Chronic obstructive pulmonary disease. Quiz the average person on the street, and how many could tell you what it is? Would you know that it's the 4th leading cause of death in the United States? Not likely. But that is one of COPD's unfortunate claims to fame.
A serious and progressive lung disease diagnosed in more than 13 million Americans, COPD develops when lungs become damaged from smoking and sometimes from heavy exposure to pollution, chemicals, or dusts. Genes may also play a role in the development of the disease.
Doctors may make a diagnosis from reported symptoms and findings from the physical exam. For many conditions, however, a diagnosis cannot be made without conducting tests. This is especially true for lung diseases.
Individuals with COPD are often diagnosed with "pulmonary emphysema." This means the air sacs, or "alveoli," of the lungs are damaged. These tiny sacs cannot be seen directly in a physical exam. So, health care providers depend on a series of tests. These tests help them diagnose...
COPD causes airways to become partially blocked, making it very hard to breathe. You can't reverse the damage it causes, and COPD has no cure. But you can do many things to slow its progression and live a longer, higher-quality life.
When COPD Is the Diagnosis
Diagnosing COPD is not a complex process. Combined with a medical history and physical exam, an easy, painless breathing test called spirometry can confirm the diagnosis. A machine called a spirometer measures how much air your lungs can hold and how fast you can blow air out of your lungs after taking a deep breath. You may need extra tests to rule out other problems or to plan treatment.
Typically, people with COPD wait a fairly long time before getting diagnosed, says Norman H. Edelman, MD, chief medical officer for the American Lung Association. Their breathing becomes more labored, but they learn how to compensate.
Besides shortness of breath - often with activity - other COPD symptoms that may prompt a visit to the doctor are coughing, wheezing, excess mucus, or chest tightness that won't go away.
Because the symptoms develop so gradually, says Edelman, "People often think, 'I'm just getting older or I've put on a little weight.' Then they hear, 'No, this is a real disease.'" So the diagnosis of COPD often comes as a shock.
Adding to the shock is stigma. "Most people who are diagnosed are smokers," says Edelman, "So there is also this sense that 'I brought it on myself.'" For this reason, it can be harder news to receive, he says.
John J. Reilly, MD, is acting chief of the pulmonary division at Brigham and Women's Hospital. "When I trained in medicine, we were basically seeing old white guys at the VA," he says. "Now, thanks to the Virginia Slims era, more women than men died of COPD in 2000."
Deb Hannigan may be from the Virginia Slims era, but she's doing all she can to stay healthy and alive and to spread awareness about COPD. Now 52, she was diagnosed at age 34, younger than most with the disease. Diagnosis is more common in those over age 40.
Because she was a medical records coder at a hospital at the time, she had some idea of what COPD was. But it wasn't until her diagnosis that the whole picture came into focus. As is true for many, Hannigan learned that she had both of the main COPD diseases - chronic bronchitis and emphysema.
Chronic bronchitis causes swelling of the airways. This makes airways narrow, which obstructs the flow of air. Chronic bronchitis also results in excess mucus production, which causes cough and further obstruction of air movement in and out of the lungs. Chronic bronchitis is diagnosed when a person reports cough and mucus on most days for three months during two consecutive years and when other conditions for cough have been eliminated as the cause.
Emphysema damages the air sacs in the lungs. Normally, these tiny balloon-like structures allow the passage of gases (oxygen and carbon dioxide) from the lungs to your blood and back out. The air sacs are normally elastic and stretch when filled with air. They spring back to their original shape when they empty after taking a breath of air. Damage to the air sacs from emphysema makes them less elastic so that it becomes difficult to push air out of the lungs. This causes air to be trapped and airways to collapse, leading to obstruction of air flow and difficulty breathing.