One of the leading causes of death in the United States is chronic obstructive pulmonary disease, known as COPD, and millions who have it likely don’t even know it, according to the National Heart, Lung and Blood Institute.
COPD kills more than 150,000 Americans each year. That’s one death every 4 minutes, according to the institute. It is the third-leading cause of death in the United States and costs Americans more than $32 billion a year.
It impacts people in every corner of the country, including many in Whatcom County.
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, according PeaceHealth physicians and its Health Information Library.
COPD is often a mix of two diseases:
▪ Chronic bronchitis: 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: 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.
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.
If you were recently diagnosed with COPD, you may have a feeling of helplessness.
Rita Williams, a nurse practitioner at PeaceHealth, said it is natural that you feel overwhelmed with a new diagnosis of COPD. What’s important to remember is that there are things you can do to control this disease:
▪ If you smoke, quit. It’s essential if you want to slow the progression of the disease. Your doctor can provide you options to help you quit.
▪ Learn about your medicines. COPD medicines are vital for staying well and active. Take all medicines as prescribed, and tell your doctor about any side effects or problems that crop up.
▪ Ask about pulmonary rehabilitation. This program offers emotional and psychological support along with practical, everyday tips and exercises to control breathing problems and stay healthy.
▪ Keep a good attitude, and take action. Develop a COPD action plan with your provider to identify when your symptoms are getting worse and you need to call or be seen by your provider.
▪ Monitor your symptoms daily and record them.
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.
The primary 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. An exacerbation can range from mild to life-threatening. The longer you have COPD, the more severe these flare-ups will be.
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.
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.
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.
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 911.
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 also can make you feel very anxious. If these feelings last, be sure to tell your doctor. Counseling, medicine and support groups can help you cope.
Pulmonary rehabilitation has become a vital tool to reduce symptoms and complications of chronic lung diseases.
In Bellingham, NorthStar Medical Specialists offers comprehensive pulmonary rehabilitation and respiratory therapy services, utilizing respiratory therapists, exercise physiologists and physicians as a team approach to help patients improve their day-to-day lives.
The goal of Pulmonary Rehabilitation is to restore the patient’s ability to do the things they enjoy, without getting so short of breath.
NorthStar Medical Specialists work to help patients:
▪ Increase their physical stamina and endurance.
▪ Decrease their shortness of breath.
▪ Learn more about their disease, medications and other treatment options.
▪ Teach them breathing and energy conservation techniques to reduce and control symptoms.
▪ Maintain healthy behaviors such as good nutrition, tobacco cessation and a home exercise program.
▪ Train them to minimize complications by avoiding infections and irritants that can worsen their breathing.
▪ Cope with feelings of depression and anxiety that often times accompanies a chronic disease.
How Is COPD Treated?
Treatment of COPD requires a careful and thorough exam by a doctor. Quitting smoking is the most important first step you can take to treat COPD. Avoiding secondhand smoke also is critical.
For people with COPD who have trouble eating because of shortness of breath or being tired, treatment may include:
▪ Following a special meal plan with smaller, more frequent meals.
▪ Resting before eating.
▪ Taking vitamins and nutritional supplements.
A broad program that helps improve the well-being of people who have chronic breathing problems may include:
▪ Exercise training.
▪ Nutritional counseling.
▪ Education on your lung disease or condition and how to manage it.
▪ Energy-conserving techniques.
▪ Breathing strategies.
▪ Psychological counseling and/or group support.
Medicines may include:
▪ A bronchodilator to relax the muscles around the airways. This helps open airways and makes breathing easier. Most bronchodilators are taken with a device called an inhaler.
▪ A steroid drug you inhale to reduce swelling in the airways.
▪ Antibiotics to treat respiratory infections, if appropriate.
▪ A vaccination during flu season.
Oxygen therapy can help people who have severe COPD and low levels of oxygen in their blood to breathe better.
Surgery for people who have severe symptoms that have not improved with other treatments could include:
▪ Lung volume reduction surgery (LVRS): Surgery to remove diseased parts of the lung so healthier lung tissue can work better. LVRS is not a cure for COPD.
▪ A lung transplant: Surgery in which one or two healthy lungs from a donor are put in the patient’s body to replace diseased lungs. A lung transplant is a last resort.
Even though there is no cure for COPD, these lifestyle changes and treatments can help you breathe easier, stay more active and slow the progress of the disease.
Source: Centers for Disease Control and Prevention
Battling Depression with COPD
It’s estimated that almost 40 percent of people with COPD suffer from depression, and it’s easy to understand why.
COPD causes a lot of changes to your body. Breathlessness, weight loss, sleeping and eating problems, and a depletion in energy are just some of the physical changes that you may experience over the course of the disease. Many of these changes can lead to feelings of loss and negativity, because you can no longer do the things you used to do. This can eventually lead to clinical depression.
Depression can actually exacerbate your physical symptoms. For example, feeling down can cause you to have trouble following your treatment plan. You may find that it’s easy to forget your medications or not exercise. You may even turn to alcohol, cigarettes or other unhealthy habits to cope, which can wreck further havoc on your body.
COPD and depression is not something to take likely. All of us have had a bad day every now and then, but when you are suffering from depression, you may experience a variety of symptoms, in addition to the effects of COPD.
That’s why it is important to learn how to recognize the signs of depression and seek help if you need it. According to an article in the “International Journal of Chronic Obstructive Pulmonary Disease,” here are some of the symptoms of depression to look out for:
▪ Fatigue and appetite changes.
▪ Sleeping problems.
▪ Thoughts about death or suicide.
▪ Hopelessness, guilt or helplessness.
How to Cope
When you have COPD, depression can add to your already fragile emotional state. People who are depressed often feel disconnected from their family and friends, and tend to feel hopeless about ever feeling good. This can make it more difficult to take care of yourself and follow the treatment recommendations of your medical team.
If you have any of the symptoms of depression, it’s important to talk to your doctor. They may want to prescribe a medication to help alleviate your depression.
It’s important to find the right medication, because many antidepressants can interfere with medications you may already be taking for your COPD.
Also, try to stay active and exercise. Joining a support group can also be beneficial to helping you connect with others. And if all else fails, do what makes you happy.
Depression can be a challenge for anyone, especially if you are suffering from COPD. If you are feeling depressed, talk to your doctor immediately and get the help you need today.