Chronic Obstructive Pulmonary Disease, also referred to as COPD, affects more than 32 million people in the United States. COPD is a progressive disease, making it harder for people to breathe over time. Many people do not even know they have it.
The goal of treatment and management is to improve a patient’s functioning and quality of life. This is often achieved by preserving optimal lung function, improving symptoms, and preventing the recurrence of exacerbations.
Currently, no treatments aside from lung transplantation have been shown to significantly improve lung function or allow COPD sufferers to live longer. When oxygen therapy is appropriate, and if smoking is stopped, many people with COPD can live a healthier life.
Once someone is diagnosed with COPD it is vital to have the patient, their family, and loved ones educated about the disease for full participation in therapy. It is important for the patient to know what long-term monitoring is and how it will work best for them.
What is COPD?
COPD is a disease of the large, central airways, the small or peripheral bronchioles (tubules), and the lungs themselves.
Most cases of COPD are the result of cigarette smoking, or exposure to noxious stimuli.
The normal inflammatory response is amplified in persons who are prone to develop COPD. No one knows how or why COPD develops or affects some people and not others.
Most patients develop chronic bronchitis, emphysema, and asthma, or some combination of them. Both chronic bronchitis and emphysema are airflow-limited conditions. Some current classifications no longer distinguish between emphysema and chronic bronchitis.
Chronic bronchitis means there is a productive cough for three months during each of two consecutive years, excluding other causes of cough.
Emphysema means there is an abnormal, permanent enlargement of the air spaces.
Asthma is a breathing disorder that is characterized as the narrowing of the airways and bronchial tubes. There are different types of asthma that will be covered in depth in this article.
How is COPD treated?
Smoking cessation is one of the main treatment plans for individuals with COPD.
Oral and inhaled medications are used for those patients who are stable enough to function normally. These drugs reduce shortness of breath and improve exercise tolerance. They are used to treat the four potentially reversible causes including:
- Bronchial smooth muscle contraction
- Bronchial mucosal congestion and edema
- Airway inflammation
- Increased airway secretions
Diet and nutritional support are an important part of comprehensive care. A healthy diet high in healthy fats, complex carbs, and fruits help those who suffer from COPD.
The mainstay of COPD treatment are inhalers known as bronchodilators. They work by dilating airways and reducing airflow resistance. These medicines provide symptomatic relief, but unfortunately, do not change the course of the disease or prolong life.
What can a COPD patient expect for long-term monitoring?
After being diagnosed with COPD, the situation varies from patient to patient. Some patients have mild symptoms, while others experience more severe problems. Generally, the longer the exacerbation, the more edema and debris are present in the airways.
All COPD patients, especially those discharged from hospitals or long-term care facilities, should receive steroids and an increase in the frequency of the inhaler therapy.
Patients are often offered close follow-up and long-term monitoring by their healthcare provider since their clinical situation can worsen in a short period of time. Other medications and respiratory therapy are decided on a case-by-case basis.
Most doctors recommend:
- Patients with severe or unstable disease should be seen monthly.
- When their condition is stable, patients may be seen biannually.
- For those patients on home oxygen, it is important to monitor oxygen saturation with a finger monitor device which are easily available over the counter.
What is pulmonary rehabilitation and what can a patient expect?
Pulmonary rehabilitation often means being able to enjoy life again, despite suffering from COPD. Shortness of breath, physical limitations, and inactivity impact quality of life significantly and pulmonary rehabilitation makes many things possible that would not otherwise be possible.
Pulmonary rehabilitation encompasses an array of therapeutic modalities designed to improve the patient's quality of life. Through intensive pulmonary therapy, COPD patients can decrease airflow limitation, prevent secondary medical complications, and alleviate respiratory symptoms.
The major goals of the comprehensive management of COPD are to lessen airflow limitation, prevent and treat secondary medical complications (eg, hypoxemia or low oxygen, infection), and to decrease respiratory symptoms and improve quality of life.
Successful implementation of a pulmonary rehabilitation program usually requires a team approach. A qualified team works together to provide the best care for a wide range of patients and their families.
COPD patients and their families can expect healthcare professionals on their healthcare team who have experience in managing COPD. For the best results, multiple specialists will partake in a patient's care plan. Some examples of specialists include physicians, dietitians, nurses, respiratory therapists, and psychosocial professionals.
This multidisciplinary approach emphasizes the following:
- Patient and family education
- Smoking cessation
- Medical management (including oxygen and immunization)
- Respiratory and chest physiotherapy
- Physical therapy with bronchopulmonary hygiene, exercise, and vocational rehabilitation
- Psychosocial support
A lifetime of monitoring
While there have been vast improvements in technology and medicine for COPD patients, there is not currently a cure. Patients who suffer from this disorder will undergo a lifetime of monitoring to ensure symptoms do not worsen. Patients can find systematic relief with medications to help alleviate discomfort.
Pulmonary rehabilitation programs are an essential part of long-term care for COPD patients and their families.
Pulmonary rehabilitation programs are conducted in outpatient settings.
Pulmonary rehabilitation programs include a number of comprehensive components that are customized to each individual patient and their families who are provided with a complete program with guidelines to continue at home as well as what to do in an emergency.
As a result of a good pulmonary rehabilitation program, improvements can be made objectively in the patient's quality of life, well-being, and overall health status.
Education is key to long-term pulmonary rehabilitation. Care preparation, anticipating possible problems, and knowing what to do if the patient's condition changes are invaluable factors in the patient's overall care.