COPD:  What You Should Know

By Alan S. Peterson, M.D.

What is COPD?

Chronic Obstructive Pulmonary Disease, or COPD, is a lung disease that makes it hard for you to breathe. Over time, your lungs become irritated or damaged. Mucus may block the airways. This makes it hard for air to get through. The air sacs in the lungs may become stiff and unable to hold enough air. Many times the air sacs lose their boundaries and small functional air cells become large sacs that cannot transfer oxygen and carbon dioxide properly. 

Who gets COPD and why?

COPD is usually caused by smoking. It takes time to develop. Most people with COPD are smokers older than 40 years of age. Younger people can also get COPD. You may be at risk if you have been exposed to fumes, smoke, or dust for a long time. There are also genes that can be inherited that increase your chances of developing COPD, even without any of the risk factors mentioned previously. 

How do I know if I have COPD?

COPD develops slowly, so you could have it for many years before you notice symptoms. The most common symptoms are coughing, wheezing, and being short of breath (feeling like you cannot get enough air). If you have a cough or a wheeze for at least three months, you may have COPD. You should certainly see your family physician or primary care provider by that point. But shortness of breath or cough that last a long time can also be caused by other diseases, such as allergies, asthma, cancer, and heart problems.

How can my doctor tell if I have COPD?

Your doctor may do a breathing test called spirometry. Sometimes a chest x-ray is also indicated. On occasion a CT or CAT scan of your lungs might be needed.

How is COPD treated?

Your doctor may give you medicines that you can breathe into your lungs for your COPD. Medicines called bronchodilators relax the muscles around your airways to help your air get through. Medicines called steroids help stop the irritation in your airways. Those that are inhaled have fewer side effects than those that are taken orally such as prednisone. Unfortunately sometimes oral steroids are needed in the more severe cases. Extra oxygen can help if you have very bad COPD. Contact your doctor right away if your symptoms suddenly get worse. 

What should I do if I get COPD?

 If you have COPD, follow these steps:

• 1. Quit smoking. If you don’t quit, you will keep damaging your lungs. Even second hand smoke from others can make your symptoms worse. Some symptoms can improve once you stop smoking. Unfortunately many can remain also.
• 2. Exercise every day. You can start by walking 20 minutes a day. Ask your doctor to help you make an exercise plan. For those with severe COPD, pulmonary rehabilitation can also be helpful.
• 3. Eat a healthful diet. If you are overweight, losing weight may help your symptoms. Ask your doctor to help you make a diet plan. Obviously a dietary consult can also be very helpful, if you are interested in trying to lose weight.
• 4. Take your medicines as directed. At least 3-4 times a year, talk to your doctor or pharmacist about how to take your medicines. Most physicians prefer that you take your medicines to every visit that you have. It is amazing how many patients and physicians think they know what they are taking, only to find out when the medicines are taken to the visit that there is confusion.
• 5. Get a flu shot every year and a pneumonia shot. If you got a pneumonia shot before age 65 and it has been at least 5 years since you got that shot, another shot should be obtained as long as you are now over 65 and five years have passed since the first shot. There is controversy about whether other patients with increased risk of pneumonia should get a second pneumonia shot ten years after the first. Some physicians feel that in those with COPD that a second shot is indicated even though they may not have received one before age 65. 

Where can I get more information?