COPD or chronic obstructive pulmonary disease is not a single disease, but rather a group of illnesses that are both progressive and chronic and cause obstruction in the lungs. Examples are emphysema, refractory asthma, chronic bronchitis, and some types of bronchiectasis.
COPD is common, particularly in smokers after middle age. According to the Mayo Clinic, it is also quite common for people not to be aware that they have it. COPD is caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. (1) Because the condition is chronic and progressive, it becomes increasingly worse, making it more and more difficult for the patient to keep up with normal, everyday activities. Let us take a look at the COPD signs, symptoms and treatments. COPD Signs, Symptoms and Treatments (Focusing on the Signs and Symptoms)
When people have COPD, it becomes increasingly difficult for them to breathe normally. Usually, it takes many years for this to become apparent, and the symptoms will get progressively worse. The most common COPD signs and symptoms include:
1. Worsening shortness of breath, starting while exercising first, but increasing to the point of waking up during the night feeling breathless.
2. Persistent phlegm coughs and wheezing.
3. Regular chest infections.
These signs and symptoms will worsen over time, making it increasingly difficult to maintain regular daily activities. Progression of the disease can be slowed down with treatment. It is common for people to have a sudden worsening of symptoms as well, which is known as an exacerbation or flare up. Most people will have a flare up during the winter.
Other symptoms associated with COPD include:
1. Feeling tired
2. Weight loss
3. Edema in the ankles
4. Coughing blood and chest pain, which could also be indicative of lung cancer or chest infections
Usually, these symptoms occur once the condition has progressed significantly.
As noted by the COPDFoundation.org, there are different types of COPD. Each type may affect how well different treatments work, how your symptoms affect your everyday life, and how they progress. If you have another health condition in addition to COPD (co-morbidity), such as high blood pressure, heart disease, heartburn, depression, or diabetes, this can also affect your COPD and how it is managed.(2)
COPD Signs, Symptoms and Treatments (Focusing on the Treatments)
Unfortunately, there is no cure yet for COPD. Nevertheless, good treatments can help slow down its progression, while also keeping the symptoms under control. The different treatment options are discussed after a person has been diagnosed with the condition. The most important treatment options are:
1. To stop smoking. Smoking is a primary cause of COPD and if the patient continues to smoke, the worsening of the disease will be much quicker. In the early COPD stages, merely stopping smoking is often enough to make the condition manageable for quite a long time.
2. Inhalers, which ensure that medication is sent straight to the longs. It is important to use an inhaler as prescribed, and as often as prescribed. There are different types of inhalers, and most people with COPD will use various kinds of inhalers, changing as their condition worsens or stabilizes. The options include:
– Short acting bronchodilators, which are commonly prescribed after diagnosis. They relax and widen the airways, making breathing easier. They can be a beta-2 agonist inhaler or an anti-muscarinic inhaler. They can be used up to four times per day.
– Long acting bronchodilators, which work similarly to the short-acting ones, but the dose lasts for 12 hours at least, meaning only two treatments per day are needed. Like their short acting counterparts, they can be either a beta-2 agonist or an anti-muscarinic, although some are now a combination of both.
– Steroid inhalers, which are prescribed to those using long-acting inhalers but who have a flare up. They contain corticosteroids, which fight inflammation.
3. Medication is offered to those who find that inhalers do not control their symptoms. Like with inhalers, different types of medication exist. They include:
– Theophylline tablets, which open and relax the airways and should be taken twice daily. Regular blood tests are required to get the dosage right. These tablets have significant side effects, which is why they are not prescribed often.
– Mucolytic capsules or tablets, which are offered to those with persistent coughs with lots of phlegm. They thin the phlegm so you can cough it up. They usually have to be taken three times per day.
– Steroid tablets, which are usually only offered during a bad flare up and for a period no longer than 14 days. They come with significant side effects and should therefore be avoided when possible.
– Antibiotics, which are prescribed if your physician suspects you have a chest infection.
4. Pulmonary rehabilitation, which is a type of education and exercise program designed for people with lung problems. It allows patients to remain physically active, while at the same time improving their emotional well-being, self-confidence, and physical health. Usually, it involves taking part in two specialized exercise classes for at least six weeks. The program is designed to be suitable for the patient’s abilities and will include both strength and cardiovascular exercises. It also provides dietary advice, emotional and psychological support, and education about COPD and living with the condition.
5. Nebulized medication may be offered if inhalers no longer work. This means that liquid medication is converted into a mist that is breathed in through a mask. This enables the patient to access higher doses of medication quickly.
6. Long term oxygen therapy, which is offered when saturation levels in the blood start to drop. This means that you will be fitted with a mask or nasal tubes, ensuring that your blood oxygen levels remain healthy. It does not address any other COPD symptoms, however. The treatment must be provided at least 16 hours per day, which means you will have to bring along the oxygen tanks with you. This is made possible through ambulatory oxygen therapy.
7. Non-invasive ventilation or NIV, which is offered in hospital settings when someone is admitted after a flare up. This means the mouth and nose, and sometimes the entire face, are covered by a mask and a portable machine is used to aid in breathing.
8. Surgery, which is very rarely offered and only suitable for people with severe COPD and who are non-responsive to other treatment methods. Three types of surgery can be done:
– Bullectomy, whereby an air pocket found in the lungs is removed, thereby making breathing easier and more comfortable by placing less strain on the lungs.
– Long volume reduction surgery, whereby a section of the lung that has been badly damaged is fully removed. This ensures the healthy remaining tissue can focus on breathing, which should become less laborious.
– Lung transplant, whereby the entire lung is replaced with healthy donor tissue.
All three of these types of surgery are major procedures that will require you to be under a general anesthetic.
How is COPD Prevented?
According to EveryDayHealth.com, one of the best ways to prevent getting COPD is to never start smoking, or to stop smoking if you already do. If you have trouble quitting smoking, there are numerous options to help you, including gums, patches, and prescription medication. Additionally, support groups and classes to help you quit smoking can often be found through hospitals, workplaces, and community associations. (3)