Nina Radcliff

Dr. Nina Radcliff


A somewhat common health problem today affects the well-being of an estimated 24 million Americans nationwide: chronic obstructive pulmonary disease. And you, or someone you love, could be one of them.

Half of people who have COPD don’t know it. Why? Symptoms can creep up gradually or be mistaken for something else, such as a cough, allergies, cold, flu or other less serious ailments. And of those who are thought to have it, few have a good grasp of what it is.

Do you know the most common symptoms of COPD are breathlessness, or a “need for air,” excessive sputum, or mucus, and a chronic cough? And no, COPD is not simply a “smoker’s cough,” but an underdiagnosed, life-threatening lung disease that can progressively lead to death.

I am joining medical and health care professionals and public health officials — as well as those who have a diagnosis and their families — in national outreach this month to raise awareness of COPD.

One of our nation’s leading killers, COPD is the third leading cause of death in our country, killing more than 120,000 people every year. And yet it remains somewhat of a silent, invisible disease.

Dr. Nina’s What You Need To Know: About COPD

What is COPD?: COPD is not one single disease, but an umbrella term describing chronic lung diseases that limit your lung airflow.

More familiar terms you may have heard over time to describe progressive lung disease may be chronic bronchitis or emphysema, which are terms no longer used but now included within the COPD diagnosis, as well as the conditions of refractory, or nonreversible, asthma and bronchiectasis.

Each of these conditions share one characteristic: The flow of air into and out of the lungs is impaired, making it difficult to breathe.

What are risk factors for COPD?: COPD is caused by long-term exposure to irritating gases or particulate matter, although exhaustive studies continue. Smoking is acknowledged as the single most important risk factor, while other chief causes including long-term exposures to lung irritants such as fumes, chemicals, dust or secondhand smoke. In addition, a genetic condition called alpha-1 antitrypsin deficiency can be a cause.

If you have been exposed to irritants or are experiencing symptoms, seek care from a health-care professional. While there is no cure at this time, seeing your physician and implementing proven treatments and lifestyle changes can improve your quality of life and slow disease progression.

What are symptoms of COPD?: Experts underscore you may experience one or more of the following:

Shortness of breath: You may find you have increased difficulty breathing when you exercise. Over time, people with COPD can actually struggle to catch their breath even when getting dressed, walking through a store or doing other routine, daily activities. In severe cases, it can occur at rest. This shortness of breath is called dyspnea.

Coughing: A chronic cough, which you may initially attribute to a cold or other minor condition, can be an early sign of COPD. Unlike other coughs, however, it doesn’t go away — or it doesn’t go away for long. This coughing is a sign your body is trying to move mucus out of the lungs or reacting to irritants. While this symptom, like others, might actually improve initially with some kind of treatment, it doesn’t get better over the long term.

Excess phlegm: Coughing up phlegm is a common symptom of COPD. Clear sputum is most common, but sputum that turns deep yellow, green, brown or red or is blood-tinged probably could mean the lungs have an infection. Healthy people can produce mucus to keep the airways moist, but with COPD, too much mucus is produced — for example, having to routinely clear your throat first thing in the morning, due to excess mucus in your lungs.

Wheezing: A whistling or squeaky sound that occurs when breathing due to narrowed airways or inflammation.

Chest pain: Chest pain or soreness can happen as a result of the effort involved in breathing or coughing that strains the chest muscles.

Lung infections: People with COPD are highly vulnerable to lung infections, whether viral or bacterial

Swelling of feet, ankles or legs: Swelling of the feet and ankles can occur in people with more severe COPD — a result of fluid retention or an indirect result of the lung disease. Fluid buildup is a symptom of heart failure, which can occur because COPD makes the heart work harder.

Increased fatigue or lack of energy: Routinely feeling tired or a lack of energy is a common problem with COPD, primarily because the body has to work so much harder to breathe.

Blueness of the lips or fingernail beds: The technical term is cyanosis and it may not be experienced by everyone who has COPD.

Unintended weight loss (in later stages): This is more common in those with emphysema-type COPD, rather than chronic bronchitis type. This weight loss may be due to muscle atrophy, resulting from a lack of exercise or ability to move around; increased energy use associated with breathing; or a combination of these factors.

If you experience any of these symptoms individually, or coupled with others, it is very important to discuss them with your health-care professional as soon as possible. Diagnosis begins with you.

Also, it is important to underscore that early on, you may have no symptoms at all. As noted earlier, it is estimated half of the people — about 12 million — who have COPD today don’t know it, primarily because people may not have what they consider obvious symptoms. One reason for this is COPD symptoms often set in very gradually over time, and consequently go unnoticed. Generally speaking, COPD is diagnosed in middle-aged and older adults. Knowing and understanding these facts is vital.

If you experience shortness of breath with exertion, wheezing, a frequent cough or chest tightness, take it seriously. For example, you may start getting short of breath at the top of the steps, but after a few months it is the 11th step, and then a few months later it is the 10th step.

What should I expect at my visit? Your health care provider will perform a thorough medical, family and social history and a physical examination and may perform testing. Spiro-metry is a common, noninvasive and painless lung function test that can detect COPD before symptoms become severe. It measures the amount of air you can blow out of your lungs (volume) and how fast you can blow it out (flow). This way, your health-care provider can tell if you have COPD, and how severe it is. The spirometry reading can help determine the best course of treatment and whether more testing is needed.

What treatments are available?

While a cure is not currently available, lifestyle changes and proper treatment can allow:

• Relief of symptoms

• Slowing down disease progression

• Improved physical activity

• Prevention of complications

• Improved overall health

Too many people mistake their increased breathlessness and coughing as a normal part of aging. And COPD can develop for years without noticeable shortness of breath. It is important to know the facts and talk to your doctor as soon as you or someone you love notices any of these symptoms. Early diagnosis is key. Take action to prevent more damage and make wise health decisions to breathe and live healthier.

Dr. Nina Radcliff, of Galloway Township, is a physician anesthesiologist, television medical contributor and textbook author. Email questions for Dr. Nina to with “Dr. Nina” in the subject line. This article is for general information only and should not be used for the diagnosis or treatment of medical conditions and cannot substitute for the advice from your medical professional.

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