Coping with COPD

Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease, characterized by persistent airflow limitation often progressive, resulting from enhanced chronic lung inflammation due to noxious particles like nicotine. (GOLD Guidelines 2015). Locally known as “emphysema,” it presents as chronic cough, breathlessness and/or sputum production. Though cannot be cured, it can be effectively treated to reduce symptoms and to improve quality of life. COPD affects about 10 percent of the world’s population and is the seventh leading cause of mortality in the Philippines. Here are some ways to cope with COPD:

1Seek professional consultation to establish diagnosis, severity and treatment. Bronchodilators remain central to symptomatic COPD treatment. Inhaled medications are preferred either as short-acting or long-acting beta-agonist or anticholinergic agents. Anti-inflammatory agents are added for the more symptomatic or frequently-exacerbating patient. Severe cases may require oxygen therapy. Treatment adherence and vigilance on side effects is essential in optimizing treatment.

2Quit smoking. Smoking cessation retards steep lung function decline. Early cessation reduces other comorbidities like cardiovascular disease and malignancies. Do not be discouraged on failed attempts.

3Stay active. COPD patients suffer from bothersome breathlessness leading to reduced physical activity. The progressive deconditioning from inactivity initiates a vicious cycle, with dyspnea becoming problematic at even lower physical demands. Regular exercise can improve oxygen utilization, strengthen muscles, improve endurance and eventually help patients breathe easier. The key is to start slow. A structured pulmonary rehabilitation program is recommended in moderate to severe COPD. Benefits include decreased dyspnea, improved quality of life, decreased healthcare utilization and reduced extent of functional decline.

4Eat right and hydrate. COPD patients spend about 700 calories/day just from breathing, 10 times higher than consumed normally. Patients should eat small frequent meals with high-protein content to supplement hypercatabolic states.

5 Get enough sleep. Sleep-deprived individuals have fewer resources to cope with stress. COPD patients are encouraged to have consistent sleeping and waking times, to avoid caffeine and to refrain from strenuous activities two hours before sleeping.

6Know about bad days. Patients experience exacerbations characterized by increased symptoms over the patient’s baseline. Early consultation and treatment is key to preventing further morbidity. Since most exacerbations are from infections, prevention is essential. Pneumococcal and influenza vaccinations are recommended for COPD patients.

7Finally, seek support. Involve your family. It is important for relatives to understand what it is like to live with COPD every day. Various institutions have COPD support groups providing psychosocial aid to cope with the stress the disease brings.

“It’s never too late” is this year’s World COPD Day theme, capturing the positive message that meaningful actions can improve respiratory health at any stage of COPD. COPD is treatable and patients can be equipped to control their disease. Indeed, it’s never too late.

Dr. Albert Bugaring Albay Jr., is head of the Central and Pediatric Intensive Care Unit of the Philippine General Hospital. The A to Z of Health information advocacy is a joint initiative of a group of medical specialists and supported by AstraZeneca Philippines aimed at raising public awareness on various diseases and providing health information and updates to the healthcare community.