COPD

Treating COPD

Although there is no cure for COPD, treatments and lifestyle changes can help manage symptoms.

Quit Smoking

Quitting smoking is the most important step you can take to treat COPD. Talk with your doctor about programs and products that can help you quit.

Many hospitals, workplaces, and community groups offer classes to help people quit smoking. Ask your family members and friends to support you in your efforts to quit. Also, try to avoid secondhand smoke and places with dust, fumes, or other toxic substances that you may inhale. (Secondhand smoke is smoke in the air from other people smoking.)

The National Cancer Institute has information on smoking cessation. Visit SmokeFree.gov and check out Clear Horizons, a quit smoking guide for adults 50+. You can also visit the website of the American Lung Association at www.lung.org, or call 1-800-QUIT NOW (1-800-784-8669).

Other Lifestyle Changes

If you have COPD, you may have trouble eating enough because of your symptoms, such as shortness of breath and fatigue. (This issue is more common with severe disease.) As a result, you may not get all of the calories and nutrients you need, which can worsen your symptoms and raise your risk for infections.

Talk with your doctor about following an eating plan that will meet your nutritional needs. Your doctor may suggest eating smaller, more frequent meals; resting before eating; and taking vitamins or nutritional supplements.

Also, talk with your doctor about what types of activity are safe for you. You may find it hard to be active with your symptoms. However, physical activity can strengthen the muscles that help you breathe and improve your overall wellness.

Treatment Goals

The goals of COPD treatment are to

  • relieve symptoms with no or minimal side effects of treatment
  • slow the progress of the disease
  • improve the ability to stay active and exercise
  • prevent and treat any complications from the disease
  • improve health overall.

Treatment for COPD can be different for each person and is based on whether symptoms are mild, moderate, or severe. Treatments include medication, pulmonary or lung rehabilitation, oxygen treatment, and surgery. There are also treatments to manage complications or a sudden onset of symptoms.

COPD Medications

  • Bronchodilators are medications that work by relaxing the muscles around your airways. This helps open your airways and makes breathing easier. Depending on the severity of your COPD, your doctor may prescribe short-acting or long-acting bronchodilators. Short-acting bronchodilators last about 4–6 hours and should be used only when needed. Long-acting bronchodilators last about 12 hours or more and are used every day.

    Most bronchodilators are inhaled directly into the lungs with the use of an inhaler. This device allows the medicine to go straight to your lungs. Not all inhalers are used the same way. Ask your health care team to show you the correct way to use your inhaler. People with mild COPD may use inhalers only when needed. Those with moderate or severe COPD may need more regular bronchodilator treatment.
  • Inhaled steroids are used for some people with moderate or severe COPD. They work to reduce the inflammation or swelling in the airways. Your doctor may ask you to try inhaled steroids for a trial period of 6 weeks to 3 months to see whether the medicine helps relieve your breathing problems.

Vaccines

Doctors recommend that people with COPD get an annual flu shot to avoid any breathing complications from the flu and a pneumococcal vaccine to prevent pneumonia.

  • Flu Shot. The flu (influenza) can cause serious problems for people who have COPD. Flu shots can reduce your risk of getting the flu. Talk with your doctor about getting a yearly flu shot.
  • Pneumococcal Vaccine.This vaccine lowers your risk for pneumococcal pneumonia (NU-mo-KOK-al nu-MO-ne-ah) and its complications. People who have COPD are at higher risk for pneumonia than people who don't have COPD. Talk with your doctor about whether you should get this vaccine.

Pulmonary Rehabilitation

In addition to medications, doctors may recommend pulmonary or lung rehabilitation (rehab) to help people with COPD stay active. Pulmonary rehabilitation may include exercise training, nutritional counseling, and education about managing the disease. The program's goal is to help you stay active and carry out your daily activities. A program of pulmonary rehabilitation would be managed by doctors, nurses, respiratory therapists, exercise specialists, and dietitians, and would be customized for each patient.

Oxygen Therapy

For people with severe COPD and low levels of oxygen in the blood, doctors may recommend oxygen therapy to help with shortness of breath. For this treatment, you're given oxygen through nasal prongs or a mask.

You may need extra oxygen all the time or only at certain times. For some people who have severe COPD, using extra oxygen for most of the day can help them

  • do tasks or activities, while having fewer symptoms
  • protect their hearts and other organs from damage
  • sleep more during the night and improve alertness during the day
  • live longer.

Surgery

For some people with severe COPD, surgery may be recommended. Surgery is usually a last resort for patients who have severe symptoms that have not improved from taking medicines.

Surgeries for people who have COPD that's mainly related to emphysema include bullectomy (bul-EK-toe-me) and lung volume reduction surgery (LVRS). A lung transplant might be an option for people who have very severe COPD.

  • Bullectomy. When the walls of the air sacs are destroyed, larger air spaces called bullae (BUL-e) form. These air spaces can become so large that they interfere with breathing. In a bullectomy, doctors remove one or more very large bullae from the lungs.
  • Lung Volume Reduction Surgery. In LVRS, surgeons remove damaged tissue from the lungs. This helps the lungs work better. In carefully selected patients, LVRS can improve breathing and quality of life.
  • Lung Transplant. During a lung transplant, your damaged lung is removed and replaced with a healthy lung from a deceased donor. A lung transplant can improve your lung function and quality of life. However, lung transplants have many risks, such as infections. The surgery can cause death if the body rejects the transplanted lung. If you have very severe COPD, talk with your doctor about whether a lung transplant is an option. Ask your doctor about the benefits and risks of this type of surgery.

If COPD Suddenly Gets Worse

People with COPD usually have symptoms that worsen slowly over time. However, they can have symptoms that suddenly get worse. Call your doctor right away if your symptoms worsen suddenly.

A cold, the flu, or a lung infection may cause your symptoms to quickly worsen. When this happens, you have a much harder time catching your breath. You should call your doctor right away if you have sudden chest tightness, more coughing, a change in your sputum (mucus), or fever. Your doctor will look at things that may be causing these sudden symptoms.

Your doctor might recommend antibiotics to fight the infection, or bronchodilators or inhaled steroids to help you breathe. Some severe symptoms may require treatment in a hospital.