Breathe Easy

November 2009

Inhale, exhale. It’s as easy as breathing—unless your breathing has been compromised by chronic obstructive pulmonary disease (COPD).

Afflicting more than 12 million people in the United States, COPD blocks regular, healthy airflow and can rob people of the energy and strength that they need. Debilitating and incurable, it is strongly linked to smoking—and is the number-four killer of U.S. women, 40 percent of whom smoke.

“In the past, COPD was considered a man’s disease,” says Norman Edelman, MD, chief medical officer for the American Lung Association. “But since so many women have taken up smoking since the 1960s, and since those cigarettes are catching up with older women now, COPD has become more prevalent in women than it is in men.”

If you smoke or have asthma or regular exposure to air pollutants, you may not be able to prevent COPD. But you can take charge of your health and keep this condition from impairing your everyday functioning. In Novem­ber, which is National COPD Awareness Month (and the month the American Cancer Society holds its Great American Smokeout, challenging people to quit cigarettes), here are some tips to help you breathe easy.

Usually appearing around age 60 or later, COPD can be the end result of taxing your lungs too long and too hard. Normally, air flows down your windpipe and into your lungs through two large bronchial tubes that branch into thousands of smaller air channels. These tubes end in tiny air sacs where the oxygen you inhale passes into your bloodstream. When you sustain the type of lung damage that leads to COPD, the bronchial tubes and air sacs lose their elasticity, impairing oxygen intake.

What causes this damage? Smoking regularly—or living with people who do. Working in conditions that expose you to chemical fumes, dusts, and vapor. Living in a heavily polluted area. Or having one of three lung problems that all cause shortness of breath.

The first of these problems is emphysema, in which airways are so damaged that they collapse when you exhale, causing wheezing and chest tightness. The second is chronic bronchitis, a persistent infection that produces yellow sputum and requires frequent coughing and throat-clearing. The third is bronchi­tis caused by chronic asthma—a lung disorder in which exposure to allergens or rapid changes in air temperature cause breathing problems and a feeling of con­striction in the chest. All these conditions can eventually lead to COPD.

Rarer COPD triggers include gastroesophageal reflux disease (GERD), which causes stomach acids to back up into the esophagus, and the genetic disorder alpha-1 antitrypsin deficiency, which can cause COPD in people as young as their 30s and 40s.

“If your doctor diagnoses you with chronic obstructive pulmonary disease, know this condition can be challenging, but is nevertheless highly manageable,” says Lawrence Grouse, MD, executive director of the COPD Coalition.

Treatments include antibiotics (to fend off respiratory infections that wors­en COPD), bronchodilators (medica­tions that come in the form of inhalers to help relax the airways), and inhaled steroids (which can reduce inflammation in the airways).

“Also helpful are oxygen therapy, in which portable devices deliver oxygen to your lungs, and pulmonary rehabilita­tion, which combines counseling, physi­cal therapy and nutrition, and exercise training,” says Grouse.

For more severe cases of COPD, doc­tors may perform lung volume reduction surgery (removing damaged tissue and creating space for remaining tissue to work efficiently) or even a lung trans­plant (replacing the most damaged lung with a healthy donor one).

Healthy habits can complement these treatments and help you live well despite having COPD.

You can improve your breathing using relaxation techniques, controlled coughing, a humidifier, and generous water intake (ideally drinking eight eight-ounce glasses a day).

You can also breathe more easily if you exercise regularly. COPD can be debilitating and weaken those affected by it. Even so, the extra flood of oxygen that exercise brings to your lungs and bloodstream can help restore the energy that you need.

Try to exercise in the morning when the smog is lightest. Take breaks when your body asks for them. Go gently at first, with light stretching and easy walks, then build slowly from there.

Eat heartily so you main­tain a healthy weight and don’t become too thin (a problem for many COPD patients). And eat health­ily so you don’t develop respiratory infections—colds, the flu, and pneumonia that can make COPD worse. “To prevent these infections, get regular vaccinations, includ­ing flu and pneumococcal shots,” says Edelman.

Avoid second-hand smoke, use air conditioners with clean filters, and stay away from polluted areas as much as possible (such as streets where there is heavy traffic). If you may be exposed to fumes or dust, wear a protective mask to prevent inhaling pollutants.

When COPD is fully developed, peo­ple affected by it can experience episodes called exacerbations, during which their symptoms suddenly get worse. “Trig­gered by respiratory infections, changes in temperature, or air pollution, exac­erbations can lead to lung failure,” says Grouse. “Get prompt medical interven­tion, and you’ll prevent exacerbations— and COPD in general—from getting the best of you.”

Molly M. Ginty lives in New York. Her work has appeared in Ms., Marie Claire, Redbook, and Women’s eNews.