Will physiotherapy help my persistent cough and weight loss

• Yes … it could be COPD, Prof Useh says

Dear Prof,

I am a 55-year old accountant with a private firm in Lagos. I’ve been coughing for three years and really need your help. I smoke about a packet of cigarettes a day when I am very busy and stressed. I go on vacation regularly in the winter months to the United Kingdom but noticed that the cough gets worse when I’m there. I’ve lost a considerable amount of weight over the last two years. I cough out a lot of phlegm which is sometimes reddish and I feel tired after a little walk. I’ve been receiving treatment in different hospital but the symptoms always recur after a short period. During my last visit to the company clinic, the doctor recommended physiotherapy as a follow up. Prof, how will this help? Will I really benefit from physiotherapy?

Lanre, Lagos

Dear Lanre,

Coughing is a symptom of so many heart and lung disorders. Your coughing might also be a response to environmental factors. If you live in a place where there are so many trees or flowers, the release of pollens by these plants might stimulate your cough reflex. Also, the furs of your cats could make you cough. Pollutants in our workplace have been known to make us cough.

The fact that your cough gets worse when you are in a very cold environment and your long history of cigarette smoking could suggest a diagnosis of Chronic Obstructive Pulmonary Disease commonly referred to as COPD. We however need to rule out other possible problems such as TB, Heart problems, Asthma, etc. Persons with COPD usually present with complaints of chronic and progressive difficulty with breathing, coughing, and sputum production. You may also have chest tightness and a high-pitched sound during breathing.

While your smoking history could be a risk of CPOD, some persons with COPD may not have a history of cigarette smoking; in such instances, it may be necessary to question exposure to second-hand smoking, occupational and environmental exposures, and family history.

Lanre, the good news is that you are not the only one in this situation. COPD is primarily present in those with a long history of smoking and those older than age 40. The possibility of COPD increases with age, and it is currently the third most common cause of morbidity and mortality worldwide. It is reported that almost 200 million people suffer from COPD

Before a comprehensive treatment plan by a team of professionals including a physiotherapist and occupational therapist, there must be a detailed assessment of your chest and whole body which will include spirometry, a 6-minute walk test, X-rays, tests of the functioning of the lungs and blood test to determine the level of oxygen and other issues. The overall treatment plan is to improve your quality of life. The non-pharmacological approach is for you to stop smoking and be involved in a guided rehabilitation programme. This programme is called pulmonary rehabilitation. You can enrol in any physiotherapy department in our public hospitals for this. The aim is to improve your physical and psychological condition and to promote long-term adherence to health-enhancing behaviours.

In this programme, exercise training is the cornerstone of pulmonary rehabilitation. Some of these exercises will focus on the chest area to improve your lung function. Generally, exercises reduce the effects of inactivity and the wasting of your muscles, resulting in less shortness of breath and an increased ability to exercise.

Best Wishes