By Dr. Dorian James, RCP, AE-C
We’ve heard the term COPD but what does that mean?
The acronym stands for Chronic Obstructive Pulmonary Disease and is primarily comprised of two conditions-chronic bronchitis and emphysema.
The statistics are overwhelming, 15 million adults in America, that’s one out of every 5 people that are afflicted with COPD.
With 377 deaths per day, that gives us a rate of one person with COPD dying every 4 minutes.
The statistic that is most alarming is an estimated 10 million more people have COPD but are undiagnosed.
But this isn’t about statistics, this is about you and/or your loved ones. This is about suffering from the symptoms of COPD that affects your abilities to engage in normal daily activities, that affects your ability to breathe without difficulty and affects your ability to even get a restful night’s sleep.
The most noticeable characteristics of COPD are a frequent cough with or without mucus production, wheezing and progressively worsening shortness of breath with activity.
COPD is mainly acquired from years of smoking, long term exposure to harmful irritants in the air in certain occupations such as working around chemicals/ fumes, factories or any work environment that exposes the lungs to anything that causes destruction of lung tissue.
Another important cause of COPD is a long history of poorly controlled asthma.
If you have been diagnosed with COPD, it is most important that you know what STAGE of COPD that you are in.
There are 4 stages beginning with the lowest- Stage I and advancing to the highest or worst stage- Stage IV.
Each stage has a different treatment plan and your care plan should be based on a thorough pulmonary evaluation to determine which Stage your condition designates.
The easiest to treat is obviously Stage I which sometimes requires little medication to manage but quitting smoking is the only treatment to prevent any further damage to the lungs.
As you progress through Stage I into the next stages, higher doses of stronger medications are required.
Quitting smoking in the early stages will prevent any further progression of the disease.
To be clear, you can be active and have relatively few symptoms in the first 2 stages of COPD but things get more complicated in the last 2 stages.
By Stage III, you are having symptoms more frequently that creates more problems for you engaging in daily routines.
There will likely be ER visits for respiratory distress with occasional inpatient hospitalizations and supplemental oxygen may be required.
The last Stage is just that, also known as endstage COPD.
At this point, the lung damage is so severe that even with the highest doses of the strongest medications, plus oxygen tanks and nebulizers, there will be brief or no relief from the symptoms of COPD.
Every breath will be a struggle until the last breath. How do we wind up at Stage IV? First of all, the inability to not only quit smoking, but also the inability of not being able to stop being around other smokers since second hand smoke is just as bad as the first.
This also means that anyone who smokes in a house where children reside is causing damage to their young, developing lung tissue and puts them at risk for asthma, illness and yes, COPD as well.
Second, people hate taking medications. Many studies show that regular medication use improves symptoms and quality of life but there are just as many studies that show that most people don’t use their medications regularly.
This is not to account for COPD’ers that may have difficulty obtaining their medications and therefore only use them when they have problems breathing.
This is for the patient that has good prescription coverage and medication access but choose to only use the medications when breathing is bothersome, because they don’t want to take a medication for breathing everyday if they have days when the breathing is more tolerable, and, they continue to smoke on top of that.
Third, most people with COPD has had such a long, slow increase in respiratory symptoms, especially cough and shortness of breath, they often do not recognize the degree of severity of their lung condition.
Other times, people do recognize that a problem exist but addressing it with a clinician means that they are going to be told to quit smoking and to use at least one medication every day.
To avoid this scenario, we either avoid going to the doctor or leave out some important details about our health.
For example, if you’re asked ”how much do you smoke”, and you answer, “about a half pack per day” but neglect to mention that’s just for the first half of the day, you’ve just left out an important detail.
In conclusion, you will not likely find a COPD patient in Stage IV that wishes they had taken the opportunity at Stage I or II to change the situation they currently find themselves in because once you get to Stage IV, there is no more hope or help available for you.
How will you know if you’re a high risk patient for obtaining Stage IV COPD?
That’s simple, check your priority list, if breathing isn’t at the top, you are certainly at the highest risk.
If it is at the top, that means you have successfully quit smoking, are using your COPD medications everyday as prescribed and you are enjoying a better quality of life for your efforts.
Best wishes on your journey to good lung health.
Dorian James, RCP Owner and Director of the Pulmedix Asthma Care Center