By Ritwick Agrawal, M.D. Princeton HealthCare System
Do you have trouble breathing during routine activities like walking up a flight of stairs or bringing in the groceries?
Do you struggle to catch your breath after just a short walk to your car or as you push the vacuum cleaner?
If so, you might be one of millions of people who suffer from chronic obstructive pulmonary disease (COPD), the fourth leading cause of death in the United States, according to the National Heart, Lung and Blood Institute.
A progressive condition — meaning it gets worse over time — COPD is most often treated by lifestyle changes and medication. Additionally, pulmonary rehabilitation programs like the one at University Medical Center at Princeton help patients with COPD breathe easier.
COPD includes two main conditions — emphysema and chronic bronchitis. Many people who have COPD have both.
In patients with COPD, less air flows in and out of the airways due to damage to the lungs, making it harder to breathe and reducing the amount of oxygen delivered through the bloodstream.
This damage most often occurs as a result of cigarette smoke and can also — although not as often — be caused by pollution and exposure to chemical fumes or dust in the environment or workplace.
Signs and symptoms of COPD include:
• An ongoing cough or a cough that produces large amounts of mucus (often referred to as “smoker’s cough”).
• Shortness of breath, especially with physical activity.
• Wheezing.
• Tightness in the chest.
It’s important to note that these symptoms are similar to symptoms for other diseases and conditions. If you are experiencing these symptoms, see your doctor for a correct diagnosis. If you are unable to catch your breath or have trouble talking, call 9-1-1 for emergency help.
COPD symptoms develop slowly and worsen over time. In the early stages, you may not even realize you have the disease. In fact, many people incorrectly associate the symptoms with aging. However, shortness of breath during normal activities and constant coughing are not natural signs of aging.
In diagnosing COPD, your doctor will likely measure your lung function with a simple test called a spirometry to determine how much air you can breathe in and out. This test can help indicate how severe your COPD is and help establish a treatment plan.
In some cases, your doctor may also order an X-ray or CT scan of your chest to see signs of COPD and determine whether another condition may be causing your symptoms.
While COPD has no cure, it can be treated.
The first step? Quit smoking.
Most people with COPD smoke or used to smoke. Fortunately, quitting helps slow the progression of the disease and can reduce the severity of symptoms. Anti-smoking medication and smoking cessation programs can help smokers kick the habit and return to a healthier lifestyle.
Additionally, doctors commonly prescribe medications such as bronchodilators and steroids to help improve your ability to breathe and prevent COPD from progressing.
Bronchodilators relax the muscles around your airways and open them up to make it easier to breathe. Doctors may prescribe short-acting bronchodilators to be used when symptoms occur or longer-acting medicine to be taken every day. Inhaled steroids are also prescribed in advanced stages of COPD. If symptoms flare up or worsen, doctors will likely prescribe oral steroids to reduce airway inflammation.
Moreover, patients with COPD are more susceptible to complications from the flu or pneumonia. Doctors will typically advise patients to get vaccines against both of these illnesses.
In the most severe cases of COPD, patients also may require oxygen therapy to help them breathe better while performing routine activities and to protect their hearts and other organs from damage caused by lack of oxygen.
Many COPD sufferers also benefit from pulmonary rehabilitation, a medically supervised program that helps improve the health and well being of patients with lung problems. At University Medical Center at Princeton, the Pulmonary Rehabilitation Program includes a customized exercise plan, as well as education sessions for patients, family members and loved ones.
The exercise plan uses a variety of fitness equipment to help patients gradually build strength and stamina. The program is individualized and modified for every patient based on personal medical needs, physical abilities and recommendations from the physician.
Education sessions are conducted by a licensed registered respiratory therapist and address topics such as:
• Breathing and relaxation techniques.
• Emergency planning.
• Medication management.
• Nutrition.
• Panic control.
• Stress management.
Most patients who participate in a pulmonary rehabilitation program report decreased shortness of breath and an increased ability to perform daily activities.
Being short of breath is a terrible feeling. With help, patients with COPD can breathe easier and improve their quality of life.
For more information about pulmonary rehabilitation or to find a pulmonologist on staff with Princeton HealthCare System, call 888-742-7469 or visit www.princetonhcs.org.
Ritwick Agrawal, M.D., is board-certified in internal medicine and specializes in pulmonary disease medicine, critical care and sleep medicine. He is a member of the medical staff at University Medical Center at Princeton.
