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32 m a s s a g e & b o d y w o r k s e p t e m b e r / o c t o b e r 2 0 1 9 education PATHOLOGY PERSPECTIVES When You Can't Catch Your Breath COPD and Massage Therapy By Ruth Werner "If I'm having trouble breathing and there's any pressure on my chest, it's too much. But, if a massage therapist can gently help to loosen my upper ribs, I can breathe so much better afterward." Chronic obstructive pulmonary disease (COPD) is a group name for a spectrum of progressive conditions that cause permanent damage to the lungs. The two main conditions under the COPD umbrella are chronic bronchitis and emphysema. Asthma is sometimes listed here too, although that is not consistent because asthma does not always cause irreversible damage. A rare condition called bronchiectasis also appears in this group—this is a complication of chronic conditions including cystic fibrosis and autoimmune disorders that cause systemic inflammation. COPD is extremely common. Of the roughly 255 million adults in the United States, it is estimated that 12–15 million have been diagnosed with this condition, and another 12 million have it but have not yet been diagnosed. This means that about 10 percent of the adults in this country are affected by COPD. Most of these are over 65 years old with a history of smoking, but this is not always the case. We invest about $50 billion a year in direct and indirect medical costs associated with COPD. It is the third leading cause of death in this country, causing between 120,000 and 155,000 deaths each year. COPD—WHAT GOES WRONG? To talk about the pathophysiology of COPD, it's useful to do a brief review of healthy lung function. For this, I refer readers to the accompanying video, in which I share my wonder and appreciation for the mechanics of breathing.

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