Chronic obstructive pulmonary disease, or COPD as it’s commonly called, is the fourth leading cause of death in the U.S., and is on the rise. While incurable, is it one of the most preventable diseases with healthy lifestyle changes.
About three years ago, 72-year-old Beverly Johnson of Holland found that she couldn’t get through a round of golf without getting winded. Johnson, who had been a lifelong smoker, had been diagnosed with breathing problems, but her condition was worsening.
“I was put on an inhaler, but I have a high pain tolerance so I kept pushing and pushing,” she recalls. “When I went in to the hospital for breathing difficulties, they did some tests and found out that I had chronic obstructive pulmonary disease.”
COPD is a general term to describe respiratory illnesses with decreased lung function, such as chronic bronchitis and emphysema. Cigarette smoking is the primary cause in most cases, but it can also develop from exposure to secondhand smoke, occupational dust or chemicals. Poor air quality and family genetics sometimes can be factors.
Common symptoms include chronic cough, shortness of breath, frequent clearing of the throat, chest tightness, wheezing and excess mucus. “COPD patients often say they have a hard time catching their breath, but it’s actually difficulty exhaling,” explains Jeff Hodges, manager of Holland Hospital’s Cardiopulmonary Services. “Air gets trapped in the lungs. They breathe in, but don’t get all the air out so stale air – carbon dioxide – just stacks up.”
Johnson’s story of how she developed COPD is pretty typical. Most past or present smokers develop the condition in their 40s, and are diagnosed when it gets progressively worse.
“Part of the increase in COPD has to do with the baby boomers getting older,” surmises Hodges. “When they were younger, smoking was the hip and cool thing to do. Now it’s catching up to them in midlife.”
Hodges stresses that recognizing the early signs of COPD and seeking immediate treatment is critical to prevent more serious health complications. “The heart and lungs are interconnected in their functions,” he says. “COPD can lead to right heart failure, which can result in congestive heart failure. So early detection and treatment is critical.”
Diagnosis and Treatment
Diagnosis is fairly simple. Doctors will give patients a spirometric test to measure lung function. Patients take a deep breath, and then exhale into the spirometer to measure air flow. The test can be repeated to monitor the progression of the disease.
While COPD is incurable, there are treatment options with the goal of giving patients the highest possible quality of life so that they remain active and independent.
Holland Hospital’s Cardiopulmonary Services Department provides comprehensive acute care to COPD patients, including diagnostic testing, ventilator management, and patient education. “The earlier we intervene, the better,” asserts Jennifer Riggs, licensed respiratory therapist and clinical educator in the hospital’s Cardiopulmonary Department. “Lifestyle changes are a big factor. They have to quit smoking, and they usually need daily inhalers and medication. Others may require oxygen. The next step is being referred to rehab by their physician.”
A vital part of lifelong management of COPD starts with participation in the hospital’s Pulmonary Rehabilitation program. Classes, held twice weekly for eight weeks, consist of monitored exercises, proper breathing techniques, and education on diet, medication use and lifestyle changes. When Johnson went through rehab, she was amazed at how much she could do with support.
“I would do the walking, rowing and bike riding,” Johnson recalls. “I loved it! I actually looked forward to it every week. The staff and other patients were like my second family. If I missed rehab, I could really feel the difference.”
Once patients “graduate,” they have the option of continuing in the hospital’s in-house Phase III maintenance rehab program, which keeps patients motivated with peer and staff support. “We have some patients who have been coming to rehab for years and years,” says Jane Martin, licensed respiratory therapist, who works with Johnson regularly. They’re also encouraged to attend the hospital’s Better Breathers Club for support (see side story).
Johnson remains committed to her maintenance program, which she says helps her cope – physically as well as mentally – with her condition. While she’s retiring her golf clubs, she keeps busy with a part-time job and enjoys spending time with her grandchildren and great-grandchildren.
Her advice to others who think they might have COPD: “Don’t wait so long. Catch it as soon as possible and get help.”