CHRONIC Obstructive Pulmonary Disease (COPD) is a common and long term condition affecting those who have had exposure to cigarette/cigar/pipe smoke – usually through direct use but also in some rarer cases through passive smoking. It generally presents in middle age or older and gradually worsens over time. The disease includes emphysema – which is damage to the air sacs within the lungs, and chronic bronchitis – this is long term inflammation of the airways.
The commonest symptom is shortness of breath, often affecting activity. This is usually mild at first but gradually worsens and can be very disabling in later stages of the disease. A persistent cough is common and can be a productive cough of white or clear sputum usually worse in the morning. There may be wheezing and an increased risk of chest infections and ‘exacerbations’. This is a sudden worsening of symptoms, termed ‘non-infective’ or ‘infective’ depending on the cause, with both viruses and bacteria potential infection triggers. Treatment usually includes a course of tablet steroids and sometimes an antibiotic. In more severe cases nebulisers and oxygen may be required, or even hospital admission.
Diagnosis is made by a lung test called spirometry, which most GP practice nurses can do. It is important to speak with your GP first however, as there are other chest conditions that can cause similar symptoms, and a chest X-ray or bloods may also be needed.
Without treatment, symptoms will continue to worsen. Inhalers can slow disease as well as treat symptoms of breathlessness and wheeze. Due to the increased risk of infection it is important that once diagnosed you take up the offer of the flu and covid vaccines as well as a pneumococcal vaccine (a bacteria that can cause a nasty pneumonia — you will be offered a one off dose at 65 years old). Physical activity is important and physiotherapy/pulmonary rehabilitation might be helpful. Some people need long term oxygen therapy in the end stages of the disease.
Stopping smoking is by far the most important thing that someone with COPD can do help themselves to slow progression of their disease. Continuing to smoke is linked to an early death, as the chemicals continue to destroy the lung tissue. ‘QUIT YOUR WAY SCOTLAND’ is a free service run by NHS24 who can help you get ready to stop smoking in a way that suits you – helpline is open Mon-Fri 9-5 on 0800 84 84 84, or speak to your local pharmacist about options to help you quit.
