By Seth Lamming
From PHN Issue 44, Fall 2020
Chronic obstructive pulmonary disease (COPD) is a common group of diseases that affect the lungs and airways. COPD is treatable and preventable, but it is the fourth leading cause of death in the United States. COPD is caused by smoking or inhaling fumes or dust over a long period of time. Sometimes genetics and environment can cause COPD, as well as untreated asthma.
The lungs are a pair of air-filled organs in the chest that allow your body to take in oxygen and exhale carbon dioxide. Air goes down the trachea (windpipe) and splits off into two bronchi (smaller windpipes) that supply each lung. The two windpipes supplying each lung branch off and get smaller and smaller, like tree roots. At the end of each airway are tiny alveoli (air sacs). Blood vessels surround the air sacs and take oxygen from them to the body.
Chronic bronchitis and emphysema are the two major categories of COPD. Many people have a combination of both, but one type usually dominates. Chronic bronchitis is when the airways become inflamed and get narrow. The airways also release a lot of thick mucus that the body cannot clear. In emphysema, the air sacs get damaged and can no longer exchange oxygen with blood vessels in the lungs. Air gets trapped in the lungs, which causes airspaces in the lungs to get permanently enlarged. The word “obstructive” in COPD refers to air getting trapped in the lungs. Physical changes to the airway make it difficult for people with COPD to fully exhale each breath.
Shortness of breath, mucus, and a cough or wheeze are the most common symptoms of COPD. Easily getting out of breath during physical activity like walking up the stairs can be an early sign. Medical providers use a history of symptoms and a lung test called spirometry to diagnose COPD. Spirometry measures how much air the lungs are able to exhale.
The best way to manage COPD is to quit smoking. Doing a combination of strength and endurance exercising, like lifting light weights and walking, can help the lungs work better. Eating a balanced diet and getting plenty of sleep are also important.
People with COPD commonly take bronchodilator inhalers for opening up the airways. Sometimes people also need inhaled steroids for reducing inflammation in the airways. Depending on how severe the disease is, you might need to use supplemental oxygen. Talking to your doctor about breathing techniques for COPD could also help with symptoms.
It is important for people with COPD to avoid getting sick. A COPD exacerbation is when something triggers symptoms to get worse for a period of time and it is harder to breathe. Exacerbations are usually caused by upper respiratory infections like a cold. Everyone with COPD should get the flu vaccine and pneumococcal vaccine. Over time, exacerbations can lead to permanent lung damage. As much as possible, always practice good hand hygiene and social distancing.