Chronic obstructive pulmonary disease, commonly known as COPD, has recently become the third leading cause of death in the United States.
Emphysema, chronic bronchitis and a small subset of asthmatic patients represent the categories of COPD, affecting 18 million Americans.
While there is no cure for COPD, it can be managed if it is identified at its early stages. Unfortunately, most people with COPD don’t realize they’re dealing with a disease.
After 20 or 30 years of smoking, people tend to become more sedentary and may attribute limitations to advanced aging, not recognizing they are becoming more disabled by their breathing. A persistent cough that varies from season to season may be written off as a typical bronchitis episode or seasonal allergies, while in reality, a frequent recurring cough is typical of COPD. People who, within a one- or two-year span, have had two or three coughing spells that seem to last for a long period of time should discuss this with their doctor.
In addition to having a history of smoking, some asthmatics with persistent airflow obstruction that progressively worsens and people with occupational hazards including exposure to dust, chemicals and smoke are at risk of developing COPD. A doctor should evaluate people who have persistent coughs or who feel limited by shortness of breath either at rest or with daily activity.
The hallmark test for the disease is spirometry, which measures a person’s airflow as he or she exhales. This simple test is performed in an office setting and takes just a few minutes.
If we don’t see patients early enough, or if they don’t quit smoking at an early enough age, the disease can progress past the point of allowing a significant intervention. We can make a much bigger difference in lung function for those who are diagnosed after 10 years of smoking as opposed to 30. Additionally, we measure smoking in “pack years,” which is arrived at by multiplying the number of cigarettes smoked per day by the number of years a person has smoked. People with a pack year history of 10 or higher are at a greater risk factor for COPD.
Treatments for COPD help reduce exacerbations and hospitalizations. There are a variety of inhalers available that can improve airflow on a day-to-day basis. Anti-inflammatories have been shown to help control asthma, and may assist with COPD. Oxygen therapy also is used.
It’s wise for COPD patients to take preventative steps whenever possible. People with debilitated respiratory status can’t easily handle injuries to their lungs or ribs, so they should always wear seat belts and be otherwise careful to avoid injury. The risk of infections can be reduced by yearly influenza shots and pneumococcal vaccines, as well as by minimizing exposure to people with viral infections.
Having difficulty breathing can lead to a downward spiral of becoming more sedentary, losing muscle strength — particularly respiratory muscle — and becoming more short of breath and more sedentary. Patients should find ways to be active, such as walking regularly.
Pulmonary rehab has been shown to help improve endurance, functional status and reduce symptoms. But by far the most important thing a person can do to improve their chances of managing COPD, is early smoking cessation and to seek early diagnosis and treatment at the very first indication that something may be wrong.
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