A lifeline for lung health and longevity
It comes so naturally to most of us that we are not even usually conscious we are doing it 17,280 times a day. Yet aware of it or not, the average person takes 12 effortless and life-sustaining breaths every minute of every day of their lives.
When things go wrong however, each and every one of those breaths can be a frightening struggle. This is the reality for Canadians with chronic obstructive pulmonary disease or COPD.
Comprising of chronic bronchitis and emphysema, COPD is the third leading cause of death across Canada, and it is on the rise. While tobacco smoking is the most common cause of COPD, a number of other factors such as air pollution and genetics also play a role, albeit a much smaller one.
The main symptoms include shortness of breath, cough, and sputum production. Sadly, COPD typically worsens over time and can ultimately lead to heart failure for the majority of sufferers.
Pulmonary complications are in fact one of the top reasons for hospitalization in Canada. Managing the ailment and rehabilitation are key to keeping patients out of the hospital. Recently named a “Top 40 Under 40” researcher by Avenue magazine for his work with patients suffering from COPD, pulmonary health is the main focus of Dr. Michael Stickland’s medical research.
Armed with a PhD in cardiopulmonary physiology from the Faculty of Physical Education and Recreation at the University of Alberta in 2004, Stickland is waging a battle for those with lung disease through his clinical work in pulmonary rehabilitation (PR).
“Pulmonary rehabilitation is an effective therapeutic strategy to improve health outcomes in patients with chronic obstructive pulmonary disease,” says Stickland. “A lot of the work that we’re doing is not only, for example, looking at how exercise and rehabilitation improves functional status and quality of life in patients, but it’s also helping to keep them out of hospitals.”
As Director of the Centre for Lung Health, which operates the primary pulmonary rehabilitation program in Edmonton, Stickland helps patients learn how to recognize lung flare-ups, how to identify triggers, how to manipulate their medications to best respond to those identifiers, and other management skills. With the help of Alberta Health Services Telehealth, the program he developed with Edmonton's Dr. Fred MacDonald is also broadcast to rural Alberta via telehealth technology akin to Skype, offering easier access for patients in remote locations.
"We have about 400 patients that are enrolled each year in Edmonton and about 100 patients get enrolled via outlying regions," says Stickland. "The object is to teach them how to breathe properly, particularly when they have chronic obstructive pulmonary disease."
A little bit goes a long way
COPD management, including the rehabilitation classes, relies heavily on exercise. Patients often shy away from physical activity because of their reduced lung function but taking brisk walks twice a day can be the difference between good and poor health.
“The Canadian Physical Activity Guidelines says you should take 10,000 steps each day,” Stickland says. “Coming into rehabilitation, our patients get about 2,500 steps per day, and some get less than that.”
The sedentary lifestyle affects more than lung function – cardiovascular disease is the number one killer in patients with COPD. More people die from heart problems caused by years of deferring physical activity than from the pulmonary complications that kept them on the sofa.
“A person in our program is more active more often,” explains Stickland. “That’s one of the things we’ve shown – rehab makes you less out of breath and gives you better exercise tolerance but, under the right conditions, it will also make you more active, and that makes your cardiovascular system better.”
Evidence from Stickland’s research shows that patients who engage in rehabilitation are hospitalized less often and for shorter periods of time than other COPD patients.
“It leads back to the disease management side. If we can get these patients active and get them walking a couple times a week, that will really improve their cardiovascular condition and reduce their cardiovascular risk,” he says.
Stickland has been repeatedly recognized for his contributions to the field of pulmonary health. He currently receives a New Investigator Salary Award from the Heart and Stroke Foundation of Canada. The Award provides salary funding for his work, and he has received operating funding from CIHR, NSERC, CFI, Heart and Stroke Foundation and Alberta Lung Association. In 2013, Stickland also received the Canadian Society for Exercise Physiology’s Young Investigator Award for his research.
In addition to continuing his previous research examining pulmonary gas exchange and chemoreceptor control of blood flow, Stickland is excited about his ongoing work examining how to increase adherence following rehabilitation, as well as how exercise rehabilitation improves the cardiovascular consequences of lung disease.
“It’s so rewarding,” he says. “Not only do I get to do the research, I also get to see the effects it has on the patients.”
Stickland is also a big believer in investing in future talent and actively encourages interested students to contact him about possible graduate opportunities in his lab, which trains undergraduate, graduate, post-doctoral and medical trainees.
“We are always looking for keen trainees who have an interest in cardiopulmonary physiology,” says Stickland. “The incidence of COPD and other lung diseases is expected to grow. In the coming years, we will need smart, passionate people working on solutions more than ever before.”