Bill Klaproth (Host): About 24 million people in the United States have COPD as many as half are unaware that they have it. So what do you need to know? Here to talk with us today about COPD is Dr. Desmond Young, a specialist in pulmonary care at Tidelands Health. Dr. Young, thanks for your time today. So let’s jump in, can you explain to us what COPD is?

Dr. Desmond Young (Guest): Yes, sir and thanks for having me on your show. COPD is basically an acronym for chronic obstructive pulmonary disease, which encompasses several subtypes including chronic bronchitis another common name emphysema and some forms of asthma. COPD can be a serious disorder, usually it’s incurable and gets worse over time. It is the third leading cause of death in the United States and unfortunately it continues to be on the rise.

Bill: And do we know what causes this?

Dr. Young: There’s a direct link between smoking and I’m sure everybody has heard that smoking can damage the lungs and it is by far the leading cause of all forms of COPD. There’s other causes of COPD, anything that you inhale that can be toxic to your lungs such as fumes, biochemicals, gases, second hand smoke, can lead to OCPD. There’s less common causes of COPD that are genetically linked.

Bill: OK. And does this usually take a long time to develop?

Dr. Young: Usually smoking over 10-15 years can lead to some form of COPD. Certainly the longer that you smoke or are exposed to secondhand smoke or the other toxic inhalants that we discussed can lead to COPD the longer that you’re exposed the more likely you are to develop some form of chronic obstructive pulmonary disease. The symptoms are very mild in the beginning which can confuse the diagnosis with other pulmonary disorders.

Bill: And what are the common symptoms associated with COPD?

Dr. Young: Typically like I said before they’re very mild in the beginning and patients don’t often realize they’re having symptoms, particularly with sedentary people. But the most common symptoms are shortness of breath usually beginning with some sort of exertional activity, cough, and some type of sputum production usually on a chronic basis, but daily sputum production.

Bill: Ok, so how do you diagnose this, how do you separate this from other diseases?

Dr. Young: Well I look at a diagnosis of chronic obstructive pulmonary disease by first having an examination by your health care provider. There’s particular things a healthcare provider can pick up on physical examination and just taking their vital signs that may trigger a provider to go more in depth to reach your diagnosis. But the gold standard for diagnosing COPD is by what’s called spirometry which is a simple breathing test that can be done by your healthcare provider.

Bill: So then we see the ads on TV all the time for treatment, how is it generally treated?

Dr. Young: The first and foremost thing of course is to try and prevent this disorder from happening and treatment goes along the same lines and that of course would be smoking cessation. As hard as that it is, it is very difficult to get people to stop smoking in some cases, but beyond smoking cessation making sure that you get your vaccinations, your age appropriate vaccinations which many of our smokers and our population need a yearly flu shot and their pneumonia vaccination. Beyond that there is pulmonary rehabilitation which is a rehabilitation program that involves exercising and learning about your disorder that is in a structured environment usually in a hospital type setting, it is an outpatient rehabilitation. Inhalers, typically when you become symptomatic with chronic obstructive pulmonary disease the provider can initiate certain types of inhalers targeted at the lung to improve your symptoms. As COPD progresses, oxygen may be necessary to provide adequate levels of oxygen in your blood to help with your symptoms. And rarely surgery is an option for certain types of chronic obstructive pulmonary disease. There are some new therapies that are in research trials at this type and some have been approved in serving certain types and in particular patients who have subtypes that fit the research protocols.

Bill: And you said this disease has no cure so can this be managed overtime with lifestyle changes, you were talking a little bit about some of the things, can you go a little bit more in-depth on that?

Dr. Young: Yes, sir, I think this is the most important thing for people to realize. The majority of my treatment for chronic obstructive pulmonary disease is smoking cessation. If we can accomplish that the majority of COPD can be prevented, not all COPD can be prevented, but the majority can be. So I think that’s the first goal is lifestyle adaptations, lifestyle changes such as smoking cessation. Activity level is an important part of managing your chronic obstructive pulmonary disease. Getting some form of exercise, moderate exercise on a routine basis can help manage your symptoms of COPD. Dealing with prevention again, is going on the get your vaccinations, your flu vaccine and your pneumonia vaccine. Using your inhalers as prescribed is a very important part of managing your COPD. And I would reach out to the patients and make sure that they talk with their provider about using their inhalers appropriately and as scheduled. That’s a very common problem with our patients is being able to use the different types of inhalers available and using them the right way.

Bill: So if it’s caught early enough and somebody makes the necessary lifestyle changes and uses the inhalers and other medical things that they’re supposed to, is this something that can be managed then long term? Somebody can live a long life with COPD?

Dr. Young: Absolutely. Doing the right things for your COPD, the things we talked about including lifestyle changes and smoking cessation, you can lead a very normal and active life with chronic obstructive pulmonary disease even into the severe stages of COPD.

Bill: So that is a good outlook then for people with COPD.

Dr. Young: Yes, it is and I think if you are at risk for COPD or if you have any of these symptoms the first thing is we can’t treat you unless we know so I would seek and talk with your healthcare provider about the possibility of having COPD if you have some symptoms or unexplained symptoms that haven’t been diagnosed with something else.

Bill: Well again the outlook is good then if you catch it early and you make the necessary lifestyle changes. Now within COPD, there can be flare ups right, how do people manage those?

Dr. Young: Yes, so a flare up the first thing we like to try and keep patients out of the hospital, certain circumstances require hospitalization, but flare ups can be treated with of course if your smoking to stop smoking but sometimes it requires additional inhalers, perhaps more frequent inhaler use. A short course of oral corticosteroids or IV steroids may be required. If you have signs or symptoms of infectious etiology of your flare up of COPD, antibiotics may be required. And those who have more severe exacerbations may need to be hospitalized for management.

Bill: Dr. Young, you talked about smoking as being a main risk factor, what other exposures should we be mindful of?

Dr. Young: Well unfortunately there’s anything that you breathe can be toxic to your lungs, particularly any inhaled smoke, that’s the main thing I tell my patients. If you’re around some type of smoke you need to try to avoid that smoke. Occupational exposures probably another big factor in causing long-term lung damage. So that would be talking with your employer or your healthcare provider individually which type of chemical is at your work to provide personal safety inhalation device to protect your lungs again whatever you’re exposed to. But in general any gases, dusts, fumes, air pollutants can be harmful to your lungs in causing COPD.

Bill: Ok, well that’s very good to know and thank you for sharing that with us Dr. Young and thank you so much for your time and talking with us about COPD. And for more information you can visit Tidelands Health Physicians Services and Facilities visit TidelandsHealth.org. This is Better Health Radio, I’m Bill Klaproth, thanks for listening.