Bouts of breathlessness during a walk, a nagging cough that won't go away--what can start as minor annoyances can turn into a life-altering condition for people with chronic obstructive pulmonary disease (COPD). We interviewed Ricardo Gomez, MD, a board-certified pulmonologist at St. Mary High Desert Medical Group, who explains what you should know about the disease that affects an estimated 24 million Americans and is the third-leading cause of death in this country, according to the American Lung Association.
Q. What is COPD?
A. This term refers to progressive lung diseases, most commonly emphysema and chronic bronchitis. The lungs and airways become damaged or inflamed, and the end result is increased difficulty in breathing--and with COPD, that difficulty only gets worse as the disease advances. COPD is different from asthma--while some people who have asthma can also have COPD and there are similar symptoms, the two conditions can have different root causes and treatment plans. Triggers for the two conditions are different as well: for asthma, it's allergens and exercise, while for COPD it's respiratory infections and cigarette smoke. Finally, asthma generally first appears in childhood, while COPD is diagnosed in middle age.
Q. What causes COPD?
A. The great majority of COPD patients--about 90 percent--have a history of smoking. COPD can also be caused by long-term exposure to chemicals and dust, usually in the workplace, as well as secondhand smoke. A smaller number of COPD patients have a genetic disposition to the disease.
Q. What are the symptoms?
A. The main COPD symptom is trouble breathing, which includes wheezing, shortness of breath or a constricting feeling in the chest. A lasting cough with phlegm is another sign; COPD sufferers may feel lethargic, lose weight or be prone to respiratory infections.
Q. What do I do if I think I have COPD?
A. Because the symptoms appear after the disease has already started progressing, a doctor's visit should be scheduled as soon as possible. Also, anyone with a history of smoking, heavy exposure to pollutants, or a family history of COPD should visit their doctor to be tested. The earlier the disease is caught, the more effective symptom control and lung function preservation can be.
Q. How does a doctor diagnose COPD?
A. The doctor should take a complete patient health history to see if there are any of the common risk factors for COPD. The doctor can also perform a breathing test called spirometry or pulmonary function testing to diagnose COPD; a CT scan of the lungs or a chest x-ray may also be done. These tests can also help determine if asthma is a possibility.
Q. How does COPD affect the body?
A. If left untreated, the breathing problems can hamper any aspect of daily life that requires exertion, from exercising to household chores to running errands. In addition, patients with COPD can find themselves at increased risk for heart issues, high blood pressure and respiratory infections, among other health problems. COPD can also affect a patient's emotional health, with possible feelings of depression as the complications of the disease affect normal life.
Q. Is COPD curable?
A. There is no cure for COPD at this time. Unlike asthma, where full lung function can be restored, COPD means a progressive decline. However, there are several medication options that can make living with the disease manageable.
Q. What are those treatment options?
A. Treatment plans are tailored to each patient. They can include:
- Medication. There are long-term, controller medications, as well as short-term ones, such as rescue inhalers, designed for use during intense episodes of breathlessness. Medications can include bronchodilators, which keep the lungs' airways open by relaxing the surrounding muscles, and corticosteroids, which reduce inflammation. Medication can be taken via pill, inhaler or nebulizer, which turns liquid medicine into a mist that can be breathed in.
- Oxygen therapy. A doctor may prescribe supplementary oxygen--the equipment and dosage instructions will vary, depending on the patient's condition and lifestyle. There are oxygen systems that can be used at home as well as portable equipment.
- Breathing techniques. The two most common ones involve belly breathing, which uses the diaphragm to support the lungs in their work, and pursed-lips breathing, which slows down the breath pattern and can help open up the airways. The doctor should give specific instructions for both methods to make sure the patient does them correctly.
- Pulmonary rehabilitation. In this treatment plan, patients receive guidance on exercise, nutrition and COPD management, among other topics, from a team of specialists. Support groups can also be a key component of pulmonary rehabilitation.
- Good hygiene. Because COPD sufferers are more vulnerable to respiratory infection, a cold or flu can result in what's called acute exacerbation--COPD symptoms get worse, and can be accompanied by fever, swollen feet and ankles or tiredness. To avoid a potential hospital stay, COPD patients should wash their hands with soap and hot water, and avoid close contact with people who are sick.
Q. Can people with COPD still live a full life?
A. Yes, if it's diagnosed earlier rather than later, and if the treatment plan is followed as instructed. So it's important to know the symptoms, or be proactive in getting tested for COPD if a risk factor is present. And of course, one of the best ways to avoid getting COPD altogether is to abstain from or stop smoking. A doctor can help recommended a smoking-cessation program for people who have trouble quitting.