Chronic Obstructive Pulmonary Disease can be Managed

Chronic Obstructive Pulmonary Disease can be Managed

By Kay Hernandez, RN, Visiting Nurse Association, Denton County LIVING WELL Magazine

What Is Chronic Obstructive Pulmonary Disease?

Chronic obstructive pulmonary disease (COPD) is a chronic disease that causes difficulty with breathing. Symptoms of COPD include coughing, wheezing, shortness of breath, chest tightness, and susceptibility to respiratory infections. Symptoms usually worsen over time and limit the ability to perform routine activities.

The two main types of COPD are chronic bronchitis and emphysema. With chronic bronchitis, the lining of the lung airways becomes irritated and swollen, causing thick mucus to form.  Breathing is difficult, resulting in frequent coughing. When the small sacks in the lungs lose elasticity so that air becomes trapped there, the condition is called emphysema.

Causes and risk factors

Smoking is the number one cause of COPD. Other risk factors include long-term exposure to air pollution, chemical fumes, and dust from the environment or workplace.

COPD is the third leading cause of death in the U.S. Over 13.5 million Americans have been diagnosed with COPD; most are over the age of 40. An estimated 15 million individuals have the disease but don’t know it because symptoms of COPD develop slowly.

Treatment

COPD is a chronic disease, meaning that it cannot be cured and will get worse over time.  Although there is no cure for COPD, there are a number of things that can be done to relieve symptoms, improve breathing, prevent flare ups, and slow the progression of the disease.

The first step is to get ongoing care. Someone with breathing problems should consult a physician. There are medications available to treat COPD that can make breathing easier. These include inhalers (bronchodilators) to open the airways, medications to reduce inflammation in the lungs, antibiotics to treat infections, and oxygen therapy.

A physician may also refer a patient to a pulmonary rehabilitation program that teaches different ways to breathe that can reduce symptoms and improve stamina. If a patient needs the healthcare provider to come to his or her home, a home care agency may be able to provide this service.

Some home care agencies provide patients with telehealth monitors that perform daily checkups in their homes. These are small electronic devices that measure patient vital signs and monitor COPD symptoms and medication dosage.

The information collected by the monitor is transmitted by satellite or telephone line from the patient’s home to a monitoring station, where a nurse evaluates the health data. If a health problem is detected, the nurse will contact the patient to discuss his or her symptoms. A trend report of information collected by the monitor may then be sent to the patient’s physician. By using a telehealth monitor, a COPD patient can get immediate attention instead of waiting for the next scheduled nursing visit or before a trip to a hospital emergency room becomes necessary.

COPD patients can be taught how to identify and avoid triggers that make breathing worse, and how and when to use medications so they will be most effective.

COPD patients can also learn how to manage their disease through lifestyle changes that will help control their symptoms and improve their level of functioning.

The first step is to quit smoking. This is the best way to slow down damage to the lungs.

Exercise can help breathing, as well as improve muscle strength in the legs. With consultation with a physician, patients may gradually increase their ability to become more active through a simple exercise regimen. Learning new ways to perform everyday tasks can help save physical energy and increase their activity, too.

Changes at home can also help COPD patients manage their symptoms more effectively. Tips include avoiding very cold air, prohibiting smoking in their homes, and reducing indoor air pollution by eliminating fireplace smoke and other airborne irritants.

Prognosis

By receiving ongoing medical care for COPD, the progression of the disease can be slowed and patients will be able to participate in increased activities and enjoy life more fully.

Lifestyle changes can also help patients feel better, become more active, slow the progress of the disease, and improve their quality of life.

Author Kay Hernandez, RN, is a telemonitor coordinator with Visiting Nurse Association.

Additional information about COPD treatment can be obtained by contacting Elaine Harrison, RN, at the Visiting Nurse Association at 214-689-2661 or harrisone@vnatexas.org.