What lifestyle changes should I make?
If you smoke, please stop. „Medically and surgically, there is nothing more beneficial to the management and improvement of COPD than smoking cessation,“ said Benjamin Sides, M.D., medical director of interventional pulmonology at Northwestern Medicine Central DuPage Hospital. To tell.
He says you also need to:
- Avoid lung irritants at home and at work.
- Eat healthy and stay active.
- Get vaccinated against influenza, COVID-19, and pneumococcal disease.
Which drugs are effective?
Treatment depends on the symptoms. Tell your doctor how often recurrences occur. Common medications that may be prescribed include:
Bronchodilators. A drug that relaxes the muscles around the airways. It is usually inhaled using an inhaler.
You may need a short-acting, or „rescue“ inhaler to relieve shortness of breath during a flare-up. The effect of one dose lasts approximately 4 to 6 hours.
If you have a lot of symptoms, long-acting bronchodilators are a better choice. The effect of this drug lasts about 12 hours. You may need to experiment with more than just classes and types to find what works best.
Carolyn Rochester, M.D., medical director of the Yale COPD Program, says there are several things to consider when choosing the right bronchodilator. This includes:
- Other health problems
- unwanted side effects
- Availability of medicines
- How well you can breathe the medicine (maximum inspiratory flow)
- What is paid by health insurance
Tell your doctor if there is anything you don't like about your treatment. They want to make sure your medication is easy to use and works as expected. „It's something that has to be constantly evaluated and reevaluated at every visit,“ Rochester says.
Combination therapy. It may be necessary to use more than one bronchodilator at the same time. „In some cases, he has up to three inhalers,“ Seides says. Each type of her COPD is treated differently.
Your doctor may suggest bronchodilators along with inhaled steroids. These are drugs that relieve inflammation of the airways. Rochester says steroids aren't suitable for everyone. However, the following cases may benefit from this type of combination therapy:
- You have a lot of seizures.
- You also have asthma.
- There is also peripheral blood eosinophilia.
Antibiotics. Viral and bacterial infections can make breathing more difficult. The airways can become swollen and filled with mucus. However, antibiotics can help improve symptoms. You may feel better before you finish taking all your medicine. However, take these medications exactly as directed by your doctor. This will reduce the chance of the infection coming back.
Other drugs. Although less common, some oral medications are used to treat COPD symptoms. It includes roflumilast and theophylline. Because of the side effects, „it's not really used anymore except in cases of really severe COPD,“ he says, Seides.
What is pulmonary rehabilitation?
It's a „medically prescribed exercise program“ for people with COPD, Sides said. Designed to help you breathe easier in your daily life. But it can also improve your overall quality of life.
Dr. Rochester says pulmonary rehabilitation can be helpful if the disease is stable. But there's evidence that if you try it within three months of being hospitalized with a COPD exacerbation, you're more likely to live longer and less likely to be hospitalized again within a year.
There is much to be gained from pulmonary rehabilitation. But the biggest benefit, Sides says, is that it strengthens the muscles that help you breathe.
Here's what else you can learn:
- breathing method
- Information about COPD
- nutrition tips
- How to deal with anxiety and depression
You will work with a team of medical professionals. This may include:
- pulmonologist
- Physical and respiratory therapists
- exercise specialist
- nutritionist
Through pulmonary rehabilitation, you can also find others with the same symptoms. You may feel more comfortable exercising and learning about COPD around people who know exactly what you're going through.
Should I try oxygen therapy?
COPD can reduce the amount of oxygen in the blood. „When your blood doesn't have enough oxygen, your brain, heart, and other organs work harder,“ Sides says.
Oxygen therapy is given through nasal prongs or a face mask. It's something you can use yourself. However, your doctor will dictate how often you should wear it and what type of device you should get.
Supplemental oxygen may have the following benefits:
- Reduces breathing problems when active
- Reduces strain on the heart and other organs
- Improves sleep and daytime fatigue
Professor Rochester said long-term oxygen therapy for around 15 hours a day could extend the lives of people with low blood oxygen levels. She says some people may find their symptoms improve with short-term use, such as when exercising, but it's not associated with a longer life.
Note that additional oxygen is not always necessary. In general, Dr. Seides says, COPD symptoms will not improve or your lifespan will be extended if your blood oxygen level is naturally above 88%. But that's something you can discuss with your doctor.
When is surgery necessary?
If nothing else works, you may need lung surgery to help you breathe better. However, such a procedure does not work for everyone. Your doctor can help you decide what's right for you.
Two common types of surgery for COPD are listed below.
- Reduced lung volume (LVRS). Doctors cut out the damaged lung tissue or remove the air. This improves the function of healthy lung tissue. It is not a cure for COPD. However, you can increase your lung capacity and make breathing easier.
- Extraction technique. Doctors can remove large air sacs that are no longer functioning. This gives the normal parts of the lungs more space to function.
A lung transplant may be required. Healthy lung tissue can be obtained from a donor. This could be an option if you have severe COPD and there's nothing else your doctor can do to help your lungs heal. A successful transplant can save lives, but it is a major surgery, Sides said. Your medical team will weigh the pros and cons with you.
Ask a question about clinical trials
Research into the treatment of COPD is ongoing. If you are interested in participating in a clinical trial, please let your doctor know. These are studies that allow new drugs and treatments to be tried.
Zides says new, less invasive treatments are in development. Examples include:
- Targeted lung denervation
- Targeted drug therapy
- Treatments that affect the mucus glands of the lungs
Be wary of commercially promoted treatments, such as stem cell therapy. „These have no proven benefits,“ Rochester says. “And in some cases, it can lead to a risk of harm, such as infection.”