Coping With Cold Weather

~ By John R. Goodman BS RRT ~

Have you ever noticed how automatic your breathing is? Normally, we don’t have to think about breathing in and out as it is controlled by respiratory centers in the brain that act as a sort of central computer. The computer is taking in hundreds of bits of information every second to make sure we breathe in the most comfortable, and efficient way possible. The information that is received by the computer comes from points both inside and outside the body.

Various “receptor cells” inside the lungs tell us how much air to breath in and breath out based on dozens of minute to minute changes in our blood chemistry, atmospheric conditions, what we had for dinner, increased physical activity, and many other factors. Other receptors located within the lung as loosely known as “irritant” receptors. Just as the term implies, irritants include things like smoke, soot, air pollution, and anything else that might make it into the air we breathe. It may be a little difficult to think of cold air as an irritant, but that is how our lungs look at it.

To many of you the term “Polar Vortex” kind of came out of nowhere in the past 2 or 3 years or so. Actually, it was first described way back in 1853. Lucky for us, the lungs are truly remarkable in their ability to decrease the temperature of very cold air before it enters our lungs. In fact, even in Antarctica where the outside air temperature might be 40-50F degrees below zero, the inspired air is warmed all the way up to body temperature (98.6degrees F) in just about .25 seconds!

Generally, there are three well known effects of breathing very cold air for more than a few minutes. Cold air affects one of the most important defense mechanisms of the lung. That is the mucus blanket that is so important for all of us in protecting the lung from major irritants. Cold air stimulates the production of mucus (ever notice your nose running when you are out shoveling the snow from you driveway?) and makes it thicker as well. Therefore, the mucus blanket does not do as good of a job at protecting the lungs from irritants or even infectious organisms.

Since the mucus blanket that lines the lungs also lines the nose, the same effects happen in the nose. Cold air just by itself can produce nasal congestion or stuffiness. This results in an increased difficulty in the body’s ability to remove inhaled viruses and bacteria, which is one of the three important functions of the nose. The other two being warming and humidifying the air we breathe.

And finally, in some patients if cold air makes it down to the lungs, some patients with sensitive airways or asthma may develop wheezing. In fact, most physicians today agree that a patient without significant asthma at rest, can indeed become quite symptomatic when they exerciseÉeven at room temperature. This is due to the cooling effect of moving more air in and out of the lungs with exercise. Exercised induced asthma can occur in almost anyone who truly has documented chronic asthma. It is not the exercise that causes the asthma, but rather the airway cooling that occurs with exercise.

There is a separate and fascinating group of people who have a condition known as “exercise induced bronchospasm.” These people do not have true asthma, or inflammation of the lungs. They don’t have typical reactions when exposed to common triggers, yet when they exercise they do have asthmatic symptoms. Symptoms for both groups of patients normally begin after several minutes of exercise and usually peak within 10 minutes into the workout.

Patients with “twitchy airways” can do a few things to minimize their exercised induced symptoms. Patients who have inhalers prescribed can certainly pre-treat themselves before they go out into the cold. Many patients find relief by simply wearing a mask or scarf over their face to help warm the outside air before it enters their lungs. This will also humidify the next breath in to a certain extent as well. And finally, on any really cold day you can decide to stay indoors and exercise in a warm, well ventilated room of your choosing.

There is an old medical saying that starts out with the followingÉ”the body in its infinite wisdomÉ” In this case your body is saying warmer is better. Usually you can’t go wrong when you do what your body believes to be in its infinite wisdom.
BREATHING MATTERS is presented by the Colorado Lung Health Connection:

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