MANAGING CHRONIC ILLNESS: COPD

What is COPD?

Chronic obstructive pulmonary disease (COPD) is a group of long-term, irreversible diseases that make it difficult to breathe because air does not flow easily out of the lungs. Over time, COPD worsens and may lead to severe shortness of breath, heart problems, and death.

Causes of COPD

Most cases of COPD develop after long-term exposure to lung irritants that damage the lungs and the airways. In the United States, the most common irritant that causes COPD is cigarette smoke. Pipe, cigar, and other types of tobacco smoke also can cause COPD, especially if the smoke is inhaled. Secondhand smoke — that is, smoke in the air from other people smoking — also can irritate the lungs and contribute to COPD.

Breathing in air pollution and chemical fumes or dust from the environment or workplace also can contribute to COPD. Other lung irritants that are inhaled over a long period of time—such as secondhand smoke, air pollution, industrial dust, and chemical fumes—are believed to contribute to COPD.

In rare cases, a genetic condition called alpha-1 antitrypsin deficiency may play a role in causing COPD. People who have this condition have low levels of alpha-1 antitrypsin (AAT)—a protein made in the liver. Having a low level of the AAT protein can lead to lung damage and COPD if you're exposed to smoke or other lung irritants. If you have this condition and smoke, COPD can worsen very quickly.

Bronchitis and Emphysema

The two diseases that generally are associated with COPD are chronic bronchitis and emphysema. In chronic bronchitis, inflammation occurs in the tubes that carry air to the lungs (bronchial tubes), narrowing the bronchial tubes and making it hard to breathe. The main symptom of chronic bronchitis is a cough that brings up mucus (sputum). In emphysema, lung tissue and the tiny air sacs (alveoli) at the end of the bronchial tubes are damaged, trapping air in the lungs. This leads to shortness of breath, the main symptom of emphysema.

Quit Smoking

COPD cannot be cured, but it can be managed. The only reliable way to slow the disease is to stop smoking.

Lifestyle Changes

Lifestyle changes, such as exercising, doing breathing exercises, and taking rest breaks, may help reduce symptoms.

Medications for COPD

Medications may reduce or relieve symptoms. Bronchodilators relax the muscles around your airways. This helps open your airways and makes breathing easier. Depending on how severe your disease is, your doctor may prescribe short-acting or long-acting bronchodilators. Short-acting bronchodilators last about 4 to 6 hours and should be used only when needed. Long-acting bronchodilators last about 12 hours or more and are used every day. Most bronchodilators are taken using a device called an inhaler. This device allows the medicine to go right to your lungs. Not all inhalers are used the same way. Ask your health care team to show you the right way to use your inhaler. If your COPD is mild, your doctor may only prescribe a short-acting inhaled bronchodilator. In this case, you may only use the medicine when symptoms occur. If your COPD is moderate or severe, your doctor may prescribe regular treatment with short- and long-acting bronchodilators.

Inhaled Glucocorticosteroids (Steroids). Inhaled steroids are used for some people who have moderate or severe COPD. These medicines may reduce airway inflammation (swelling). Your doctor may ask you to try inhaled steroids for a trial period of 6 weeks to 3 months to see whether the medicine is helping with your breathing problems.

If you suffer from COPD, be sure to keep up with vaccines and flu shots. The flu (influenza) can cause serious problems for people who have COPD. Flu shots can reduce your risk for the flu. Talk with your doctor about getting a yearly flu shot. The Pneumococcal Vaccine lowers your risk for pneumococcal pneumonia (nu-MO-ne-ah) and its complications. People who have COPD are at higher risk for pneumonia than people who don't have COPD. Talk with your doctor about whether you should get this vaccine.