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So You Have COPD. Now What?

"You have COPD," the doctor said. Joe, a handsome man in his late 60's, heard it and paused. His thoughts were suspended for a moment, a moment that seemed like an hour. Normally a friendly guy, a talker, Joe was now speechless. Anxiety and a thousand questions rose from within, causing him to be breathless -- even more so than usual.

His doctor continued, explaining what type of disorder it was and what could be done about it. Maybe Joe heard that. Maybe he didn't.

"You're going to have this for the rest of your life. It's not going to go away."

"I'm always going to be short of breath like this? This is terrible! I can't do anything around the house anymore without gasping."

"Right now you're recovering from a bad bout of pneumonia. We'll do some tests and see how the next few weeks go."

"Now hold on here, doc. The pneumonia came out of the blue. I was fine before that. So pretty soon I should be fine again, right?"

"Well, chances are, this has been coming on for a long time. It can take years before we notice shortness of breath in COPD. Our lungs can put up with quite a bit of abuse."

Only slightly calmer now, Joe said, "OK, doc. So I have this, this COPD, or whatever you want to call it. There must be something that will help. A pill I can take, or something?"

"There are medicines you can take, but this is, for all intents and purposes, irreversible. The damage is done." The doctor repeated, "You'll have this for the rest of your life."

"The rest of my life?" Now wait a minute. "That sounds so. final. There must be some mistake. I've worked hard all my life. I just retired, and now I've got things to do. Plans to travel. Grandchildren to spoil. "

"I know, Joe. I'm sorry. But this is the way it is. The nurse will be back in a few minutes to tell you about your new medicines. I'll see you in a few weeks."  

This scene may be familiar to you. But even if it is not, chances are you know someone with whom it is. COPD, Joe's diagnosis is the fourth leading cause of death in the United States (behind heart disease, cancer and stroke), and the only one of the top ten on the rise. COPD deaths in women tripled in the last two decades. It is estimated that as many as 24 million Americans have symptoms of COPD. Despite its ease of diagnosis, COPD remains profoundly under-diagnosed while in its milder and more treatable form.

COPD stands for "Chronic Obstructive Pulmonary Disease." COLD stands for "Chronic Obstructive Lung Disease." These two terms can be used interchangeably, but may be used exclusively in one geographic region or another. Chronic means that the disease is present at all times. It does not go away. Obstructive refers to difficulty getting air "out" of the lungs. Pulmonary , of course, refers to the lungs. A person with COPD has at least two of the following: emphysema, asthma or chronic bronchitis.


How can someone who does not have lung disease possibly imagine what it is like to work so hard to breathe? This may give you a hint of what it is like. If you do not have lung disease and are in good health, try the following.

Take a big, deep breath. Blow out just part of it. Now try to take another deep breath. You probably feel as if your lungs are over inflated. Do this once again. After several years of breathing this way, the lungs actually get bigger and lose their elastic quality, which is what originally aided them in expelling stale air. The more damaged portion of the lungs compress the better parts like an inflated automobile air bag. The lungs don't have much room to move. The air sacs where oxygen exchange takes place, as well as the tubes that connect the air sacs to your trachea, or windpipe, become damaged and weak and can collapse. This is emphysema. Its main cause is cigarette smoking and exposure to air pollution. There is difficulty in getting air out of the lungs making emphysema an obstructive lung disease. Emphysema is chronic in nature because it has evolved over a long time and even on good days, it is always there.

Another form of emphysema is Alpha-1 Antitrypsin Deficiency, (A-1AD) , which is inherited. This disease strikes people in their 20's, 30's, 40's, and 50's. People who have inherited an altered AAT gene from each parent are considered to have severe deficiency and likely to develop the disease.

Now pinch your nose so you can breathe only through your mouth. Breathe out through a straw. Pinch the straw until it is almost closed off. In asthma the bronchial tubes, or airways, inside the lungs are inflamed or swollen and then squeezed and tightened by constricting muscles in the airways. Thick mucous clogging the bronchial tubes also restricts the ability to breathe. There is difficulty in getting air out of the lungs. Asthma is an obstructive disease but although not curable, is considered controllable and reversible. 

Chronic Bronchitis is when the lining of the airways becomes inflamed and irritated by long term exposure to tobacco smoke and / or pollution. With chronic bronchitis there is a lot of thick mucous production, causing a cough on most mornings. In this disease the lungs' natural cleaning system, cilia, millions of tiny hair-like structures that normally sweep mucous upward, become destroyed or paralyzed. Chronic Bronchitis is another obstructive lung disorder.

This is an excerpt from Breathe Better, Live in Wellness: Winning Your Battle Over Shortness of Breath by Jane M. Martin.

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