COPD (Chronic Obstructive Pulmonary Disease) is a serious lung disease that, over time, makes it hard to breathe. It is the 4th leading cause of death in the United States and causes serious, long-term disability. The number of people with COPD is increasing. More than 12 million people are currently diagnosed with COPD and an additional 12 million likely have the disease and don't even know it.
In people who have COPD, the airways—tubes that carry air in and out of your lungs—are partly blocked, which makes it hard to get air in and out.
When COPD is severe, shortness of breath and other symptoms of COPD can get in the way of even the most basic tasks, such as doing light housework, taking a walk, even washing and dressing.
How does COPD affect breathing?
The "airways" are the tubes that carry air in and out of the lungs through the nose and mouth. Healthy airways and air sacs in the lungs are elastic—they try to bounce back to their original shape after being stretched or filled with air, just the way a new rubber band or balloon does. This elastic quality helps retain the normal structure of the lung and helps to move the air quickly in and out.
In people with COPD, the air sacs no longer bounce back to their original shape. The airways can also become swollen or thicker than normal, and mucus production might increase. The floppy airways are blocked, or obstructed, making it even harder to get air out of the lungs.
Many people with COPD avoid activities that they used to enjoy because they become short of breath more easily.
Symptoms of COPD include:
- Constant coughing, sometimes called "smoker's cough"
- Shortness of breath while doing activities you used to be able to do
- Excess sputum production
- Feeling like you can't breathe
- Not being able to take a deep breath
When COPD is severe, shortness of breath and other symptoms can get in the way of doing even the most basic tasks, such as doing light housework, taking a walk, even bathing and getting dressed.
COPD develops slowly, and can worsen over time, so be sure to report any symptoms you might have to your doctor as soon as possible, no matter how mild they may seem.
Everyone at risk for COPD who has cough, sputum production, or shortness of breath, should be tested for the disease. The test for COPD is called spirometry.
Spirometry can detect COPD before symptoms become severe. It is a simple, non-invasive breathing test that measures the amount of air a person can blow out of the lungs (volume) and how fast he or she can blow it out (flow). Based on this test, your doctor can tell if you have COPD, and if so, how severe it is. The spirometry reading can help your doctor determine the best course of treatment.
How Spirometry Works
Spirometry is one of the best and most common lung function tests. The test is done with a spirometer, a machine that measures how well your lungs function, records the results, and displays them on a graph for your doctor. You will be asked to take a deep breath, then blow out as hard and as fast as you can using a mouthpiece connected to the machine with tubing. The spirometer then measures the total amount exhaled, called the forced vital capacity or FVC, and how much you exhaled in the first second, called the forced expiratory volume in 1 second or FEV1. Your doctor will read the results to assess how well your lungs are working and whether or not you have COPD.
There are many things people at risk for COPD can do:
If you smoke, the best thing you can do to prevent more damage to your lungs is to quit. To help you quit, there are many online resources and several new aids available from your doctor. The National Cancer Institute has information on smoking cessation. Visit SmokeFree.gov, the American Lung Association, or call 1-800-QUIT NOW for more information.
Avoid Exposure to Pollutants
Try to stay away from other things that could irritate your lungs, like dust and strong fumes. Stay indoors when the outside air quality is poor. You should also stay away from places where there might be cigarette smoke.
Visit Your Doctor on a Regular Basis
See your doctor regularly even if you are feeling fine. Make a list of your breathing symptoms and think about any activities that you can no longer do because of shortness of breath. Be sure to bring a list of all the medicines you are taking to each doctor's visit.
Take Precautions Against the Flu
Do your best to avoid crowds during flu season. It is also a good idea to get a flu shot every year, since the flu can cause serious problems for people with COPD. You should also ask your doctor about the pneumonia vaccine.
Am I At Risk?
Most people who are at risk for getting COPD have never even heard of it and, in many cases, don't even realize that the condition has a name. Some of the things that put you at risk for COPD include:
COPD most often occurs in people age 40 and over with a history of smoking (either current or former smokers), although as many as 1 out of 6 people with COPD never smoked. Smoking is the most common cause of COPD-it accounts for as many as 9 out of 10 COPD-related deaths.
COPD can also occur in people who have had long-term exposure to things that can irritate your lungs, like certain chemicals, dust, or fumes in the workplace. Heavy or long-term exposure to secondhand smoke or other air pollutants may also contribute to COPD.
In some people, COPD is caused by a genetic condition known as alpha-1 antitrypsin, or AAT, deficiency. While very few people know they have AAT deficiency, it is estimated that close to 100,000 Americans have it. People with AAT deficiency can get COPD even if they have never smoked or had long-term exposure to harmful pollutants.
Once you have been diagnosed with COPD, there are many ways that you and your doctor can work together to manage the symptoms of the disease and improve your quality of life. Your doctor may suggest one or more of the following options:
Bronchodilators are medicines that usually come in the form of an inhaler. They work to relax the muscles around your airways, to help open them and make it easier to breathe. Inhaled steroids help prevent the airways from getting inflamed. Each patient is different—your doctor may suggest other types of medications that might work better for you.
Your doctor may recommend that you participate in pulmonary rehabilitation, or "rehab." This is a program that helps you learn to exercise and manage your disease with physical activity and counseling. It can help you stay active and carry out your day-to-day tasks.
Physical Activity Training
Your doctor or a pulmonary therapist recommended by your doctor might teach you some activities to help your arms and legs get stronger and/or breathing exercises that strengthen the muscles needed for breathing.
Lifestyle changes such as quitting smoking can help you manage the effects of COPD.
If your COPD is severe, your doctor might suggest oxygen therapy to help with shortness of breath. You might need oxygen all of the time or just some of the time - your doctor will work with you to learn which treatment will be most helpful.
COPD patients with very severe symptoms may have a hard time breathing all the time. In some of these cases, doctors may suggest lung surgery to improve breathing and help lessen some of the most severe symptoms.
Symptoms of COPD can get worse all of a sudden. When this happens, it is much harder to catch your breath. You might also have chest tightness, more coughing or a change in your cough (becomes more productive, more mucus is expelled), and a fever.
When symptoms get worse quickly, it could be a sign of a lung infection. There could be other causes for symptoms getting worse, such as heart disease related to severe lung damage. The best thing to do is call your doctor right away so he or she can find out what the cause of the problem is and take steps to treat it.
When To Get Emergency Help
Seek emergency help if your usual medications aren't working and:
- You find that it is unusually hard to walk or talk (such as difficulty completing a sentence).
- Your heart is beating very fast or irregularly.
- Your lips or fingernails are gray or blue.
- Your breathing is fast and hard, even when you are using your medication.
Be prepared and have information on hand that you or others would need in a medical emergency, such as a list of medicines you are taking, the name of your doctor and his/her contact information, directions to the hospital or your doctor's office, and people to contact if you are unable to speak or drive yourself to the doctor or hospital.