Lung Health - CF Buzz

The importance of lung health

Cystic fibrosis primarily affects the lungs and the digestive system. This makes managing lung health a key part of managing CF.

It’s important to work with a CF health team to work out the best possible health care plan, and to monitor daily changes in your lungs.

 

Monitoring lung health

CF affects everyone differently so it is important to know what is healthy for you.

Watch out for the following symptoms that might indicate the health of your lungs has changed:

  • More sputum production
  • A change in the colour of your sputum
  • Coughing more
  • Feeling more short of breath or tight or wheezy in your chest
  • A temperature of 37.7°C or higher (check your temperature with a thermometer)
  • Losing weight
  • Not feeling like eating
  • Feeling tired and not having much energy

 

If you have any of these symptoms and you can’t talk to your CF team or get to a GP:

  • Take your bronchodilators (like Ventolin) more often
  • Increase how often you do your airway clearance
  • Drink supplemental drinks if you are not eating enough

 

Get help as soon as you can, and if the situation gets worse and you still can’t see your GP, head to the emergency department.

 

Viral illnesses

Having CF makes people more susceptible to viral illnesses.

 

Viral illness symptoms include:

  • Feeling unwell quickly over one to two days
  • A sore throat
  • Aches and pains

 

Influenza, or the flu, can have all of the symptoms above plus:

  • A temperature of 38°C or higher – check with a thermometer
  • Chills and sweats
  • Nausea and vomiting

 

Dealing with the flu
  • If your temperature is 37°C or higher and you have signs of the flu, call your CF team and/or see your GP ASAP
  • Rest, drink plenty of fluids and supplemental drinks if you don’t feel like eating
  • Have the flu vaccination every year (unless your CF doctor says not to)

 

Airway clearance

Clearing your airways and taking inhaled and/or nebulised medications is a key part of treating CF.

Using bronchodilators like salbutamol (commonly known as Ventolin) opens the airways and helps get mucus out of the lungs, medications in which all reduce the risk of chest infections.

 

Inhalation devices

Using inhalation devices, or puffers, incorrectly can change the amount of medication that reaches your lungs. It’s a good idea to check in with your CF team to make sure you’re using them properly.

Using a spacer with your puffer is also a great idea. It can help more medication reach your airways, where it is needed, and not leave it in your mouth and throat where it’s not needed.

It’s important to wash your spacer before using it to remove the static charge inside. Otherwise medication sticks to the plastic and doesn’t reach your lungs.

The National Asthma Council Australia recommends:

  • Clean your spacer before you use it for the first time and then once a month
  • It’s normal for your spacer to look a bit cloudy
  • Wash your spacer in warm water with kitchen detergent and allow to air dry without rinsing
  • Drying with a cloth or paper towel can result in electrostatic charge (‘static’) on the inside of the spacer, which makes the medication stick to the sides
  • Wipe the mouthpiece clean of detergent before use

Check with your CF team you are using and cleaning your devices correctly.

The National Asthma Council Australia has some great videos showing the correct use of puffers.

 

Nebulisers

A nebuliser is used to turn liquid medication into a vapour that can be inhaled.

There are many different types of nebuliser pumps and bowls, so check with your CF team before buying one to make sure you’re getting the best one for you. Some private health funds provide a rebate.

Basic nebuliser technique with air pump and nebuliser bowl:

  • Your nebuliser bowl should be upright
  • Use a mouthpiece rather than a mask for better delivery to the lungs
  • Place the mouthpiece on top of your tongue
  • Hold the mouthpiece with your hands, don’t bite it between your teeth
  • Breathe steadily, taking occasional slow deep breaths

 

Sputum cultures

People with CF are more prone to developing lung infections, and so it is important for sputum cultures to be taken on a regular basis.

Sputum is a mixture of saliva and mucus coughed up from the respiratory tract. If bacteria or fungus is growing in the lungs, it can be identified using a sputum culture.

Two of the most common bacteria found in the lungs of people with CF are Staphylococcus aureus (Staph) and Pseudomonas aeruginosa (Pseud).

After the sputum culture is taken, the pathology lab tests it for micro-organisms like bacteria and fungus. Viruses, like influenza, on the other hand are identified by a throat swab, not from a sputum culture.

Different bacteria need different antibiotics, so identifying the exact type of bacteria in the lungs mean doctors can match the right antibiotic to kill it.

 

Antibiotics

Antibiotics are medications used to kill, or at least reduce the amount of, bacteria in the body. They can be taken orally, topically, inhaled, nebulised or taken intravenously (IV).

Sometimes, bodies can build resistance to certain antibiotics, so it’s important to take the entire course of any treatment to help reduce this possibility.

Most of the population are encouraged not to take antibiotics when they have a viral illness, but it’s been shown that people with CF who have a viral illness are likely to benefit from antibiotics. But remember not to take antibiotics unless they have been prescribed by your doctor.

 

Exercise

Exercise has many benefits – it improves mood, improves bone health and increases fitness and general wellbeing. All things that are important to managing cystic fibrosis.

Your CF health team will be able to help you work out an exercise plan to suit your specific needs. The plan needs to be reviewed regularly to make sure you’re still getting the best out of it.

The plan should include:

  • Aerobic exercise to improve cardiovascular fitness
  • Strength training to improve muscle strength and endurance
  • Stretching for thoracic (chest) mobility and posture
  • Pelvic floor exercises to prevent urinary incontinence
  • Weight bearing exercise for strong bones

 

The benefits of exercise far outweigh the negatives, but for people with CF there are a few things to take into special consideration before hitting the streets or the gym.

 

Exercise and nutrition

Getting the right nutrition is essential for anyone with CF, but it’s really important when it comes to exercise. You will be able exercise more efficiently when your body has enough energy, protein, fluids and salt.

Try to eat and hydrate 30 to 60 minutes before, and 30 minutes after exercise with foods like:

  • Milk, smoothies, yoghurt, custard or a nutritional supplement drink e.g. Sustagen
  • Sandwiches with cheese, jam or peanut butter
  • Muesli bars, health bars or fruit e.g. banana

 

Exercise and hydration

Staying hydrated during exercise is important as you lose a lot fluid through sweat. Drink before you start, during and after you exercise. The best way is to sip regularly on fluids like water, sports drinks, milk and drinks like Sustagen.

Sweating also means you are losing extra salt. Because people with CF already have problems absorbing salt properly, it’s important to replace what you lose through exercise. Try sports drinks with sodium in them or salt tablets, especially if you get cramps, are exercising in warm weather or for long periods.

 

Exercise and blood glucose levels

Exercise affects the blood glucose level (BGL). They can drop after exercise and stay low for hours afterwards. If you have CF related diabetes, this is an important factor to remember when exercising.

Check your BGL before and after you exercise and don’t exercise if your BGL is below 6 or above 15mmol/L. Have some high GI snacks (e.g. jelly beans) on hand when you are exercising in case your BGL drops, and if you’re finding it hard to maintain your BGL, talk to your CF team.

See the CF Related Diabetes page for more information about managing diabetes.



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