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Emphysema is one of the most common forms of chronic obstructive pulmonary disease (COPD). COPD is the 4th leading cause of death in the United States and throughout the world. A long-term lung disease, COPD/emphysema occurs when there is damage to the air sacs in the lungs. These air sacs pick up oxygen from the air. When the air sacs are damaged they cannot pick up enough oxygen, which causes breathing problems.
Cigarette smoking is the leading cause of COPD/emphysema, but breathing in other types of lung irritants over time-such as chemicals, dust or pollution-may also contribute to the disease. While there is no cure for COPD and the damage done to the airways and lungs cannot be reversed, the disease can be controlled with medications, breathing treatments and pulmonary rehabilitation. Whatever the method chosen, the main goal of treatment is to help relieve patients' symptoms so they can breathe easier.
Symptoms and Diagnosis
Symptoms of COPD include:
Cough
Mucus (sputum)
Shortness of breath, especially upon exertion
Recurrent chest infections or bronchitis
Wheezing
Tightness in the chest
Diagnosing COPD involves several steps. First, your physician will conduct a physical exam to listen to your lungs. Your doctor will talk to you about your symptoms, any family history of lung disease, and your history of exposure to lung irritants-including tobacco from cigarette smoking. Next, a breathing test called spirometry will be used to confirm your diagnosis of COPD. During the test, you will be asked to exhale for as long and hard as you can into a tube attached to a machine called a spirometer, which will measure both your lung capacity and how quickly you can exhale after taking a deep breath. The results of the spirometry test will help your doctor confirm whether or not you have COPD, and if so, to what extent (e.g., mild, moderate or severe).
To definitively rule out other respiratory disease with symptoms similar to COPD, additional testing may be recommended. Chest X-rays will help physicians determine how much lung damage, if any, has been done, and blood tests can help measure the oxygen and carbon dioxide levels in your blood.
Once a COPD diagnosis is confirmed, there are a number of things you can do to help manage your disease. A combination of preventive strategies, medications and pulmonary rehabilitation, will help you best manage your COPD.
Managing COPD
Preventive Strategies
If you're a smoker, the first and most important thing you should do is stop smoking! This will slow the progress of the disease and make it easier for you to breathe than if you continued to smoke. In addition, do your best to avoid the second-hand smoke of others and other lung irritants (e.g., air pollution, chemicals or dust) that can worsen your symptoms. Other preventive tips include:
Losing weight, if necessary, as excess weight requires you to do more breathing to accomplish the same amount of physical activity
Getting a flu shot and pneumococcal vaccine to reduce your risk of contracting the flu or pneumonia, respectively
Seeking treatment for potential chest infections as early as possible, as COPD impairs your lungs' defense mechanisms and causes infections to linger
Using respiratory therapy devices (e.g., inhalers, nebulizers and oxygen) as instructed
Medications
As a COPD patient, your doctor may recommend you use any of the following types of medications:
Bronchodilators: These medications open your airways by relaxing the surrounding muscles. They may be administered as pills, liquid or inhalers.
Steroids: Inhaled steroids are used to help reduce airway inflammation and are typically administered to patients with moderate or severe COPD. These medications may be used on a trial basis for 6 weeks to 3 months so their effectiveness in alleviating breathing difficulties can be determined.
Oxygen: Oxygen therapy is recommended to patients with severe COPD who are struggling with shortness of breath. This therapy will help to maintain appropriate oxygen levels in the blood, thereby prolonging your life, protecting your heart and other vital organs from damage, improving your sleep patterns at night and mental alertness during the day, and making it easier to complete activities of daily living.
Pulmonary Rehabilitation
Based on a medical evaluation, your physician will customize a pulmonary rehabilitation program specially designed to help you remain as active as possible in your daily life. This coordinated program typically includes aspects such as education on COPD, disease management training (coping strategies), nutrition advice, exercise and counseling. A number of health care professionals-doctors, nurses, respiratory therapists, physical therapists, exercise physiologists and dietitians-collaborate, as a team, to provide you with the comprehensive care you need.
