What is it, and what can be done to relieve symptoms?
Sometimes the biggest obstacle in treating and understanding a condition or disease is the difficulty in defining the precise ailment. Chronic Obstructive Pulmonary Disease (COPD) is often defined as a progressively worsening lung disease that causes breathing difficulties. Yet the COPD Foundation itself defines COPD as an ‘umbrella term’ that can be used to describe a variety of progressive lung diseases.
Those diseases can include emphysema, chronic bronchitis, and non-reversible asthma. COPD is primarily characterized by increasing breathlessness over time.
As COPD is currently progressive and incurable, the emphasis turns to disease management and the easing of symptoms. As the Foundation’s website reads, “People can live for many years with COPD and enjoy life.”
The signs and symptoms of COPD are fairly simple—shortness of breath and persistent, frequent coughing—yet complicated all the same because of the extremely common nature of these symptoms and the fact that they can be telltale signs of anything as minor as the common cold. This is why COPD often progresses for years without any healthcare intervention.
Providers are encouraged to become familiar with the spirometry test, which is simply explained as a test to evaluate how well the lungs are performing their function. Since a person can live for years without noticing symptoms of COPD, often leading to progressively worsening stages of the disease by the time a diagnosis is made, the spirometry test is recommended for anyone with:
- A history of smoking, or if you are a current smoker,
- A history of exposure to potentially harmful lung irritants,
- A history of COPD in your family
The spirometry test is performed by having the patients blow all of the air in their lungs into a mouthpiece connected to a machine known as a spirometer. The spirometer then works to determine two numbers: the amount of air blown out in the first second, and the total amount of air blown out in six seconds or more.
These numbers are represented as FEV1 and FVC (sometimes FEV6 is used). FEV1 stands for the Forced Expiratory Volume in the first second—the amount of air you exhaled in the first second of blowing. FVC stands for Forced Vital Capacity—the amount of air that you exhaled in one entire breath.
People with COPD have an FEV1/FEV6 (FVC) ratio less than 70 percent. The FEV1 percentage predicted indicates how severe the airways are obstructed (blocked or narrowed).
Less than 80 percent of predicted is considered moderate COPD, and less than 50 percent of predicted is severe. People with asthma will have a low FEV1/FEV6 ratio when they are having an attack, and then will return to normal or almost normal after using fast-acting medications.
A spirometry test can also show your doctor how severe your COPD may or may not be. There are several stages of COPD. The extent of your COPD is classified into four different stages (mild, moderate, severe, very severe) that are defined by your symptoms and the results of your Spirometry Test.
It’s important to note that the stages of the disease are not a predictive factor of how long a person is expected to live, nor should they be used to determine the severity of symptoms.
Who should get tested, and how?
According to the COPD Foundation, anyone with the following traits of symptoms should be tested:
- Has a history of smoking
- Has long-term exposure to air pollutants (including pollution and second-hand smoke)1
- Has chronic coughing with or without sputum
- Has wheezing
- Has shortness of breath that has become worse over time
- Cannot keep up with people of your own age
The longer one waits to receive a diagnosis, the higher the chances of worsening symptoms than if those symptoms were treated immediately with medication or therapy. Additionally, many adults have been incorrectly diagnosed with asthma, when a proper diagnosis will ensure that the patient receives proper treatment. While no cure for COPD is available, there are methods available to ensure people can live longer and with higher qualities of life.