COPD, (chronic pulmonary obstructive disease), is an umbrella term describing lung diseases such as emphysema, chronic bronchitis, and non-reversible asthma. This disease is characterized by increasing breathlessness. COPD can be managed, but not cured. It is the third leading cause of death in the United States, with more than 11 million diagnosed. Millions more may have the disease without knowing it.
The 5-year mortality rate ranges from 40% to 70%, depending on disease severity, while the 2-year mortality rate is 50%. Moreover, overall survival rates are worse compared to people with many common cancers. Indeed, COPD is the only leading cause of death that is increasing. (See Graph-2).
COPD most often occurs in people 40 years of age and older who have a history of smoking. These may be individuals who are current or former smokers. While not everybody who smokes gets COPD, most of the individuals who have COPD (about 90% of them) have smoked.
COPD can also occur in those who have had long-term contact with harmful pollutants in the workplace. Some of these harmful lung irritants include certain chemicals, dust, or fumes. Heavy or long-term contact with secondhand smoke or other lung irritants in the home, such as organic cooking fuel, may also cause the disease.
Non smokers can still develop COPD. Absence of the Alpha-1 Antitrypsin protein is the genetic risk factor for emphysema. Without the Alpha-1 protein, white blood cells attack and destroy the lungs. The World Health Organization and the American Thoracic Society recommends that every individual diagnosed be tested for Alpha-1 protein.
Symptoms may include:
- an increase or decrease in the amount of mucus or sputum, also called phlegm, that is produced in the lungs and coughed up
- the presence of blood in the sputum
- shortness of breath that is persistent
- a chronic cough present throughout the day
- a general feeling of ill health
- swelling of the ankles
- difficulty sleeping
- using more pillows or sleeping in a chair instead of a bed to avoid shortness of breath
- unexplained increase or decrease in weight
- increasing morning headaches, dizzy spells, or restlessness
- increased fatigue and lack of energy
COPD: Rehabilitation Techniques
Rehabilitation for COPD patients is not a one size fits all protocol but can be tailored to the severity level of the patient.
Some techniques used are:
- Smoking cessation. Stopping smoking can help slow the decline in lung function as measured by FEV1.
- Oxygen therapy. When the lungs cannot function well, inhaled oxygen helps get enough oxygen into the blood to meet the body’s needs.
- Nutrition. People with COPD often lose weight, which can lead to loss of muscle mass. Underweight people with COPD often have greater difficulty breathing. Proper diet is a must.
- Bronchodilators. These medications relieve symptoms, improve exercise capacity, and improve airway obstruction. They work by opening up the air passages and making it easier to breathe. There are many different kinds of bronchodilators. Atrovent, for example, is short acting, so it’s used for the immediate relief of symptoms. Spriva, by contrast, is long acting, so it’s used to help keep airways open day to day.
- Corticosteroids. These drugs, such as prednisone or budesonide, are used to reduce inflammation and to treat symptoms, especially symptoms of an exacerbation. These medications may help slow the progression of the lung symptoms.
- Vaccines. COPD can flare up and worsen when you get sick, so it’s important to get the flu shot and the pneumonia shot.
- Antibiotics. Antibiotics treat bacterial infections and are used primarily during an exacerbation.
COPD: Pulmonary Rehabilitation
There are COPD patients that can be rehabbed with more natural methods that will build fitness and make breathing easier, such as the following:
- Breathing techniques
- Emotional and group support
- Learning more about your medications
- Strategies for living better
Exercises may done one-on-one with a trainer or as part of a group. Exercises that are effective in making breathing easier are:
Lower body: Most rehab centers offer a set of exercises that center on leg workouts. They vary from simply walking on a treadmill or around a track to more intense stair climbing. Most of the proven benefits of pulmonary rehab are shown in studies of people doing leg exercises.
Upper body: The muscles in the upper body are important for breathing, as well as for daily activities. Arm and chest exercises might include turning a crank against resistance or just lifting your arms against gravity.
Breathing: Blowing through a mouthpiece against resistance may increase the strength of your breathing muscles. These exercises may be helpful for people with very weak breathing muscles.
Strength training: Most pulmonary rehab exercises focus on building endurance. Adding strength training, such as lifting weights, has been shown to be helpful as well.