer survivor with high blood pressure, iron deficiency and a few extra pounds. She has only vague memories of her days on a ventilator, waking up in pain unable to talk or move, before drifting back into a troubled sleep full of dreams of her deceased relatives. Her husband, Carlos, with no previous medical condition, had a totally different experience. He spent three days on a ventilator, mildly sedated, spending his days napping or sitting in an armchair watching television.

Yet both now face the ordeal of recovering from their treatments. Fortunately, they were able to avoid the worst-case scenario, a condition known as Post-ICU syndrome that can afflict as many as half of Covid-19 patients who survive on a ventilator, says the Cleveland Clinic’s Khouli.



“These patients become deconditioned,’’ he says. “Some behave like they are really paralyzed, as if they are quadriplegics. They can barely move their muscles.’’
Hospitals are gearing up to treat these survivors, who already number in the hundreds. 

Some, like SUNY Downstate Medical Center in New York, are setting up entire rehabilitation floors to help people coming off ventilators learn how to live again. Others are trying to cut back use of the device, avoiding a rush to ventilators when oxygen may be all that’s needed.

There are also devices in development to help with recovery, such as Liberate Medical’s VentFree Muscle Stimulator. It uses electrical stimulation to trigger contractions in the abdominal wall muscles, allowing patients to “exercise,” even while they are unconscious, to keep them in some semblance of shape. The goal is to help wean them off the devices faster and ultimately boost survival rates, says Chief Executive Officer Angus McLachlan.





Aguilar handout
Diana and Carlos Aguilar, married 35 years, are reunited at home after both were infected with Covid-19 and intubated at Somerset hospital.
Source: Carlos Aguilar Jr.
In patients who develop acute respiratory distress — a common condition with Covid-19 marked by dramatic drops in oxygen levels — there is a second stage where scarring in the lungs develops, the University of California Irvine’s Lee says. As inflammatory and other cells invade the space, the architecture of the lungs is permanently changed.

The machines also can cause cognitive impairment, Rodricks says. A patient who worked as an accountant may have a tough time going back to work. An elderly person who was previously independent might struggle to perform daily tasks such as driving or grocery shopping. And a runner might never be able to hit the same pace again.


“Your overall condition may take some time to get back to its pre-Covid, pre-ICU state — if it ever gets back to that pre-ICU state,” he says.

The recovery will be sweeter for Diana Aguilar, now that Carlos has rejoined her after being released from the hospital on April 14. So far, three weeks after her release, it’s been mercilessly slow. Diana still feels weak, with a shortness of breath and vivid nightmares that she’s back in the hospital, tied to the bed, unable to breathe. But she’s thankful.

“There is some miracle that I’m here and he’s here,” she says. “I feel like God gave us another opportunity in this life.”

https://www.bloomberg.com/news/articles/2020-04-24/life-after-ventilators-can-be-hell-for-coronavirus-survivors