Signs of COPD? An Expert Answers Your Questions

Having trouble catching your breath? Getting winded just walking the dog? Your lungs may be sending you a signal. Get a pulmonologist’s perspective on spotting the early warning symptoms of COPD and what to do to keep your lungs healthy at any age... Once thought of as a man’s, and even a coalminer’s, disease, chronic obstructive pulmonary disease (COPD) is now on the rise in women. “COPD was considered a man’s disease because more men than women smoked and worked in factories,” says Stephen Mueller, M.D., a pulmonologist at Methodist Charlton Medical Center in Dallas, Texas. “In fact,” he says, “a much larger population of women are developing COPD primarily because they’re smoking as much as men.” According to the National Heart Lung and Blood Institute (NHLBI), more than 12 million people are living with the disease and 12 million more may not realize they have early stage COPD, which blocks airflow and makes it tough to breathe. The best way to prevent it is to stop smoking – immediately. But educating yourself about the warning symptoms of COPD, symptoms and treatment options could save your life or that of a loved one, Mueller says. The best news: If COPD is diagnosed early enough, you can slow down – even stop – lung damage, says Mueller. Here, Mueller explains symptoms of the disease, risk factors and the latest treatments for COPD. What is COPD? COPD describes a number of progressive chronic lung diseases, including emphysema and chronic bronchitis that slowly kill healthy lung tissue. Emphysema causes the air sacs in the lungs to lose their flexibility, which prevents oxygen from entering the bloodstream, making it hard to breathe. Chronic bronchitis, or ‘smoker’s cough,’ is a chronic lung disease caused by inflammation that leads to bronchial tube scarring. This produces excessive mucus that causes frequent coughing and respiratory infections. When these conditions prevent air from flowing freely throughout the lung, parts become damaged or die. Air trapped in the dead or dying areas keeps the lungs from operating on full power, and the COPD patient has a hard time breathing. Until we discover a way to grow or build new lung tissue, there’s no cure for the disease. Who is at risk for COPD? Smokers. The No. 1 contributing factor for developing COPD is smoking. At least 80% of all COPD cases are related to smoking. What are some other risk factors? Genetics may play a role in early symptoms of COPD development, even if a person never smokes, but it’s rare. Unfortunately, there are no genetic tests that can identify who is at risk for developing the disease. Environmental factors, such as volatile chemicals, certain hardeners used in factories and diesel fuel fumes can injure lungs. Coal miners and those who work with asbestos or even cement increase their risk for developing symptoms of COPD. Long-term exposure to high ozone, the main ingredient in urban smog, is thought to contribute to COPD because it deprives the lungs of fresh air. Age is also a factor. Most people develop emphysema in their late 70s or 80s. So, as we age, everyone is at risk for COPD? Yes, eventually just about everyone will develop COPD simply through aging. After age 35, you begin to lose about an ounce of lung tissue a year. It’s a slow process and isn’t noticeable in most healthy people. Smoking can quadruple the speed of the tissue loss, reducing lung capacity and increasing the likelihood of becoming oxygen dependent. But after 40-50 years of this cumulative loss, you may get winded doing simple things, such as carrying groceries from the garage. Patients generally don’t die of age-related COPD. Does having asthma predispose you to COPD? Yes and no. Untreated and uncontrolled asthma can stiffen airways and cause similar symptoms of COPD, such as difficulty in breathing. Do men and women have similar symptoms of COPD? Unlike heart disease, the symptoms are similar. However, the progression of the disease in women seems to be faster, especially if they continue smoking once diagnosed or are diagnosed in the later stages of the disease, or don’t take their prescribed medicines. Unfortunately, no one knows why. What are the symptoms or warning signs of COPD? Chronic bronchitis and coughing up clear mucous are certainly early warning signs of COPD. But its hallmark is shortness of breath. Regardless of frequency, it’s a sign of COPD you should address with your doctor. Most patients in the early stages of COPD feel great sitting or resting. But they’re out of breath if they walk 10 feet. If you suddenly feel winded or short of breath after normal activities, such as walking the dog, grocery shopping or riding a bike, see your physician. Is early diagnosis important in treating or managing symptoms of COPD? Early diagnosis may halt – or slow – its progression. Proper medication can open the airways and improve lung function, which makes it easier to breathe. How is COPD diagnosed? There are several non-invasive ways to test for lung disorders, such as emphysema, but only one will diagnose COPD: a lung function test. What is that? Called a spirometry, this two-step, non-invasive test measures the amount of air your lungs can hold and how fast you can blow the air out of your lungs. The test can detect COPD before you have any symptoms, track the disease’s progression and monitor treatment. The optimum air-flow range depends on [several factors], such as age, weight, smoking history, etc. If a person is diagnosed with COPD, is it too late to quit smoking? It’s never too late to quit. Smoking destroys lung tissue continuously. Quitting now halts the accelerated destruction process, giving the lungs the opportunity to age normally. Is COPD diagnosis an automatic death sentence? No, COPD is an irreversible condition, but some patients have successfully managed the symptoms of this chronic lung disease for more than 20 years. What medications are typically prescribed in the treatments of COPD? Most COPD medications are inhaled, just like asthma drugs. They’re used to widen the airways and make it easier to breathe. Two common drugs are Symbicort (budesonide/formoterol fumarate dihydrate) and Advair (fluticasone propionate and salmeterol). Both were initially designed for asthma treatment, but have been approved by the Food and Drug Administration (FDA) to treat COPD. What are the side effects of those medications? They have side effects that vary with every patient. The most common is dry mouth, which is temporary and may be managed with designated mouth rinses or by changing medicines. Cost is a much bigger factor and deterrent for people. Many COPD medications are expensive and aren’t covered under prescription plans, insurance or Medicare. Are there alternative remedies for COPD? There’s insufficient scientific information to support any benefits of alternative remedies. Acupuncture may help symptoms a little, but not much. Herbs and other treatments have not been effective in treating COPD. Does exercise help manage symptoms of COPD? Most definitely. Aerobic activity, such as walking or riding a stationary bike, improves lung power and capacity, and allows you to be active without getting winded. Can surgerical treatments of COPD minimize symptoms? The most common surgical procedure is lung volume reduction surgery, which removes about 30% of each lung to allow air to circulate more easily. There are currently two surgical options used with this in-patient procedure. A sternotomy is a surgical incision made through the breastbone that allows the surgeon to remove the affected tissue through the chest. The second, a thoracoscopy, is less invasive. It uses graspers and staplers inserted through small incisions on either side of the chest to remove damaged tissue and reseal the remaining lung. Both procedures require hospital stays between 5-10 days and multiple weeks of pulmonary rehabilitation. Unfortunately, it’s a short-term solution. The disease typically recurs two to three years after surgery, which is one reason the procedure is rarely covered by insurance. Gradually, the lung cells begin to die again, symptoms re-occur and patients again become easily winded and need oxygen. What new treatments are on the horizon? A new minimally-invasive procedure is being tested in the U.S. It uses umbrella-shaped valves inserted into the lungs through a bronchoscope (a flexible tube passed into the bronchial tubes through the mouth or nose) to redirect airflow from diseased portions to healthier areas.