Are you one of the 12 million who do not even know they have it?
This month is National Chronic Obstructive Pulmonary Disease (COPD) Awareness Month, an internationally recognized effort to focus on increasing awareness of the disease — often referred to as a silent killer.
Did you know that COPD is one of our nation’s leading killers? It is the fourth leading cause of death in the United States — and yet many do not know what it is, what the symptoms are, nor the steps to take to gain improved health.
A lung disease, COPD causes obstructed airflow in the lungs and results in breathing problems. It is used to describe such lung diseases as emphysema, chronic bronchitis and severe asthma.
The American Lung Association estimates there are 24 million Americans in the U.S. living with COPD — but only 12 million have received a diagnosis. Yes, astonishingly that means half of the people who have COPD don’t even know it.
Why? COPD symptoms can creep up gradually or be mistaken for something else, such as a cough, allergies, cold, flu or other less serious ailments. And add to this, of those people who are thought to have it — few have a good grasp of what it is.
I am joining with medical and healthcare professionals, public health officials and organizations —– as well as those who have been diagnosed and their families — in a national outreach this month to bring important awareness of COPD.
Dr. Nina’s what you need to know: about COPD
What is COPD? First, COPD is not one, single disease, but rather an umbrella term used to describe progressive and chronic lung diseases — emphysema, chronic bronchitis, refractory (non-reversible) asthma, bronchiectasis — that cause airflow blockage and breathing-related problems.
Emphysema occurs when the lung’s microscopic, delicate air sacs become damaged and lose their elasticity. Normally, they are like a midway inflated balloon that maintains its roundish or oval shape, thus facilitating movement in and out of the lungs with every breath. However, with emphysema, the air sacs mimic an amorphous, grocery store plastic bag that easily collapses. As a result, air gets trapped instead of moving in and out of your lungs.
With chronic bronchitis, inflammation combined with too much mucus causes our breathing tubes to become swollen and clogged. And, refractory (non-reversible) asthma is a form of asthma where the airway’s tightening and swelling does not respond properly to asthma medications. Bronchiectasis describes thickening of the breathing tubes secondary to inflammation and infections.
Each of these conditions share one common understanding: the flow of air into and out of the lungs is impaired, making it difficult to breath.
What are risk factors for COPD? While exhaustive studies continue, moreover COPD is caused by long-term exposure to irritating gases or particulate matter. And, smoking is acknowledged as the single most important risk factor. Other chief causes include long-term exposures to lung irritants such as fumes, chemicals, dust or second-hand 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, see your healthcare provider. While there is no cure at this time, being diagnosed early and implementing proven treatments and lifestyle changes can improve your quality of life and slow down disease progression.
What are symptoms of COPD? Symptoms of COPD grow slowly over years. You may have frequent or long-lasting coughs that produce mucus. You may suffer from shortness of breath that gets worse with mild activity, loss of sleep, or with stress or anxiety. You may also notice wheezing or chest tightness when you breathe.
• Shortness of breath: The medical term for this is “dyspnea.” And, often, experiencing an increased difficulty with breathing during exercise is the first noticeable sign of COPD. Over time, people with COPD can actually struggle to catch their breath with routine, daily activities such as getting dressed, walking through a store or light housework. In severe cases, it can occur at rest.
• Coughing: A chronic cough, which may initially be attributed 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 does not go away for long. This coughing is a sign your body is trying to move mucus out of the lungs or reacting to irritants. And 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 (sputum or mucus) is a common symptom of COPD. Clear-colored sputum is most common, but sputum that turns deep yellow, green, brown or red or is blood-tinged probably could mean that the lungs have an infection. And yes, healthy people can produce mucus to keep the airways moist, but with COPD, too much mucus is actually produced. Generally, the cough tends to be worst in the morning and improves as the day progresses.
• Wheezing: A whistling or squeaky sound that occurs when breathing due to narrowed airways or inflammation.
• Chest pain: Pain or soreness can occur 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: Severe COPD can put a strain on the heart, and even cause heart failure with resultant fluid retention.
• 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 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. The weight loss may be due to muscle atrophy (resulting from a lack of exercise or ability to move around); increased energy expenditure associated with breathing; or a combination of these factors.
If you are experiencing any of these symptoms individually, or coupled with others noted — it is very important to discuss them with your healthcare professional as soon as possible. Detection and 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 that half of the people (approximately 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 that, oftentimes, COPD symptoms set in insidiously — they are gradual 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 are experiencing 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 healthcare provider will perform a thorough medical, family and social history; physical examination; and may perform testing. Spirometry 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 healthcare provider can tell if you have COPD, and how severe it is. The spirometry reading can help determine the best course of treatment and if further testing is needed.
What treatments are available? While a cure is not presently available, lifestyle changes and proper treatment can allow for symptom relief, slowing down of disease progression, improved physical activity, prevention of complications and improved overall health.
COPD is not just, simply, a “smoker’s cough,” but an under-diagnosed, life-threatening lung disease that may progressively lead to death. Too many of our loved ones mistake their increased breathlessness and coughing as a normal part of aging. And yes, COPD can develop for years without noticeable shortness of breath. It is important you 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.