Q& A Breakthrough Reprint Respiratory Concerns Respiratory Concerns for Children & Adults This article is based on information from the fact sheet, OI Issues: Maintaining Health During the Adult Years, and book, Osteogenesis Imperfecta: A Guide for Nurses, both published by the OI Foundation. What is the repiratory system? What problems will this cause? The respiratory system’s job is to bring oxygen into the body and remove carbon dioxide, the waste product of breathing, from the body. The respiratory system is made up of two parts: the upper respiratory tract includes the nose, ears, sinuses, mouth and the structures found in the throat, and the lower respiratory tract includes the trachea, bronchial tubes and the lungs. The ribs and diaphragm assist the lungs as they expand and contract with each breath. In the lungs, impurities from the air are filtered out and the oxygen is transferred to the blood system. Oxygen is the fuel that all cells and all organs in the human body need to function. Getting enough oxygen is important for good health. Breathing problems can lead to shortness of breath, tiredness, insomnia, migraine headaches, sleep apnea, and can make the person more susceptible to infections such as pneumonia. Restrictive pulmonary disorder, a reduction of lung capacity, is common in people with severe OI or any one who has decreased chest volume, chronic bronchitis or asthma. Respiratory complications leading to pneumonia or heart failure represent a significant cause of death for people with Type II or Type III OI. What are the common causes of upper respiratory problems? • Viral infections such as colds and flu. • Bacterial infections such as bronchitis and pneumonia. • Allergies. Who should be concerned about respiratory function? Respiratory health is a concern for children and adults with OI who: • Are short in stature. • Have scoliosis, kyphosis or both (kyphoscoliosis). • Have chest or rib cage deformities such as pectus carinatum or pectus excavatum. • Lead a sedentary life style. As a rule, the more severe the OI, the more susceptible the person will be to lung or breathing problems. Why does OI affect respiration? Deformities of the spine and ribs can limit the space available for the lungs to expand. This decreases the amount of air in the lungs, which means that less oxygen is available to the body and that the lungs cannot get rid of all of the carbon dioxide. Pulmonary (lung) complications can occur due to rib fractures, muscle weakness of the chest wall, heart valve disorders, chronic bronchitis and asthma. Breakthrough Winter 2004 What can be done to prevent a serious respiratory problem? There are four things that every person with OI can do to protect themselves from serious respiratory problems. 1. Treat all respiratory infections, even colds and coughs, immediately. 2. Seek prompt treatment for any difficulty breathing. 3. Have your respiratory function tested. Adults with Type III or Type IV OI, or spine curvature, should see a pulmonologist every 1-2 years. 4. Exercise to promote deep breathing. Talk with your doctor about how to do this safely. What else can be done? • Children and adults should have any spine curvature • • • • • monitored. In some cases surgery may be necessary. Discuss with your doctor how you can exercise safely to develop muscle strength and lung capacity. Talk with your doctor about whether you are a candidate for the flu shot or pneumonia vaccine. Do not smoke, and avoid exposure to second-hand smoke. Use of supplemental oxygen and use of BiPAP, a positive pressure breathing device, can help manage pulmonary function. Asthma inhalers during the day are sometimes beneficial. People with chronic asthma may need additional medications. Page 6
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