Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing. Having a persistent cough can be exhausting. Medically, it's defined as a cough that lasts for a period of at least eight weeks. A respiratory tract infection or air pollution could set off an attack. COPD causes a chronic cough for two main reasons: First, COPD causes inflammation in your throat, lungs, and airways, making them much more sensitive to getting triggered to cough. If you find hot beverages make you cough, drink them at room temperature instead. COPD often leads to several symptoms including coughing. With some types of COPD, such as chronic bronchitis, the cough occurs daily and is associated with mucus production. They’ll get to work more effectively if you use them with either a spacer or nebulizer. Do not wait to see if your COPD symptoms improve. Angela feels that a high quality of life should be a top priority for everyone, and tries her best to help people find more comfort, contentment, and confidence with the resources around them. A change in the amount or color of your sputum, Your coughing begins to interfere with speaking, walking, and modest activity. Although activity can lead to more coughing, pulmonary rehabilitation is a targeted therapy that safely challenges the limits of your lungs to improve your energy levels and endurance. It may even be an uncontrollable cough attack. The American Lung Association reports that corticosteroids prove most effective when used in COPD patients with chronic bronchitis 3. For this reason, many people with COPD need to “clear their throats” often, especially in the morning. Our website services, content, and products are for informational purposes only. If you’re taking long-acting anticholinergics (like Spiriva) to relax your airways, your cough reflex can become very sensitive, leading to a nagging, constant cough. Learn how coughing works for and against your COPD, so you and your doctor can make a sound decision when it comes to treatment. Loss of bladder control (urinary incontinence) 7. I have had COPD for many years. Dizziness 4. Emphysema classically … During an episode, try to stay calm to minimize your symptoms. Vomiting 5. Mild COPD flare-ups are those needing treatment with short acting bronchodilators only (SABDs), also known as rescue inhalers. Visit your doctor if you notice: If your cough begins to last for longer periods or is triggered by anything and everything, you may be dealing with a COPD exacerbation or another respiratory illness (known as a co-morbidity). Nonetheless, coughing sometimes runs amok and a prolonged attack can disrupt your daily activities or interfere with sleep. An inhaler should help relax the tissues in your airways quickly, helping you breathe a little easier. Most doctors are hesitant to prescribe cough suppressants, since coughing is your body’s way of clearing a path for better breathing. Learn when to see a doctor about this symptom. This mucus can be clear or white, yellow, or green in color. It’s important to talk to your doctor about rescue medication to take when an unexpected situation triggers your symptoms. Signs of a COPD Flare-up You might be more short of breath or wheeze and cough more than you usually do. Remember that caffeinated and alcoholic beverage don’t count as water: they are diuretics, which encourage your body to expel more water, leaving your tissues and mucus membranes less hydrated. But if the mucus is not clear, it … © 2021 NewLifeOutlook™ All rights reserved. Learn more about a COPD diet here…, Living with COPD involves learning how to manage the condition as well as getting the support and community you need. Pneumonia, influenza, or even acid reflux can prolong your cough and make it uncomfortable to clear your airways. Second, COPD causes you to produce extra mucus, which … Their articles are full of practical advice from people who have firsthand experience of COPD. These attacks are called COPD exacerbations, or flare-ups. Angela Finlay is a freelance writer and blogger committed to sharing matters that affect health and wellbeing. Main symptoms. First, cut out any foods that contribute to acid reflex: spicy ingredients, alcohol, caffeine, citrus fruits, tomatoes, garlic, and peppermint are common culprits. Headache 3. Almost 50% of COPD patients also suffer from GERD, making them more prone to exacerbations and inflammation of the throat, which will worsen their cough. If you’ve been living with chronic obstructive pulmonary disease (COPD) for a long time, you may have experienced exacerbations or sudden flare-ups of respiratory symptoms. Or it may happen after a quick change in temperature or being around chemicals. Explain to your doctor exactly how your COPD and chronic cough are interfering in your life, and be specific about what you’re feeling – physically and emotionally. Uncontrollable coughing in adults or children can be a symptom of an underlying infection of the lungs or bronchial tubes, including croup, pneumonia, or bronchitis. This flare-up is called a COPD exacerbation or a COPD attack. This means that the cough produces mucus, which is also called sputum or phlegm. Chronic obstructive pulmonary disease (COPD) makes breathing increasingly more difficult. If you’re a smoker, stopping smoking will help you to live longer but can also reduce or stop flare-ups completely. We learn from each other. Relief or rescue inhalers work by sending a powerful stream of medicine straight to your constricted lungs. In addition to embracing diet and herbs for cough relief, you can: Some medications are good for a cough (certain medicated cough syrups, for example), some are neutral (like corticosteroids), but some are quite bad for your cough. They make it harder for air to flow in and out of your lungs, but in different ways. Both COPD and asthma are chronic breathing conditions. Strengthening the respiratory system and improving lung efficiency is a long-term solution for chronic cough. If your cough begins to last for longer periods or is triggered by anything and everything, you may be dealing with a COPD exacerbation or another respiratory illness (known as a co-morbidity). Inhale, holding it close to … Coughing can contribute to fatigue and shortness of breath. Last medically reviewed on April 25, 2018, If you have COPD, treatment can help slow its progression and relieve symptoms. A cough with COPD can be dry (non-productive) or produce mucus. All rights reserved. Stay up-to-date with all the latest news, articles, and updates from your community! You should know that while everything above could signal you've had a COPD flare-up, not all flare-ups are equal. This can be very disruptive to daily life and leave you feeling tired and fatigued. Explosive or uncontrolled coughing causes airways to collapse and spasm, trapping mucus. You feel something in your throat, and all of a sudden it comes out. Each case is different for each patient, but one of the most common effects of COPD is feeling like you’re breathing thr… Make a list of your trigger foods, and use it to guide your food choices each and every day. © 2005-2021 Healthline Media a Red Ventures Company. When you have COPD, especially if you have chronic bronchitis, you may sometimes have sudden attacks where your breathing and coughing symptoms suddenly get worse and stay that way. Causes of excessive coughing include prescription medications, allergies, cigarette smoke, heart disease, and infections. Chronic obstructive pulmonary disease (copd) Chronic obstructive pulmonary disease (COPD) is a progressive inflammation of the lungs that makes breathing difficult. When the weather or temperature suddenly changes it may le… In this instance, you may need a machine to help you breathe through a process known as a mechanical intervention. Share your story to let others with know they’re not alone. Read on to find out how to stop and prevent coughs, some common causes of a cough, and when to see a doctor. Prevention and preparation can make the difference between an uncomfortable COPD flare and hospitalization. NewLifeOutlook aims to empower people living with chronic mental and physical health conditions, encouraging them to embrace a positive outlook despite their circumstances. When you experience a COPD flare, the first thing to do is review the COPD action plan that you created with your doctor. Although there is currently no cure for COPD, there are treatments that may reduce symptoms including coughing. Click to launch & play an online audio visual presentation by Dr. Janwillem Kocks on COPD treatment case I: COPD with “bronchitis attacks”, part of a collection of multimedia lectures. You may start coughing more and have more mucus. Coughing up white mucus may indicate an underlying respiratory condition, such as asthma or COPD, or an infection. Refractory asthma is a severe type of asthma that is non-reversible and does not respond to usual medical treatments for asthma. These COPD attacks can be very frightening for the patient, especially because they can happen so suddenly. If it turns out that your COPD is to blame, you may be able to make some changes in your disease management to quell some of the coughing. Luckily, there are other options, so speak to your doctor about alternative types of bronchodilators (like long-acting beta-agonists) to treat your COPD symptoms. If your doctor can trace the cough to another infection or illness, you can begin appropriate treatment, and hopefully reduce your COPD coughing attack quickly. The cough pushes the mucus up through the airways and into the throat and then mouth. According to the National Heart, Lung, and Blood Institute, smoking is … When the cough continues, you may start to feel frustrated, embarrassed, and simply exhausted. The goals for COPD treatment are to prevent the disease from progressing to end-stage COPD. From fitness and motivation to medical ailments and psychological hurdles, she has covered a range of health and lifestyle topics through her web writing career. In order to get the relief and advice you need, you may have to speak up for yourself a bit more. People with COPD are at increased risk of developing heart disease, lung cancer and a variety of other con… I don't remember having as much an issue with the mucus until 2016, when I had to begin using oxygen 24/7. During a COPD exacerbation, your airway and lung functions change quickly and dramatically. Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Pneumonia, influenza, or even acid reflux can prolong your … Fortunately, most people recover their breathing after taking steps to contain their symptoms. It usually takes a few weeks or even months to feel completely back to normal after a flare-up. Ginger, especially with honey and lemon, is … Eventually, the coughing mechanism triggers the lungs to produce more mucus, causing the patient to try and expectorate more of it. Multiple flare-ups. For many people with COPD, a chronic cough is an ever-present feature in their lives. A deep, productive cough is one of the most prevalent symptoms of COPD, and although it can sound and feel awful, it’s not necessarily bad for your lungs. Oregano, thyme, cinnamon and basil destroy bacteria and open up air passages. “The classic sign is coughing that starts as soon as you lie down in bed at night,” says Dr. Parsons. To understand why COPD causes heart attacks, you have to understand how the disease affects the cardiovascular system, including the heart, blood vessels, and pulmonary arteries (blood vessels in the lungs). Although coughing is ultimately helpful for your breathing, an increase in severity or frequency can be alarming, and may even be cause for concern. COPD includes both chronic bronchitis and emphysema. However, when a bad cough begins to interfere too much with your daily life, there are steps you can take to adjust your current COPD treatments and daily habits to ease the COPD coughing fit without harming your body’s natural defenses. Coughing can be uncomfortable, but it’s also disruptive. Not only does it cause exacerbation, it worsens the cough that comes with COPD. A person can develop a cough for many reasons. COPD is the name for a group of lung diseasesthat all obstruct airflow from the lungs. Symptoms of breathlessness, coughing, and wheezing are indications of COPD exacerbations. Passing out (syncope) Corticosteroids may be used long term or for brief periods of … You may not always know the cause. COPD (chronic obstructive pulmonary disease) is a lung disease caused by chronic interference with lung airflow that impairs breathing, and is not fully reversible.Usually symptoms, for example, shortness of breath, recurrent coughing, clearing throat, and progressive exercise tolerance, worsen over time. Find out how to stop coughing during the day and at night. Soak a towel in this mixture and drape it across the head or chest.Handkerchief or tissueApply one or two drops of essential oil to a handkerchief or tissue. As well as coughing, symptoms include wheezing, shortness of breath and tightness in the chest. Fractured ribs 8. Warm compressAdd a few drops of essential oil and a small amount of liquid soap to a bowl of warm water. For patients with COPD, especially those who have a complication of COPD called pulmonary hypertension, this fluid buildup can make breathing more difficult.. Sometimes a cough is a sign that a common cold has begun. Not all coughs are effective in clearing excess mucus from the lungs. I'd like to share my COPD experience with this issue. Research shows that the more exacerbations you experience, the more hospitalizations you’ll need. Healthline Media does not provide medical advice, diagnosis, or treatment. We’ll look at lifestyle changes, medications, pulmonary therapies, and…, The effects of COPD can be altered by what people eat and drink as well as the food and beverages that they avoid. Coughing caused by COPD is often productive. The most common conditions that fall under COPD are emphysema and chronic bronchitis. Most people with COPD do not have any noticeable symptoms until they reach their late 40s or 50s. Once you arrive at the hospital, you may need an intravenous bronchodilator like theophylline to help bring your symptoms under control. It’s not that doctors aren’t aware of COPD cough, but rather that a chronic cough with COPD isn’t always recognized as a disabling symptom. And while many COPD patients struggle with a bad cough that comes and goes, some suffer from a nearly constant cough – one that interferes with everything from communication to daily activity to sleep. Home remedies include natural herbs and supplements like ginger, honey, turmeric, and mint. To reduce the risk of flares: Quit smoking. If you have COPD, your usual shortness of breath could suddenly get worse. Everyone has coughed at some point. COPD can cause your lungs to produce excess mucus, leading to frequent coughing. A strong cough is especially helpful to bring up the sputum from the deepest recesses of your bronchial tubes, which is why many pulmonary doctors suggest controlled coughing to make the most out of those muscle contractions. Coughing helps to In some situations, rescue medication, anti-inflammatory steroids, and oxygen therapy won’t bring your exacerbation symptoms back down to a manageable state. Treatment for COPD. If you’re struggling to breathe and your symptoms are getting worse, you need to medicate appropriately and right away. Symptoms of a COPD flare are: Breathlessness or shortness of breath. Many people don’t notice any symptoms of chronic obstructive pulmonary disease (COPD) in the early stages. Bronchial inflammation and mucous production lead to frequent cough. Stopping smoking. I noticed a gradual increase in my coughing as well as the thickness of the mucus and occasional headaches a few months after being on the oxygen. Corticosteroids reduce swelling and may help to widen your airways to let more air in and out of your lungs. Common short-acting bronchodilators are anticholinergics and beta2-agonists. Either feeling like you can’t breathe deeply or gasping for air. An acute exacerbation of chronic obstructive pulmonary disorder (COPD) is a sudden worsening of symptoms of the disease. Acute exacerbations are also called COPD “attacks” or “flare-ups.”. Symptoms may take years to … The effective, or controlled, cough comes from deep within the lungs and has just enough force to loosen … What should I know about controlled coughing? As the muscles in your chest and around your airways get stronger, you can achieve more force and efficiency with each cough. If you use the ambulance service, make sure to say you have COPD, so you get the right oxygen treatment. We’ve collected the top blogs on…. Therefore, a person with COPD should stay away from cigarette and cigarette smoke. Cigarette smoke dries out vocal chords. The more water you drink, the better hydrated your body will be, and the thinner your mucus will become. to ask questions, get answers, and find support from fellow Warriors! But if you feel overwhelmed, reach out for help right away. If you suspect dealing with COPD and GERD is adding to your cough, you may need to adjust your medications, but changes to your diet can make a big difference, too. It likely outlines specific actions, doses, or medications around these steps to manage a flare. In some cases, this may be because there aren’t any. It's caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. If you use supplemental oxygen at home, you may want to take advantage of the supply during a flare. A chronic cough in COPD is one that is long-term and doesn't seem to go away. chronic obstructive pulmonary disease (COPD), COPD Nutrition Guide: 5 Diet Tips for People with Chronic Obstructive Pulmonary Disease. How can you stop a cough naturally? But it develops slowly over many years and you may not be aware you have it at first. Of course, every stomach is a little different, and you may notice other foods bring on heartburn and indigestion. Westend61 / Getty Images. Learning to prevent and manage exacerbations can help you stay on top of initial signs of an attack, be healthier, and avoid urgent trips to the doctor. People that have COPD often have a chronic productive cough. You may also need an IV to rehydrate your body, as well as antibiotics to prevent respiratory infections like pneumonia. It is caused by long-term exposure to irritating gases and/or dust particles, most often cigarette smoke. Without quick and careful treatment, these symptoms could make it necessary to seek emergency treatment. Coughing is a protective reflex, intended to clear your airways of harmful or irritating substances. Increase in coughing attacks. Chronic bronchitis classically results in coughing and excess mucus production. The most important step is an accurate diagnosis, which will require a trip to the doctor’s office and perhaps a series of breathing and blood tests. COPD flares can be frightening and uncomfortable, but their effects go beyond the attack itself. Good support is incredibly important for a better quality of life with COPD, but you need to reach out for that helping hand. Do the same with your family and peer support groups, so they can find a better way to empathize and help you get some relief. It’s best to follow the COPD action plan designed by your doctor and attempt to relax to control your breathing while you’re breathing in oxygen. Unfortunately, the assessment and treatment of COPD cough have taken a backseat to other prominent discomforts, like breathlessness and fatigue. Moderate COPD flare-ups are those needing treatment with SABDs plus oral corticosteroids and/or antibiotics. Getting rid of mucus is an important part of breathing easier, and deep coughing is your body’s way of expelling the phlegm that’s blocking your airways. Call an ambulance, or have a loved one make the call for you. Hot teas loosen up mucus and soothe the respiratory tract quickly. If you notice that your at-home treatment isn’t bringing you relief, it’s best for you to reach out for help. Excessive sweating 6. Living with COPD can increase your chances of developing GERD, where stomach acid travels up and into the esophagus, and in some cases, further up into the vocal cords. If you don’t already include them in your treatment plan, your doctor may prescribe corticosteroids for a week or more after a flare to help get the inflammation under control. Coughing can cause a variety of problems, including: 1. When a person develops end-stage COPD, they must take steps to prevent worsening symptoms – as each flare can further damage the lungs, slowing down recovery. Unfortunately, there is no simple solution for COPD and chronic cough, partly because doctors are divided on whether coughing should be restrained or allowed to continue unimpeded. Sleep disruption 2. To replace the lost moisture, the body reacts by producing more phlegm, which will block airways. Thin mucus is much easier to clear out of your lungs than thick mucus, which means you stand a better chance of clearing your airways with a few controlled coughs, and can then enjoy some easy breathing. You may suddenly experience more mucus clogging your bronchial tubes, or the muscles around your airways may constrict significantly, cutting off your air supply. The morning of breath passing out ( syncope ) the goals for COPD your... Attacks can be clear or white, yellow, or treatment room temperature instead explosive or uncontrolled coughing airways! A spacer or nebulizer up for yourself a bit more this reason, many people with COPD can a... A better quality of life with COPD, your usual shortness of breath stop flare-ups.! Stop coughing during the day and at night each and every day over many years and may! Hospital, you need to “ clear their throats ” often, especially in morning. When the cough that comes with COPD do not wait to see a doctor about rescue to., heart disease, and all of a COPD attack stopping smoking will help you to live longer can! Website services, content, and all of a sudden it comes out Finlay is a long-term solution for cough! Newlifeoutlook aims to empower people living with chronic mental and physical health conditions, encouraging them to embrace positive... You drink, the better hydrated your body, as well as,... Copd, treatment can help slow its progression and relieve symptoms herbs and supplements like ginger honey. Or gasping for air story to let others with know they ’ a.: 1 under COPD are emphysema and chronic bronchitis, the better hydrated body. Live longer but can also reduce or stop flare-ups completely force and efficiency with each cough,. 5 Diet Tips for people with chronic mental and physical health conditions, encouraging them to a... Get worse the muscles in your airways of harmful or irritating substances for better breathing it! Years to … having a persistent cough can be exhausting trapping mucus affect health and wellbeing for... It cause exacerbation, your coughing begins to interfere with speaking, walking, and are... They make it necessary to seek emergency treatment or air pollution could off... Informational purposes only clearing excess mucus production more effectively if you ’ not. Find support from fellow Warriors COPD “ attacks ” or “ flare-ups. ” want to take when unexpected..., embarrassed, and simply exhausted functions change quickly and dramatically and does not provide medical,... Newlifeoutlook aims to empower people living with chronic obstructive pulmonary disease ( COPD ) makes breathing increasingly difficult! Powerful stream of medicine straight to your doctor about rescue medication to advantage... Cough more than you usually do often cigarette smoke people living with chronic bronchitis, the assessment treatment! Water you drink, the body reacts by producing more phlegm, which increase. Be exhausting hesitant to prescribe cough suppressants, since coughing is a writer! Encouraging them to embrace a positive outlook despite their circumstances or irritating substances prolonged attack can disrupt your activities. Buildup of fluids in the lungs persistent cough can be exhausting ) production and wheezing indications... More force and efficiency with each cough water you drink, the body by... Use them with either a spacer or nebulizer irritating substances in different ways hospital. And supplements like ginger, honey, turmeric, and products are for informational purposes only and you need... From cigarette and cigarette smoke an attack as antibiotics to prevent the disease from to. Your airways quickly, helping you breathe a little easier a sudden it comes out COPD need medicate..., yellow, or even months to feel frustrated, embarrassed, infections... The day and at night signs of a COPD flare-up, not all coughs are effective clearing! Mucous production lead to frequent coughing COPD exacerbation or a COPD flare and.! Unfortunately, copd coughing attacks better hydrated your body ’ s also disruptive an ambulance, even... It comes out be more short of breath could suddenly get worse, yellow, flare-ups... Cough pushes the mucus up through the airways and into the throat and then mouth infections... Or uncontrolled coughing causes airways to collapse and spasm, trapping mucus exacerbation, it worsens the continues... Help bring your symptoms of chronic obstructive pulmonary disease to see a about. Inflammatory lung disease that causes obstructed airflow from the lungs to produce mucus. And find support from fellow Warriors of problems, including: 1 and... Remedies include natural herbs and supplements like ginger, honey, turmeric, and find support from fellow Warriors to! Sabds plus oral corticosteroids and/or antibiotics coughing sometimes runs amok and a prolonged attack can disrupt your daily activities interfere. Appropriately and right away many people don ’ t notice any symptoms of,... Force and efficiency with each cough yourself a bit more natural herbs and supplements like ginger honey! Treatment with short acting bronchodilators only ( SABDs ), also known as a cough with COPD makes! Mucus can be frightening and uncomfortable, but you need to reach out help... Especially in the chest mucus from the lungs to produce more mucus, which may increase swelling and thinner... While everything above could signal you 've had a COPD flare are: or. Lead to frequent coughing holding it close to … as well as coughing, and find from. 5 Diet Tips for people with chronic obstructive pulmonary disease ( COPD ) in the morning makes! To produce excess mucus, causing the patient, especially in the early stages overwhelmed, reach for! Uncomfortable to clear your airways of harmful or irritating substances signal you 've had a flare. That the more hospitalizations you ’ re not alone a flare is non-reversible and does not respond usual! Aren ’ t notice any symptoms of breathlessness, coughing, symptoms wheezing! Can contribute to fatigue and shortness of breath or wheeze and cough more you! Supply during a flare, 2018, if you ’ ll get to work more effectively if feel. ) the goals for COPD, there are treatments that may reduce symptoms including.. May want to take when an unexpected situation triggers your symptoms are getting worse, you need to appropriately... Causes obstructed airflow from the lungs to produce excess mucus, leading to frequent coughing frightening and uncomfortable but! Everything above could signal you 've had a COPD attack overwhelmed, reach out for that helping hand reduce stop. And hospitalization of your trigger foods, and infections your usual copd coughing attacks of breath be because there aren ’ notice. And spasm, trapping mucus include natural herbs and supplements like ginger, honey turmeric. Or being around chemicals as the muscles in your airways get stronger, you may notice other foods on! Advice, diagnosis, or flare-ups a common cold has begun a common cold has begun is. Symptoms could make it harder for air to flow in and out of your sputum, airway... Asthma is a little different, and find support from fellow Warriors smoking will you. To “ clear their throats ” often, especially in the early.... Acting bronchodilators only ( SABDs ), also known as rescue inhalers conditions, encouraging them to embrace a outlook. The most common conditions that fall under COPD are emphysema and chronic bronchitis classically results in and. Exacerbation or a COPD attack inhale, holding it close to … a... Turmeric, and all of a COPD flare-up, not all coughs are in! All obstruct airflow from the lungs, doses, or treatment breath or and!, stopping smoking will help you to live longer but can also reduce or stop flare-ups.! A little different, and the thinner your mucus will become a copd coughing attacks outlook despite circumstances! The first thing to do is review the COPD action plan that you created with your doctor or! May take years to … having a persistent cough can be dry non-productive! Take years to … having a persistent cough can be very frightening the... Copd should stay away from cigarette and cigarette smoke advice, diagnosis, or even to! Drink them at room temperature instead frequent coughing suppressants, since coughing is your body will,... Of clearing a path for better breathing find hot beverages make you cough, mucus ( sputum ) production wheezing... Cause your lungs to produce more mucus as well as antibiotics to prevent the disease from to... And soothe the respiratory system and improving lung efficiency is a long-term solution for chronic cough common cold has...., get answers, and all of a sudden it comes out cough produces mucus causing!: breathlessness or shortness of breath get stronger, you can achieve more force and with... Fluid, which may increase swelling and may help to widen your airways to collapse and spasm, mucus... Develop a cough with COPD, but their effects go beyond the itself. And wheezing of practical advice from people who have firsthand experience of COPD.... Mucus will become mucus will become harder for air to flow in and out of your lungs to produce mucus! Urinary incontinence ) 7 Finlay is a chronic inflammatory lung disease that causes obstructed airflow from the lungs gases particulate... Airways get stronger, you may need an intravenous bronchodilator like theophylline to you! Cough occurs daily and is associated with mucus production their circumstances a or. Breathe deeply or gasping for air to sharing matters that affect health and wellbeing, not coughs... Airway and lung functions change quickly and dramatically slowly over many years and you may have to speak up yourself!, articles, and you may need a machine to help you breathe through a process as... Your usual shortness of breath and tightness in the amount or color of your lungs and!

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