This month, the COPD community comes together to focus awareness on the disease that the National Center on Health Statistics claims affects nearly 38 million Americans, 12 million of whom have not yet been diagnosed. “COPD” is the abbreviation for chronic obstructive pulmonary disease, a significant health burden, but one that is preventable and treatable. COPD is the fourth leading cause of death in the United States.
What Is COPD?
COPD is a group of chronic inflammatory lung diseases that cause obstructed airflow from the lungs, making it hard to breathe. COPD usually is caused by long-term exposure to irritating gases or particulate matter, such as cigarette smoke. People with COPD can develop heart disease, lung cancer, and other life-threatening illnesses.
Normally, airways and air sacs (alveoli) in the lungs are elastic. When people breathe, the airways bring air into the air sacs in the lungs and back out again, similar to air filling and being released from a balloon. But people with COPD experience less air flow in and out of the lungs because of the following:
- Airways and air sacs become less elastic
- Walls between air sacs are destroyed
- Walls of the airways become thick and inflamed
- Airways make more mucus than usual and become clogged
Emphysema and chronic bronchitis are the two most common types of COPD. Emphysema occurs when air sacs at the end of the smallest air passages (bronchioles) are destroyed as a result of damaging exposure to cigarette smoke or other irritating gases and particulate matter. Chronic bronchitis is inflammation of the lining of the bronchial tubes, which carry air to and from the air sacs in the lungs.
COPD can worsen over time, but it is treatable.
Symptoms of COPD
Common symptoms of COPD are:
- Shortness of breath during physical activities
- Wheezing
- Tightness in the chest
- Chronic cough that may produce mucus (sputum)
- Frequent respiratory infections
- Low energy
- Unintended weight loss (in later stages of the disease)
- Swelling in the ankles, feet, or legs
- Experiencing exacerbations, symptoms that become worse and persist for several days
It is advised to see a doctor if symptoms do not improve or get worse, or if a fever or a change in sputum occur, indicating an infection.
Causes and Risk Factors for COPD
The following risk factors contribute to COPD: 
- Smoking: Smoking is the leading cause of COPD, with between 75 and 90 percent of people with COPD being cigarette smokers or having been smokers. According to the American Lung Association, a burning cigarette releases more than 7,000 chemicals, all of which are harmful. The toxins weaken the lungs’ defenses against infections, narrow air passages, cause swelling in air tubes, and destroy air sacs. Other types of smoking, including pipe and cigar, also can contribute to COPD.
- Long-term exposure to lung irritants: Secondhand smoke, air pollution, chemical fumes, and dusts from the environment or workplace can contribute to COPD.
- Age: The average age of diagnosis is 40 years old.
- Genetics: People who carry the rare alpha-1 antitrypsin gene deficiency are prone to COPD, and the disease occurs in families.
- Health history: A history of childhood respiratory infections can contribute to COPD.
To make a diagnosis, a health-care provider will ask about your personal medical history and your family medical history, as well as your symptoms. Lab tests may be performed to include a lung-function test such as a spirometry test, a chest X-ray or CT scan, and blood tests.
Managing COPD
Although COPD cannot be cured, treatments can help with symptoms and to slow the progress of the disease. Complications may also be treated as they arise. Treatments include the following:
1. Lifestyle changes to include:
- Quitting smoking
- Avoiding secondhand smoke
- Changing homes or jobs to be away from environmental or workplace irritants
- Meal planning to meet your nutritional needs
- Physical activity to strengthen muscles that aid in breathing and to improve overall wellness
2. Medicines, including:
- Bronchodilators, which relax the muscles around airways; steroids may be included to reduce inflammation
- Vaccines for the flu and pneumococcal pneumonia, diseases that pose a major risk for COPD sufferers
- Antibiotics to clear bacterial lung infections
3. Oxygen therapy used all the time or only at certain times.
4. Pulmonary rehabilitation to help ease breathing to include:
- Exercise
- Disease-management training
- Nutritional counseling
- Psychological counseling
5. Surgery is a last resort but may be required when medicines and other therapies are not effective. Surgery may involve:
- Removing damaged lung tissue
- Removing large air spaces that can form when air sacs are destroyed
- Lung transplant in severe COPD cases
Prevention and Help for COPD
Because the number one cause of COPD is cigarette smoking, not smoking is the best way to prevent COPD. Help with quitting tobacco, including e-cigarettes and vaping, is available on the American Lung Association (ALA) website or by calling 800-LUNGUSA Monday through Friday, 6 a.m.–4 p.m. PDT (messages can be left after hours). For nonsmokers, avoid lung irritants as much as possible, including secondhand smoke, chemical fumes, and dust particles.
For more information on COPD and other lung diseases, contact the San Diego/Imperial Office of the ALA at 619-297-3901 or by email, or visit the ALA website .
The ALA also sponsors the Better Breathers Club program to provide support and education to people living with lung disease. A chapter meets at Herrick Library the third Friday of each month when the library is open, but during the pandemic, meetings are held online only. See the Better Breathers Club website for information on joining a local support group and to register for the hour-long COPD Management During the Pandemic webinar, which is provided on demand.
Herrick Library Resources on COPD
The following books and DVDs can be reserved and checked out from Herrick Library via curbside pickup:
- Aligned and Well: When You Can’t Breathe, with Katy Bowman: A DVD featuring biomechanical scientist Bowman, who analyzes how human movement can be improved to aid in breathing.
- The Comfort of Home for Chronic Lung Disease: A Guide for Caregivers, by Maria Meyer and Paula Derr: A book for caregivers and family members to help them understand common problems faced by people with chronic lung diseases.
- The COPD Solution: A Proven 10-Week Program for Living and Breathing Better with Chronic Lung Disease, by Dawn Lesley Fielding: Respiratory therapist Fielding shares the program she uses in her practice that has helped 100 percent of her patients improve their breathing.
- COPD: Learn More, Breathe Better: A DVD presented by the National Institutes of Health that increases awareness and understanding of lung diseases and conditions.
- Lung Disorders: Your Annual Guide to Prevention, Diagnosis, and Treatment, by Stephen Mathai: Dr. Mathai presents an up-to-date annual guide to prevention, diagnosis, and management of lung problems, including COPD.
- Natural Therapies for Emphysema and COPD, by Robert Green Jr.: This book takes a nutritional and alternative medicine approach to treat emphysema and COPD.
- Positive Options for Living with COPD: Self-Help and Treatment for Chronic Obstructive Pulmonary Disease, by Teri Ann Allen: A comprehensive guide to help COPD sufferers work with their physical limitations to live a full and healthy life.
- Take Control of Your COPD: A Guide to Better Living: A patient-education video that explains COPD and how to improve overall well-being.
Sources: American Lung Association, COPD Causes and Risk Factors, https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/what-causes-copd#:~:text=Long%2Dterm%20exposure%20to%20air,%2Drelated)%20can%20cause%20COPD; Mayo Clinic, COPD, https://www.mayoclinic.org/diseases-conditions/copd/symptoms-causes/syc-20353679#:~:text=Chronic%20obstructive%20pulmonary%20disease%20(COPD,(sputum)%20production%20and%20wheezing; MedlinePlus, COPD, https://medlineplus.gov/copd.html; Office of Disease Prevention and Health Promotion, Respiratory Diseases, https://www.healthypeople.gov/2020/topics-objectives/topic/respiratory-diseases#:~:text=Currently%20more%20than%2025%20million,have%20not%20yet%20been%20diagnosed
Graphics: National Institutes of Health, https://www.nhlbi.nih.gov/health-topics/education-and-awareness/copd-learn-more-breathe-better/copd-awareness-month; MedlinePlus, https://medlineplus.gov/ency/article/000091.htm
