Chronic obstructive pulmonary disease, or COPD, is a type of lung disease that makes breathing difficult. While COPD is a chronic condition, various treatments and a newer surgical procedure can help relieve symptoms in some patients.
In this video, San Diego Health host Susan Taylor talks about COPD with Samir Makani, MD, a pulmonologist who is director of interventional pulmonology and bronchoscopy at Scripps Memorial Hospital Encinitas.
COPD is caused by damage to the lung tissue. Smoking and vaping are leading causes of COPD; about 20 to 30% of smokers have underlying COPD.
Chronic lung infections can also lead to tissue damage. Chronic asthma, which causes the air passages in the lungs to tighten, can be another cause. Normally after an asthma attack, the air passages will relax with rest or treatment. In chronic asthma, the tissues remain contracted instead of relaxing, which interferes with normal breathing.
The main symptoms of COPD are shortness of breath when you’re active or even at rest, as well as a chronic cough. COPD symptoms typically begin after age 50, though they can start sooner or later. If a person continues to smoke or vape, or is exposed to chemicals, such as diesel fuel, COPD will likely worsen and may significantly affect everyday activities.
“COPD can limit exertion, say if you wanted to go hiking or do some type of sporting event,” says Dr. Makani. “It can also limit what we call your activities of daily living. It can be difficult to even take a shower, go get the mail or simple tasks that you would do on a day-to-day basis.”
If you are coughing or having shortness of breath and your primary care provider believes you may have COPD, they’ll refer you to a pulmonologist, who specializes in lung conditions.
You’ll have breathing tests to measure how well your lungs are functioning, how much oxygen your body is absorbing and the volume of air you inhale and exhale. One of the characteristics of COPD is a limited ability to exhale fully, so air becomes trapped in the lungs and causes a condition called lung hyperinflation. Based on the test results, your pulmonologist will determine whether you have COPD or another lung-related condition and your treatment options.
COPD treatments depend on the type and severity of the lung damage. In milder cases, inhalers can help expand the lungs and improve your oxygen intake and airflow. You may need to use supplemental oxygen during the day, at night, or both. Pulmonary rehabilitation, which Dr. Makani describes as an exercise program for the lungs, can help stretch and strengthen lung tissue and help with hyperinflation.
For more severe cases, a procedure called lung volume reduction surgery (LVRS) is designed to decrease hyperinflation by reducing the overall lung size, allowing the remaining lung tissue to function more efficiently.
In addition, a newer procedure called Zephyr valve treatment reduces severely hyperinflated lungs using minimally invasive surgical techniques. Using an endoscope that goes through the mouth down into the lungs, the surgeon places endobronchial valves called Zephyr valves into the lungs to decrease the volume from inside the lung. Patients stay in the hospital for three days to ensure there are no complications, and usually start to notice an improvement in how they feel about 10 days later.
“Usually at the one-month mark, when patients come see me for follow up, is when they really experience the difference,” says Dr. Makani. “They’re able to do the things they were having challenges with before, simple things such as making their bed, taking a shower, going to walk their dog.”
Dr. Makani says the best way to prevent COPD is avoid or quit smoking or vaping.
“We all have some degree of lung decline as part of the aging process,” he explains. “If you quit smoking or vaping, it usually takes five to 10 years to recover back to what a normal person’s lung decline would be.”
If you’ve smoked for years or have had chronic lung infections, it’s a good idea to talk to your primary care doctor — especially if you’re having shortness of breath at rest or when you’re active — to diagnose and treat potential COPD before it worsens.