Causes for disease vary

Breath is synonymous with life.

For years, the American Lung Association’s public-service announcements had the tagline, “When you can’t breathe, nothing else matters.” And it’s true.

According to the Centers for Disease Control and Prevention, chronic Obstructive pulmonary disease is a leading cause of people losing the ability to breathe.

According to the National Institutes of Health, the term COPD was not widely used until recently.

Dr. Paul M. Schuler is a board-certi ed pulmonologist at Pulmonary and Critical Care Specialists in Shreveport. “COPD describes a group of lung conditions that make it dif cult to empty the air out of the lungs,” Schuler said. “COPD can be serious. COPD can be disabling, and COPD is the third leading cause of death in the United States. The two major medical conditions associated with COPD are chronic bronchitis and emphysema.”

The CDC lists COPD as the third leading cause of death in the United States. An estimated 16 million people are diagnosed with COPD in the United States alone; an estimated 14 million more are estimated to be undiagnosed.

According to the National Institues of Health, patients with COPD have reduced air ow through their airways because of one or more of the following:

• The airways and air sacs lose their elasticity,

• The walls between many of the air sacs are destroyed,

• The walls of the airways become thick and in amed, and/or

• The airways make more mucus than usual, which can clog them.

The National Institutes of Health reports that in years past, six times as many men as women died of COPD. The number of women with COPD has grown recently to the extent that today, more women die from COPD than do men – due in part to increased use of tobacco by women, but less screening of women for COPD may also be a factor. According to the American Lung Association, women are more vulnerable than men to lung damage from cigarette smoke and other pollutants due to their smaller lungs and having less respiratory muscle to move air in and out, causing irritants to become more concentrated and cause more damage. Additionally, estrogen, a female hormone, worsens the lung damage by altering the way nicotine breaks down in the body into harmful compounds.

“The most common cause of COPD is cigarette smoking,” Schuler said. “Air pollution, exposure to respiratory irritants and genetics also play a role in development of COPD.” A study published in the European Respiratory Journal in 2009 puts the number of COPD cases due to smoking at approximately 80 to 90 percent.

“Some of the warning signs of COPD would be a cough, sputum production and shortness of breath. COPD develops slowly,” Schuler said. “Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking or taking care of yourself.”

According to the NIH, medications used to treat COPD include:

• Inhalers (bronchodilators) to open the airways,

• Inhaled steroids to reduce lung in ammation, and

• Anti-in ammatory medications. In severe cases or during are-ups, patients may require:

• Steroids by mouth or intravenously,

• Bronchodilators through a nebulizer,

• Oxygen therapy, and

• Breathing assistance from a machine. Schuler said COPD can be diagnosed clinically by observing these symptoms and con rming the diagnosis by measuring

lung function by spirometry, using a simple device that measures the volume and rate of ow of breath.

“There is no ‘cure’ for COPD but there are treatments that can improve symptoms such as medications that open airways and help people breathe better,” Schuler said.

Some severe symptoms may require treatment in a hospital. Those experiencing them should seek emergency care if:

• There is dif culty catching one’s breath or talking,

• Lips or ngernails turn blue or gray (This is a sign of a low blood oxygen level.)

• They nd themselves not mentally alert,

• The heartbeat is very fast, and/or the recommended treatment for symptoms that are getting worse stops working.

Not smoking is emphasized by a study by the University of Nebraska, University of Manchester and Hvidovre University Hospital in Denmark, which came to the conclusion that virtually all lifelong smokers will develop COPD, provided that other smoking-related diseases fail to claim their lives beforehand.

According to the NIH, persons with COPD must stop smoking to slow lung damage and give themselves the best chance of a longer life.

– Michael Stone