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Living with COPD

Created date

August 23rd, 2011

Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease in which the lung is damaged, making it hard to breathe. COPD refers to a group of conditions, including emphysema, chronic bronchitis, or a combination of both. COPD has replaced stroke as the third leading cause of death in the U.S. behind heart disease and cancer, according to the Centers for Disease Control and Prevention (CDC).

The disease process

Cigarette smoking is the most common cause of COPD. Smoking or being in occupations in which you were exposed to dust, fumes, asbestos, or other airborne particles can all damage lung tissue, says Austin Welsh, M.D., medical director at Tallgrass Creek, an Erickson Living community in Overland Park, Kans. Pipe, cigar, and other types of tobacco smoking can also cause COPD, as can secondhand smoke. According to the CDC, genetics or having recurrent infections may also play a role. The changes that lead to COPD typically begin in your 40s or 50s, but you probably won t notice. By the time you have symptoms, the disease process has already started, Welsh says. With COPD, less air gets in and less air goes out of the airways. The air sacs in your lungs start to lose their elasticity or deteriorate and you don t have as many available to help your lungs exchange oxygen, Welsh says. As a result, you have to work harder to get air in and out. When the disease is advanced, shortness of breath and other symptoms can get in the way of even the most basic tasks, such as doing light housework, taking a walk, even washing and dressing. It can be much harder to walk even for a short distance like you used to, Welsh says. You have to slow down and pace yourself.

Treatment can help

Quitting smoking is the best strategy to prolong your life if you have COPD, says Richard Castriotta, M.D., director of the Division of Pulmonary and Sleep Medicine at the University of Texas Health Science Center at Houston (UTHealth) Medical School. The mainstay of treatment is the use of supplemental oxygen, which can add years to your life but only if it s medically determined that you need it, Castriotta continues. Using oxygen when it s not necessary may be of no benefit or can harm you. People with COPD tend to need oxygen when they re physically active, but some also need it when they re sleeping because oxygen levels decrease during sleep even in healthy people, Castriotta adds. In advanced stages of the disease, some people benefit from assistive devices at night that can relieve tired breathing muscles. These can be non-invasive positive pressure ventilation (NPPV) or proportional positive airway pressure (PPAP), in which air is delivered through a mask. Having to use oxygen is easier than it used to be. New lightweight devices are available that don t require refilling and are easy to carry.

Medications and surgery

When it comes to medications, inhaled medications tend to be more helpful than pills, according to Castriotta. Medications can certainly improve your quality of life by relieving symptoms such as shortness of breath, and reducing exacerbations of the disease, he explains. Surgery for COPD is not as common as it used to be. Lung volume reduction surgery, in which damaged lung tissue is removed, has not been shown to be particularly beneficial and may even increase the risk of death in some people, Castriotta says. In rare cases, a lung transplant is indicated for severe cases of COPD. It can improve how well someone functions, but there s no proof that a transplant will prolong life, he adds.

What to do to help yourself

Pulmonary rehabilitation can go a long way to improve your fitness and function in your daily life, Castriotta says. A pulmonary rehabilitation team is a group of health care professionals that can include doctors, nurses, respiratory therapists, physical therapists, occupational therapists, exercise therapists, a sociologist, social workers, and dietitians who work together with you and your doctor. It s a series of supervised exercises and training, and education and behavior modification techniques that teach you how to live better with the disease, Castriotta explains. Preventing exacerbations is an important part of treatment. People with COPD should get a flu shot every year, Castriotta advises. It can reduce the chance of a hospitalization due to pneumonia or a worsening of your disease. And although some people with COPD are afraid to be active, there s no need to fear exercise. People with COPD should get as much activity as possible, Castriotta says. A pulmonary rehabilitation team can help you determine what level of activity is safe for you. Castriotta says that research has shown that simply walking every day may add years to your life, even if you have COPD. Walk slowly and don t work up a sweat, he says. You can be tested to find out how much oxygen you need during exercise, and when you sleep. To stay as functional as possible, Welsh advises that you keep regular appointments with your pulmonologist, have regular testing such as pulmonary function tests to check how your disease is progressing, stick to your medication schedule, and stay active.