Chronic Obstructive Pulmonary Disease (COPD) is one of the most common diagnoses made in our office. COPD is a term used to reflect a disease characterized by both chronic coughing with sputum production and pulmonary emphysema.
Although many people with COPD have somewhat advanced airflow obstruction when diagnosed, this syndrome is not considered a death knell. There are many things we have to offer the patient with COPD.
Primary on the list is smoking cessation. It is absolutely necessary that patients with COPD stop smoking. If they have difficulty, we are frequently able to offer services through our office to assist with smoking cessation. As you know, many modalities are now available to assist patients with their efforts in smoking cessation.
Many different inhaled medications have been shown to be effective in treating the COPD patient. Oxygen therapy is needed for some, and all patients require education. COPD treatments are often divided into controller and rescue medicines. Rescue or reliever medicines are taken when patients are acutely short of breath. These medicines have a quick onset, but often do not last very long. They may have to be taken several times each day. Controller medicines do not relieve acute episodes and should not be taken in emergencies. They help to control the underlying disease and should be taken on a regular basis regardless of how a patient feels from day to day. These controller medicines have been shown to modify the disease over the long term, and, taken regularly, reduce the need for the reliever medicines. Some have even been shown to reduce the frequency of exacerbations of COPD which often require treatment with steroids and antibiotics. Supplemental oxygen has been shown to improve quality of life and even prolong survival in patients whose oxygen saturation is low enough (<88%) consistently.
Pulmonary rehabilitation has proved quite useful in this group of patients to improve well being, exercise tolerance, quality of life, and to help decrease hospitalizations. Patients tend to be more satisfied after successfully completing pulmonary rehabilitation due to their physical conditioning, but the educational component in pulmonary rehab is equally important.
Many patients will find themselves physically limited by COPD. Patients who understand that this is a chronic disease will be quicker to develop adaptive skills and techniques that are necessary for successfully living.