Chronic Obstructive Pulmonary Disease (COPD)

COPD

Chronic obstructive pulmonary disease (COPD) is a term used to describe several different progressive lung diseases characterized by long-term breathing problems and poor airflow. Those afflicted with COPD often produce large amounts of mucus when coughing and have shortness of breath, chest tightness, and other symptoms.

TYPES OF CHRONIC PULMONARY OBSTRUCTIVE DISEASE

Not all types of COPD are the same. Each affects how well different treatments work, how your symptoms affect daily life and how the disease progresses. If you have another health condition in addition to chronic obstructive pulmonary disease, such as high blood pressure, heart disease or diabetes, it can also affect how you manage your COPD symptoms. Because it is progressive, COPD manifests itself through increased breathlessness that will typically worsen over time. Currently, it is incurable, but with the correct diagnosis and treatment, you can manage daily activities, such as walking or getting dressed, and breathe better. People can live for many years with COPD and enjoy life when they get proper care.

Emphysema

In this form, your lungs' tiny air sacs, called alveoli, are damaged. When the walls of the damaged air sacs become stretched, and your lungs get bigger, making it hard to move air in and out. Old air gets trapped inside the alveoli, leaving little or no room for new air. It’s harder to get oxygen in and carbon dioxide out. Emphysema develops over time, causing the lung's air sacs to rupture and creating one big air pocket instead of many smaller ones. This reduction in the lungs' surface area traps air and prevents oxygen from moving through the bloodstream.

Chronic Bronchitis

Another common lung disease classified as an obstructive pulmonary disease is chronic bronchitis. This inflammation of the bronchial airways inside your lungs occurs when the cilia, the tiny, hair-like structures that line the airways, become damaged. Damaged cilia can’t sweep up mucus to keep your airways clean. This makes it harder for you to cough, so your airways are often swollen and clogged, making breathing difficult. The Role of Breathing Exercises in the Treatment of COPD by the American Academy of Family Physicians (AAFP) notes that "Patients with COPD who are treated with breathing exercises versus standard care showed an improvement in exercise capacity, with inconsistent changes in dyspnea and health-related quality of life."

Refractory (Non-Reversible) Asthma

Patients have refractory asthma when they experience persistent symptoms, frequent attacks or low lung function despite taking medications. In an asthma attack, bronchial airways tighten and swell. Medications can usually reverse this by returning the airways to normal. In refractory asthma, medications cannot reverse the tightening and swelling. Some patients must take oral steroid tablets like prednisone to help manage their asthma.

COPD TYPICAL SYMPTOMS AND SIGNS

It’s easy to think that shortness of breath and coughing are a normal part of aging, but these could be signs of COPD. The disease can progress for years without noticeable shortness of breath. Common symptoms differ among patients, but early signs include:

• Increased shortness of breath
• Coughing with sputum production
• Wheezing or chest tightness
• Recurring lung infections like acute bronchitis or pneumonia

Tobacco smoking is the leading cause of COPD, resulting in about 85 to 90 percent of cases. When a cigarette burns, it creates chemical fumes from more than 7,000 substances, many of which are harmful. The toxins in tobacco smoke weaken your lungs’ defense against infections and cause an inflammatory response, resulting in the narrowing of the small airways and the breakdown of lung tissue. Only about 20 to 30 percent of smokers develop COPD. The majority have other types of lung damage, including lung cancer, which is why it is essential to get a complete evaluation if you have difficulty breathing.

Environmental factors, such as the air you breathe daily at work, home and outside, can also play a role in developing COPD. Long-term exposure to air pollution, secondhand smoke and dust, fumes and chemicals and workplace exposure to other irritants can cause COPD. Even fumes from cooking and heating in poorly ventilated buildings can contribute to chronic obstructive pulmonary disease.

Alpha-1 deficiency causes a rare form of COPD that affects a small number of people. This form of emphysema is caused by a genetic condition that affects the body’s ability to produce the Alpha-1 protein, affecting the lungs. The protein is made in the liver and travels to the bloodstream to protect the lungs. Patients who have this type of COPD often have liver problems as well.

DIAGNOSIS

Doctors frequently misdiagnose chronic obstructive pulmonary disease, so often, patients do not get a definitive diagnosis until they have severe COPD. Most diagnoses use a breathing test called spirometry to determine poor airflow.  In contrast to asthma, the airflow reduction does not improve much with a bronchodilator.

Tests may include:

• A lung function test measures how much air you can inhale and exhale and if your lungs deliver enough oxygen to your blood. Spirometry is a simple breathing test and can often detect COPD before you have symptoms. Other lung function tests include measures of lung volumes, diffusing capacity and pulse oximetry
• Chest X-ray, which can show emphysema and rule out other lung problems or heart failure
• Arterial blood gas analysis that measures how well your lungs bring oxygen into your blood and remove carbon dioxide

COMPLICATIONS FROM COPD

Patients with COPD can suffer a variety of complications. You may experience:

• • Increased respiratory infections such as colds, pneumococcal pneumonia and the flu, making it even more difficult to breathe
  • An increased risk of heart disease, including heart attack
  • An increased risk of lung cancer
  • High blood pressure in the arteries of the lungs
  • Depression, if you can’t do normal activities

PREVENTION AND TREATMENT

Reducing exposure to risk factors can prevent most cases of COPD. While treatment can slow worsening, there is no cure. The most essential step in prevention and any treatment plan is to stop smoking, as it can eventually reduce your ability to breathe.

Other treatments include vaccinations, pulmonary rehabilitation programs that combine education, exercise, nutrition advice and counseling and medications such as bronchodilators, inhaled or oral steroids, combination inhalers, theophylline and antibiotics to reduce inflammation. Some people may benefit from long-term oxygen therapy or lung transplantation. Patients who have periods of acute respiratory infection may require increased use of medications and hospitalization as needed.

Dr. Kaur at VIVAA will discuss all the risk factors involved and then develop a personalized plan to help relieve symptoms and prevent the progression of COPD. She can help patients quit smoking with the help of medications and patches that, in turn, will slow down the worsening of COPD and possibly avoid severe lung damage. She aims to get people back to normal activity levels without shortness of breath.

Contact us today for a no-obligation consultation on treating COPD by calling 425-250-9999 to learn how we can serve your needs.