More than 12 million people are diagnosed with chronic obstructive pulmonary disease (COPD). But many more may have the disorder and not know it. What are the symptoms to watch out for and how is the disease diagnosed and treated? Here’s what every woman needs to know. Plus, are you ready to quit smoking, a leading cause of COPD?
COPD, or chronic obstructive pulmonary disease, is a disorder that makes breathing difficult and gets worse over time. It’s a major cause of disability, and the fourth leading cause of death in the United States.
The Causes
The term COPD includes two main conditions – emphysema and chronic bronchitis.
In emphysema, the walls between many of the lungs’ air sacs are damaged, causing them to lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. If this happens, the amount of gas exchange in the lungs is reduced.
In chronic bronchitis, the lining of the airways is constantly irritated and inflamed. This causes the lining to thicken. Lots of thick mucus forms in the airways, making it hard to breathe.
COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking or taking care of yourself.
Most cases of COPD occur as a result of 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.
Breathing in secondhand smoke, air pollution and chemical fumes or dust from the environment or workplace also can contribute to COPD.
Most people who have COPD are at least 40 years old when symptoms begin. Although uncommon, people younger than 40 can have COPD. For example, this may happen if a person has alpha-1 antitrypsin deficiency, a genetic condition.
Symptoms to Watch for
The signs and symptoms of COPD include:
An ongoing cough, or one that produces large amounts of mucus (often called “smoker’s cough”)
Shortness of breath, especially with physical activity
Wheezing (a whistling or squeaky sound when you breathe)
Chest tightness
These symptoms often occur years before the flow of air into and out of the lungs declines. However, not everyone who has these symptoms has COPD. Likewise, not everyone who has COPD has these symptoms.
Some of the symptoms of COPD are similar to the symptoms of other diseases and conditions. Your doctor can find out whether you have COPD.
Getting Diagnosed
Your doctor will diagnose COPD based on your signs and symptoms, your medical and family histories, and test results.
They may ask whether you smoke or have had contact with lung irritants.
If you have an ongoing cough, your doctor may ask how long you’ve had it, how much you cough, and how much mucus comes up when you cough. He or she also may ask whether you have a family history of COPD.
Your doctor will examine you and use a stethoscope to listen for wheezing or other abnormal chest sounds.
You also may need one or more tests to diagnose COPD:
Lung function tests measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood.
The main one of these is spirometry. During this painless test, a technician will ask you to take a deep breath in. Then, you’ll blow as hard as you can into a tube connected to a small machine, called a spirometer, that measures how much air you breathe out and how fast you can blow it out.
Your doctor may have you inhale medicine that helps open your airways and then blow into the tube again. He or she can then compare your test results before and after taking the medicine.
Spirometry can detect COPD long before its symptoms appear. Doctors also may use the results from this test to find out how severe your COPD is and to help set your treatment goals.
The test results also may help find out whether another condition, such as asthma or heart failure, is causing your symptoms.
Your doctor may also recommend other tests, such as:
A chest X-ray or chest CT scan. These tests create pictures of the structures inside your chest, such as your heart, lungs and blood vessels. The pictures can show signs of COPD and other conditions, such as heart failure.
An arterial blood gas test. This measures the oxygen level in your blood using a sample taken from an artery. The test can help find out how severe your COPD is and whether you may need oxygen therapy.
How It’s Treated
COPD has no cure yet. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease.
Quitting smoking is the most important step you can take to treat COPD. Talk with your doctor about programs and products that can help you quit.
Many hospitals have programs that help people quit smoking, or hospital staff can refer you to a program. Ask your family members and friends to support you in your efforts to quit. Also, try to avoid secondhand smoke.
Other treatments for COPD may include medicines, vaccines, pulmonary rehabilitation (rehab), oxygen therapy and surgery. Your doctor also may recommend tips for managing COPD complications.
Medicines
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 4-6 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 with an 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 glucocosteroids are used to treat people whose COPD symptoms flare up or worsen. These medicines may reduce airway inflammation.
Your doctor may ask you to try inhaled steroids for a trial period of 6 weeks to 3 months to see whether the medicine helps relieve your breathing problems.
Vaccines
Flu shots: Influenza can cause serious problems for people who have COPD. Talk with your doctor about getting a yearly flu shot.
The pneumococcal vaccine lowers your risk of pneumococcal pneumonia and its complications. People who have COPD are at higher risk of pneumonia than people who don’t have COPD. Talk with your doctor about whether you should get this vaccine.
Pulmonary rehabilitation
This is a medically supervised program that helps improve the health and well-being of people who have lung problems.
Rehab may include an exercise program, disease management training, and nutritional and psychological counseling. The program’s goal is to help you stay more active and carry out your daily activities.
Oxygen therapy
If you have severe COPD and low levels of oxygen in your blood, oxygen therapy can help you breathe better. For this treatment, you’re given oxygen through nasal prongs or a mask.
Surgery
In rare cases, surgery may benefit some people who have COPD. This is usually a last resort for people who have severe symptoms that have not improved from taking medicines.
Bullectomy: When the walls of the air sacs are destroyed, larger air spaces called bullae form. These air spaces can become so large that they interfere with breathing. In a bullectomy, doctors remove one or more very large bullae from the lungs.
In Lung Volume Reduction Surgery, surgeons remove damaged tissue from the lungs. This helps the lungs work better. In carefully selected patients, LVRS can improve breathing and quality of life.
A lung transplant may benefit some people who have very severe COPD. During a lung transplant, your damaged lung is removed and replaced with a healthy lung from a deceased donor.
A lung transplant can improve your lung function and quality of life. However, lung transplants have a high risk of complications. These include infections and death due to the body rejecting the transplanted lung.
Managing Complications
COPD symptoms usually slowly worsen over time. However, a cold, the flu or a lung infection may cause your symptoms to quickly worsen. You may have a much harder time catching your breath. You also may have chest tightness, more coughing, changes in the color or amount of your sputum (spit), and a fever.
Call your doctor right away if this happens. He or she may prescribe antibiotics to treat the infection and other medicines, such as bronchodilators and inhaled steroids, to help you breathe.
Some severe symptoms may require treatment in a hospital.
Living With COPD
COPD has no cure yet. However, you can take steps to manage your symptoms and slow the progress of the disease.
Avoid lung irritants
If you smoke, quit. Many hospitals have programs that help people quit smoking, or hospital staff can refer you to a program.
Try to avoid other lung irritants that can contribute to COPD. Examples include secondhand smoke, air pollution, chemical fumes and dust. (Secondhand smoke is smoke in the air from other people smoking.)
Keep these irritants out of your home. If your home is painted or sprayed for insects, have it done when you can stay away for a while.
Keep your windows closed and stay at home (if possible) when there’s a lot of air pollution or dust outside.
Get emotional support
Living with COPD may cause fear, anxiety, depression and stress. It’s important to talk about how you feel with your health care team. Talking to a professional counselor also can help. If you’re feeling very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life.
Joining a patient support group may help you adjust to living with COPD. You can see how other people who have the same symptoms have coped with them. Talk with your doctor about local support groups or check with an area medical center.
Support from family and friends also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you.
Adapted from “Lung Diseases: COPD” by the National Heart, Lung and Blood Institute, a division of the National Institutes of Health.
For more information, visit our COPD Health Center.
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