Chronic Obstructive Pulmonary Disease

What is chronic obstructive pulmonary disease?

Chronic obstructive pulmonary disease (COPD) is a medical condition that causes breathing problems. COPD includes chronic bronchitis and emphysema. COPD damages the bronchiole tubes and alveoli in your lungs. The damage makes it hard for oxygen to get into your bloodstream and for you to breathe.

What causes COPD?

You may have COPD at any age. You may be at higher risk of having COPD if you have had other lung conditions. These include asthma and lung infections such as tuberculosis. COPD is most commonly caused by exposure to the following:

• Tobacco smoke, including second-hand smoke
  
  
• Dust, chemicals, or smoke used in the workplace
  
  
• Air pollution

What are the signs and symptoms of COPD?

You may have more than one of the following signs and symptoms:

• Trouble breathing that gets worse with exercise
  
  
• Chronic cough
  
  
• Chronic production of sputum (thick fluid from your lungs)
  
  
• Wheezing (difficult breathing that makes a whistling sound)
  
  
• A feeling of tightness in your chest
  
  
• A bluish tint to your skin, lips, or nails

How is COPD diagnosed?

Your caregiver will ask about your symptoms and examine you. You may need any of the following tests:

• Spirometry: A spirometer measures how well you can breathe. You will take a deep breath and then push the air out as fast as you can. This test measures how much air you are able to push out. This is called forced expiratory volume (FEV). The test results show caregivers how small your airways have become.
  
  
• Arterial blood gas test: This is also called an ABG test. Blood is taken from a blood vessel in your wrist, arm, or groin. Your blood is tested for the amount of oxygen, acids, and carbon dioxide.
  
  
• Sputum sample: Sputum is collected in a cup when you cough. It is sent to a lab to check for a lung infection.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use the x-ray to look for damage to the lungs.
  
  
• Exercise test: This checks how long you can walk or do other exercise. It will show how well your lungs work and help caregivers plan your treatment.

How is COPD treated?

COPD is a serious condition that gets worse over time. Lung damage from COPD cannot be reversed. However, treatment may help prevent more damage. Treatment may also help you breathe easier and return to your normal daily activities.

• Medicines:
  
  
  • Bronchodilators: These help open your airways so you can breathe better. They are most often taken using one of the following devices:
    
    
    • Inhaler: This is a hand-held device that delivers medicine that you breathe in.
      
      
    • Nebulizer: This is a machine that turns liquid medicine into mist that you breathe in through a mouthpiece.
    
    
  • Corticosteroids: These help decrease swelling in your lungs. They may be inhaled or taken as a pill.
    
    
  • Antibiotics: These are used to treat lung infections.
  
  
• Pulmonary rehabilitation: This program can help you function better with COPD. You will learn how to manage your symptoms and help keep them from returning. Pulmonary rehabilitation may include walking and other exercises that build up your lung strength.
  
  
• Oxygen: You may need to use oxygen if you have severe COPD. You breathe in oxygen through a nasal cannula or a face mask. A nasal cannula is a pair of short, thin tubes that rest just inside your nose.
  
  
• Surgery: You may need surgery if you have severe COPD and all other treatments have failed. A lung reduction is when part of your damaged lung is removed to help you breathe better. A lung transplant is when your lung is replaced with a lung from a donor. Ask your caregiver for more information about surgery for COPD.

What is an exacerbation of COPD?

An exacerbation is when your COPD symptoms suddenly get worse. You may have a harder time breathing, your cough may get worse, and you may cough up more sputum. You may have a fever, increased heart rate, or feel sleepy. An exacerbation may be caused by a lung infection, air pollution, or other lung irritants. Sometimes the cause of an exacerbation is unknown. Your caregiver may change your treatment to help relieve exacerbations.

How can I help manage my COPD and prevent exacerbations?

• Avoid cigarette smoke and other irritants: Do not smoke or breathe in smoke from other people's cigarettes. Wear protective gear if your workplace has dust and chemicals that bother you. Stay inside when air quality is bad.
  
  
• Get early treatment if your symptoms are getting worse: This may help you recover faster. Know what to do in case of an exacerbation.
  
  
• Get plenty of exercise: Talk to your caregiver about the best exercise plan for you. Exercise can help decrease breathing problems and improve your health.
  
  
• Use pursed-lip breathing: Pursed-lip breathing can be used any time you feel short of breath. It can be especially helpful before you start an activity.
  
  
  • Take a deep breath in through your nose.
    
    
  • Slowly breathe out through your mouth with your lips slightly puckered. You should make a quiet hissing sound as you breathe out.
    
    
  • Repeat this exercise several times. Once you are used to doing pursed-lip breathing, you can use it any time you need more air.
  
  
• Vaccines: To prevent influenza (flu), all adults should get the influenza vaccine. They should get it every year as soon as it becomes available. The pneumococcal vaccine is given to adults aged 65 years or older to prevent pneumococcal disease, such as pneumonia. People aged 19 to 64 years at high risk for pneumococcal disease also should get the pneumococcal vaccine. It may need to be repeated 5 years later.

What are the risks of having COPD?

• You may be more likely to get colds and the flu. High blood pressure may occur in your lungs. You are at greater risk of lung cancer. You may develop chest pain or heart disease. You can have a heart attack. You may have headaches, nausea, and seizures. It may be hard for you to sleep. Surgery for COPD can cause infection and respiratory failure. This can be life-threatening.
  
  
• Lack of oxygen may cause damage to your organs, such as your heart or kidneys. You may develop anemia (not enough red blood cells) and glaucoma (eye disease caused by too much fluid in the eye). You are at greater risk of having osteoporosis (brittle bones) and broken bones. You may feel isolated because of your limited function and become depressed.

When should I call my caregiver?

Call your caregiver if:

• You have a fever.
  
  
• You have trouble talking or doing your usual activities because it is hard to breathe.
  
  
• You have a cough that lasts 3 months or longer.
  
  
• You cough up more sputum than is normal for you.
  
  
• You wheeze more than is normal for you.
  
  
• You have a bluish tint to your skin, lips, or nails.
  
  
• You have swelling in your legs or ankles.
  
  
• You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

• You are confused, dizzy, or feel like you may pass out.
  
  
• Call 911 or an ambulance if you have any signs of a heart attack:
  
  
  • Discomfort in the center of your chest that feels like squeezing, pressure, fullness, or pain, that lasts for more than a few minutes or keeps returning
    
    
  • Discomfort or pain in your back, neck, jaw, stomach, or one or both of your arms
    
    
  • Feeling sick to your stomach
    
    
  • Having trouble breathing
    
    
  • A sudden cold sweat, particularly in combination with chest discomfort or trouble breathing
    
    
  • Feeling very lightheaded or dizzy, particularly in combination with chest discomfort or trouble breathing

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Learn more about Chronic Obstructive Pulmonary Disease