COPD

Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a lung disease in which the lungs are damaged, making it hard to breathe. In COPD, the airways—the tubes that carry air in and out of your lungs—are partly obstructed, making it difficult to get air in and out.
Cigarette smoking is the most common cause of COPD. Most people with COPD are smokers or former smokers. Breathing in other kinds of lung irritants, like pollution, dust, or chemicals, over a long period of time may also cause or contribute to COPD.

In COPD, the airways and air sacs lose their shape and become floppy. Less air gets in and less air goes out because:
The airways and air sacs lose their elasticity (like an old rubber band).
The walls between many of the air sacs are destroyed.
The walls of the airways become thick and inflamed (swollen).
Cells in the airways make more mucus (sputum) than usual, which tends to clog the airways.

COPD is IRREVERSIBLE. You can not undo the damage.

The signs and symptoms of chronic obstructive pulmonary disease (COPD) include:
Cough
Sputum (mucus) production
Shortness of breath, especially with exercise
Wheezing (a whistling or squeaky sound when you breathe)
Chest tightness

A cough that doesn't go away and coughing up lots of mucus are common signs of COPD. These often occur years before the flow of air in and out of the lungs is reduced. However, not everyone with a cough and sputum production goes on to develop COPD, and not everyone with COPD has a cough.

The severity of the symptoms depends on how much of the lung has been destroyed. If you continue to smoke, the lung destruction is faster than if you stop smoking.

Treatment

Quitting smoking is the single most important thing you can do to reduce your risk of developing chronic obstructive pulmonary disease (COPD) and slow the progress of the disease.
Your doctor will recommend treatments that help relieve your symptoms and help you breathe easier. However, COPD cannot be cured.

The goals of COPD treatment are to:
Relieve your symptoms with no or minimal side effects of treatment
Slow the progress of the disease
Improve exercise tolerance (your ability to stay active)
Prevent and treat complications and sudden onset of problems
Improve your overall health

The treatment for COPD is different for each person. Your family doctor may recommend that you see a lung specialist called a pulmonologist (pull-mon-OL-o-gist).

Treatment is based on whether your symptoms are mild, moderate, or severe.

Medicines and pulmonary rehabilitation (rehab) are often used to help relieve your symptoms and to help you breathe more easily and stay active.

COPD Medicines
Bronchodilators
Your doctor may recommend medicines called bronchodilators that work by relaxing the muscles around your airways. This type of medicine helps to open your airways quickly and make breathing easier. Bronchodilators can be either short acting or long acting.

Short-acting bronchodilators last about 4 to 6 hours and are used only when needed.
Long-acting bronchodilators last about 12 hours or more and are used every day.

Most bronchodilator medicines are inhaled, so they go directly into your lungs where they are needed. There are many kinds of inhalers, and it is important to know how to use your inhaler correctly.
If you have mild COPD, your doctor may recommend that you use a short-acting bronchodilator. You then will use the inhaler only when needed.
If you have moderate or severe COPD, your doctor may recommend regular treatment with one or more inhaled bronchodilators. You may be told to use one long-acting bronchodilator. Some people may need to use a long-acting bronchodilator and a short-acting bronchodilator. This is called combination therapy.

Inhaled glucocorticosteroids (steroids)
Inhaled steroids are used for some people with moderate or severe COPD.

Inhaled steroids work to reduce airway inflammation. Your doctor may recommend that you try inhaled steroids for a trial period of 6 weeks to 3 months to see if the medicine is helping with your breathing problems.

Flu shots
The flu (influenza) can cause serious problems in people with COPD. Flu shots can reduce the chance of getting the flu. You should get a flu shot every year.

Pneumococcal vaccine
This vaccine should be administered to those with COPD to prevent a common cause of pneumonia. Revaccination may be necessary after 5 years in those older than 65 years of age.

Pulmonary Rehabilitation
Pulmonary rehabilitation (rehab) is a coordinated program of exercise, disease management training, and counseling that can help you stay more active and carry out your day-to-day activities. What is included in your pulmonary rehab program will depend on what you and your doctor think you need. It may include exercise training, nutrition advice, education about your disease and how to manage it, and counseling. The different parts of the rehab program are managed by different types of health care professionals (doctors, nurses, physical therapists, respiratory therapists, exercise specialists, dietitians) who work together to develop a program just for you. Pulmonary rehab programs can include some or all of the following aspects.

Medical evaluation and management

To decide what you need in your pulmonary rehab program, a medical evaluation will be done. This may include getting information on your health history and what medicines you take, doing a physical exam, and learning about your symptoms. A spirometry measurement may also be done before and after you take a bronchodilator medicine.

Setting goals
You will work with your pulmonary rehab team to set goals for your program. These goals will look at the types of activities that you want to do. For example, you may want to take walks every day, do chores around the house, and visit with friends. These things will be worked on in your pulmonary rehab program.

Exercise training
Your program may include exercise training. This training includes showing you exercises to help your arms and legs get stronger. You may also learn breathing exercises that strengthen the muscles needed for breathing.