Living with chronic obstructive pulmonary disease
Chronic Obstructive Pulmonary Disease (COPD) is a "pulmonary umbrella", under which reside emphysema, chronic bronchitis and bronchiectasis. Restrictive lung diseases include pulmonary fibrosis and sarcoidosis. These related diseases all share a common bond: shortness of breath that never goes away. About 80-90% of COPD patients are current or former long-term smokers. Other risk factors: heredity, secondhand smoke, environmental air pollution, and a history of childhood respiratory infections.
Emphysema is progressive damage to the lungs, resulting from destruction of tissue and loss of elasticity in the alveoli, where oxygen enters and carbon dioxide exits the bloodstream. If the lungs are damaged by the chemicals in cigarette smoke or by the persistent inflammation and coughing of chronic bronchitis, the delicate walls of the alveoli may become progressively enlarged, inelastic, and far less functional.
Chronic bronchitis is a persistent inflamation of the bronchial tubes in the lungs, producing a recurrent cough with large amounts of mucus. When the cells lining the airways are irritated beyond a certain point, the tiny cilia (hairlike projections) that normally trap and eliminate foreign matter cease to function properly. The buildup of irritants leads to the production of excess mucus, which clogs air passages and produces the characteristic heavy cough of bronchitis.
Restrictive Lung Disease may include connective tissue lung disease, chest wall diseases, neuromuscular disorders, or environmental exposures to asbestos or coal dust. Lung volume and capacity are reduced.
Bronchiectasis is a rare condition where the bronchial tubes become enlarged and form pockets that can attract infection. The tiny hairs, called cilia, that clean the bronchial walls from dust, germs and excess mucus are destroyed. Bronchiectasis is usually an inherited or congenital disease.
A short list of COPD symptoms:
The onset of COPD is usually very gradual. It develops over a number of years, and symptoms may not appear until COPD has already progressed quite far.
Chronic cough and frequent clearing of the throat
Shortness of breath, especially during exercise or exertion
Increased effort to breathe
Increased mucus in the lungs
Feeling fatigued most of the time
A COPD patient's lungs are not able to easily take in oxygen and expel carbon dioxide. Lung walls lose their flexibility. Airway walls collapse and close off smaller air passages and narrow larger ones. The passageways that are open collect mucus. Exhaling is hard because airways collapse, and trap stale air in the lungs.
Symptoms and severity may vary; still, all COPD patients will notice a gradual inability to fully inhale and exhale. Repeated coughing irritates the airways further.
Many lung patients have chronic mucus production. Watching for changes in the color of mucus can help identify infections. If you are ill, seek treatment right away to prevent damage to your airways.
COPD Care Programs
Ideally, COPD is diagnosed early. The reality is if diagnosis is made in a person’s 50s or 60s, their lung function is already significantly compromised and quality of life is less than desired. The best outcome is when the patient and physician or pulmonary specialist work together to set realistic goals:
- Stop smoking, and avoid places where smoking is allowed.
- Use of bronchodilators to open up the lung’s air passages and prevent bronchospasms.
- Inhaled or oral corticosteroids to reduce inflammation.
- Antibiotics at the first sign of a respiratory infection to prevent further lung damage.
- Expectorants to help loosen and expel mucus from the airways.
- Diuretics to rid the body of water retention.
- Medications to strength the ability of the heart to pump blood.
- Pulmonary rehabilitation exercise program to strengthen muscles and improve endurance.
When To Call the Doctor
- If you notice a change in color, thickness, odor or amount of mucus.
- Chest tightness that does not improve with your normal medications.
- Fever or chills.
- Increased shortness of breath, wheezing or coughing.
- Swollen ankles.
For detailed information about lung disease, go to: www.lungusa.org