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Dr. James Hubbard, of Colorado Springs, Colo., is a family practitioner and publisher of MyFamilyDoctorMag.com, a website written by health care providers. He recently started the blog "The Survival Doctor," offering advice for times when medical aid is unavailable.
My patients usually call it emphysema. Every time smokers get a chest X-ray, they ask about it. And well they should. COPD is the third leading cause of death in the United States. So if the chest X-ray is normal, are you in the clear? Or if you're diagnosed, then what? Here, I answer some of the questions I hear most.
Q: What is COPD?
Chronic obstructive pulmonary disease is a lung disease with two major subtypes, emphysema and chronic bronchitis. Many people have a mixture of the two.
Q: How does it affect the lungs?
The lungs consist of airways that end in millions of sacs. The sac walls are so thin that oxygen can move through them into nearby blood vessels, and carbon dioxide can move from the blood vessels into the sacs to be blown out of the lungs.
Emphysema destroys some of the sac walls. Several sacs become one larger one. There's less surface area for air exchanges to take place, so your body gets less oxygen.
Emphysema also makes the sacs less elastic so they can't get rid of the carbon dioxide and replace it with fresh oxygen. Think of filling a paper bag and a balloon with air. Open both, and air in the balloon comes out faster and more completely, ready to be filled with refreshed air.
Chronic bronchitis inflames the larger airways. The walls swell and produce more mucous, making the openings smaller so it's harder for air to flow.
Q: What are some warning signs I may be developing COPD?
Any cough that won't go away. Becoming increasingly short of breath during physical activities. Frequent episodes of acute bronchitis or lung infections. Staying ill longer. Most people who get COPD are over 40 years old.
Q: I smoke, but so far my chest X-ray looks fine. I don't have COPD, right?
A pulmonary function test is much better for diagnosing COPD. Also called spirometry, the test measures how much air you've blown through a tube and how fast you've blown it. If you have COPD, your lungs hold more air (stale and carbon-dioxide filled), and you blow it out slower due to the loss of elasticity and the clogged airways.
Q: If I stop smoking, will it go away?
No, but stopping smoking can slow future damage significantly.
Q: So if I don't smoke, I won't get it?
About 80 percent of sufferers get COPD from smoking. About 1 percent lack an enzyme, which puts them at high risk. Then there's secondhand smoke, smog and exposure to toxic fumes at work or from a hobby.
Q: What can I do if I'm diagnosed?
Prescription medicines can decrease the inflammation and mucous buildup. Stay current on your flu and pneumonia vaccines. Your doctor or respiratory therapist can recommend breathing exercises to help your lungs work as efficiently as possible.
Q: Yes, but what can I do?
Avoid secondhand smoke. Avoid toxic fumes. Stay inside on bad pollution days. Exercise-under medical supervision. Exercise builds the muscles you use for breathing and trains your heart to help get oxygen to the needed places. Avoid crowds during flu season.
Your body works harder with COPD. You use more energy. Eat a nutritious diet so the rest of your body functions at full capacity.
