how chemical fumes or dust from the environment or workplace also can contribute to COPD.

Pipe, cigar, and other types of tobacco smoke also can cause COPD, especially if the smoke is inhaled. Breathing in secondhand smoke, air pollution, and chemical fumes or dust from the environment or workplace also can contribute to COPD. (Secondhand smoke is smoke in the air from other people smoking. ) In rare cases, a genetic condition called alpha-1 antitrypsin deficiency may play a role in causing COPD. People who have this condition have low levels of alpha-1 antitrypsin (AAT)—a protein made in the liver. Having a low level of the AAT protein can lead to lung damage and COPD if you’re exposed to smoke or other lung irritants.

If you have this condition and smoke, COPD can worsen very quickly. Signs and symptoms: The signs and symptoms of COPD include: * An ongoing cough or a cough that produces large amounts of mucus (often called “smoker’s cough”) * Shortness of breath, especially with physical activity * Wheezing (a whistling or squeaky sound when you breathe) * Chest tightness These symptoms often occur years before the flow of air into and out of the lungs declines. However, not everyone who has these symptoms has COPD. Likewise, not everyone who has COPD has these symptoms.

Some of the symptoms of COPD are similar to the symptoms of other diseases and conditions. You can find out whether you have COPD. If you have COPD, you may have colds or the flu (influenza) frequently. If your COPD is severe, you may have swelling in your ankles, feet, or legs; a bluish color on your lips due to a low blood oxygen level; and shortness of breath. COPD symptoms usually slowly worsen over time. At first, if symptoms are mild, you may not notice them, or you may adjust your lifestyle to make breathing easier. For example, you may take the elevator instead of the stairs.

Over time, symptoms may become severe enough to see a doctor. For example, you may get short of breath during physical exertion. How severe your symptoms are depends on how much lung damage you have. If you keep smoking, the damage will occur faster than if you stop smoking. In severe COPD, you may have other symptoms, such as weight loss and lower muscle endurance. Some severe symptoms may require treatment in a hospital. You—with the help of family members or friends, if you’re unable—should seek emergency care if: * You’re having a hard time catching your breath or talking. * Your lips or fingernails turn blue or gray. This is a sign of a low oxygen level in your blood. ) * You’re not mentally alert. * Your heartbeat is very fast. * The recommended treatment for symptoms that are getting worse isn’t working. Diagnostic Procedures: Your doctor will diagnose COPD based on your signs and symptoms, your family and medical histories, and test results. He or she may ask whether you smoke or have had contact with lung irritants, such as secondhand smoke, air pollution, chemical fumes, or dust. If you have an ongoing cough, your doctor may ask how long you’ve had it, how much you cough, and how much mucus comes up when you cough.

He or she also may ask whether you have a family history of COPD. Your doctor will examine you and use a stethoscope to listen for wheezing or other abnormal chest sounds. You also may need one or more tests to diagnose COPD. Lung Function Test: Lung function tests measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood. The main test for COPD is spirometry. Other lung function tests, such as a lung diffusion capacity test, also may be used. Spirometry; During this painless test, a technician will ask you to take a deep breath in.

Then, you’ll blow as hard as you can into a tube connected to a small machine. The machine is called a spirometer. The machine measures how much air you breathe out. It also measures how fast you can blow air out. Your doctor may have you inhale medicine that helps open your airways and then blow into the tube again. He or she can then compare your test results before and after taking the medicine. Spirometry can detect COPD long before its symptoms appear. Doctors also may use the results from this test to find out how severe your COPD is and to help set your treatment goals.

The test results also may help find out whether another condition, such as asthma or heart failure, is causing your symptoms. Other Tests Your doctor may recommend other tests, such as: * A chest x ray or chest CT scan. These tests create pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. The pictures can show signs of COPD. They also may show whether another condition, such as heart failure, is causing your symptoms. * An arterial blood gas test. This blood test measures the oxygen level in your blood using a sample of blood taken from an artery.

The test can help find out how severe your COPD is and whether you may need oxygen therapy. Treatment – Medical/Nursing: COPD has no cure yet. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease. Quitting smoking is the most important step you can take to treat COPD. Talk with your doctor about programs and products that can help you quit. Other treatments for COPD may include medicines, vaccines, pulmonary rehabilitation (rehab), oxygen therapy, and surgery. Your doctor also may recommend tips for managing COPD complications.

The goals of COPD treatment include: * Relieving your symptoms * Slowing the progress of the disease * Improving your exercise tolerance (your ability to stay active) * Preventing and treating complications * Improving your overall health Specialists Involved To assist with your treatment, your family doctor may advise you to see a pulmonologist. This is a doctor who specializes in treating people who have lung disorders. Medicines Bronchodilators Bronchodilators relax the muscles around your airways. This helps open your airways and makes breathing easier.

Depending on how severe your disease is, your doctor may prescribe short-acting or long-acting bronchodilators. Short-acting bronchodilators last about 4 to 6 hours and should be used only when needed. Long-acting bronchodilators last about 12 hours or more and are used every day. Most bronchodilators are taken using a device called an inhaler. This device allows the medicine to go right to your lungs. Not all inhalers are used the same way. Ask your health care team to show you the correct way to use your inhaler. If your COPD is mild, your doctor may only prescribe a short-acting inhaled bronchodilator.

In this case, you may only use the medicine when symptoms occur. If your COPD is moderate or severe, your doctor may prescribe regular treatment with short- and long-acting bronchodilators. Inhaled Glucocorticosteroids (Steroids) Inhaled steroids are used to treat people whose COPD symptoms flare up or worsen. These medicines may reduce airway inflammation. Your doctor may ask you to try inhaled steroids for a trial period of 6 weeks to 3 months to see whether the medicine helps relieve your breathing problems. Vaccines Flu Shots The flu (influenza) can cause serious problems for people who have COPD.

Flu shots can reduce your risk of the flu. Talk with your doctor about getting a yearly flu shot. Pneumococcal Vaccine This vaccine lowers your risk of pneumococcal pneumonia (nu-MO-ne-ah) and its complications. People who have COPD are at higher risk of pneumonia than people who don’t have COPD. Talk with your doctor about whether you should get this vaccine. Pulmonary Rehabilitation Pulmonary rehabilitation, or rehab, is a medically supervised program that helps improve the health and well-being of people who have lung problems.

Rehab may include an exercise program, disease management training, and nutritional and psychological counseling. The program’s goal is to help you stay more active and carry out your daily activities. Your rehab team may include doctors, nurses, physical therapists, respiratory therapists, exercise specialists, and dietitians. These health professionals work together and with you to create a program that meets your needs. Oxygen Therapy If you have severe COPD and low levels of oxygen in your blood, oxygen therapy can help you breathe better. For this treatment, you’re given oxygen through nasal prongs or a mask.

You may need extra oxygen all the time or just sometimes. For some people who have severe COPD, using extra oxygen for most of the day can help them: * Do tasks or activities, while having fewer symptoms * Protect their hearts and other organs from damage * Sleep more during the night and improve alertness during the day * Live longer Prognosis: COPD, or chronic obstructive pulmonary disease, is a disease of the lungs that develops over many years and gradually gets worse with time. When you have COPD your airways become persistently blocked, which can eventually make breathing difficult.

More than 12 million Americans have been diagnosed with it, and another 12 million might have COPD without knowing it. COPD encompasses two diseases commonly caused by smoking: emphysema and chronic bronchitis. It’s the fourth leading cause of death in the U. S. But while COPD can’t be cured, there are steps you can take to improve symptoms, prevent complications such as pneumonia, and improve your quality of life. Just like people living with heart disease, people with COPD can make changes to their lifestyle to vastly improve how they feel and function each day.

Here are five important measures to discuss with your doctor:  1. Stop Smoking Cigarette smoking is the most significant reason that people develop COPD. While kicking the habit won’t return your lungs to normal condition, it will delay progression of symptoms because the rate of decline of lung function returns to that of nonsmokers. “In susceptible people, smoking accelerates the lung function decline of aging. Your lungs will age faster, and if you stop smoking, you go back to normal aging,” says Gail Weinmann, MD, deputy director for the Division of Lung Diseases at the National Heart, Lung and Blood Institute.

It’s also a good idea to avoid crowds during flu season. Because COPD leaves a person more prone to pneumonia, patients also should talk to their doctors about also getting the pneumococcal vaccine, Weinmann says. 4. Seek Regular Medical Care and Take Medications as Directed Your doctor can prescribe drugs, such as bronchodilators and corticosteroids, to treat your symptoms. Bronchodilators, which are usually delivered through an inhaler, relax muscles around your airways. This, in turn, opens them up and eases breathing. Inhaled corticosteroids fight inflammation in the airways.

Patients with COPD frequently have other health problems, too, such as heart disease, vascular diseases, gastroesophageal reflux (GERD), and type 2 diabetes, Weinmann says. “People with COPD are likely to have other diseases, and it’s important that they treat all of their diseases. ” In fact, heart disease and COPD share overlapping symptoms, which can lead people to mistakenly attribute heart disease to lung disease. According to Weinmann, these shared symptoms include shortness of breath, including breathlessness when exercising or waking up at night, and sometimes a sensation of chest tightness. 5.

Consider a Pulmonary Rehabilitation Program and Learn to Exercise Your doctor may suggest a pulmonary rehabilitation program. Such programs won’t actually improve lung function, but they can help people with COPD to stay more active and independent. You’ll learn exercises to strengthen your arms and legs, as well as exercises that aim to strengthen muscles for breathing. “Pulmonary rehab includes a variety of exercises for the lower and upper extremities, as well as breathing techniques and counseling,” Weinmann says. Some patients feel reluctant to join a pulmonary rehab program, but Weinmann encourages them to try it. Once the lung is damaged, it doesn’t really ever repair itself, so it’s very important that individuals stay in good shape in every way that they can. It’s very common for patients with COPD to become deconditioned. It’s hard for them to breathe, so the tendency is to not do anything at all. Reconditioning their muscles and their heart can make them feel a lot better. ” “Some patients feel that they have greatly benefited from it [rehab],” she adds. “It has improved their quality of life and their exercise ability. You have to keep at it. It’s not something that you can do once. “