Health Secrets	UPDATED: Monday, February 27, 2006
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Fighting and Coping With Lung Disease

Posted on Wednesday, March 01, 2006

COPD Requires Good Health Care

By Wendy J. Meyeroff
THE ERICKSON TRIBUNE

The odds are you have never heard of COPD, chronic obstructive pulmonary disorder. It is a disease in which the lung is damaged, making it hard to breathe. According to the National Heart, Lung, and Blood Institute (NHLBI), COPD is the fourth leading cause of death and illness worldwide. COPDInternational says it estimates 16 million people in the U.S. have this disorder.

Types of COPD

The most common cause of COPD is smoking, but other lung irritants can cause the problem. People who worked in factories with various air pollutants, like asbestos, can be affected. Pollution, dust, and other chemicals absorbed in heavy dosages can also contribute.

The two most common forms of COPD are emphysema and chronic bronchitis. “Emphysema is the actual loss of lung tissue. Bronchitis is where the lung passages shrink; it’s like trying to breathe through a tube the size of a straw, instead of your thumb. In both cases it can get to the point where you can no longer get enough oxygen into your lungs to support your activities,” says Leslie Brandwin, medical director of Greenspring, a community in Virginia built and managed by Erickson.

Early Diagnosis Is Important

The more severe COPD is, the more at risk you are for problems like heart failure and the more likely your overall quality of life will be (or is already) impaired. As with most illnesses, the sooner COPD is diagnosed, the more likely you are to keep such effects to a minimum.

There are two major obstacles to diagnosis. The first is simply the public’s lack of awareness about the condition. COPD International estimates in the U.S. alone, 14 million or more people are still undiagnosed.

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The second obstacle is COPD tends to creep up over time. In the early stages, these disorders present few or minimal symptoms. Things like chronic cough or breathing hard after some brisk activity are often easily dismissed as overwork, stress, or other things. That is why it is not unusual for COPD not to be diagnosed until people are in their 50s or even older.

Besides listening to your lungs and asking about your personal and family history, the best way for doctors today to diagnose if you have COPD—and determine how advanced it is—is to perform a simple test called a spirometry. “We do it right here in the office. You breathe into a large hose attached to a machine, called a spirometer. It measures two things: air volume and flow. How much air can you push out of your lungs and into the hose and how fast can you do it without exhausting yourself,” says Brandwin.

Have You Heard of Pulmonary Rehab?

The first course of treatment for COPD is medications. The two types most commonly used are bronchodilators that relax the muscles around your airways and glucocorticosteroids designed to reduce airway inflammation. Both are designed to make breathing easier.

“The steroids can be taken orally or inhaled. For some people, inhaling steroids is equally effective as taking it by mouth and a lot less troublesome as far as side effects. Inhaled steroids tend not to be absorbed so you don’t get the weight gain, puffy cheeks, and other steroid side effects,” says Brandwin.

Beyond medication, another treatment is getting more respect: pulmonary rehabilitation. It’s a combination of exercise, disease management training, and counseling. “It’s very interesting to see the results of pulmonary rehab. From not doing more than sitting on the side of the bed, a month or two later they are getting around. They may be using an oxygen tank, but at least they are off the bed,” says Brandwin.

Flying’s More Accessible

Another major advance is not about treating COPD, but living with it. Most people with COPD live an active and rich life, just like people with other chronic diseases. But one area has always been pretty much closed to them: air travel.

Since oxygen is highly combustible it used to be extremely difficult for travelers with COPD to find air passage. Even when airlines provide oxygen service, it’s very expensive (up to $1,500) and does not extend to people who are unexpectedly diverted; you must find your own oxygen during layovers.

Last summer the FAA allowed people to start bringing their own portable oxygen concentrators. Unlike tanks with pure oxygen, these draw oxygen in from the air and are not considered hazardous. They may still be expensive (check with your insurance plan), but for some people the new regulations and these devices make life with COPD even more optimal.

If you smoke or have any breathing problems, talk to your doctor now about testing for COPD. The sooner you get treated, the fewer obstacles you will face continuing a healthy, active lifestyle.