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What to Expect after COPD Diagnosis

Chronic obstructive pulmonary disease (COPD) is a disease that dramatically, negatively affects your quality of life. People with COPD are prone to shortness of breath, wheezing, tightness of the chest and coughing that can happen in episodes caused by chronic inflammation. You are also prone to bacterial and viral infections.

COPD is the fourth most common cause of death in the United States, killing approximately 120,000 patient per year.

While COPD is most recognized for episodes of wheezing and breathlessness, the disease is generally slowly persistent and progressive in nature. Standard medical treatment can be successful in relieving signs and symptoms and reducing the harshness of flareups/exacerbations.

COPD includes treatment with steroids to reduce inflammation and inhaled bronchodilators and other oral medications.

Effective treatment and early diagnosis are important as they can decrease the severity and number of exacerbations and in turn prolong survival rates. Some patients can live with COPD for several decades with continued treatment and participation in a pulmonary rehabilitation program.

Additionally, more than 80% of patients with COPD have a history of smoking cigarettes. Some patients have it secondary to chemical inhalation exposure. Most are obese or overweight. Significant weight loss can also occur in severe COPD and is a sign of end-stage COPD disease with a poor prognosis.

At one point, we categorized different types of COPD, chronic bronchitis and emphysema. All patients with chronic respiratory disease have an element of each, although one symptom/component will typically predominate in each individual.

Chronic bronchitis is distinguished by a chronic sputum production and cough. Emphysema is categorized by destruction and enlargement of the lungs air spaces.

When examined, a patient with severe COPD has diminished breath sounds, crackles at the lung bases, wheezes, and distant heart sounds. The COPD patient’s diaphragm is limited in movement, meaning the patient cannot take deep breaths. In extremely end-stage disease, the chest size is increased, often referred to a “barrel-chest”.

End-stage COPD patients lean forward to use all the respiratory muscles of the chest and accessory neck muscles to inhale air in. COPD can progress to cause right-sided heart failure, as the right side of the heart cannot pump blood into the damaged lungs.

Physicians utilize pulmonary function tests (PFT’s) to assess the severity of COPD. These tests measure how fast a patient can move in and out of their lungs in one second. X-ray and especially CAT scans also are used to determine lung damage.

Arterial blood gases are a series of blood tests to measure how much carbon dioxide and oxygen is in the blood. As you decline with COPD disease, your oxygenation goes down and carbon dioxide levels increase. Blood gas abnormalities significantly worsen with COPD exacerbations and often become worse during sleep or exercise.

Secondary to most COPD patients having a significant history of smoking, most patients have other diseases associated with smoking, especially cardiovascular (heart) disease. These patients are also have a high liability for smoking related malignancies/cancers.

Your compliance in a pulmonary rehabilitation program is your key to success in having a good quality of life. In a comprehensive pulmonary rehabilitation program you will receive smoking cessation counseling and exercise and nutrition therapy. You will become stronger and learn how to modify your activities to assure you are a productive member of your family and society.