Cystic Fibrosis and Surfing: A Literature Review
University of Texas at El Paso
Cystic Fibrosis is a rare and deadly disease affecting the respiratory and digestive systems of the body. There is no cure for this genetic disease, but advancements are being made to improve the lives of cystic fibrosis patients. The sport of surfing has been found to possibly relieve cystic fibrosis patients from some of their symptoms. The salty air of oceans is inhaled and allows cystic fibrosis patients to breathe deeply, a pleasure that is rare for them. Due to this discovery, a hypertonic saline solution has been created to aid cystic fibrosis patients across the world that do not have daily access to the ocean.
Cystic Fibrosis and Surfing: A Review of the Literature
Cystic Fibrosis is a life-threatening disease that affects over 30,000 Americans and many more across the globe (Mull, 2010). It is a chronic disease that damages both the lung and digestive systems. A thick and sticky mucus is created due to an infected gene inherited through family members that builds up in the lungs. The clogging of the lungs leads to lethal lung infections. The mucus also obstructs the pancreas, making it difficult for the body to break down and absorb food because natural enzymes are stopped (Welsh, 1995). Approximately 1,000 new cases of cystic fibrosis are diagnosed each year in the United States, with more than 70% of these patients being diagnosed by age two (CFF, 2009).
Cystic fibrosis, or CF, is a disease that primarily affects children, but improvements in technology and treatments are lengthening the lives of CF patients. Researchers continue to search for a possible treatment for CF patients and a remedy could be the sport of surfing. Surfing is an outdoor activity that allows a person to glide along ocean waters due to the force of a wave propelling them forward on a surf board. According to Australian researchers, it may be possible that this simple act of wave-riding could help treat cystic fibrosis. In order to determine if surfing could be a form of treatment for CF patients, one must answer these three questions:
1. What is cystic fibrosis and how does it affect patients?
2. Does surfing improve the lives of cystic fibrosis patients? Is there causation or merely correlation?
3. Is there a way to transfer the healing element of surfing into a medical form for clinical use?
The following literature review will discuss cystic fibrosis, the effects it has on CF patients, the possibility of surfing’s influence on CF, and the possible transformation of surfing’s natural remedies into a medicine for clinical use.
Cystic fibrosis is a chronic, inherited disease that harms the respiratory and digestive systems. It is the most common life-threatening disease inherited in the white population (Sharma, 2010). Cystic fibrosis is caused from a defect in a gene, called the cystic fibrosis transmembrane conductance regulator (CFTR) gene, which is transported from parent to child. This gene creates a protein that controls the movement of salt and water through the cells of one’s body, but CF patients struggle with proper movement through cells because of the defect in this gene (Schoenstadt, 2008). This defect creates a thick and sticky mucus that builds up in the lungs which leads to numerous lung infections. Other symptoms experienced by CF patients include: persistent coughing, salty skin, shortness of breath, difficulty with bowel movements, and a lack of proper weight gain or growth even with a healthy diet (CFF, 2009).
At the moment, cystic fibrosis has no cure, but treatments are available to remedy some of the symptoms of this deadly disease. CF patients endure long hours of treatment each and every day to attempt to relieve discomfort caused by CF and help break down the mucus. According to the U.S. Department of Health and Human Services, the goals of treatment are to (Schoenstadt, 2009):
Many medicines are used in order for these goals to be achieved. These medicines include anti-inflammatories, antibiotics, bronchodilators, mucus-thinning drugs, and many more (Schoenstadt, 2009). Exercise is recommended to keep the respiratory system in good health also. When a CF patient exercises, it is very important to replenish the salt that is lost through sweat. CF patients tend to release large amounts of salt through sweat glands; therefore the body needs to regain the lost sodium (CFF, 2009). Along with antibiotics and exercise, many CF patients participate in chest physical therapy. This involves the pounding of one’s chest to break up mucus and is typically performed each day. The pounding can be uncomfortable for many patients; therefore devices such as the electric chest clapper and inflatable therapy vest have been created. The goal of these treatments is to break up the mucus building up in the lungs so the patient can cough it up (Cystic). Specialized breathing techniques have been proven to help with this difficult task as well.
As mentioned earlier, cystic fibrosis is an inherited disease, reigning from genes and DNA from the parents. Cystic fibrosis patients receive the disease by obtaining two copies of the defective CF gene- one from each parent (CFF, 2009). If both parents carry this gene, but do not have the disease, their child has a 25% chance of becoming a carrier and inheriting the disease, a 50% chance of becoming a CF carrier without the disease, and a 25% chance of receiving neither the gene nor the disease (CFF, 2009). The cystic fibrosis gene is carried by over ten million people, or 1 in 31 Americans, and is the most common lethal disease inherited by the white population (Sharma, 2010). The 30,000 Americans living with the cystic fibrosis disease have a possibility of over 1,400 different mutations of the gene. These different mutations affect the severity of one’s symptoms (CFF, 2009).
A majority of cystic fibrosis patients are diagnosed at birth, although some will not be diagnosed until later years of their life. The most common test for CF, used by doctors, is the Sweat Test. The Sweat Test indicates whether or not a person has cystic fibrosis based on chloride levels that exit the body through sweat. An electrode is placed on the skin, forcing sweat glands to produce sweat. The sweat is collected and the chloride level is measured (CFF, 2009). According to the Cystic Fibrosis Foundation, the level of chloride is measured and compared to these numbers (2009):
For children who are less than six months old:
For people over the age of six months:
Once a person has been diagnosed with cystic fibrosis, they can seek help from a team of medical doctors and CF experts to receive the best treatment possible. Advances in CF treatments have drastically lengthened the lives of CF patients. In the 1950s, few children would live to experience elementary school, but now specialized treatments have immensely changed that statistic. For the first time in the history of this disease, about 45% of CF patients are surviving to reach adulthood at age 18 (CFF, 2009). Though numerous advancements have been made to improve the lives of CF patients, there is still no cure; therefore patients must continue to thrive on any possible treatments.
Does surfing improve the lives of cystic fibrosis patients? Is there causation or merely correlation?
Cystic fibrosis is a life threatening disease with no cure, but researchers are now finding that the sport of surfing could possibly improve the lives of CF patients and even lead to finding a cure. Surfing is a sport that allows a person to glide across the water due to the force of a wave in the salty ocean. Surfing requires physical involvement, as the athlete must paddle themselves into a wave to accomplish the task of surfing. It also requires the athlete to push themselves up from a prostrate position up onto their feet as quickly as possible while the surfboard glides along the face of the wave. Once standing, the athlete’s core muscles are in constant use as the body needs to maintain balance while the board is forced along by the wave. The sport of surfing is becoming famous around the globe, but the connection between cystic fibrosis and surfing was first discovered in Australia.
Australian surfers and researchers realized a correlation between surfing and cystic fibrosis while providing treatment to children. At a CF clinic in Australia, it was noted that the patients who regularly surfed felt increasingly better and had stronger lung functions than the non-surfers (Surfline, 2008). Researchers in Australia teamed up with Dr. Scott Donaldson and the University of North Carolina at Chapel Hill to test this theory. Donaldson reports, “Surfers with cystic fibrosis had fewer lung exasperations [than non-surfers]” (Peck, 2006). Mark Elkins, a researcher at Sydney’s Prince Alfred Hospital adds, “Surfers said their chests and sinuses felt clear and they coughed up much of the thick mucus that clogs their lungs. Doctors wondered why. Was it the exercise? Or was it the saltwater?” (Carroll, 2008). Researchers and doctors concluded that it was a combination of both exercise and salt water.
As a form of primary research, some interviews were conducted with people to determine if they experienced healing powers from the ocean. Eric Ramos, a Hawaiian, has been surfing for over 16 years. He discovered the effects surfing has on CF patients while competing on the North Shore with some Australian surfers who had CF. When asked if he has seen surfing and the oceans heal before, Ramos quickly answered, “Yes. Surfing is a way of life for Kanaka Maoli [Hawaiians]. Surfing frees the soul and the body. That’s why you can still see old men in their 60's that still surf. Surfing is a complete visual of life itself. If you look at the water long enough you can understand what I mean.” Ramos truly believes that surfing has the ability to heal the average person, along with CF patients. Ramos concluded the interview by noting how important communication was to the evolvement of surfing and CF. He mentioned that nearly every child desires to surf, and if the CF children knew it could save their life, they would do anything to try it. The people just need to have the information.
The greatest opposition to surfing’s remedy on cystic fibrosis is the lack of communication. Many CF patients and families have never heard of this possible treatment, therefore they do not have access to it. Due to this fact, many people may have initial doubts of the ocean’s power on CF because they are uninformed. Once the facts are provided and CF patients experience the healing from surfing, this opposition will diminish.
Is there a way to transfer the healing element of surfing into a medical form for clinical use?
Once cystic fibrosis patients realized the positive effects surfing has on their breathing and treatment, doctors desired to understand why this was occurring. Researchers focused on these patients and noted that the salty air breathed while surfing, combined with exercise, was able to relieve some pain felt by CF patients and allow them to finally breathe with ease. Due to this discovery, a hypertonic saline solution has been created for CF patients who do not have the luxury of surfing each day (Surfline, 2008). The hypertonic saline solution has twice as much salt as the ocean for stronger effects on the body (Carroll, 2008). The solution is breathed through a machine to provide the same positive effect surfing creates. The saline solution is able to lubricate the lungs and prevent mucus build up. Donaldson and other researchers were actually surprised by the success a simple sodium chloride solution had on CF patients. It seemed too simple, but provided the greatest remedy for patients (Peck, 2006). Corky Carroll writes in The Orange County Register (2008):
Australian doctors found that 41 percent of those who received the treatment [hypertonic saline solution] avoided serious complications such as weight loss, coughing up blood or a dangerous infection as compared with 16 percent of the other patients. The solutions helped remove mucus from the lung for at least eight hours, according to the UNC study of 24 patients, also published in the journal [New England Journal of Medicine]. Many CF patients across the globe now inhale this hypertonic saline solution every day, mimicking a “surf session” to relieve the symptoms of cystic fibrosis (Surfline, 2008).
The life-threatening genetic disease of cystic fibrosis does not currently have a cure, but advancements in treatments have been improving and lengthening the lives of CF patients. The discovery of surfing’s natural remedies has been found to help CF patients feel better. The salty air inhaled while surfing has been correlated to allowing CF patients breathe easier. Due to this discovery, a hypertonic saline solution has been created so CF patients across the globe may have access to the healing effects of surfing, regardless of actually riding a wave in the ocean. This advancement in cystic fibrosis research could possibly lead to a cure for the deadly disease. As for now, cystic fibrosis patients are encouraged to seek the sea for their natural medicine.
Carroll, C. (2008, January 25). How Surfing Helps Cystic Fibrosis Patients. The Orange County Register. Retrieved from http://www.ocregister.com/news/surfing-129322-cystic-fibrosis.html
CFF. (2009, October 10). About Cystic Fibrosis. Cystic Fibrosis Foundation. Retrieved from http://www.cff.org/AboutCF/
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