Looking After your Heart and Lungs especially During the COVID-19 Pandemic

– Dr. Sampurna Man Tuladhar

Excerpts from the online session conducted by Dr. Sampurna Man Tuladhar, Consultant Cardiothoracic Surgeon on 7 May 2020 with Bihani Social Venture.  https://www.youtube.com/watch?v=ocnzkvy7YwM

More than 2000 people dying in a single day is not a small number, moreover the number of medical professionals especially, doctors and nurses have been affected and have succumbed to the coronavirus. People in Nepal are also highly anxious about the pandemic that has affected the entire world. The lack of awareness and testing on a large scale had added to the worry of the coronavirus affecting a large number of the population in context to Nepal. 

Corona virus symptoms are varied

 Most of the times, it comes as fever, dry cough, fatigue, among others.  These symptoms can be mistaken to that of flu, cold and cough. Corona virus is a huge family of viruses. This kind of virus is mutating which makes it very dangerous. Although this virus has around 10% mortality rate, it has a very high rate of infecting others. Unfortunately, senior citizens (people above 60 years), those living with co-morbidity or having low immunity system are vulnerable to this virus.

What makes our lungs so vulnerable?

As living beings, we need to breathe. The oxygen which goes into our lungs is circulated through our alveoli and blood vessels. Different kinds of toxins, pollutions, allergic substances in the environment like dust particles and pollen are changing with the season as the environment is not stable. So, the air can sometimes be dry, then immediately become humid, windy or hot in temperature; and our lungs have to adapt to it very quickly. Fortunately most of the times, our lungs adapt quickly to changes, but if we are not careful, it can be dangerous especially, when exposed to deadly viruses such as the coronavirus.

The flu virus has been around for a very long time

We have invented and conquered many things with the help of science; from fire to rockets, but it has always been a challenge to tackle common cold. “There are two main types of influenza (flu) virus: Types A and B. The influenza A and B viruses that routinely spread in people (human influenza viruses) are responsible for seasonal flu epidemics each year” (https://www.cdc.gov/flu/about/viruses/index.htm). It is like the key of a lock, the pattern of the key depends on which lock it can open. But if the lock’s pattern changes, the key will not work. And there are millions of combinations of patterns that the protein can form.

So it is impossible to find one cure for common cold as the protein keeps on changing. These viruses are so intelligent that they go inside our blood cells and cell nucleus, then instruct the cells to create new viruses. This is because it has millions of years of practice to perfect it. So, there’s no chance for humans to come up with an anti-viruses. The only thing that is on our side is our immune system which also has millions of years of practice to fight the virus. But the immune system takes around 1 week or more to adapt to the new virus.

Keep rooms well ventilated

The other things that harm the lungs are temperature, fumes and smokes. So the main thing we need to keep in mind is to well ventilate our rooms. There should be cross flow of air and dust should be controlled, although it can be difficult in dusty and crowded places like Kathmandu. We have to find a way to keep it to the minimum as far as possible. We can put plants or trees that can control the dust to some extent.

Keep temperature regulated

  • Temperature control is very important, especially when temperature drops
  • Elderly are especially vulnerable to temperature changes so keep it regulated

Practice social distancing

  • Avoid crowd and huge gatherings even if it is with family
  • Avoid people with existing infections, coughs or transferrable health conditions
  • Socially distance but do not isolate yourself, stay in touch with near and dear ones through other means using technology and precautions

How do we know if our symptoms are because of COVID-19?

It is a very tricky question. Many might have similar illness as cough and cold, breathing problems, fatigue, Bronchitis, etc. Basically, this is also a kind of cold and cough. If you have breathing problems like Chronic Obstructive Pulmonary Disease (COPD), bronchitis or asthma, but no fever, then it is not COVID-19. But if you have fever along with those symptoms, there might be something to worry about.

If symptoms are visible

  • Stay at home
  • Take paracetamol
  • Drink warm liquid
  • Take good rest – You have to give the immune system time to fight the virus
  • Avoid going to the hospital in a hurry, as there is higher chance of exposure of the virus due to the crowd

What can we do from our side during this pandemic?

We have been told this multiple times not to take these things lightly during the pandemic.

  • You should wash your hands frequently with soap for 20 sec
  • Use tissues or handkerchief while coughing and sneezing
  • Wash your hands more often than usual
  • Avoid touching your face – The virus might spread or infect through the mucosa of the eye, not from the skin
  • Keep the soles of your feet and footwear clean

Use of Masks

  • There is no need to wear masks indoors, but it is a must when you are going to a social environment
  • There are 3 layers in surgical masks which not many people know
  • The normal masks usually have 1-2 layers
  • The US guidelines say you can even use a good scarf as a mask
  • Mask is not only going to protect you, but others as well if you have the infection
  • In a hospital setting in Nepal, usually the medical professionals are given 4 masks each. They use 1 mask for a whole day, and dry the other 3 in air for 3 days
  • It takes around 48 hours for viruses to die in air
  • You can also clean it in hot water.

Keep yourself healthy by helping or supporting others

We, being social animals, do not have a habit of staying at home. We need to communicate socially with people whether physically or using multimedia like social media apps, phone calls, etc.

  • We appreciate when people reach out to us and vice versa therefore, it is important to feel useful
  • The pandemic is an opportunity for all to reach out to the ones we love and care for
  • It also helps if we are able to support those in need
  • When you support others in need, it gives you happiness and a sense of purpose helping your overall wellbeing
  • You can support from a distance or in whatever way you can without coming in contact with others  

The importance of a healthy diet and keeping physically active

  • As a human being, what we eat and do is also important
  • If you are a heart disease patient, you should try to avoid deep fried food
  • Burnt oil is dangerous for the heart and overall health
  • You should practice cardio exercises as it is very important
  • Avoid watching TV and social media for too long
  • Make a plan of what you are going to do for the day
  • You can find various exercises online, but the main thing is doing them
  • Have dinner 3 hours before bed time
  • Avoid long gaps between meals
  • Finish eating food just before you are full
  • Eat a little bit of ghee, as it is not fried
  • Consume nuts, seeds, red/orange/yellow fruits and vegetables, turmeric and garlic
  • Be aware of saturated fats like cheese butter coconut oil; and unsaturated fats like avocado, olive oil, peanut butter, vegetable oil, fish oil, nuts, and seeds
  • In general, saturated fat is harmful for the heart, lean a lot towards unsaturated fats with limited intake of saturated fats

Importance of breathing for healthy lungs and overall wellbeing

  • Lungs are a very versatile organ
  • Breathing exercises including as a form of yoga is hugely beneficial to strengthen our lungs
  • Besides physical breathing, mental breathing is also important
  • Sit or lie down in a comfortable position, relax your back and neck, and breathe in and out naturally noticing the sensation we feel while breathing
  • It is best to practice breathing for at least 20 minutes daily

Engage in activities – hobbies or learn new ones

  • Avoid a sedentary lifestyle
  • Instead of sitting in front of the TV, try learning new skills like painting, reading, learning musical instruments, etc.
  • You can always learn new activities from your family members or access it online for free
  • Keep yourself engaged and active

Importance of sleep

  • Getting enough sleep is vital to rejuvenate your body and for a fresh mind
  • Try falling asleep same time every night
  • Before sleeping, take time to relax, read a book, listen to music, drink good herbal tea or warm liquid
  • Avoid using cell phone in bed
  • Over sleeping is not good for health, 7 to 8 hours of sleep daily is good enough for adults

Monitor your health

  • Monitor sugar and blood pressure levels at home
  • Many hospitals have given the doctors’ phone number and names for free online consultation
  • Do not hesitate to consult your doctor, call or message them

To summarize, our heart and lungs are very vulnerable, take care of them. Keep yourself mentally and physically active. Be disciplined in your activities, keep track of your wellbeing, sleep well, maintain hygiene, keep your room airy and temperature regulated. Stay safe and take care. Maintain social distance but do not isolate yourself.

Dr. Sampurna Man Tuladhar is the Co – Founder of Maitreya Bodhi Home Care & Clinic and  Consultant Cardiothoracic Surgeon. Maitreya Bodhi Home Care and Service has been opened with the vision to provide the best Home Care Service and Clinic facilities to Elderly. https://bit.ly/2SpVi0p
Article transcribed and edited by Ritchie Sampson