COPD, or chronic obstructive pulmonary disease, is an umbrella phrase that covers multiple diseases of the lungs, including emphysema, chronic bronchitis and asthma. It is a progressive issue that causes permanent damage but isn't necessarily an early death sentence. Physicians have many tools for treatment at their disposal that work toward improving a patient's quality of life. The outlook for someone with COPD depends at which stage it is diagnosed, with the earlier COPD being discovered the better. COPD does not mean that a normal lifestyle and lifespan cannot be lived out.
Each word of COPD represents a symptom and the progression of the issue. “Chronic” means the condition is not going to heal; only become worse. “Obstructive” means the lungs are obstructed from being able to inflate fully and transfer oxygen to the body. “Pulmonary” is the part of the cardiovascular system that draws oxygen to the body and carries away deoxygenated blood. “Disease” refers to the fact that there is more than one issue playing a role in the problem. When it’s put all together, it’s used as a shorthand description for any number of conditions that cause the lungs to degrade.
Understanding how the lungs work is crucial to understanding how COPD affects them. Taking a breath means drawing air down the trachea, or windpipe, and directly into the bronchial tubes, or airways, in the lungs. The bronchial tubes branch out into smaller and narrower tubes known as bronchioles. The bronchioles terminate in tiny sacs called alveoli, but the oxygen drawn into the lungs through a single breath doesn’t stop at the end of the alveoli.
Capillaries, or small blood vessels, thread through the walls of the alveoli, facilitating the direct transmission of oxygen into the blood. When the oxygen gets to the alveoli, it it absorbed into the bloodstream and carbon dioxide is removed from the bloodstream in a process known as “gas exchange.” Another aspect of the airways and air sacs is elasticity. This feature allows the lungs to expand for the intake of oxygen and deflate when the air is breathed out.
The lungs work in concert with the pulmonary system to bring oxygen to the body and brain in a constant cycle. It happens every time a breath is taken, regardless if it is taken while sitting in a chair or running a sprint. COPD degrades and eventually destroys the functionality of the lungs through various forms of damage that include:
A diagnosis of COPD involves all of the above damage, which makes it hard to breathe. One of the causes, emphysema, is a condition in which the walls between the air sacs are destroyed primarily from smoking. This results in larger and fewer alveoli with which to perform the gas exchange. The alveoli also lose their original shape and become floppy, devoid of their important elasticity along the way.
Chronic bronchitis is another contributor toward COPD, and has tobacco smoke as a culprit alongside cold viruses and bacteria. Chronic bronchitis creates a condition in which the lining of the bronchial tubes are always irritated and inflamed. Asthma is also sometimes implicated, although it has a different cause and effect than COPD and does not cause permanent lung damage; however, when an asthmatic smokes, the result is inflammation of the lungs with a cough that can then spiral into COPD.
The primary cause of COPD and its affiliated diseases is poor air quality, including cigarette smoke and outdoor and indoor pollution, such as that from chemicals. Anything that irritates the lungs over a long period can lead to any one of the diseases that make up COPD. It’s possible for an individual to quit smoking, yet still have COPD decades later as the damage has been done and its progression cannot be halted.
COPD is not a young person’s disease. Rather, it is almost always diagnosed in individuals age 40 and up. This is due to the fact that it takes years of smoking or infection for the damage to occur. It’s the third leading cause of death in the US and a major cause of disability. In fact, it’s possible to have COPD and not know it because the symptoms are similar to the flu or a cold. The general symptoms are:
More severe cases can cause swelling in the ankles, feet or legs, weight loss and lower endurance.
A physician can employ many diagnostic tools to determine a case of COPD and its severity. Generally, the physician interviews the patient to learn what the patient is experiencing in terms of symptoms. This can include a cough with mucus, fatigue, lack of mental acuity, bluish fingertips and wheezing. The doctor may also ask what kind of environment in which the patient has been working, and if there are chemicals, dust, air pollution or fumes in the atmosphere. The patient should inform the physician of family members that have had the disease as well, as heredity is a potential contributing factor.
The physician listens to the lungs to assess whether crackling, wheezing or any unusual chest sounds are there that shouldn’t be. He or she may order chest X-rays or a CT scan to evaluate the condition of the lungs. Another test that can be used is known as a spirometry test. This involves exhaling into a machine as rapidly as possible to test for airflow. The volume of air that is exhaled can be an indicator as to how well or poor the lungs are performing. An arterial blood gas test measures the level of oxygen in the blood via a blood sample taken from an artery. It can indicate how severe the COPD is and if oxygen therapy is necessary. Once a diagnosis of COPD has been made, the physician explores treatment options that can best be employed to alleviate the symptoms and improve quality of life for the patient.
Many of the treatments for COPD are the same as treatments for asthma. The idea is to open up the existing airways and alveoli as much as possible to transfer oxygen into the bloodstream. Treatments for COPD include:
These drugs relax the muscles around the airways, allowing them to open up and make breathing easier. They’re usually prescribed as an inhaler for the fastest delivery of medication to the muscles. Bronchodilators come in short- and long-acting forms. Which type the physician prescribes is dependent upon the presentation of COPD.
Combination Bronchodilators/Inhaled Corticosteroids:
Steroids work by reducing inflammation in the airways and easing the passage of air into the lungs. Steroids by themselves are not recommended for treatment, hence the combination with a bronchodilator.
It is important to prevent influenza and pneumonia from taking hold and causing an infection. Vaccines keep these illnesses at bay and protect the function of the lungs.
This treatment consists of exercise, disease management training, nutritional and psychological counseling. Exercise helps to increase lung capacity even when there’s existing damage to the lungs. Strengthening the healthy section of the lungs can compensate for the inability of the damaged parts to perform.
This is typically used when the disease reaches a severe stage. Using pure oxygen can aid in doing tasks throughout the day, protect the heart and organs from damage, increase the quality of life and extend longevity.
This is usually the last resort for those who have severe symptoms and have not benefitted from taking medications. Surgery can involve removing enlarged alveoli known as bullae that have become ineffective, allowing the less damaged or healthy alveoli to perform more efficiently. Lung reduction surgery removes damaged tissue, also allowing the healthier sections to perform better. Some cases of COPD may be so severe as to require a lung transplant, which comes with its own host of risks but may be able to restore a quality of life to the patient.
COPD doesn’t develop overnight, nor does it progress quickly. Catching it in the earlier stages means treatment and management are more effective than if it had been found at a later stage. The first thing to do is to quit smoking if that hasn’t already been done. In the case that chronic bronchitis is involved, the physician works to treat the problem and stop it from coming back for a better quality of life.
The sooner COPD is found, the more possible it is to live out the majority of a normal lifespan with the disease, provided it is properly managed. However, it needs to be noted that it does slowly rob the individual of quality of life. Going through the normal motions of daily life may become more difficult unless measures are taken to improve lung capacity. It’s best to follow the physician’s orders to manage the disease properly and prevent it from becoming a burden sooner than later.
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