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Don't Let COPD Take Your Breath Away

November 20, 2012

Are you bothered by a chronic, nagging cough? Do you find yourself short of breath while performing everyday activities? Are you easily fatigued? Do you struggle with frequent respiratory infections? If so, you may be one of the millions of Americans with chronic obstructive pulmonary disease (COPD).

"COPD is a progressive disease that makes it difficult to breathe," says Sherry Harrington, RCP, co-coordinator of the Pulmonary Rehabilitation Program at Washington Hospital. "As the disease gets increasingly worse, it gets more and more difficult to breathe, and it becomes harder to live a normal life. Unfortunately, COPD even can cause long-term disability and early death."

November is National COPD Awareness Month. According to the American Lung Association, COPD is the third-leading cause of death in the U.S. More than 12 million people in the U.S. are known to have COPD. Up to 12 million more Americans may have the disease without realizing it since the symptoms of COPD develop slowly over time.

"Sometimes when people are older, they assume that COPD symptoms such as fatigue and shortness of breath are just signs of aging, and they ignore those symptoms until the disease is more advanced," explains Rose Stortz, RCP, who co-coordinates the Pulmonary Rehabilitation Program with Harrington. "People who have symptoms of COPD should consult their doctor and request a pulmonary function test because there are many ways to treat and manage the disease, especially when it is found early."

COPD can include chronic bronchitis or emphysema, with most people having a combination of both conditions. In chronic bronchitis, the linings of the air passages in the lungs become inflamed, usually following a respiratory infection, producing mucus secretions and coughing. In emphysema, there is progressive damage to the air sacs (alveoli) in the lungs, and air gets trapped in the lungs.

"People with COPD also are more prone to getting respiratory infections such as the flu and pneumonia, which can make symptoms worse," Stortz says. "That's why getting flu and pneumonia immunizations are especially important for people who have COPD."

Harrington notes that the primary cause of COPD is smoking. "The more you smoke, and the longer you smoke, the more likely you are to develop COPD," she says. "Second-hand smoke also can cause COPD, as can heavy air pollution and exposure to irritating dusts or chemicals in the workplace. There also is a genetic form of COPD that causes emphysema, but is extremely rare."

Diagnosis and Treatment of COPD

The basic test for COPD is a lung function test known as spirometry. The patient blows air out as hard as possible into a small machine that measures the amount of air and the speed of the airflow. Chest X-rays and CT scans or blood tests to measure the amounts of oxygen and carbon dioxide in the blood might also be helpful in diagnosing COPD.

While there is no cure for COPD, various lifestyle changes and medical treatments can relieve the symptoms and slow the progression of the disease. Joining a support group such as the Better Breathing for Life Club at Washington Hospital also can help people with COPD learn how to cope with their illness.

"First and foremost, if you smoke, get the help you need to stop," Harrington says. "You also should avoid second-hand smoke, and make sure no one smokes in your home. In addition, there are various medications that can be used to help manage COPD, including oral steroids, bronchodilators to open the airways and inhaled steroids to reduce lung inflammation. In some cases, COPD patients may need oxygen therapy if they have a low level of blood oxygen. People who are supposed to be on oxygen need to use it faithfully. Otherwise the disease can progress more rapidly."

Patients with suspected or confirmed COPD should contact their physicians to see if they are a candidate for the Pulmonary Rehabilitation Program.

"A diagnostic test called a Pulmonary Function Test (PFT) is used to determine if a patient qualifies for Pulmonary Rehabilitation. This test usually takes about an hour and a half," Harrington says. "Most health insurance plans cover this test. The PFT is also routinely done to monitor disease progression."

The Pulmonary Rehabilitation Program entails a two-hour session, twice a week for a two-month period. Medicare now allows patients to participate in pulmonary rehabilitation only once over their lifetime, but patients who took part in such a program prior to 2010 may be able to repeat the program.

"We help our patients learn effective breathing techniques and muscle re-training exercises," Harrington explains. "We also encourage them to incorporate more exercise into their daily lives. Building up their strength helps their lungs and hearts work more efficiently. We take 'baby steps' with them and start slowly. Sometimes they are surprised at what they can do after just a few weeks."

Harrington and Stortz also counsel their patients in other ways to maintain their health and avoid respiratory infections such as colds and the flu that can be more serious for people with COPD.

"All the general precautions for avoiding illness are even more important for people with COPD," Stortz says. "Get plenty of rest. Drink lots of fluids. Eat a healthy diet. Exercise regularly. Wash your hands frequently and stay away from sick people. If you have allergies or asthma, make sure you follow your doctor's treatment plan and take any medications as prescribed."

"If you have COPD and you do develop a respiratory infection in spite of everything, don't wait to see your doctor," she emphasizes. "Treating the illness quickly can help prevent serious complications."

For more information about the Pulmonary Rehabilitation Program at Washington Hospital, visit www.whhs.com/pulmonary-rehabilitation/ or call 510-494-7025. For information about the Better Breathing for Life Club, Washington Hospital's support group for people with chronic lung diseases including COPD, call 510-494-7025.