For people with COPD, symptoms may include shortness of breath, cough with or without sputum (saliva and mucus spit out), some chest pain or heaviness, and wheezing. To determine if someone has COPD, a doctor will ask about symptoms, family history and smoking, and will test the person's lung function. The doctor may also do a chest x-ray or some blood tests. The lung function test is important, as it shows how long it takes the person to blow out all of his or her air. Someone with COPD takes much longer than a healthy person to blow out all of the air, because the airways are obstructed and the air gets trapped.
COPD is often divided into two types: chronic bronchitis and emphysema. Too much mucus in the airways causes chronic bronchitis. Mucus can clog the airways, making it difficult for air to pass to the lungs. Two things indicate chronic bronchitis - blocked airways, tested with a lung function test, and more than three months of cough and sputum for at least two years in a row. Emphysema results from the air sacs in the lungs being damaged and becoming larger. As a result, the airways around the air sacs collapse. People with emphysema suffer from shortness of breath, especially with activity, and they sometimes have a cough and sputum.
If possible, it is best to use an inhaler with a spacer. A spacer helps to trap the medication so that you do not have to co-ordinate inhaling with pressing on the canister. This makes it easier to get more of the medication into the airways, and reduces the chances of side effects.
Once a person has been diagnosed with COPD, the doctor recommends treatment. The first step in managing COPD is to stop smoking. Since smoking can worsen COPD symptoms and increase the chances of getting infections, quitting is an essential step towards lung health. Smoking is an irritant and affects the body's natural ability to clean the airways, making infection more likely. As people with COPD get infections more easily, it is often recommended that they receive the pneumococcal vaccination (only needed once) and influenza vaccination (every fall).
People with COPD must also carefully consider their surroundings and reduce their exposure to known irritants. Irritants include second-hand smoke (being around other people while they are smoking), pollution, strong smells such as perfumes and chemical smells, and changes in the weather. The best strategy for managing these irritants is to avoid them. Stay away from smoke and fumes, and reduce exposure to extreme weather changes by wearing a scarf or even staying indoors during very cold weather.
Going to pulmonary rehabilitation classes may also help. People with COPD learn appropriate exercise and breathing techniques to achieve their best physical potential. The extercises are particularly good for those who, even with medication, are limited in their activities. One breathing technique commonly taught is pursed-lip breathing. This is done by breathing in slowly through the nose, and exhaling slowly through pursed-lips as if whistling. This type of breathing can be helpful when experiencing shortness of breath. The classes may also teach conditioning exercises, and strategies which save energy, reduce effort, and improve respiratory muscles.
Some prescription medications can help reduce the symptoms of COPD, but they cannot reverse the damage in the airways. Bronchodilators relax the muscles around the airways, making it easier to breathe. Short-acting bronchodilators are usually taken as needed every four to six hours. Long-acting bronchodilators are taken twice daily and relieve symptoms throughout the day.
Theophyllines are bronchodilators that are taken orally once or twice a day. They are usually not the first choice of medications to treat COPD. With these drugs, side effects such as nausea, stomach cramping, diarrhea and headache can occur. It is also important to regularly monitor the amount of theophylline in the blood to make sure the right dose is being given.
Anticholinergic drugs decrease the mucus in the airways, and help to reduce the tightening in the airways. They are most commonly taken up to four times a day.
About 10 to 20 per cent of people with COPD benefit from inhaled or oral steroids. These reduce inflammation inside the airways. They do not work quickly and must be used regularly to be effective. It can not be predicted who will benefit from these medications. They must be tried for a few weeks to see if they help. People taking inhaled steroids should rinse their mouth after each use to reduce the chance of side effects such as a mouth or throat infection.
When the amount of oxygen in the blood falls below certain levels it becomes difficult to continue everyday activities. Low oxygen can affect the way you think, cause heart problems and even death. People with COPD who suffer from low oxygen are given oxygen therapy through a face mask or tube (nasal cannula) under the nose. Oxygen therapy helps to prolong the life of people with COPD who have low oxygen in their blood. Oxygen also improves their quality of life, as portable oxygen makes possible daily activities such as walking and grocery shopping. A doctor prescribes oxygen based on the person's needs and condition. It is generally given for at least 15 hours per day, and the amount of oxygen is carefully monitored. Respiratory home care providers visit those who need oxygen to assist the family in using the equipment and ensure that the needs of the person on oxygen are being met. It is essential that homes where oxygen is used are non-smoking, due to the potential fire risk.
With proper medical care, lung rehabilitation, medication, and dedication, people with COPD are able to achieve a good quality of life. In most cases COPD can be prevented. By stopping smoking and encouraging young people not to start, you can help reduce the burden of COPD in Canada.