AN INTRODUCTION TO COPD
COPD stands for Chronic Obstructive Pulmonary Disease. It can be either emphysema or chronic bronchitis, a combination of both, or other lung disorders. Regardless of the underlying cause, COPD represents serious lung disease that progressively grows worse. As the airways within the lungs thicken, collapse, or fill with mucus, breathing gradually grows more difficult.
Pretty scary stuff, and rightfully so. COPD is the 3rd leading cause of death in the United States, killing more than 120,000 people each year, one death every 4 minutes. The death rate from COPD is exceeded only by heart disease and cancer. Even more disturbing, the death rate for COPD is the only one in the top three that is increasing, especially among women!
Over 15 million people have been diagnosed with COPD, and it is estimated that at least another 12 to 15 million have the disease and are not yet aware of it. The onset of COPD is very gradual and subtle, leading people to blame their increasing shortness of breath on age or simply being overweight or out of shape. The symptoms are subtle, but they increase over time, slowly encroaching more and more on the lifestyle of the COPD patient. As the disease progresses, everyday tasks become more difficult, making it a leading cause of disability.
With COPD, the airways and alveoli or air sacs within the lung lose their elasticity. Healthy lung components stretch and contract with each breath, aiding in the air movement. Emphysema gradually breaks down the walls of the alveoli, leaving less and less surface for the exchange of oxygen and carbon dioxide with the blood. Chronic Bronchitis causes the airway passages to thicken and fill with mucus, disrupting and partially blocking the airflow.
As might be expected, the symptoms of COPD include shortness of breath with exertion, a feeling that you cannot take a deep breath, excess mucus, wheezing, and coughing. Again, the effects of COPD make themselves known gradually, so anyone noticing any of these signs would be wise to check with their physician.
Due to the normally slow development of symptoms, those with COPD may find themselves limiting or giving up certain activities to compensate for their increasing inability to breathe properly. A phrase quoted in “COPD 101”, a presentation by the American Lung Association, says, “When it’s hard to breathe, it’s hard to do anything.” Exercise, sports activities, travel, and social interaction may all suffer.
Smoking, especially cigarettes, is by far the leading cause of COPD. Secondhand smoke, air pollution, and industrial chemicals and fumes are also contributing factors. In some people, a genetic condition known as alpha-1 antitrypsin deficiency can lead to a tendency to develop COPD, even if the individual never smoked.
If an individual shows any of the symptoms of COPD, it is important to reveal those feelings to their doctor. Spirometry is a simple breathing test that measures lung capacity and the ability to rapidly expel air from the lungs. As lungs age, they gradually lose breathing capacity. One of the measurements of the spirometry test is the FEV1, or forced expiratory volume in one second. It is expressed as a percentage of the expected volume, given the patient’s age, height, and weight. The lower the FEV1 percentage, the higher the severity of the COPD. The spirometry test is simple, painless, and non-invasive.
Life does not end with a diagnosis of COPD. There are a number of things that can and should be done to fight the disease and improve the quality of life. First and foremost, if the patient is still smoking, they should quit. Regardless of age of number of years of smoking, on the average sustained quitters feel better, live longer, and remain more active than sustained smokers.
There are many medications available for COPD patients, including short-acting and long-acting bronchodilators to relax the muscles of the airways, corticosteroids to reduce inflammation, and antibiotics to fight infection. Immunizations for influenza and pneumonia can help to defend against those diseases. Depending upon the type and severity of the COPD, a patient may be prescribed one or several of the medications.
Pulmonary rehabilitation and training in exercise routines are normally indicated for the COPD patient, to assist them in staying as strong as possible and to help them learn about the disease and develop routines to make it easier to make it through their day.
Supplemental oxygen may be prescribed in order to help the patient feel better and live longer. Depending on the severity of the COPD, oxygen may be required 24 hours a day, or only part of the time, such as when exercising or sleeping. The extra oxygen simply provides compromised lungs with an easier way to provide the needs of the body’s cells.
Various surgeries are also available for some patients, such as lung reduction surgery, implantation of one-way valves to aid in removing trapped air, and lung transplants.
As with any disease, knowledge is power. There are many sources available to learn more about COPD, its causes, effects, and treatment. Your physician or pulmonologist is a good place to start. The American Lung Association is a wonderful resource, as are the COPD Foundation and the National Heart, Lung, and Blood Institute.