Chronic obstructive pulmonary disease (COPD)

What is COPD?

When you breathe, air travels through tubes in your lungs—called airways—to millions of tiny air sacs. In a healthy lung, the airways are open and the air sacs fill up with air. Then the air goes quickly out.

COPD makes it hard to get air through the airways and into and out of the air sacs.

COPD includes two lung problems:

• “Chronic bronchitis” is increased cough and mucus production caused by inflammation of the airways. Bronchitis is considered chronic (or long-term) if a person coughs and produces excess mucus most days during three months in a year, for two years in a row.
• “Emphysema” is associated with damage of the air sacs and/or collapse of the smallest breathing tubes in the lungs.

How is COPD diagnosed?

A COPD diagnosis is typically confirmed with spirometry, which measures lung function. Spirometry is the most common way doctors evaluate the level of airflow obstruction. During a spirometry test, you’ll be asked to blow into a large tube connected to a spirometer. This measures how much air your lungs can hold and how quickly you can expel that air from your lungs. Spirometry can detect COPD before you even experience any symptoms. Pulmonologists may also use chest x-rays or other tests to help diagnose COPD.

If you are diagnosed, your pulmonologist may prescribe medication and suggest dietary changes and exercises that can help. Don’t forget that family and friends can be a tremendous source of support. If you are being tested for COPD, having a friend or family member there with you may be helpful.

Many find that getting support from others with the same condition may also be a good idea.

A COPD diagnosis can feel like something that turns your life upside down, but there are a lot of things you can do to manage COPD that might help you maintain a positive outlook. If you think about it, the earlier you know that you have the disease, the sooner you can start to manage it. And with the proper treatment, many people are able to slow down further loss of lung function.

What causes COPD?

The largest cause of COPD is a history of smoking cigarettes. Habitual smoking can inflame the linings of the airways in the lungs and can make the airways lose their elastic quality. Other external factors that put you at risk of developing COPD are exposure to air pollution, secondhand smoke, and occupational dust or chemicals. Heredity can also play a role. Scientists have discovered what’s known as an alpha-1-antitrypsin deficiency, which is the source of a small proportion of cases of COPD. Researchers also suspect that other genetic factors may make certain smokers predisposed to the disease.

Signs & Symptoms of COPD

Common signs and symptoms of COPD include coughing that may produce mucus, shortness of breath, and fatigue. As the disease progresses, these COPD symptoms may become more problematic.

COPD is a progressive disease, meaning it typically gets worse over time. That’s why it’s extremely important to talk to your healthcare provider right away if you’re experiencing any symptoms common to COPD. The sooner you’re diagnosed, the better you and your doctor can start to manage it. Making some adjustments in your lifestyle is always a good place to start.

Some signs and symptoms of COPD include cough with mucus, shortness of breath, and fatigue. When these signs first occur, people often mistakenly attribute them to aging, being out of shape, or “smoker’s cough.” They may limit their level of activity to accommodate these COPD symptoms without even realizing it. There are also instances when it’s hard for doctors to be sure whether a patient has COPD or asthma. These are just a few reasons why it’s important to really understand the symptoms of COPD.

Since COPD is a progressive disease, many signs and symptoms may be mild at first and become more severe over time. Signs and symptoms of COPD may vary and include:

• Shortness of breath or “dyspnea”: when you breathe harder but feel like you’re running out of air
• Persistent (chronic) cough
• Coughing up mucus/phlegm
• Difficult or labored breathing during physical activity or while resting
• Wheezing (air trying to flow through a narrow airway)
• Higher frequency of pneumonia and lung infections

Other signs and symptoms that could be associated with COPD:

• Fatigue/tiredness
• Weight loss
• Morning headaches (breathing decreases during sleep, which means less oxygen comes in and more carbon dioxide builds up in the blood, which may cause headaches)

At times, any or all of the respiratory related symptoms may suddenly “flare up” or get worse than usual. These episodes of more severe symptoms are known as exacerbations, and they should be taken seriously.

Avoiding Triggers

COPD can be challenging to manage. Avoiding triggers — or things that cause your COPD symptoms to get worse — can be a huge help. Here are some actions you can take:

• Quit smoking
  • If you haven’t done so already, quitting smoking is one of the most important steps you can take to help your COPD. Additionally, try to avoid secondhand smoke.
• Keep your home clean
  • Keep your home clean and free from excess dust. Removing mold and mildew from bathrooms and sinks is also helpful
• Use a cooking vent
  • Make sure the cooking vent is working well so that cooking fumes can be drawn out of your home.
• Avoid air pollution
  • If air pollution levels are high, stay inside
• Help prevent serious health risks
  • Ask your healthcare provider if and when you should get the flu and/or pneumonia vaccines. These shots can help protect you from getting these illnesses, which are major health risks for people who have COPD.
• Avoid large crowds 
  • Avoid large crowds in the fall and winter, when flu season is at its peak.
• Wash your hands often
  • Wash your hands often to help prevent the spread of germs, and have people around you do the same.
• Try to avoid cold air
  • Try to avoid cold air. It can trigger bronchospasms and shortness of breath. 

Help decrease your chance of an exacerbation

• Talk to your healthcare provider about things you can do to avoid triggers and help reduce your chance of exacerbations in the future.
• Get a flu shot and ask if you need a pneumonia vaccine.
• Keep taking your medications as prescribed.
• Keep your distance from anyone who has the flu, a cold, or a sore throat.
• Wash your hands frequently with soap and water to help protect against infection.

Keep in mind, COPD symptoms aren’t just something you wake up with one morning. They develop slowly. The lung is fairly resilient and can sustain a considerable amount of damage before it starts producing any symptoms. By the time most people are diagnosed, they may have already lost some of their lung function. Certain COPD symptoms, like fatigue and shortness of breath affect each individual differently. That’s why it’s important to talk to your healthcare provider if you notice a change in any of the symptoms listed above.

With proper treatment and a COPD management plan you can minimize your symptoms and enjoy a better quality of life.