Living with chronic obstructive pulmonary disease

Chronic Obstructive Pulmonary Disease (COPD) is a "pulmonary umbrella", under which reside emphysema, chronic bronchitis, bronchiectasis, and asthma. Other lung diseases include pulmonary fibrosis and sarcarcoidosis. These related diseases all share a common bond: the ability to almost take a person’s breath away. About 80-90% of COPD patients are current or former long-term smokers. Other risk factors: heredity, secondhand smoke, environmental air pollution, and a history of childhood respiratory infections.

Emphysema weakens and breaks the air sacs in the lungs. Lung tissue cannot easily expand and contract. Airways collapse and the patient has difficulty breathing. Emphysema is almost always a result of long-term smoking.

Chronic bronchitis is an inflammatory disease that begins in the small airways of the lungs, and moves to the larger airways. Mucus takes up permanent residence, and opens up the bronchial tubes to harbor bacterial infections. The result is the same: the patient struggles to take in air.

Asthma is a chronic lung condition that affects individuals with very sensitive or hyper-responsive airways. Airways narrow and constrict as they become irritated by certain "triggers," such as environmental allergens, secondhand smoke, dust, cold air, exercise and stress.

Restrictive Lung Disease may include connective tissue lung disease, chest wall diseases, neuromuscular disorders, or environmental exposures to asbestos or coal dust. Lung volume and capacity are reduced.

Lung cancer results from uncontrolled growth of abnormal lung cells in response to the build-up of tars, nicotine, and other carcinogens. Lung cancer is almost always the result of long-term smoking.

Bronchiectasis is a rare condition where the bronchial tubes become enlarged and form pockets that can attract infection. The tiny hairs, called cilia, that clean the bronchial walls from dust, germs and excess mucus are destroyed. Bronchiectasis is usually an inherited or congenital disease.

A short list of COPD symptoms:

• Chronic cough and frequent clearing of the throat
• Shortness of breath, especially during exercise or exertion
• Increased effort to breathe
• Chest tightness
• Increased mucus in the lungs
• Feeling fatigued most of the time
• Difficulty sleeping

And the patient feels…well, lousy!

A COPD patient’s lungs are not able to easily take in oxygen and expel carbon dioxide. Lung walls lose their flexibility. Airway walls collapse and close off smaller air passages and narrow larger ones. The passageways that are open collect mucus. Exhaling is hard because airways collapse, and trap stale air in the lungs.

Symptoms and severity may vary; still, all COPD patients will notice a gradual inability to fully inhale and exhale. Repeated coughing irritates the airways further, and each attack further weakens the patient’s lung function.

Many lung patients have chronic mucus production. Watching for changes in the color of mucus can help identify infections. If you are ill, seek treatment right away to prevent damage to your airways.

COPD Care Programs

Ideally, COPD is diagnosed early. The reality is if diagnosis is made in a person’s 50s or 60s, their lung function is already significantly compromised and quality of life is less than desired. The best outcome is when the patient and physician or pulmonary specialist work together to set realistic goals:

1. Stop smoking, and avoid places where smoking is allowed.
2. Use of bronchodilators to open up the lung’s air passages and prevent bronchospasms.
3. Inhaled or oral corticosteroids to reduce inflammation.
4. Antibiotics at the first sign of a respiratory infection to prevent further lung damage.
5. Expectorants to help loosen and expel mucus from the airways.
6. Diuretics to rid the body of water retention.
7. Medications to strength the ability of the heart to pump blood.
8. Pulmonary rehabilitation exercise program to strengthen muscles and improve endurance.

When To Call the Doctor

• If you notice a change in color, thickness, odor or amount of mucus.
• Chest tightness that does not improve with your normal medications.
• Fever or chills.
• Increased shortness of breath, wheezing or coughing.
• Swollen ankles.

For detailed information about lung disease, go to: www.lungusa.org