Coping with COPD

COPD treatment options and lifestyle changes

/ Author:  / Reviewed by: Robert Carlson, M.D

Chronic obstructive pulmonary disease (COPD) is a group of lung diseases that includes emphysema and chronic asthmatic bronchitis.

As the airways are damaged in this group of diseases, airflow is blocked during exhalation and breathing becomes harder and harder.  

The Mayo Clinic reports that "COPD is a leading cause of death and illness worldwide."

Treatment Goals

Long-term smoking is the usual suspect causing COPD, and once the damage is done, quitting won’t reverse the harm caused to the lungs. Because of this, the Mayo Clinic reports that treatment for COPD focuses on managing symptoms and minimizing continued damage. 

According to the US Department of Health and Human Services' National Heart Lung and Blood Institute (NHLBI), treatment may have several additional goals, including improving the patient’s tolerance for exercise and ability to stay active, preventing complications and treating them if they do occur, as well as improving the overall health and well-being of the COPD patient.

Doctors work with patients to help determine the best course of action for their individual case and decide which treatment options suit them best.

Medicating COPD

The NHLBI reports that several different medications may be prescribed by doctors to help patients cope with COPD. Bronchodilators are one type of such medication, usually taken through an inhaler, which sends the medicine straight to the lungs.

Bronchodilators aim to relax the muscles around the airways, in turn opening them and making it easier to breathe. The type of bronchodilator prescribed and the frequency of use will depend on the severity of the COPD.

Inhaled Glucocorticosteroids are also prescribed to help treat some COPD patients.

These “inhaled steroids” aim to reduce the inflammation of the airway and, according to NHLBI, “Doctors use inhaled steroids to treat people whose COPD symptoms flare up or worsen.”

However, the Mayo Clinic reports that “prolonged use of these medications can weaken your bones and increase your risk of high blood pressure, cataracts and diabetes,” so this treatment option may be prescribed in only moderate or severe cases.

Vaccines, Therapies and Rehab

For some COPD patients, doctors may recommend various vaccines, like the flu shot or a pneumococcal vaccine.

Both influenza and pneumococcal pneumonia can cause serious problems for people with COPD. By proactively protecting themselves with these vaccines, potential complications may be avoided.

If these infections do come into play, antibiotics may be used to fight off the bacteria and help avoid aggravation of COPD symptoms.

Pulmonary rehabilitation is sometimes used to help treat COPD patients. In this program, the focus is improving the overall wellness of people with chronic respiratory problems.

According to NHLBI, the rehab may include exercise programs, nutritional counseling, psychological counseling and disease management training. Experts of all sorts may be involved, including “doctors, nurses, physical therapists, respiratory therapists, exercise specialists and dietitians.”

For some with severe COPD, oxygen therapy may be used. This therapy utilizes nasal prongs or a mask to deliver oxygen to the patient and help them breathe easier.

These patients have low levels of oxygen in the blood and can use oxygen therapy to help improve their quality of sleep, complete various activities throughout the day, protect their internal organs and overall minimize symptoms. Some may use the extra oxygen from oxygen therapy all the time, while others only use it during certain times.

Surgical Treatments

According to NHLBI, “Surgery usually is a last resort for people who have severe symptoms that have not improved from taking medicines.” Risks can be inherent in these options, so patients and doctors will need to weigh the risks and benefits before making a surgery decision.

A surgery known as bullectomy can help those with extensive damage to the walls of their air sacs. The destruction of these walls creates large air spaces called bullae, which can interfere with breathing.

Through surgical removal of these bullae, patients may be able to breathe better.

For some patients, a lung volume reduction surgery that removes damaged lung tissue can help the lungs work more effectively and symptoms improve.

According to the Mayo Clinic, “This creates extra space in your chest cavity so that the remaining lung tissue and the diaphragm work more efficiently”.

In very severe cases of COPD, a lung transplant may be undertaken. In these cases, a deceased donor’s healthy lung is used to replace the damaged lung of a COPD patient.

Lung transplants can help patients improve quality of life and breathing abilities, but NHLBI reports that they may also be a risky option, due to the risk of infection and rejection of the transplant. Furthermore, a lung donor may not be immediately available.

Lifestyle Makeover

According to both NHLBI and the Mayo Clinic, quitting smoking is the most essential step to treating COPD.

“It's the only way to keep COPD from getting worse — which can eventually result in losing your ability to breathe,” reports the Mayo Clinic.

Quitting smoking can be a difficult and challenging tasks, but doctors can help provide programs, products, and suggestions to help patients kick the habit. Support groups also help many along this path to a smoke-free life.

It is also important for COPD patients to avoid secondhand smoke and other irritants like fumes, smoke or toxic substances that could be inhaled. These irritants can aggravate symptoms and make COPD worse.

NHLBI suggests that patients discuss an eating plan with their doctor, as for some people with severe COPD, their symptoms of fatigue and breathing problems can make eating difficult.

Doctors can help patients maintain a balanced diet that supplies sufficient calories and nutrients, improving overall wellness, helping patients fight off infection and aiding with other COPD symptoms.

Though it can be challenging to be physically active with breathing symptoms, NHLBI reports that “physical activity can strengthen the muscles that help you breathe and improve your overall wellness.” Doctors can also help patients find the correct, safe type of physical activity for them.

Visiting a respiratory therapist can help patients learn to better control their breathing and breathe more efficiently day in and day out. These professionals can also teach breathing positions and relaxation techniques that may help when patients become winded.

The Mayo Clinic also recommends that patients avoid crowds and cold air, or that they should protect themselves from these factors through the use of face masks.

A surgical mask can help prevent germs from aggravating the lungs in crowded areas, and a cold-air face mask can help prevent the aggravation and shortness of breath that cold air can sometimes cause.

There are a variety of methods available for treating the group of diseases that makes up COPD. Doctors will help patients determine the best options for them to help them cope, ease symptoms, prevent complications and breathe a little easier.

Review Date: 
November 17, 2012