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    Understanding COPD (Chronic Obstructive Pulmonary Disease)

    Raghav Gupta, MD, FCCP Deaconess Pulmonary and Critical Care 01/17/2019

    Raghav Gupta, MD, FCCP,  Deaconess COPD Medical Director, led the development and creation of the Deaconess COPD Readmission Reduction Program. Dr. Gupta is nationally and internationally recognized in the world of Pulmonary Medicine. Below he shares key facts about COPD.

    COPD stands for Chronic Obstructive Pulmonary Disease, which includes emphysema and chronic bronchitis. When someone has COPD, they may experience breathlessness/shortness of breath, cough, wheezing, and production of mucus/phlegm.  All of these symptoms can affect their quality of life and daily function. COPD is the 4th leading cause of death in the U.S., and prevention and careful management is critical in delaying the onset or effects.

    Preventing Lung Disease
    As a lung specialist, I can’t emphasize enough the importance of preventing lung disease BEFORE it starts. The single most important step in preventing these diseases is to not smoke, and if you do smoke, QUIT.

    • Quitting is easier said than done, but by quitting smoking, you may add years to your life and life to your years.
    • Avoid triggers (dust, mold, strong odors/scents, pollution, stress) that your body is particularly sensitive to.
    • If you work around dust and chemicals, protect yourself with the appropriate mask designed for that material, which should be provided by your employer.
    • Avoid cigarette/tobacco smoke—first AND second-hand. “Third-hand” smoke, which is the residue left on clothing and furniture, is bad as well. So avoid places where people smoke indoors.
    • Proper nutrition, hydration and good health habits overall are good for your entire body—lungs included! (If you’re having problems with thick mucus, being well-hydrated can help with that.)
    • If certain lung diseases run in your family, such as asthma, alpha-1 anti-trypsin deficiency, etc., partner with your doctor for any needed screenings, tests and preventive care.
    • If you notice a persistent change in your breathing, such as a cough, shortness of breath, wheezing, etc. see your doctor.

    Diagnosing COPD 
    When diagnosing COPD, the following is all considered and gathered by your physician:

    • Symptoms
    • Duration
    • Exposures/lifestyle/work history
    • Family history
    • An overall assessment

    A commonly used test is a pulmonary function test, also known as a PFT. A PFT entails several breathing tests, checking for lung capacity and speed of inhalation and exhalation. A breathing treatment may be given to see if it changes the test results when the test is repeated.

    Managing COPD
    Staying active is important to help your lungs stay conditioned. If you don’t regularly use your breathing muscles, they become weaker and weaker, and you use them less efficiently. That can set up more problems, such as increased susceptibility to infection. Air needs to be exchanged. Follow the advice of your doctor and other health care professionals to find out which activities are best for you, and how much you should do.

    Keep appointments with your primary care doctor and specialists, so that they can help you manage your COPD symptoms.

    How to prevent COPD exacerbations, hospitalizations and readmissions
    COPD leads to a large number of emergency room visits each year.  Plus, many people find themselves back in the hospital within 30 days because they don’t know how to take care of the disease once they go home.

    At Deaconess, we offer COPD patients support and assistance from a team of people who teach self-care at home to prevent future hospitalizations. Here are steps you can take to help stay out of the hospital:

    • Educate yourself and family members. Deaconess has respiratory therapists available to teach patients using the COPD patient education booklet and answer questions.
    • Learn self-care skills for home such as proper inhaler use and secretion clearance techniques from our team.
    • Review smoking cessation techniques if needed.
    • Get your annual flu and pneumococcal vaccinations.
    • Keep follow up appointments with your primary care physician or pulmonologist.  Pulmonary rehabilitation and palliative care referrals are sometimes needed after a hospitalization, and your care team will determine the need for referrals during follow up appointments. 

    You won’t be alone in managing your disease at home.  Deaconess offers telemedicine services with a nurse monitoring your treatment.  Your nurse is available to answer questions and solve problems that arise with your self-care.  

    Following these steps and taking advantage of the services available for COPD patients can lead to a better quality of life and fewer hospitalizations.

    Special tips for winter
    In the winter, several things happen that cause respiratory patients to suffer.

    The cold air outside can be a significant irritant to airways. When a COPD patient inhales dry, frigid air, the airways can tighten almost instantly. The warm, very-dry, stagnant indoor air also creates problems. Without air exchange, and by people “re-breathing” so much of the same air over the winter months, illnesses are easily exchanged. That’s why the flu season peaks January – March.

    Normal, healthy airways have warm and moist air.  The body has mechanisms for making inhaled air warm and moist, and for clearing secretions.  These natural processes don’t function properly among those with COPD. There are some things that can be done to help manage and/or prevent these problems during the winter.

    • First, limit your time in the cold air. You may be able to breathe through a scarf over your nose and mouth. This can warm the air somewhat, but be careful that it’s not even more difficult to breathe.
    • Continue your regular maintenance therapies. This may include inhaled long-acting bronchodilators, anti-inflammatories, and other prescribed treatments. If you have regularly-scheduled breathing treatments, it’s very important to not miss them!
    • Avoid people who are sick! This may mean limiting your social, church and family activities during this time of year. Influenza is very dangerous for people with severe COPD and asthma, and special precautions should be taken.
    • If you haven’t gotten a flu shot this year, do it! (Unless you have specific medical reason not to.) Immunity usually starts 2 weeks after the shot. And practice good hygiene (washing hands, don’t touch your face, etc.), and avoid those who, well, don’t have good hygiene, such as not covering coughs & sneezes.



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