Patients with abnormal curved spine often developed breathing difficulties. Dr Ong Thun How from the Department of Respiratory and Critical Care Medicine at Singapore General Hospital explains how a new ventilation machine helps them.
She has always liked to exercise and run about. When she was in primary school, she would slide down grassy slopes with her sister on their way home from school. And just 10 years ago, she went on a hiking holiday in England. But today, 58-year-old Mdm LF Phang can’t walk for long without feeling tired.
Mdm Phang suffers from kyphoscoliosis, where the curvature of the spine has become severely exaggerated.
"I've had a slight hump in my back since I was in my 20s. One of my shoulders was higher than the other. But the hump wasn’t obvious. I didn’t have any issues until I suffered a bad fall at an MRT station in 2005. The pain in my back worsened after that," said Mdm Phang.
"Now I can’t walk for long as I feel very tired. Even a short walk to a nearby bus stop is tiring. I also can’t stand for too long because there is a lot of pressure on my spine and hips."
At first, Mdm Phang consulted only a sinseh (a traditional Chinese physician). She sought help from the
Singapore General Hospital (SGH), a member of the
SingHealth group, when her symptoms worsened. She came under the care of
Dr Ong Thun How, Senior Consultant,
Department of Respiratory and Critical Care Medicine, and Director, Sleep Disorders Unit, SGH.
Respiratory problems in scoliosis patients
According to Dr Ong, most people acquire a slight curvature in the spine, especially as they grow older. "In a small group of patients, however, the curvature gets very exaggerated. The normal space within the chest for the lungs gets compressed, leaving little room for the lungs to breathe," she said.
When that happens and patients develop respiratory failure as a result of the curvature, surgery is usually no longer an option. "So what we then do is, we support their breathing," Dr Ong said.
BPAP machine improves oxygen level and ventilation
When the lungs are packed into such a small space, they begin to rely on the diaphragm to pump air. But when the patient is sleeping, the diaphragm is relaxed and doesn’t move well. As a result, the patient’s oxygen level drops while the carbon dioxide level goes up. A device is usually prescribed to help the patient breathe, especially when sleeping.
"We give patients the BPAP (bi-level positive airway pressure) machine because we know the machine can improve their oxygen level and ventilation. According to our data, the survival rate of patients over 10 years has been significantly improved by the BPAP machine, in contrast to patients who use only an oxygen machine or are not on this treatment," Dr Ong said.
Mdm Phang uses a BPAP breathing machine every night when she sleeps and her quality of life has improved greatly. The machine pumps air into her lungs via a mask which she wears over her mouth and nose. "The mask can be a bit uncomfortable, but that’s okay," she said. "I had an asthma attack once and I used the machine. I could breathe better after that."
Read on to learn how the BPAP machine works to help kyphoscoliosis patients.