November is National COPD Awareness month. If you watch television, you have probably seen commercials for COPD treatments and medications. If you live in eastern North Carolina, you almost certainly know someone with COPD — you may even have it yourself.  What exactly is COPD? COPD, or chronic obstructive pulmonary disease, is the medical term used to describe the five progressively debilitating obstructive lung diseases. These diseases limit (obstruct) airflow in the lungs and decrease the amount of oxygen entering the blood to fuel the body. In the United States, COPD has come to mean only two or three of these respiratory diseases, chronic bronchitis, emphysema and, sometimes, asthma. The prevention, recognition and treatment of chronic bronchitis and emphysema are the focal points of National COPD Awareness month.
The prevalence of COPD in American adults has reached epidemic levels and continues to grow. According to the Center for Disease Control’s most recent data (2011), COPD is the third leading cause of death in the U.S., up from fourth place in 1998. A study conducted by East Carolina University found that five year COPD-related adult death rate in eastern North Carolina’s mirrors that of the U.S. as a whole (120 deaths per 100,000 people).  Unfortunately, our region’s COPD mortality rate is 4 percent higher than all the rest of North Carolina. Tragically, the majority of these deaths were preventable because 80 percent to 90 percent of all COPD diagnoses are directly related to smoking, including long-term exposure to second-hand smoke.  COPD can also be caused by years of exposure to dust and chemical fumes, occupational hazards found in farming, factory work and even hair salons.
COPD is particularly dangerous because it develops slowly over time, and with the exception of a lung transplant, it has no cure. Even worse, by the time symptoms develop, up to half of a person’s lung function has already been destroyed. Over time, exposure to smoke and other irritants causes thickening of the lungs’ airways due to constant inflammation. Mucus thickens and becomes trapped, further blocking the airways. The lung walls lose their elasticity, making it difficult to move air around in the lungs. The amount of oxygen available to pass from the lungs to the bloodstream is decreased. Symptoms include productive cough with thick, nasty phlegm during most months of the year, fatigue, chest tightness, wheezing and increased shortness of breath when doing everyday activities.   Fortunately, with lifestyle changes, advances in respiratory medications and treatments, and the use of supplemental oxygen, the progression of COPD can be slowed and managed.
National COPD Awareness Month has three goals – disease prevention, early diagnosis and disease management — goals shared by all respiratory care practitioners every day of every month of every year.

Prevention
The easiest way to prevent COPD is to never start smoking.  If you already smoke, quitting before you start to have symptoms can delay and sometimes even stop the future development of the disease. Try to avoid irritants like second-hand smoke and chemical fumes. If you must work in heavily polluted areas, wear a mask.

Early diagnosis
The COPD Foundation, as part of its DRIVE 4 COPD campaign, designed a short screening tool to help determine if you have, or are at risk for developing COPD. By going online to www.drive4copd.com, you can answer the five questions and get information about your score to share with your doctor. Your doctor can then decide if further evaluation is needed. The earlier COPD is diagnosed, the easier it is to treat and manage.

Disease management
We always try to encourage COPD patients, especially those newly diagnosed with the disease, to view it not as a death sentence, but rather as a call to action. If you have COPD, you have two choices: you can manage your disease or you can let it manage you. In the Cardiopulmonary Services Department at Vidant Beaufort Hospital, we are working toward the development and use of written COPD management plans for our patients hospitalized with COPD or COPD-related illnesses, to help them avoid future hospitalizations and enjoy fuller lives. Each patient’s plan will be developed not by the RCPs for the patient, but by the patient with our help. Plans will focus on common areas such as lifestyle changes, nutritional needs and choices to boost energy, signs and symptoms that need immediate medical care, medication management and quality of life goals, all designed to enable each patient to take control of his or her quality of life. Having an active support system is also a critical part of successfully managing life with COPD. A great place to get that support is by participating in our Better Breathers group, a free monthly gathering for anyone that has, or is interested in, any type of respiratory disease. Most of our group has COPD, and it will only take one meeting for you to see that COPD does not manage them.
November is also the month of Thanksgiving. This year, if you have healthy lungs, I encourage you to be thankful for the gift of easy breathing. If you have COPD, I encourage you to be thankful for the advances made in pulmonary medicine — and for turkey. Protein is very important for people with COPD, so eat another slice.
Alene Payne Warden, MSHE, RRT/RCP, is the manager of cardiopulmonary services at Vidant Beaufort Hospital.