COPD (Chronic Obstructive Pulmonary Disease)

I. What is COPD?
Chronic obstructive pulmonary disease, or COPD disease, refers to a group of diseases that cause airflow blockage and breathing-related problems. It includes emphysema, chronic bronchitis, and in some cases asthma. Chronic bronchitis is inflammation and eventual scarring of the bronchi (airway tubes). Emphysema is enlargement and destruction of the alveoli (air sacs) within the lungs. Many persons with COPD have both of these conditions.

COPD is a leading cause of death, illness, and disability in the United States. In 2000, 119,000 deaths, 726,000 hospitalizations, and 1.5 million hospital emergency departments visits were caused by COPD. An additional 8 million cases of hospital outpatient treatment or treatment by personal physicians were linked to COPD in 2000.

II. COPD Symptoms and Diagnosis
The early signs of Chronic Obstructive Pulmonary Disease (COPD) for which many people seek medical attention before being formally diagnosed include marked shortness of breath with exertion, a cough that won’t go away or frequent respiratory infections. This is often at a point when the disease is already advanced. Many people might be identified earlier if their doctors routinely screen all patients who are smokers or previous smokers.

Early discovery of a breathing problem and appropriate treatment can prevent the disease from progressing to the point that it seriously affects the way you live and work. Anyone who has an ongoing cough or shortness of breath, even if it seems minor, should see his or her doctor. Morning cough, for example, is not normal. It is a result of smoking and indicates that there is irritation and swelling within the lung. Shortness of breath while exercising, climbing stairs, or walking can also be a sign of a breathing problem. Many people simply feel that they are “out of shape,” slowing down, or getting older when, in fact, they are working harder to breathe and this can be a copd sign and symptom.

Persons with chronic obstructive pulmonary disease symptoms have difficulty breathing because they develop smaller air passageways and have partially destroyed alveoli. The air passageways also become clogged with mucus, a slimy substance.

Some other symptoms of COPD include:

• Chronic cough
• Increased sputum (mucus coughed from the airways)
• Shortness of breath
• Limitation of physical activity

If you suspect you may have COPD, your doctor can perform a couple of simple tests to help determine if that is the case.

A spirometer can tell whether your breathing is normal. It takes only a couple of minutes to blow into this machine, which can detect a change in your breathing ability even before you do. Fortunately, many physicians have a spirometer in their offices. The next time you see a doctor, ask for a spirometry test if you think you might have COPD.

Another very simple test can be done with a peak-flow meter. This device measures the openness of the airways or airflow and can detect small changes before symptoms appear. A peak-flow meter can be used to monitor airflow at home or at work.

Once COPD has been diagnosed, recognizing worsening signs and symptoms of Chronic Obstructive Pulmonary Disease (COPD) is an important part of managing your illness. Knowing when symptoms are changing is helpful so that treatment and other interventions can begin quickly. Early treatment is most effective and likely preserves lung function long term. If severe symptoms are present, it is vital to begin the appropriate treatment right away.

III. COPD Causes
In the United States, tobacco use is a key factor in the development and progression of COPD, but asthma, exposure to air pollutants in the home and workplace (like silica dust), genetic factors, and respiratory infections also play a role. In the developing world, indoor air quality is thought to play a larger role in the development and progression of COPD than it does in the United States.

Breathing in other kinds of lung irritants, like pollution, dust, or chemicals over a long period of time may also cause or contribute to COPD.

About 80 percent to 90 percent of COPD cases are caused by smoking, and a smoker is 10 times more likely than a nonsmoker to die of COPD.

IV. COPD Treatment
Treatment of COPD requires a careful and thorough evaluation by a physician. Your physician may perform a number of tests to evaluate your breathing condition and determine if you have COPD. If you are still smoking, your physician will assist you in quitting. Medical treatment cannot reverse permanent damage to the lung tissue; however, in many cases, COPD medications may be prescribed to lessen shortness of breath. As lung damage progresses, the lungs’ ability to transfer oxygen into the blood decreases and oxygen therapy may be necessary.

The most important aspect of treatment is avoiding tobacco smoke and removing other air pollutants from the patient’s home or workplace. Symptoms such as coughing or wheezing can be treated with medication. Respiratory infections should be treated with antibiotics, if appropriate. Patients who have low blood oxygen levels in their blood are often given supplemental oxygen.

Pulmonary rehabilitation, a form of therapy which is often overlooked, may actually be the most beneficial. Research shows that this comprehensive approach to treating COPD results in less shortness of breath, improved functioning and a better quality of life. A pulmonary rehabilitation program utilizes a team of health care professionals working together to develop an individualized program to manage your COPD. This program should include medical management, education, emotional support, exercise, breathing retraining and nutritional counseling.

V. Coping with COPD
By making lifestyle and activity changes, you can take an active role in treating your COPD and help improve your health.

You can resume your regular activities as you feel better, but follow your doctor’s activity guidelines. Increase your activities slowly when your symptoms improve, and always listen to your body so you know when it’s time to take a rest break.

Returning to work
If you have been in the hospital for your COPD, your doctor will tell you how soon you can return to work after you go home. Your return to work will be based on your overall health, symptoms and your rate of recovery.

You should try to work as long as you are able. If you have a job that requires a lot of physical work, you will need to change some of your job-related activities. This may involve job re-training or taking disability.

Talk to your doctor about the type of job you have and your COPD prognosis. Your doctor can help you decide if your job will affect your lung condition and if you need to make changes.

Take care of your emotional health
Your diagnosis of COPD, your symptoms, changes in your energy and your concern for the future may cause you and your loved ones to feel angry, depressed, worried or overwhelmed. Your concerns are normal. As you begin taking charge of your health and making positive changes, you may find these feelings start to fade. However, if negative feelings continue and interfere with your ability to enjoy life, talk to your doctor. Professional counseling might help you feel better.

If you think about suicide or feel worthless or helpless, contact your health care provider or an emergency mental health group right away.

Talk with your doctor
Your doctor will help you manage your health. To make the most of your office visits:

• Make a list of what you want to talk about and write down your doctor’s responses to your questions.

• Keep a diary to record changes in your condition and in how you feel. Bring this with you to your doctor visits.

• Ask about other health services that may benefit you, such as physical therapy, occupational therapy, counseling or a dietary consultation.

Seek COPD support from your family
The support of family and friends is very important. Social support is the single most important buffer against stress. Here are some tips you can offer to your family or friends when they ask you how they can help. Family and friends can:

• Help you remain as active and independent as possible.

• Provide emotional support.

• Help with household chores and with grocery shopping and other errands as necessary.

• Learn what they can about your condition and prescribed treatment by attending doctors’ appointments with you.

• Provide encouragement and help you follow your prescribed treatment plan.

Reduce stress
Stress and anxiety can make you feel short of breath and cause your COPD symptoms to become worse. Shortness of breath can lead to even more anxiety, faster breathing and fear.

You cannot avoid stress; it is part of daily life. However, developing effective ways to manage stress and learning to relax can help you prevent shortness of breath and avoid panic. Here are some ways to manage stress:

• Learn to change thought patterns that produce stress. What you think, how you think, what you expect and what you tell yourself often determines how you feel and how well you manage rising stress levels.

• Practice relaxation exercises. Relaxation exercises are simple to perform and combine deep breathing, releasing of muscle tension and clearing of negative thoughts. If you practice these exercises regularly, you can use them when needed to lessen the negative effects of stress.

• Exercise! It’s an excellent way to burn off the accumulated effects of stress.

• Get enough sleep. If you are not sleeping well, you will have less energy and fewer resources for coping with stress. Developing good sleep habits is very important.

• Follow the recommended nutritional guidelines. Junk food and refined sugars low in nutritional value and high in calories leave you feeling out of energy and sluggish. Limiting sugar, caffeine and alcohol can promote health and reduce stress.

• Delegate responsibility. Stress overload often results from having too many responsibilities. You can free up time and decrease stress by delegating responsibilities. Take a team approach and involve everyone in sharing the load.

You can find more information on living with copd and how to cope with Chronic Obstructive Pulmonary Disease and a list of support groups for COPD at http://copd-support.com/.

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