Chronic obstructive pulmonary disease (COPD) is a progressive lung disease caused by damage to the lungs, usually from smoking. Once called emphysema or chronic obstructive bronchitis, COPD causes shortness of breath, coughing, wheezing, and a buildup of mucus in the lungs.
A lung disease that impairs respiratory function, COPD is an umbrella term for several conditions, including emphysema and chronic obstructive bronchitis. Long-term damage to the lungs causes the airways to lose their elasticity, making it difficult for the lungs to inflate.
The majority of people who develop COPD are smokers and former smokers, although exposure to chemicals and other pollutants and a history of asthma are also risk factors for COPD.
The early signs of COPD can be extremely subtle and usually include being short of breath during physical activity. But in the earliest stage of the disease there may be lung damage without any noticeable symptoms. The full set of symptoms of COPD includes chronic cough, inability to catch one's breath during exertion, occasional wheezing, and sometimes a feeling of tightness in the chest.
Doctors diagnose COPD with tests that measure lung function. Two measures, FVC and FEV1, are used to measure how much air a person's lungs can hold and how quickly a person can breathe out. In COPD, a person's FEV1 measure (amount of exhalation within one second) is lower than normal, and the FVC measure (exhalation in one breath) is often higher than normal. Additional tests include a chest X-ray or CT scan and a blood test for arterial blood gas (ABG), which records whether there's a higher-than-normal level of carbon dioxide in the blood.
COPD is a progressive disease, which means that breathing and lung function gradually decline throughout the course of the condition, progressing through a series of distinct stages. However, the speed of the progression and the specific symptoms experienced vary widely from person to person. Some people live with COPD for decades, while others decline more rapidly. The four stages of COPD require different levels of care and support.
In stage I COPD, also known as mild COPD, patients have little impairment and may not notice any symptoms.
In stage II COPD, also known as moderate COPD, lung function is 50 to 80 percent of normal and breathing difficulties begin to be noticeable but not overly restrictive.
In stage III COPD, also known as severe COPD, breathing is significantly impaired and patients typically need help with mobility and coping with daily tasks.
In stage IV COPD, also known as very severe COPD, breathing is restricted more than 50 percent, and patients are likely to need chronic oxygen therapy. Symptoms are noticeable even when at rest.
There are numerous medications used to control the symptoms of COPD. Most people with COPD rely on inhalers to control the symptoms. Of course, medicine is always developing and changing, and in recent years a number of new treatments for COPD have been introduced.
Treatment for COPD often focuses on preventing exacerbations or flares, which occur when the condition worsens suddenly and can result in hospitalization. In more advanced cases of COPD, oxygen therapy may be used to ease breathing. There are surgical treatment options for COPD, but they're high-risk and not commonly used except in stage IV COPD.
In many cases, occupational therapy or pulmonary rehabilitation is also recommended for the breathing problems associated with COPD. Therapists work with COPD patients to learn more about lung disease and how to coordinate breathing with physical activity and exercise. Through a series of rehabilitative exercises, those with COPD can build up their tolerance for exertion and increase their capacity for movement and exercise.
Appetite can be an issue for COPD patients who may have difficulty keeping weight on. Learning how to cope with meal planning for COPD can help overcome this challenge.
Those with COPD gradually lose the ability to function independently and become increasingly dependent on others, causing caregiving requirements to grow over time. Spouses, adult children, and other family members typically take on the burden of day-to-day care, resulting in increasing stress and isolation.
Gaining access to support and resources will be increasingly important for family members as time goes on. Types of support and resources include:
Joining support groups in the community or online.
Hiring in-home care providers, such as elder companions and personal care assistants, home health aides (including skilled nursing and occupational therapy), meal services, and transportation services.
Practicing good physical and emotional self-care.