Chronic obstructive pulmonary disease, better known as COPD, is the third-leading cause of death in the U.S., according to the American Lung Association. It affects about 25 million Americans.
COPD, a lung disease that gets worse over time, includes chronic bronchitis and emphysema. It causes the airways in the lungs to become inflamed and thicken, and the tissue where oxygen is exchanged is destroyed.
“Many times, the first time a COPD patient is seen is in the emergency room with a flare-up,” said Dr. Mei Lan Han, associate professor of internal medicine in the Division of Pulmonary and Critical Care at the University of Michigan Health System and a volunteer spokesperson for the American Lung Association. “They can’t breathe and they don’t know why. They didn’t know they had it.”
That’s because patients often overlook symptoms like shortness of breath, chronic cough, and wheezing, and write them off as due to getting older, smoker’s cough, or being out of shape.
Even if you’re self-aware and go to the doctor, not every person presenting with symptoms is screened, Han said.
“Your physician will consider risk factors, such as smoking, exposure to secondhand smoke, having a dusty, dirty job, or chronic bronchitis,” Han said.
If you are at risk for COPD, your physician will give you a test to see how well your lungs work, Han explained. You will blow air into a machine called a spirometer. The machine measures the amount of air you blow out and how fast.
“If your airflow is obstructed, you won’t be able to get air out as quickly as normal people,” Han said.
Although it’s often not diagnosed until a person is a senior citizen, COPD can start as early as your 30s, she said. It even can start in childhood if you have repeated respiratory infections that are treated with antibiotics or are around secondhand smoke. Early detection is important.
Treating the Disease
All medications are not created equal, and proper medications are prescribed on a case-by-case basis.
Many times, bronchodilators are used to reduce inflammation and reduce the risk of future flare-ups, according to Han. Anticholinergics are prescribed, as well, to prevent muscles around the airway from tightening.
A combination of these medications can be added to one inhaler or nebulizer solution.
For some people diagnosed with COPD, lifestyle changes are necessary.
“If you smoke, stop,” Han said.
Dietary changes may also be required, and proper exercise is important.
In most cases, patients are prescribed pulmonary rehabilitation. This takes place in a hospital or clinic and can include exercise training, nutritional counseling, education, breathing strategies, and support groups, according to the National Heart, Lung and Blood Institute.
“Rehab includes aerobics and strength training,” Han added. “When you have impaired lungs, you can train to close-to-normal capacity.”
Living With COPD
As with many chronic illnesses, COPD patients suffer a higher rate of depression than most people.
“People have a tendency to compare themselves and their capabilities to who they were before and what they could do,” said Barry Jacobs, director of behavioral sciences for the Crozer-Keystone Family Medicine Residency in Springfield, Pennsylvania. “COPD patients now feel confined by a disease that tethers them to an oxygen tube and greatly saps their energies. They often also feel guilty for smoking for many years.”
“It’s normal to feel despair,” added Jane Martin, assistant director of education at the COPD Foundation. “Someone who used to be a firefighter now can’t walk from the chair to the bathroom. They feel washed up and useless.”
Jacobs said these people may benefit from “counseling that encourages them to be present, not future, focused.” And they’re encouraged to find “ways of enjoying the capabilities they still retain, and to forgive themselves for past behavior.”
Volunteering to do something that isn’t physically taxing can also help you get over that feeling of uselessness, Martin said.
“You can give someone a ride to the doctor, or you can volunteer in an elementary school to listen to a child read,” she said.
More than depression, anxiety can be overwhelming.
“People are literally terrified that they won’t be able to breathe and others won’t be able to help them,” Jacobs said. “They can gain anxiety relief from progressive muscular relaxation and visualization.”
The most important thing to remember is that you’re not alone.
“Your feelings are normal, and other people feel the same way,” Martin said. “You can join a local or an online support group… Education is key. The more you know about what you are dealing with, the easier it is to cope.”