What is COPD?

First, let's review what COPD stands for.

Chronic

Obstructive

Pulmonary

Disease

(COPD)

What is it?

COPD is a chronic pulmonary inflammatory illness that needs to be taken seriously for proper management and better quality of life. Although there is no cure for COPD, pulmonary treatment and management can go a very long way in improving overall health.

With COPD, the airways in your lungs become inflamed and thicken, and the tissue where oxygen is exchanged, the alveoli and respiratory bronchioles, are destroyed. Due to the reduction of flow of air in and out of your lungs, less oxygen gets into the tissues of your body leading to increased difficulty in getting rid of carbon dioxide, a metabolic-waste byproduct. As the disease gets worse, shortness of breath makes it harder to remain active causing a vicious cycle between muscle atrophy decreasing quality of life.

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Lungs Sketch

Sometimes referred to as either chronic bronchitis or emphysema, most people will have symptoms of both conditions, so health professionals prefer to call the disease COPD. However, some doctors think that chronic bronchitis may be present even though a person does not have the airway obstruction characteristic of COPD. Your doctor can explain your condition and the best way to treat it.

While many cases of COPD can be prevented and treated, some conditions are hereditary such as alpha-1 deficiency.

 

How Serious is COPD?

COPD is the third leading cause of death by disease in the United States. More than 16.4 million people have been diagnosed with COPD, but millions more may have the disease without even knowing it. The number of COPD cases is growing still without a cure and leading to premature disability.

 

What demographic is most affected?

Deaths resulting from COPD in women are higher than in men. There are a few reasons why this happens.

 

The tobacco industry heavily targeted women In the late 1960s. Naturally we saw a spike in women smokers and now seeing a resulting increase in new cases of smoking related diseases, including COPD, as women age.

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*Tobacco companies would market heavily towards women in the 1960's, implying that smoking was "liberating" and "sophisticating" for women.

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Women are more vulnerable than men to lung damage from cigarette smoke and other pollutants. Although it is not clear as to the reasons, it is believed their lungs are smaller and estrogen may play a role in worsening lung disease.

Women are often misdiagnosed. Because COPD has long been thought of as a man’s disease, many doctors still do not expect to see it in women and miss the proper diagnosis.

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What Causes COPD?

Over time, exposure to irritants that damage your lungs and airways can cause chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. The main cause of COPD is smoking, but nonsmokers can get COPD too.

 

Smoking

About 85 to 90 percent of all COPD  cases are caused by cigarette smoking. When a cigarette burns, it creates more than 7,000 chemicals, many of which are harmful. The toxins in cigarette smoke weaken your lungs' defense against infections, narrow air passages, cause swelling in air tubes and destroy air sacs—all contributing factors for COPD.

Environment

What you breathe every day at work, home and outside can play a role in developing COPD. Long-term exposure to air pollution, secondhand smoke and dust, fumes and chemicals (which are often work-related) can cause COPD.

Alpha-1 Deficiency

A small number of people have a rare form of COPD called alpha-1 deficiency-related emphysema. This form of COPD is caused by a genetic (inherited) condition that affects the body's ability to produce a protein (Alpha-1) that protects the lungs.

COPD Risk Factors

Smoking is the biggest risk factor for chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. It increases your risk of both developing and dying from COPD. Approximately 85 to 90 percent of COPD cases are caused by smoking. Female smokers are nearly 13 times as likely to die from COPD as women who have never smoked; male smokers are nearly 12 times as likely to die from COPD as men who have never smoked.

 

What Are COPD Symptoms?

Recognizing the initial symptoms of COPD can be very hard for many individuals until the later stages of the disease. Sometimes people think they are short of breath or less able to go about their normal activities because they are "just getting older" or are “unfit”. Shortness of breath can be an important symptom of lung disease. Here is a list of COPD symptoms. If you experience any of these symptoms, or think you might be at risk for COPD, it is important to discuss this with your doctor for a Pulmonary Functions Test for early treatment and management of the illness.

  • Chronic cough

  • Shortness of breath while doing everyday activities (dyspnea)

  • Frequent respiratory infections

  • Blueness of the lips or fingernail beds (cyanosis)

  • Fatigue

  • Producing a lot of mucus (also called phlegm or sputum)

  • Wheezing

Remember: Procrastinating and waiting for worsening symptoms directly affects valuable treatment time that could be lost. Early detection of COPD is key to successful treatment.

Diagnosing COPD

In order to diagnose chronic obstructive pulmonary disease, the process involves a thorough pulmonary functions examination testing and cardiovascular evaluation, symptoms and medical history.

 

Health History

Your doctor will want to know if you:

  • Smoke or have a history of smoking

  • Are exposed to secondhand smoke, air pollution, chemicals or dust

  • Have symptoms such as shortness of breath, chronic cough or lots of mucus

  • Have family members who have had COPD

Doctor

Testing for COPD

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Spirometry, Plethysmography and Diffusion Lung Capacity Test: If you are at risk for COPD or have symptoms of COPD, you should be tested through a full pulmonary functions test. The test usually involves 3-4 tests.

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Spirometry:

is a simple test, yet very forceful test, of how well your lungs work. For this test, you blow air into a mouthpiece and tubing attached to a small machine. The machine measures the amount of air you blow out and how fast you can blow it.

Spirometry can detect COPD before symptoms develop. Your doctor also might use the test results to find out how severe your COPD is and to help set your treatment goals.

Plethysmography:

This enclosed test involves breathing and panting through a mouth piece in an enclosed chamber where the resistance of your airways are calculated. The more resistance there is, the more obstructions are present.

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Diffusion Lung Capacity Test:

A simple test where we assess the rate of diffusion of small amounts of Carbon Monoxide (CO)  through the lungs. Because CO is 200x more easily absorbed than Oxygen to the red blood cells, we are able to rapidly determine how effective your lungs are diffusing gasses in general to your vasculature.

Other Tests: 

Your doctor may also want you to have a chest X-ray and/or other tests, such as an arterial blood gas (ABG) test, which measures the oxygen level in your blood. This test can show how well your lungs are able to move oxygen into your blood and remove carbon dioxide from your blood. ABGs are not necessary for diagnosis of COPD however it can tell us the severity of the disease and how long it has been affecting the patient by assessing the acidity of the blood gas through measurement of Bicarbonate levels, Carbon Dioxide retention and content of oxygen available in the blood.

Oxygen Equipment Maintenance

Treating COPD

Once diagnosed with chronic obstructive pulmonary disease, which includes chronic bronchitis and emphysema, it is common to have questions and the answers may not be as clear as you’d like at first. Much like many other illnesses such as sleep apnea, symptoms differ from patient to patient and not always the same. Furthermore, the treatment and medications can be ery different from person to person. It is important to talk to your doctor and therapist about your treatment options and to get answers to all of your questions.

 

COPD Medications:

A variety of medicines are used to treat COPD and there is no "best" medicine for all people. Each person's COPD is different and your doctor and healthcare team will work with you to set up the best plan to address your symptoms and needs. Learn more about your treatment options »

By taking the right medicine at the right time, you can:

  • Breathe better

  • Do more of the things you enjoy

  • Have fewer flare-ups or exacerbations

The important factor when considering medication is to follow the instructions to the T.

If you are prescribed with an MDI inhaler, it is ESSENTIAL to obtain a spacer (AeroChamber) for optimal delivery of the medication to the distal ends of the lungs that are needing the medication - not the back of the throat or trachea where majority of medication is deposited without an AeroChamber.

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Pulmonary Rehabilitation

If you or someone you love suffers from a chronic lung disease like COPD, there is hope for rebuilding strength and enjoying a fuller, more active life. Pulmonary rehabilitation programs typically combine education, exercise training, nutrition advice and counseling.

2 effective pulmonary rehabilitation exercises are:

Incentive Spirometry:

An easy method of making your respiratory muscles stronger and more effective.

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Aerobika (Oscillating Positive Expiratory Pressure):

Important to help loosen stubborn thick mucus that is stuck inside the lungs that we are not aware of. These can cause, and often do cause, mucous plugs that further reduce the areas of the lung being ventilated.

CPAP/BiPAP:

Patients with COPD are much more likely to have Sleep Apnea or a sleep breathing disorder that is treated with CPAP. CPAP may help maintain the lungs inflated and recover some collapsed areas of the lungs leading to better oxygen diffusion and carbon dioxide release. Sleep Apnea Affects people in all age groups, all sizes and both sexes. Once thought to be an overweight issue has turned out to be a much, much more common illness unknowingly affecting roughly 60% of the population, making it a silent killer by placing excess stress on the heart and the lungs.

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Supplemental Oxygen

Patients with COPD are much more likely to have Sleep Apnea or a sleep breathing disorder that is treated with CPAP. CPAP will also help maintain the lungs inflated and recover some collapsed areas of the lungs leading to better oxygen diffusion and carbon dioxide release. Sleep Apnea Affects people in all age groups, all sizes and both sexes. Once thought to be an overweight issue has turned out to be a much, much more common illness unknowingly affecting roughly 60% of the population, making it a silent killer by placing excess stress on the heart and the lungs.