COPD, or Chronic Obstructive Pulmonary Disease, is one of the leading causes for hospitalization in the United States. It's a very costly disease to the patient and their families, and it’s just so heartbreaking to see formerly healthy, strong men and women hunched over, struggling to breathe.
What is COPD?
There are two kinds of diseases that affect our lungs. One is an acute disorder, such as an upper respiratory infection, a cold or pneumonia. An acute lung disease might also be the result of infection, injury or bleeding. The second is a chronic disorder, such as COPD, which persists over time.
Chronic lung disorders can be divided into two classes: obstructive and restrictive. Obstructive means there's something that causes the airway not to stay open when a person is breathing out. Air gets trapped inside the lungs, which makes it difficult to breathe. With restrictive lung disorders, you see scar tissue, maybe the patient lost a lung and now has inflammation from the scar tissue or tumor and it restricts their ability to take a deep breath.
COPD is a chronic disease that affects the lungs. With obstructive, the airways are blocked and it’s difficult to get any air out and enough air in. Emphysema and bronchitis are chronic, but bronchitis may not necessarily be obstructive. Asthma is a disease of inflammation, which can be acute or chronic.
Who’s Affected by COPD?
COPD is an umbrella term that includes emphysema, chronic bronchitis, certain types of bronchiectasis, and sometimes asthma. With COPD, we focus on emphysema more than anything else. It's a disease that primarily affects cigarette smokers.
It’s interesting that COPD and emphysema only affect one in five cigarette smokers, because. I thought it was much higher. While only 20 percent of smokers will get COPD, almost 100 percent of patients with COPD are smokers. It’s probably a genetic predisposition that determines whether a person smokes, but no one knows what triggers COPD or emphysema in certain smokers
What Happens to Patients with COPD?
COPD causes a couple of changes in the lungs that make it very difficult to breathe. We describe smokers with COPD as either “pink puffers” or “blue bloaters.” The pink puffer might be a very overweight man who’s very pink and puffy, trying to huff and puff and breathe. The blue bloater is somebody who’s skinny, dusty-colored and coughing up lots of stuff. They are very bloated because they're keeping air inside.
It takes longer for patients with COPD to breathe out because they can’t get the oxygen to go where it needs to go. Your airway is like a vacuum cleaner hose. It has different little rings that go around it and it stays open whether air is going in or going out. Unfortunately, with long-term damage from smoking, you lose that elasticity and the airway collapses as the air pushes its way out. A person takes a breath in and then they try to breathe out, and the airway collapses and traps the air inside.
Our lungs are like bubble wrap. They have little tiny cells all over that transfer oxygen into the bloodstream. Another thing that happens with a long-term smoker is those little cells become big cells and blips, and they can't transfer the oxygen back and forth. These patients struggle to take oxygen in and then can't get it out. It's very uncomfortable and scary not to be able to get your breath.
How is COPD Treated?
The first thing we do is try to get the patient to stop smoking, because we want to get as much production out of that lung and those bronchial tubes as we can. If a person continues to smoke, the airway system or vacuum cleaner fails to clear debris from the lungs. The debris chronically irritates the lung lining and the bronchial tubes, which results in mucus build-up and narrowing of the bronchial tube lining.
The mucus is thick and hard to get out, which results in patients straining to cough to get it out. We want patients with COPD to stop smoking so their vacuum cleaner system can regrow and clear out all of the debris in the lungs.
Secondly, we work to improve their oxygenation. If they're not getting enough oxygen, we give them an oxygen tank to wear to keep air flowing through the bloodstream. We also want to keep the lung lining and the lining of the bronchial tubes as clean as possible, so we may prescribe a mucolytic, a drug agent that breaks open mucus. Some patients may need a bronchodilator or inhaler to encourage the bronchial tubes to stay open longer, so they can breathe in and breathe out.
Can COPD be Prevented?
The moral of this story? Don't smoke. We occasionally see emphysema in a non-smoker, but most of the time the disease affects people who smoke cigarettes. Many times, it’s people who started smoking in their 20s or 30s. All of a sudden they just fall off a cliff between age 50 and 55, and it's the point of no return.
Only 7 percent of people over the age of 70 are smokers; the rest are either dead or they're on oxygen. Smoking is an addiction, so it’s best not to start or stop early, because you might end up walking around with an oxygen tank on your back.
Dealing with COPD is a miserable thing, but it doesn’t have to be. Smoking is the leading culprit for developing COPD, and I see the toll that smoking takes on the body every day. Encourage those around you, even if they only smoke on occasion, to not smoke at all.
If you struggle to breathe, please visit your doctor early and get tested for COPD. At Westfield Premier Physicians, we do a pulmonary function test once a year on all of our patients over the age of 40. If we stop it early, then we've just saved another life.
If you have questions or want more information about the effects of COPD and how to treat it, please give me a call at (317) 867-1115.