If you’re one of the 12 million Americans diagnosed with COPD (chronic obstructive pulmonary disease), you’re at a turning point.
Though you're facing a life-threatening lung disease, knowing that you have it means you can start taking action. That puts you ahead of another 12 million Americans who don't yet know they may have COPD.
"We have no cure, no treatments that will stop progression or reverse the condition," says James Kiley, PhD, director of the lung-disease division of the National Institutes of Health. "But we can do better by getting to people early."
The first symptoms of COPD are frequent coughing and more mucus or phlegm coughed up from the lungs. Your chest may start to feel tight. The coughing begins to disturb your sleep. You may feel tired, and become short of breath when walking up a hill or a flight of stairs.
It's tempting to think of these symptoms as just a part of normal aging. But they may not be.
"If you've smoked, are over 45, get short of breath doing daily activities, or are backing off your exercise regimen because of a little breathlessness at the end -- all those are reasons not just to talk with your primary care provider but maybe to talk to a lung specialist," Kiley says.
COPD diagnosis depends on a test called spirometry. The test measures how much air you can force from the lungs and how fast it blows out.
There is no such thing as an average case of COPD. One person's experience may differ dramatically from another's.
"Most people don't seek medical attention until they are short of breath and unable to do normal activities,” says pulmonologist Sandhya Khurana, MD, of New York’s University of Rochester Medical Center. “By the time this happens, there's been a critical loss of some lung function."
In general, lung function declines slowly but steadily, until there's a sudden worsening of symptoms. That speeds up lung damage.
To monitor someone with COPD, doctors keep tabs on their current symptoms, lung function tests, and other conditions such as heart disease and diabetes that are often also seen in people with COPD.
Diagnosed early enough, a person with risk factors for COPD might be able to get off the slippery slope of worsening lung function.
"At that point, the most important thing would be to really quit smoking," Khurana says. "And then their other focus would be being up to date on immunizations -- a flu shot and a pneumonia shot. If someone had no symptoms but just these frequent infections and very early signs of decline, that person would not necessarily progress to worsening COPD."