FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

SMOKING THE CAUSE OF MOST "COPD" DEATHS

Question: I'm short of breath most of the time. I even have trouble when I walk a few blocks. My doctor said I have chronic obstructive pulmonary disease, which he explained is a lung problem. But what type of lung problem is it?

Answer: Chronic obstructive pulmonary disease, or COPD for short, is a condition that produces shortness of breath because the person has trouble inhaling and exhaling properly. COPD is a disorder of the tubes that carry air into and out of the lungs, rather than being a problem in the movement of the chest during breathing or in the way the air sacks inside the lungs (alveoli) work.

There are several things that can cause COPD. An inherited condition is responsible for a small percentage of cases. Exposure to dust particles especially grain dust, cotton fiber, or metals (usually from welding) is a more frequent cause. However, it is the use of tobacco that makes COPD the fifth-leading cause of death in the United States. Eighty percent of those with COPD have this illness because of smoking. In fact, smoking two pack of cigarettes per day increases the likelihood of dying from COPD by 20 times. Quitting smoking decreases, but doesn't eliminate, the likelihood of developing this disease in later years.

COPD affects 25 million individuals, most of whom are over the age of 50. Men are stricken more often than women primarily because more men smoke tobacco. In addition to the shortness of breath that you describe, most people who suffer from COPD have a chronic cough that produces phlegm and are prone to "wheezing."

Question: My doctor gives me some medication, but it hasn't helped very much. Are there other treatments for COPD?

Answer: There is currently no cure for COPD. However, there is much that can be done to help the individual with this condition live a more normal life. The most important treatment is the avoidance of the lung irritants that brought on the condition. It is imperative that tobacco and smoke of all types be avoided along with eliminating dust exposure. These measures will not "heal" the damage, but they will keep the condition from getting worse.

The damage to the bronchial tubes often brings about some degree of asthma along with the COPD. Medications to help with the asthma component of the illness may give some relief to the shortness of breath. This is probably the type of medication your doctor has given you. As your story demonstrates, some individuals with COPD have very little asthma and, therefore, get little relief from medication.

Influenza, sinus infections, sore throats and bronchitis can be very serious illnesses for those with COPD. So, it is wise to get a flu shot each year. It also makes sense to avoid exposure to those who are obviously ill with a respiratory infection and to avoid large, indoor crowds, particularly in areas with poor ventilation, where it is easier to catch a cold. Many doctors give their patients with COPD a prescription for an antibiotic that is to be taken at the first signs of a respiratory illness. You may want to talk to your doctor about the benefits this could have for you.

A balanced diet and regular exercise are also important for those with COPD. Regular exercise, even though it makes you short of breath, helps keep the heart, lungs, and muscles of respiration in good shape. Inactivity only worsens an increasing cycle of breathlessness, poor physical conditioning, and fatigue. So, talk to your doctor about an exercise program to keep you fit and breathing while you continue to avoid smoke and dust.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.