COPD (chronic obstructive pulmonary disease) is a disorder of lung function characterized by shortness of breath, cough, and sputum production.
Almost always associated with smoking, COPD has been an increasing cause of both death and disability over the past several decades. In this condition, the lungs and its airs sacs and airway become damaged and narrowed over time, leading to obstruction to airflow, and inefficient oxygen transport into the blood stream. The two most common subtypes of COPD are emphysema (with the major damage affecting the air sacs) and chronic bronchitis (with the major damage affecting the airways).
80 percent of COPD patients have a significant history of tobacco smoking; many others have a history of second hand exposure. The particles and irritants inhaled injure lung tissue and cause inflammation. With chronic exposure, this inflammation leads to scarring and the replacement of normal delicate tissue with denser, non-functioning areas.
If you have shortness of breath, cough and/or sputum production on a chronic basis, and a history of exposure to cigarette smoke, you should consult your primary care provider. After a careful history and physical examination, (s)he may recommend further testing, in particular a pulmonary function test (PFT). In this non-invasive test a patient goes through a number of breathing maneuvers, and airway flow and speed is measured.
The foundation of therapy for COPD is tobacco cessation. No matter how much damage has been caused, scientific studies show it is never too late to stop. Whether by will power alone, or with the aid of medication, this is an essential step in the care of the COPD patient. Another mainstay is following vaccination protocols, particularly with an annual influenza vaccine and an initial pneumococcal pneumonia vaccine.
There is no cure for this condition, but there are a number of medications which provide symptomatic relief and an improved life style. “Bronchodilators” are inhaled agents that work by dilating, or opening up, damaged airway. Steroids, either inhaled or oral, act by decreasing lung inflammation.
Patients with COPD are at risk for intermittent worsening of their condition (exacerbations of COPD), which are usually caused by infections. Because of other smoking related illnesses, particularly heart disease, such exacerbations are often serious and require hospitalization.
In severe cases, patients may require temporary breathing support through the use of a ventilator-a machine hooked to a tube which is placed through the mouth and down the main airway (trachea). As disease progresses, there is a small risk that a patient will become dependent on this machine, and require it to maintain their life. An important, although difficult, issue for all patients with COPD to discuss with their primary care physician is who should make medical decisions in this situation (i.e. the designation of a health care proxy). In addition, the patient’s own wishes re ventilator support should be discussed.
For an appointment with a NuHealth pulmonary (lung) specialist in COPD, please call 516-572-6262.
