COPD

COPD stands for chronic obstructive pulmonary disease. It is the name used to describe a number of conditions, including bronchitis and emphysema, where people have difficulty breathing because of long term damage to their lungs.

COPD leads to damaged airways in the lungs, causing them to become narrower and making it harder for air to get inn and out of the lungs, the word “chronic” means that the problem is long term.

The changes that occur in your lungs when you have COPD may vary depending upon the exact nature of your disease. But the final result is obstruction (blockage) of the airways (the tubes that carry air in and out of your lungs). Obstruction happens in the airways themselves, due to inflammation and too much mucus or phlegm.

Damage can also happen to the small airways and air sacs in your lungs. This leads to the lungs losing their stretchiness. This loss results in a lack of support for the airways, which can collapse, trapping air in the lungs when you breathe out.

What are the Symptoms of Chronic Obstructive Pulmonary Disease?

  • COUGH is usually the first symptom to develop.  It is productive with sputum.  It tends to come and go at first, and then gradually becomes more persistent.  You may think of your cough as a “smokers cough” in the early stages of the disease.  It is when the breathlessness begins that people often become concerned.
  • BREATHLESSNESS and wheeze ay occur only when you exert yourself at first.  For example, when you climb stairs.  These symptoms tend to become gradually worse over the years if you continue to smoke.  Difficulty with breathing may eventually become quite distressing.
  • SPUTUM the damages airways make a lot more mucus than normal.  This forms sputum (phlegm).  You tend to cough up a lot of sputum each day.
  • CHEST INFECTIONS are more common if you have COPD.  A sudden worsening of symptoms is called an exacerbation.  Wheezing with cough and breathlessness may become worse than usual if you have a chest infection and you may cough more sputum.  Sputum usually turns yellow or green during a chest infection.  Chest infections can be caused by bacteria or viruses.  Bacteria which can be killed using antibiotics cause about 1 or 2 or 3 exacerbations of COPD.  Viruses not killed with antibiotics are a common cause of exacerbations too, particularly in the winter months.  The common cold virus may be responsible for up to 1 in 3 exacerbations.

Other symptoms of COPD can be vaguer. Examples are weight loss, tiredness and ankle swelling.

Stopping smoking is the most important treatment. No other treatment may be needed if the disease is in the early stage and symptoms are mild.

Get immunised

Two immunisations are advised:

A yearly flu Jab each autumn protects against possible influenza and any chest infection that may develop due to this.

Immunisation against pneumoccus (a germ that can cause serious chest infections) this is a one off injection and not yearly like the flu jab.

Try to lose weight if you are over weight

Obesity can make breathlessness worse. If you are overweight or obese it is harder to exercise and exercise males you more breathless. It becomes a bit of a vicious cycle.  If you are obese the chest wall is made heavy by fat. This means that you have to work much header to breathe in and take a good breath, to inflate the lungs and expand the chest. A dietician may be able to give you advice on healthy eating and studies have shown that people worth COPD who exercise regularly tend to improve their breathing, ease symptoms and have a better quality of life.

Treatments for stable chronic pulmonary disease

The main treatments are medications given in devices called inhalers. The medicine within the inhaler is in a powdered form which you breathe in. Some people find inhalers more difficult than others to use. The medicines in standard inhalers reach the lungs better if used with a spacer device.

Regular Follow Up

If you have COPD, we will call you yearly for a check-up or annual review. You can discuss your medication and the nurse will assess your inhaler technique. Perform a Spirometry test to assess your lung function and ask how your lung condition affects your life regular reviews allow monitoring of the severity of your COPD, and gives an opportunity for health promotion such as help with stopping smoking or weight control.

Spirometry

The most common test used in helping to diagnose and monitor the condition is called Spirometry.  This test estimates lung volumes by measuring how much air you can blow out into a machine. Two results are important; the amount of air you can blow out in one second and the total amount you can blow out in one breath, your age, height and sex affect your lung volumes. So your results are compared to the average predicted for you age, height and sex.

A value is calculated form the amount of air that you can blow out in one second divided by the total amount of air that you blow out in one breath. A low value indicates that you have narrowed airways.

For further information please see the British Lung Foundation website.