This is one of the most common lung diseases. Under the umbrella of COPD are two diseases in particular—emphysema and chronic bronchitis. These two diseases are usually but not always caused by smoking. The major symptoms are shortness of breath, cough and sputum. The onset is usually insidious. Gradual progressive symptoms over years slowly cause increasing problems. Although COPD is gradual at the onset, often it is diagnosed during an exacerbation or acute increase in symptoms. These exacerbations can be caused by viral respiratory infections or bacterial infections, exposure to cigarette smoke or air pollution.
Among those whom have never smoked, COPD can be caused by chronic dust exposure (usually from factories), a very rare genetic disease and certain types of injection drug abuse. Both emphysema and chronic bronchitis causes similar symptoms. Shortness of breath with exertion is the most common early symptom. Cough with sputum production is also typical. As the disease progresses, patients may complain of wheezing, fatigue and eventually swelling of the legs. Acute exacerbations usually are noticed as increased symptoms develop over several days. Severe exacerbations can be life threatening and require hospitalization. Less severe exacerbations can be managed at home with adjustments in medications.
COPD is diagnosed by taking a history, physical exam, breathing tests and chest XRays or CT scan. Once the diagnosis is confirmed, your doctor will create a treatment plan. The first and most important step in treating COPD is to stop smoking immediately. In addition, there are many medications that can help reduce symptoms, decrease the frequency of exacerbations and improve your exercise capacity. First line medications are usually inhalers. Exacerbations are often treated with antibiotics, steroids and increased frequency of breathing treatments. If you are so short of breath that you are unable to speak a full sentence without gasping for air, it is an emergency and you need to be get medical attention immediately.
In addition to medications for COPD, several other treatments are very important. If your oxygen saturations (levels) are low, you will need to use oxygen. This is the only intervention that has been proven to improve your survival. Additionally, your doctor may want you to participate in Pulmonary Rehabilitation (supervised exercise and lung education). There are also two surgical options for very carefully selected patients. Lung Volume Reduction Surgery (LVRS) and lung transplantation—these two surgeries are only appropriate for a small percentage of patients. Your doctor will discuss these options if your disease is very severe and you are an appropriate candidate.
Annual influenza vaccination and pneumonia vaccination every five years are generally encouraged.
The lung doctors at Arizona Pulmonary Specialists are experts in the diagnosis and treatment of COPD. Our team of doctors, nurses and respiratory therapists will work with you to ensure you understand your medications and other treatments.
At Arizona Pulmonary Specialists, we are actively involved in many research studies. We often have studies of new medications for COPD. Ask your doctor if you are interested.
At Arizona Pulmonary Specialists we are actively involved in many research studies. We often help test new medications for COPD. Ask your doctor if you are interested.