If you have ever smoked cigarettes, you are at a high risk for chronic obstructive pulmonary disease (COPD)—a leading cause of death in the United States. COPD is a serious lung disease that makes it hard to breathe. Symptoms include shortness of breath, a constant cough, and wheezing.
What causes COPD?
Long-term exposure to lung irritants that damage airways and lungs are the most common causes of COPD. 75% of people who have COPD smoke or have smoked during their life. Cigarette smoking is the most common irritant, followed by pipe, cigar and other types of tobacco smoke, especially if the smoke is inhaled. People who have a family history of COPD are more likely to develop the disease if they smoke.
Secondhand smoke, air pollution, or chemical fumes or dust from the environment or workplace can also contributed to COPD. Please do not smoke in your home or car with children present. You are only increasing their risk of developing this deadly disease.
Though rare, a genetic condition called alpha-1 antitrypsin (AAT) deficiency may also be a cause of COPD. People with this condition have low blood levels of AAT which is a protein made in the liver. If you have this condition and couple it with smoking, COPD can worsen very quickly.
Those with asthma can also develop COPD, but with treatment, inflammation and narrowing of the airways can be reversed.
What are the symptoms of COPD?
Most people who have COPD are at least 40 years old when symptoms begin. Although uncommon, people younger than 40 can have COPD. This may occur, for example, if a person has a health issue, such as the AAT deficiency. In the beginning stages of COPD, symptoms may be mild or even absent. As the disease progresses, symptoms usually become more severe. Common signs and symptoms include:
- An ongoing cough or a cough that produces a lot of mucus; this is often called smoker’s cough
- Shortness of breath, especially with physical activity
- Wheezing or a whistling or squeaky sound when you breathe
- Chest tightness
- More prone to colds and or other respiratory infections such as the flu
Not everyone who has the symptoms described above 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.
Sometimes, simple changes to your lifestyle may help make breathing easier. You may opt to take the elevator rather than use the stairs. But over time, the symptoms won’t go away and they will only get worse and become severe enough for you to see a doctor.
Once you do see a doctor, there’s a simple breathing test, called spirometry, for COPD. It’s fast and painless. You take a deep breath and blow as hard as you can into a tube connected to a small machine, called a spirometer. The machine measures how much air you breathe out. It also measures how fast you can blow air out.
Based on this test, your health care provider can tell whether you have COPD. The test also shows how severe it is. Health care providers who specialize in lung rehab can work with you to help you breathe better and stay more active.
If you keep smoking, the damage from COPD will occur faster than if you stop smoking. In severe cases of COPD, you can have symptoms such as:
- Swelling in the ankles, feet, or legs
- Weight loss
- Lower muscle endurance
- Weight loss; and lower muscle endurance
The most severe symptoms may require treatment in a hospital. You should seek emergency care if you are experiencing the following:
- You are having a hard time catching your breath or talking
- Your lips or fingernails turn blue or gray, a sign of a low oxygen level in your blood
- People around you notice that you are not mentally alert
- Your heartbeat is very fast
- The recommended treatment for symptoms that are getting worse is not working
How do you treat COPD?
There is no cure for COPD, but with medications, you can breathe a little easier.
Bronchodilators relax the muscles around your airways. This helps open your airways and makes breathing easier. Depending on the severity of your COPD, 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 using a device called an inhaler. This device allows the medicine to go straight to your lungs. Not all inhalers are used the same way. Ask your health care providers to show you the correct 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 use the medicine only when symptoms occur.
If your COPD is moderate or severe, your doctor may prescribe regular treatment with short- and long-acting bronchodilators.
In general, using inhaled steroids alone is not a preferred treatment. If your COPD is more severe, or if your symptoms flare up often, your doctor may prescribe a combination of medicines that includes a bronchodilator and an inhaled steroid. Steroids help reduce airway inflammation.
Your doctor may ask you to try inhaled steroids with the bronchodilator for a trial period of 6 weeks to 3 months to see whether the addition of the steroid helps relieve your breathing problems.
Pulmonary rehabilitation is a broad program that helps improve the well-being of people who have chronic breathing problems. Rehab may include an exercise program, disease management training, and nutritional and psychological counseling. The program’s goal is to help you stay active and carry out your daily activities.
Your rehab team may include doctors, nurses, physical therapists, respiratory therapists, exercise specialists, and dietitians. These health professionals will create a program that meets your needs.
If you have severe COPD and low levels of oxygen in your blood, oxygen therapy can help you breathe better. For this treatment, oxygen is delivered through nasal prongs or a mask.
You may need extra oxygen all the time or only at certain times. For some people who have severe COPD, using extra oxygen for most of the day can help them:
- Do tasks or activities while experiencing fewer symptoms
- Protect their hearts and other organs from damage
- Sleep more during the night and improve alertness during the day
- Live longer
Keeping up with vaccinations is very important for patients with COPD due to the risk for more severe complications. Talk to your doctor about getting the flu shot and the pneumococcal pneumonia vaccines.
Can you prevent COPD?
Yes. The best way to prevent COPD is to not start smoking in the first place. If you are a smoker, it’s ever too late to stop. Tried quitting in the past? Try again. Many people who have trouble quitting on their own find support by joining a group with other smokers who are also trying to quit. Many hospitals, workplaces, and community groups offer classes to help people quit smoking. Talk to your doctor about programs and products that can help you quit, too. Asking your family and friends to support your efforts is important to your success in fighting the addiction to nicotine.