ILD or Interstitial Lung Disease refers to large group of lung disorders most of which causes progressive scaring of lung tissue .The scaring associated with ILD eventually affects your ability to breathe and get enough oxygen into your blood stream.
Interstitial lung disease seems to occur when an injury to your lungs triggers an abnormal healing response. Ordinarily, your body generates just the right amount of tissue to repair damage. In ILD, the repair process goes awry and the tissue around the air sacs (alveoli) becomes scarred and thickened. This makes it more difficult for oxygen to pass into your blood stream.
Once lung scarring occurs, its generally irreversible. Medication can slow the damage of ILD but can never regain full use of lungs.
Interstitial lung disease is felt to be caused by a misdirected immuneor healing reaction to a number of factors, including:
Occupational and environmental factors
Long-term exposure to a number of toxins and pollutants can damage your lungs. These may include:
- Silica dust
- Asbestos fibers
- Grain dust
- Bird and animal droppings
Some people who receive radiation therapy for lung or breast cancer show signs of lung damage months or sometimes years after the initial treatment.
Many drugs can damage your lungs, especially:
- Chemotherapy drugs. Drugs designed to kill cancer cells, such as methotrexate (Trexall) and cyclophosphamide (Cytoxan).
- Heart medications. Some drugs used to treat irregular heartbeats, such as amiodarone (Cordarone, Nexterone, Pacerone) or propranolol (Inderal, Inderide, Innopran).
- Some antibiotics. Nitrofurantoin (Macrobid, Macrodantin, others) and sulfasalazine (Azulfidine).
Lung damage can also result from:
- Systemic lupus erythematosus
- Rheumatoid arthritis
The list of substances and conditions that can lead to interstitial lung disease is long. Disorders without a known cause are grouped together under the label Idiopathic Pulmonary Fibrosis or Idiopathic Interstitial Lung Disease. Depending upon the location, severity, and pattern of lung involvement, the idiopathic interstitial lung diseases have been further subdivided into categories. Examples of different types of idiopathic interstitial lung disease include:
- usual interstitial pneumonitis (UIP),
- bronchiolitis obliterans with organizing pneumonia (BOOP),
- lymphocytic interstitial pneumonitis (LIP), and
- desquamative interstitial pneumonitis (DIP)
Factors that may make you more susceptible to interstitial lung disease include:
- Age. ILD is much more likely to affect adults, although infants and children sometimes develop the disorder.
- Exposure to occupational and environmental toxins.
- Radiation and chemotherapy.
- Oxygen. Continually inhaling very high levels of therapeutic oxygen for more than 48 hours at times can harm the lungs. Please consult your doctor about your requirement of O2 as very patient’s need is different.
Interstitial lung disease can lead to a series of life-threatening complications, including:
High blood pressure in your lungs (pulmonary hypertension) This condition affects only the arteries in your lungs. Pulmonary hypertension is a serious illness that becomes progressively worse.
Right-sided heart failure (cor pulmonale). This serious condition occurs when your heart’s lower right chamber (right ventricle) — which is less muscular than the left .
Respiratory failure. Respiratory failure occurs when severely low blood oxygen levels along with rising pressures in the pulmonary arteries and the right ventricle cause heart failure.
Exercise and ILD
Physical training is safe and very important for people with ILD. Improvements in functional exercise capacity, dyspnea (breathlessness) and quality of life are seen immediately following training, with benefits also evident in IPF (Interstitial Pulmonary Fiberois). There is little evidence regarding longer-term effects of physical training.
Physical training such as Walking, cycling on a stationary Bi-cycle has the advantage of helping to maintain the muscle tone. As physical exercise needs energy which is in short supply in ILD and IPF people, they tend to stop this activity. Breathing is difficult therefore again exercise is reduced thus creating loss of muscle which create problems in ability of doing minor things like even taking bath. Loosing the abilty to walk, being self sufficient make ILD person mentally depressed which again has a effect on breathing .This creates a reverse cycle.
Physical exercise does not have any effect on the disease itself rather gives energy to the suffering person to maintain a near normal life and fight the disease. Psychological benefits are also numerous. Physical exercise creates a positive cycle which brings about improvement in the health.
Various yoga exercise can help a person. If ILD has been diagnosed in early stages, yoga and other exercises can take you far. I am into counselling and rehabilitation of People with COPD and ILD. Everyday I meet people with various difficulties, lack of awareness about the disease. But at times some of them walk in with such comfort and ease that I fail to tag them as a ILD people. At this point they counsel me by telling me how they have managed so well. Believe me, they are simply being positive, taking their medicine in correct manner, eating right, doing their breathing exercises, physical exercise is as important as eating their food.
Asana practice An exercise program can halt the “downward spiral” in ILD. As you can imagine, the progress of disease causes further impairment, which in turn increases inactivity. Inactivity itself may contribute to the deterioration of the lungs . A comprehensive program including breathing training, stretches and yoga postures can increase endurance and strengthen the entire musculature. Through proper breathing exercises, more oxygen is available for muscles throughout the body to do their job. Asanas can help to increase the strength and efficiency of muscles. Postures that actively engage the chest, shoulders, neck, midsection, pelvis and spine will improve the strength and efficiency of the breathing muscles. According to an individual’s level of fitness, he or she should learn forward bends, backbends, spinal extension and flexion, side bends and spinal twists. If there is a problem lying down, the poses should be done in either a standing or sitting position.
Some guidelines for practice of yoga poses
1. Some may prefer to do soft, slow, continuous breathing with pursed lips, which may provide greater stamina for exercising and also help control shortness of breath.
2. For those who are able, it is helpful to coordinate breathing with movement. As an example, in uttanasana (standing forward bend) one exhales while bending forward and inhales while coming back up, taking a longer time bending forward. Forward bends help one exhale more completely and strengthen the expiratory muscles. You can do it in any manner as shown below, but right.
3. Standing backbends such as the beginning of sun salutation are good for the chest muscles. But one should avoid excessive backbending or dropping the neck back. Some people can’t bring their arms to shoulder level or over the head. In such cases, arm and hand variations are necessary.
4. Mountain pose with arms stretched, hands clasped or hands behind the back in reverse namaste (for those who have such flexibility) helps with axial extension and chest mobility.
5. Warrior I is good for strengthening the breathing muscles employed during inhalation and exhalation.
6. Standing side bends such as triangle are particularly good for strength and flexibility of the rib cage and for improving the capacity for side rib diaphragm breathing. If one experiences neck tension or breathing difficulty, one should look down rather than up at the extended hand in triangle pose. If one has difficulty standing and balancing in the triangle position, sitting side bends are a good alternative.
7. Cat pose can help with exhaling and inhaling more effectively. Extending the legs alternately in the cat pose, sometimes referred to as “dynamic cat pose,” may be done to strengthen the hips and legs. It helps to optimize the inhalation-exhalation ratio. Depending on your breathing status at the time, you can work more on exhalation or inhalation.
8. Cobra pose (bhujangasana) may also be utilized to strengthen the respiratory muscles. One should work up to staying in the pose for a minute or more, then rest and repeat the posture.
9. Finally, yoga poses that restrict breathing should be used with caution. For example, the pose of the child (balasana) may be uncomfortable for some people as it causes pressure against the diaphragm. Kindly begin these yoga exercises with a trained Yoga teacher if possible.As a person with ILD gains strength and stamina, repetitions of the postures can create an aerobic effect, efficient improving in cardiac efficiency. Lungs and heart work in coordination to supply oxygenated blood to the body in a more way. The increase in efficiency of lungs and conditioning of the muscles will result in decreased production of carbon dioxide and lactic acid, which will prevent muscle fatigue.
Walking is a highly beneficial exercise for people with ILD, and if they can do diaphragm breathing while walking, the benefits are likely to be even greater.Even if you are unable to do yoga ,do your walking.When people with ILD become proficient at yoga postures, they will also be able to include in their routine such activities as walking daily for 30 to 60 minutes, occasionally swimming and lifting light weights once or twice a week.