COPD stands for chronic obstructive pulmonary disease. This is a term used for a number of conditions; including chronic bronchitis and emphysema.
COPD leads to damaged airways in the lungs, causing them to become narrower and making it harder for air to get in and out of the lungs. The word ‘chronic’ means that the problem is long-term.
- Chronic bronchitis: bronchitis means ‘inflammation of the bronchi’. These are the tubes or airways which carry oxygen from the air through the lungs. This inflammation increases mucus production in the airways, producing phlegm which makes you cough.
- Emphysema: this is where the alveoli (air sacs) in the lungs lose their elasticity. This reduces the support of the airways, causing them to narrow. It also means the lungs are not as good at getting oxygen into the body, so you may have to breathe harder. This can result in shortness of breath.
What causes COPD?
The most common cause of COPD is smoking. Once you give up smoking, you gradually reduce the chances of getting COPD – and you slow down its progress if you already have it.
Occupational factors, such as coal dust, and some inherited problems can also cause COPD. Whether pollution is a factor is under investigation.
How is COPD diagnosed?
Cough, phlegm and shortness of breath can be symptoms of COPD. Some people may only notice their symptoms in winter, or they might put them down to bronchitis or ‘smoker’s cough’. This means that they might not seek help at an early stage of the disease. The sooner people seek treatment the better.
The best way to confirm diagnosis is through spirometry. This is a simple breathing test which you can usually do at your GP’s surgery. You just have to blow into a machine. This will indicate whether your airways have narrowed. In some cases you may need more detailed tests and a referral to hospital.
How do people feel?
The symptoms of COPD vary depending on how bad it is, and how people have adapted to their problems. In mild cases, symptoms like a cough, phlegm and shortness of breath may only be present during the winter or after a cold. In more severe cases, you may be short of breath every day. With more severe COPD, because of breathlessness, normal activities can become more difficult.
COPD can lead to feelings of anxiety because of breathlessness. People with COPD may reduce their activities to avoid becoming breathless. But by reducing activity levels you become less fit and therefore get breathless even sooner when you try to do any activity. People with COPD may adapt their lifestyles to reduce breathlessness – but keeping as fit as possible is important.
Some hospitals run pulmonary rehabilitation courses. These programmes involve exercise and education. Pulmonary rehabilitation improves your exercise performance, your health and your quality of life. Your doctor/nurse can tell you more.
Care and support from family and friends can do a lot to relieve anxiety and depression. The BLF’s Breathe Easy support network offers information and advice to people with COPD and other lung conditions. For more details, contact Breathe Easy at the address overleaf.
Can we prevent COPD?
COPD cannot be cured once you have it, but treatments may help. For most people, stopping smoking reduces the risk of developing COPD and also slows down its progression. However, some people develop COPD for other reasons which may be more difficult to prevent.
There is no cure for COPD but a lot can be done to relieve its symptoms.
- Stopping smoking – stopping smoking will help improve your coughing and phlegm.
- Diet – look after your weight, eat a balanced diet and try to keep as mobile as you can.
- Bronchodilators – if your main symptom is breathlessness, then you may benefit from a bronchodilator. A bronchodilator is an inhaler that delivers medicine to make your airways wider. There are different types of bronchodilators which work in different ways and they can be of benefit if they are used together.
- Nebulisers – nebulisers can provide bigger doses of medicines but inhalers are just as effective. What you are given depends on how • you respond to treatment.
- Steroids – if you become suddenly more short of breath and your symptoms get worse, you may be experiencing what is known as an ‘exacerbation’. Your doctor may give you a short course of steroids for a few days. Some people take a steroid inhaler regularly but your doctor will decide if this is necessary for you.
- Antibiotics – if your phlegm changes colour, becomes stickier, or there is more of it, your doctor may give you a course of antibiotics.
- Flu vaccination – a flu vaccination every autumn is also worthwhile, as flu can cause exacerbations.
Exacerbations – also known as flare-ups – are common in COPD, but taking your treatment regularly may help to reduce how often they happen. Always seek treatment for any exacerbation as soon as you can.
What about oxygen?
Some people with COPD develop low oxygen levels in their blood. Oxygen treats this lack of blood oxygen, it does not treat breathlessness. If you have low blood oxygen levels, the long-term use of oxygen at home could be of benefit to you.
To find out if oxygen can help you, see your doctor who will arrange for tests in a hospital. You will have your blood oxygen measured.
If necessary you will be prescribed oxygen at home using an oxygen concentrator. This is an electrically operated machine that takes air from the oxygen in your home. You can breathe the oxygen in through nasal ‘cannulae’ (small, soft plastic tubes that fit just inside your nostril) or a mask. The oxygen supply tube from the concentrator may be many feet long, so you can move around the house while having your oxygen treatment.
Some people will be given portable oxygen as well as their concentrator. Various small oxygen cylinders are available. They can last for several hours and make shopping or travelling easier.
Once your oxygen needs have been assessed, your oxygen will be provided by an oxygen supply company. Which company supplies you depends on where you live. The hospital will give you details.
The oxygen supply company will also make arrangements for you to receive oxygen while travelling in the UK and Europe.
Remember, there are treatments for COPD and the earlier you get help the better.