Understanding COPD and Its Effects

Eighty percent of chronic obstructive pulmonary disease, or COPD, is caused by smoking. Effective treatment requires making simple lifestyle changes.

When Mary Layton was hit by what she thought was a series of bad colds nearly 40 years ago, her physician prescribed antibiotics to ease her symptoms.
“I worked in advertising and we all smoked and drank—that was just the way things were in those days,” Layton recalls. “I didn’t have a clue what COPD was. It certainly didn’t enter my mind that I could have such a dreadful condition, and that cigarettes were causing it.”
Two decades later, doctors finally determined that she had in fact, as a result of years of smoking, developed chronic obstructive pulmonary disease (COPD)—a long-term lung disease that slowly damages the airways or breathing tubes that carry air in and out of the lungs.
“COPD is complicated,” says Layton, who, after being diagnosed in 1993 co-founded the COPD Canada to help inform people about the disease. “There’s still much to be done and much to be learned.”

What is COPD?

“COPD covers several diseases related to the lungs,” says Dr. Pat Camp, a clinician scientist with the University of British Columbia James Hogg Research Centre and a physical therapist at Vancouver’s St. Paul’s Hospital.

“It’s a term that’s been used among health care professionals and researchers for 20 or so years, but it’s only recently entered into public awareness.”

According to the Canadian Lung Association, COPD includes more familiar diseases such as chronic bronchitis and emphysema (many people with COPD suffer from both), and impacts one’s ability to breathe.

“COPD affects different parts of the respiratory system and results in changes in the airways and lungs,” Camp explains.

“The airway walls thicken and the air sacs lose their elasticity, so they can’t widen when more air is required in the lungs, making breathing harder. The airways also produce excessive mucus, which the body has a hard time clearing.”

COPD in Canada

As many as 750,000 Canadians have COPD. That figure, says the Asthma Society of Canada, is growing; experts estimate COPD will become the third-leading cause of death worldwide by the year 2020.

Scarier still: there’s been a substantial increase of COPD in women in recent years, with a tripling of the female mortality rate over the past 20 years compared with a stable mortality rate in men over the same period. These frightening statistics, says Camp, may be due to an increase in smoking rates in women, which began over 50 years ago.

“Recent studies show women may also be more susceptible to the effects of cigarette smoke than men,” she adds. “There’s additional evidence to suggest a gender bias may exist with respect to diagnosis, and women may be more likely to be diagnosed with asthma, and men with COPD, regardless of their underlying condition.”

Diagnosis

The best way to find out if you have COPD is to get tested.

“Don’t be one of those people who says, ‘I’ll get tested as soon as I quit smoking,\” Layton cautions. “Even if you have no symptoms but you’re over 40 with a history of smoking, you should still request a spirometry test.”

This simple, noninvasive test requires blowing air as long and hard as possible into a mouthpiece. A computer then analyzes the test data to determine your level of lung function.

“Healthy individuals can blow out 80 percent of the air in their lungs in the first second of the test,” Camp explains. “Those with COPD will blow less, because their lung function is compromised.”

And, while there’s no known cure for COPD, it can be treated.

Treatment

“If you’re still smoking, the first thing to do is quit,” says Layton, who kicked the habit the same year she was diagnosed.

While pharmaceuticals can be a part of COPD’s medicinal therapeutic regime, Camp emphasizes the importance of making healthy lifestyle changes (see sidebar) and participating in a pulmonary rehabilitation program.

“Pulmonary rehabilitation is a specialized exercise program for people with long-term lung diseases like COPD,” she explains. “It teaches you how to exercise, how to get the most from your breath, and how to manage your disease.

“There’s strong evidence that pulmonary rehabilitation is very helpful for COPD patients, and the Canadian Lung Association’s website offers an excellent directory of such programs across the country, so you can find one near you.”

Dietary changes for COPD sufferers

Low levels of some nutrients may contribute to poor lung function:

vitamins A, C, and E
potassium
magnesium
selenium
zinc
omega-3 fatty acids

Eat frequent small meals that include these essential nutrients. Avoid reclining either during or after the meal to help manage the added expenditure of energy required to eat and digest meals.

Other lifestyle changes for people with COPD

Exercise

Though difficulty breathing makes exercise difficult, a steady increase in activity level with the guidance of your health care practitioner is essential. Ask about a pulmonary rehabilitation program and learn more about how to breathe easier.

Mind/body techniques

Yoga and tai chi, deep breathing, relaxation, and meditation exercises may help manage the symptoms of COPD. Acupuncture may help relieve shortness of breath.

Supplements

Many studies have pointed to the possible benefits of several nutritional and herbal supplements to help relieve the symptoms of COPD:

N-acetylcysteine
magnesium
L-carnitine
eucalyptus (Eucalyptus globulus)
ginseng (Panax ginseng)
mullein (Verbascum densiflorum)

It is critical that you consult with your health care practitioner to protect yourself from possible side effects or interactions with other medications.

No laughing matter

Comedian Mary Walsh is serious about COPD

Canadian actress Mary Walsh, best known for her work on the CBC TV show This Hour Has 22 Minutes, is committed to spreading the word about COPD.

“I first decided to get involved with the local [Newfoundland] chapter of the Canadian Lung Association because COPD has affected several members of my family,” says Walsh. “I discovered that people don’t know much about the disease, but as a leading cause of death in Canada and the world, they should.”

That initial involvement lead to Walsh acting as spokesperson for World COPD Day—an annual event organized by the Global Initiative for Chronic Obstructive Lung Disease to improve awareness and care of COPD around the world—on November 18, 2009.

Though uncertain she’ll be asked to repeat the role in 2010 (this year on November 19), she remains dedicated to the cause.

“You can get so much help if you get diagnosed early with a simple spirometry test,” says Walsh. “Unfortunately, it isn’t done often enough because awareness of the disease is not very high.”

Improving quality of life

With no cure for COPD, Walsh firmly believes that early diagnosis and proper treatment thereafter are paramount to the well-being of those suffering from the condition.

“Your quality of life can improve immensely,” she says. “You can get started on exercise and rehabilitation that are designed to improve your lung function and make it easier for you to breathe. There is a whole series of things you can do—but you must get tested first.”

Walsh now makes a point of asking her doctor for the COPD diagnostic test with every checkup—and hopes other Canadians will, too.

“Until it becomes a standard it’s up to you to look after your own health and ask for that test,” says Walsh. “Whether you’re a smoker or not, because not every smoker gets COPD and not everyone suffering with COPD is a smoker, ask for that test—it will help you breathe better.”

COPD symptoms

The Canadian Lung Association, which includes a national COPD program called BreathWorks, lists the following symptoms:

a cough that lasts a long time, or coughing up mucus
feeling short of breath, especially during any kind of physical activity
lung infections that last a long time (flu, acute bronchitis, pneumonia)
wheezing
unexpected weight loss

COPD causes

Smoking causes 80 percent of COPD cases in countries such as Canada, though other factors may contribute to the development of the disease:

exposure to second-hand smoke or air pollution, including dust and chemicals
repeated lung infections as a child
rare genetic condition called alpha-1
antitrypsin deficiency