The 4 Stages of COPD

stages of copdWhen doctors diagnose and evaluate patients for chronic obstructive pulmonary disease – or COPD –  treatment and rehab, they distinguish between four stages of COPD: mild, moderate, severe and very severe. Emphysema, chronic bronchitis and non-reversible (refractory) asthma all fall under the COPD umbrella.

While COPD has no cure, that doesn’t mean there’s no hope. With the right knowledge, the right rehab and – perhaps most important – the right attitude, you can significantly improve your quality of life. Understanding the 4 stages of COPD will give you a better picture of your condition, and will make it easier for you to convey what you’re experiencing to your loved ones and your resident staff.

What Do the 4 Stages of COPD Mean?

In order to establish a diagnosis of COPD, your doctor will first perform a spirometry test. That sounds complicated, but it’s really just a machine that measures the amount of air you can inhale, and how forcefully you can then exhale it. That gives the doctor an impression of how well your lungs are working.

After that, the GOLD (Global Initiative for Chronic Obstructive Lung Disase) system test will very likely be performed. This test uses the results of a forced expiratory volume (FEV1) test to check the amount of air the patient can expel from their lungs in a single second. Based on the results, your doctor will determine the stage of your COPD.

Stage 1 – Very Mild

If you have mild COPD, then your symptoms will be just that – mild. You’ll have slightly limited airflow, so slight you won’t even notice it much beyond an occasional cough that will have more mucus in it than usual. That’s why most people never hear about this stage: They don’t yet realize there’s something wrong. Stage 1 has an FEV1 score of 80% or higher

Stage 2 – Moderate

At this point, your airflow is significantly more limited. You might be experiencing wheezing or coughing, and you’ll notice that you become short of breath after performing physical activities that used to be easy. This is when most people begin to realize that something’s wrong. FEV1 result: 50%-80% of normal.

Stage 3 – Severe

At stage 3, the limited airflow has a significant impact on daily functioning. Breathlessness occurs a lot more often, making any strenuous physical activity just about impossible. The shortness of breath and increased coughing will likely make you feel very tired, too – a symptom known as emphysema fatigue. You will probably be seeing a lot more of your doctor if you have stage 3 COPD. FEV1 result: 30%-50% of normal.

Stage 4 – Very Severe

Stage 4 is the last stage of COPD and is sometimes known rather ominously as end-stage COPD. This doesn’t refer to end of life, though; it refers to the end of the COPD spectrum. Flare-ups become much more frequent at this stage, and they can be life-threatening. The functioning of the lungs deteriorates, and more aggressive medical treatment might be needed. It sounds very bleak, and there’s no denying that at this stage the disease is very difficult to deal with. That’s not to say that stage 4 patients can’t improve their quality of life; they can. It does, however, take more work and a lot of determination.

What is common to all stages of COPD is the importance of getting treatment and enlisting the help of close friends and family. Sometimes, after a flare-up, a short-term stay at a skilled nursing facility can give you the space, quiet and medical attention you need to keep going.

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