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How to manage chronic obstructive pulmonary disease (COPD)?

Q: My father (age 68 years) resides at our native place in Vadodara, Gujarat after retiring 2 years back as a supervisor in a cotton textile mill and now stays at home. He has been a bidi smoker for more than 40 yrs. For the last 2 years he has developed some health problems. We consulted an ENT doctor as his voice is very low. The doctor said that there is damage to the vocal cords resulting in low output of voice and no medicine was prescribed. The cardiologist diagnosed high BP and diabetes and prescribed treatment. As he cannot walk steadily and often loses his balance injuring himself, we consulted a neurologist. The CT scan and MRI show no problem in the brain and he asked us to continue the medicines for BP and diabetes. My father normally does not like too many medicines and nor can he control sugar, salt, oil etc. He also cannot give up bidi smoking and loses his temper frequently. Now in the winter season he has difficulty in breathing and once had a bad attack at night. The cardiologist has since changed the medicines. Could you please give your expert advice on this so that he can breathe normally and speak with a normal voice? Thanks

A:Your father seems to be having a condition called chronic obstuctive pulmonary disease (COPD) which is due to age changes in the lungs and also hastened by the habit of smoking. This leads to build up of very small pressure of air needed to help in speaking called bellows. Since the capacity to push air through the vocal cords is low, because of weak lung force and age, the voice is feeble. He needs a respiratory physician to check his lung function and an ENT surgeon to do an endoscopy. STOPPING SMOKING will be a great help.

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