COPD: What Patients and Caregivers Should Know

Chronic Obstructive Pulmonary Disease, or COPD, is a disease that millions of Americans live with each day. In honor of COPD Awareness Month and to share more about this complicated respiratory disease, we asked COPD expert Meilan King Han, M.D., medical director for the Women's Respiratory Health Program at the University of Michigan and a principal investigator at the American Lung Association Airways Clinical Research Center network, what patients and caregivers should know about COPD.

What exactly is COPD?

Chronic Obstructive Pulmonary Disease, or COPD, includes chronic bronchitis and emphysema, and is caused by exposure to irritants such as cigarette smoke that damage your lungs and airways over time. Symptoms typically include shortness of breath, wheezing and the production of mucus. Some of my patients tell me they have difficulty getting air out and are particularly bothered by shortness of breath with mild to moderate exertion like climbing stairs or carrying a laundry basket. 

Who should be concerned about COPD and how does someone get diagnosed?

The main cause of COPD is smoking, but nonsmokers can also develop this chronic lung disease. What you breathe every day at work, home and outside can play a role in developing COPD. Long-term exposure to air pollution, secondhand smoke and dust, fumes and chemicals (which are often work-related) may contribute to developing COPD. Genetic risk factors also play a role.

Many people don't experience the symptoms of COPD until the disease has progressed. It's important to recognize these signs and talk to your doctor. It is important not to wait for symptoms to become severe. Early detection of COPD can lead to better management of the disease. If you have any of the symptoms or exposures to risk factors, talk to your doctor about a breathing test called "spirometry" which can help diagnose COPD. COPD is manageable, but first you need a diagnosis.

How common is COPD?

The disease is increasingly common, and is the third leading cause of death in the U.S., yet many Americans are unaware that they have this disease. In fact, between 2007 and 2010, around 8.5 million adults were diagnosed with COPD, but another 18 million had evidence of impaired lung function (breathing ability), signaling they may have undiagnosed COPD. This happens because many people don't recognize symptoms of COPD until later stages of the disease.

What is it like to live with COPD?

Some patients plan their day around things they know will cause shortness of breath, like going up stairs or even taking a shower, as they know they will be worn out after doing these things, and will need to rest. As a doctor who works with COPD patients, many of my patients tell me they have trouble walking longer distances and need to stop to catch their breath. Patients may become frustrated that they aren't able to do the things they used to be able to do. Some patients also experience periodic "flare-ups" of the disease where they experience increased cough, shortness of breath and mucous production. We call these exacerbations. These are often treated with antibiotics and or steroids, but there are other medications available that if taken on a daily basis, can help reduce breathlessness and the frequency of exacerbations.

However, because COPD can progress very slowly, some people may have it and not know that their shortness of breath is not just a result of getting older or being out of shape, so they don't mention this to their doctors. As a result, many patients with COPD are diagnosed when they are already in the moderate to severe range, rather than earlier stages.  At the end of the day, those individuals living with undiagnosed COPD could get treatment to greatly improve their quality of life, including management tools and support through Better Breathers Clubs, but they need to ask their doctor and communicate with their healthcare team.

You work with COPD patients, what are frequent questions you hear?

Many of my patients ask me what they can do to help themselves get better. Quitting smoking is the number one most important step, and the American Lung Association has proven-effective resources to help you quit for good. Regular exercise is also incredibly important and may include a formal pulmonary rehabilitation program. This is a supervised education and exercise program tailored to patients with lung disease. Patients with COPD should discuss with their doctor whether pulmonary rehabilitation is right for them.

For patients who require oxygen, I often hear about trouble with carrying oxygen tanks. Imagine being incredibly out of breath, as if you just completed a marathon, then carrying a backpack full of bricks up the stairs. I find we frequently need to work with a patient's durable medical equipment provider to find the right oxygen solution that fits their needs and lifestyle.

What resources are available for those living with COPD?

One important part of managing your COPD is learning how to talk to your doctor and other healthcare professionals about how you feel, how to take your medicines and other medical treatments. Finding support and help from others who share your disease is another key part of coping with COPD. The American Lung Association offers a COPD Management Plan, Better Breathers Club, online support groups and more. 

What else should patients with COPD be aware of?

COPD is treatable and a manageable disease. However, it's important to be aware that many patients with COPD also have increased risk for lung cancer. This is certainly something to be aware of, and I encourage you to speak with your doctor about your risk and whether screening for lung cancer is right for you.

How can loved ones and caregivers best support those living with COPD?

It can be difficult to have a COPD diagnosis, not only for patients but also caregivers. The Lung HelpLine (1-800-LUNGUSA) is there to provide support for all affected by this disease.