COPD

COPD

What is chronic obstructive pulmonary disease (COPD)?

COPD is a lung disease that makes it hard to breathe. It is caused by damage to the lungs over many years, usually from smoking.

COPD is often a mix of two diseases:

• Chronic bronchitis (say “bron-KY-tus”). In chronic bronchitis, the airways that carry air to the lungs(bronchial tubes ) get inflamed and make a lot of mucus. This can narrow or block the airways, making it hard for you to breathe.
• Emphysema (say “em-fuh-ZEE-muh”). In a healthy person, the tiny air sacs in the lungs are like balloons. As you breathe in and out, they get bigger and smaller to move air through your lungs. But with emphysema, these air sacs are damaged and lose their stretch. Less air gets in and out of the lungs, which makes you feel short of breath.

COPD gets worse over time. You can’t undo the damage to your lungs. But you can take steps to prevent more damage and to feel better.

What causes COPD?

COPD is almost always caused by smoking. Over time, breathing tobacco smoke irritates the airways and destroys the stretchy fibers in the lungs.

Other things that may put you at risk include breathing chemical fumes, dust, or air pollution over a long period of time. Secondhand smoke also may damage the lungs.

It usually takes many years for the lung damage to start causing symptoms, so COPD is most common in people who are older than 60.

You may be more likely to get COPD if you had a lot of serious lung infections when you were a child. People who get emphysema in their 30s or 40s may have a disorder that runs in families, called alpha-1 antitrypsin deficiency. But this is rare.

What are the symptoms?

The main symptoms are:

• A long-lasting (chronic) cough.
• Mucus that comes up when you cough.
• Shortness of breath that gets worse when you exercise.

As COPD gets worse, you may be short of breath even when you do simple things like get dressed or fix a meal. It gets harder to eat or exercise, and breathing takes much more energy. People often lose weight and get weaker.

At times, your symptoms may suddenly flare up and get much worse. This is called a COPD exacerbation (say “egg-ZASS-er-BAY-shun”). An exacerbation can range from mild to life-threatening. The longer you have COPD, the more severe these flare-ups will be.

How is COPD diagnosed?

To find out if you have COPD, a doctor will:

• Do a physical exam and listen to your lungs.
• Ask you questions about your past health and whether you smoke or have been exposed to other things that can irritate your lungs.
• Have you do breathing tests, including spirometry, to find out how well your lungs work.
• Do chest X-rays and other tests to help rule out other problems that could be causing your symptoms.

If there is a chance you could have COPD, it is very important to find out as soon as you can. This gives you time to take steps to slow the damage to your lungs.

How is it treated?

The best way to slow COPD is to quit smoking. This is the most important thing you can do. It is never too late to quit. No matter how long you have smoked or how serious your COPD is, quitting smoking can help stop the damage to your lungs.

Your doctor can prescribe treatments that may help you manage your symptoms and feel better.

Medicines can help you breathe easier. Most of them are inhaled so they go straight to your lungs. If you get an inhaler, it is very important to use it just the way your health provider shows you.
A lung (pulmonary) rehab program can help you learn to manage your disease. A team of health professionals can provide counseling and teach you how to breathe easier, exercise, and eat well.
In time, you may need to use oxygen some or most of the time.

People who have COPD are more likely to get lung infections, so you will need to get a flu vaccine every year. You should also get a pneumococcal shot. It may not keep you from getting pneumonia. But if you do get pneumonia, you probably won’t be as sick.

How can you live well with COPD?

There are many things you can do at home to stay as healthy as you can.

• Avoid things that can irritate your lungs, such as smoke and air pollution.
• Use an air filter in your home.
• Get regular exercise to stay as strong as you can.
• Eat well so you can keep up your strength. If you are losing weight, ask your doctor or dietitian about ways to make it easier to get the calories you need.

Dealing with flare-ups: As COPD gets worse, you may have flare-ups when your symptoms quickly get worse and stay worse. It is important to know what to do if this happens. Your doctor may give you an action plan and medicines to help you breathe if you have a flare-up. But if the attack is severe, you may need to go to the emergency room or call .

Knowing that you have a disease that gets worse over time can be hard. It’s common to feel sad or hopeless sometimes. Having trouble breathing can also make you feel very anxious. If these feelings last, be sure to tell your doctor. Counseling, medicine, and support groups can help you cope.

When you have chronic obstructive pulmonary disease, or COPD, your usual symptoms might become worse rather quickly — or you may even get new ones.

You may hear your doctor or nurse call this an “exacerbation.” Think of it as a flare-up. During one of these bouts, you may suddenly have more trouble breathing or make more noise when you do.

These flare-ups are often linked to a lung infection caused by a virus or bacteria, such as a cold or some other illness. Smoggy or dirty air can also make your symptoms get worse in a hurry.

It’s important to know the warning signs that a flare-up is coming on so that you can avoid it if possible. These exacerbations can cause your COPD to get worse or put you in the hospital.

Early Warning Signs of a Flare-Up

Self-awareness is important with COPD flare-ups. Only you can know how you feel on a typical day — how your breathing feels and how much you cough. Pay close attention when things change.

One obvious sign of an oncoming flare-up is shortness of breath. You feel like you can’t get enough air. You might notice it during light physical activityor even when you are at rest.

Other things you should watch out for:

• Noisy breathing. Your breath makes strange noises. Wheezing suggests mucus or pus is blocking your airways. Gurgling or rattling could mean fluid in your lungs.
• Irregular breathing. You feel like you have to use your chest muscles to breathe instead of your diaphragm. Your breathing becomes uneven. Sometimes your chest moves a lot faster; sometimes it’s much slower.
• Worse coughing. It’s more severe or you cough more often than usual. It could be dry or bring up yellow, green, or bloody phlegm. It gets worse when you lie down — so much that you may have to sit in a chair to sleep.
• Changes in skin or nail color. You see a bluish tint around your lips or notice that your nails seem blue or purple. Your skin looks yellow or gray.
• Trouble sleeping and eating. You can’t get to sleep, and you don’t feel like eating.
• You can’t talk. You’re unable to get any words out. You have to use hand gestures to let someone know something is wrong with you. This is a late and dangerous sign of worsening breathing.
• Early-morning headaches. You start the day with a throbbing head because of a buildup of carbon dioxide in your blood.
• Swollen ankles or legs or belly pain. These symptoms are linked to problems with your heart or lungs.
• Fever. A higher temperature could be a sign of infection and an oncoming flare-up.
• You should call your doctor at once if you or a loved one with COPD are showing symptoms of a flare-up.

When to Get Emergency Care

Sometimes, your flare-up could start to become severe. You might not have enough time to wait for a visit to your doctor’s office. Call 911 if you have these symptoms:

• Chest pain
• Blue lips or fingers
• You’re confused or get very easily upset
• You’re so short of breath you can’t talk

Severe COPD flare-ups are potentially life-threatening, so fast action is important with these symptoms.

How to Avoid Flare-Ups

Of course, the best thing that can happen is to avoid as many flare-ups as possible in the first place. One thing you should do is to schedule and keep regular appointments with your doctor, even if you’re feeling perfectly fine at the time.

Here are some other tips to keep COPD flare-ups at bay:

• Ask your doctor whether you are due for a pneumonia and pertussisshot.
• Wash your hands often with warm water and mild soap.
• Use hand sanitizer when you can’t wash your hands.
• Try to stay away from crowds during cold and flu season.
• Drink enough water to stay hydrated.
• Take sleep time seriously. When your body is tired, you’re more likely to get sick.​

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