Living Healthy with COPD
There is good news for people diagnosed with COPD – you can still live a long, healthy life! Join lung specialist Dr. Sunil Swami for a conversation about what to do to breathe better now and how to care for your lungs so you can keep feeling your best well into the future.
Featured Speaker:
Dr. Swami offers his patients a full spectrum of advanced diagnostic and therapeutic treatments for all levels of lung disease including, asthma, bronchitis, COPD, lung cancer and sleep apnea.
Learn more about Dr. Swami
Sunil Swami, MD
Dr. Sunil Swami attended medical school at the Medical University of the Americas in Nevis. He trained at the Boston University School of Medicine for his Internal Medicine residency where he developed a particular interest in treating patients with asthma, a condition that is often misdiagnosed. He completed a Pulmonology fellowship at the Boston University School of Medicine.Dr. Swami offers his patients a full spectrum of advanced diagnostic and therapeutic treatments for all levels of lung disease including, asthma, bronchitis, COPD, lung cancer and sleep apnea.
Learn more about Dr. Swami
Transcription:
Living Healthy with COPD
Cheryl Martin: Chronic obstructive pulmonary disease or COPD is a term used to describe chronic lung diseases like emphysema and chronic bronchitis. Now, there's some good news for people diagnosed with C O P D. You can still live a long, healthy life. Learn how. Coming up next
Welcome to the Live Greater podcast series, Information for a Healthier You from the University of Maryland Medical System. I'm Cheryl Martin.
With me as Dr. Sue Neil Swee, interventional pulmonologist at UM, Capital Region Health. We'll talk about. To do, to breathe better now and how to care for your lungs so you can keep feeling your best well into the future.. Dr. Swami, glad to have you on.
Dr. Sunil Swami: Thank you for having me.
Cheryl Martin: To start us off, Doctor, give us a quick overview of COPD, what it is and how it affects the body?
Dr. Sunil Swami: Sure. So like you said, COPD stands for chronic obstructive pulmonary disease, and what this is is inflammation in the small airways of the lung, which narrows those airways. So air can get in just fine into the lung. The problem lies where, when you have to breath out these airways prematurely close, and you trap air in the chest, which causes a sensation of feeling shorter breath. Another thing that can happen is destruction of the surrounding lung structures or the air sacks of the lung, which can be described as emphysema which can lower your oxygen level over time.
This inflammation can be caused by smoking, but you know, the prevalence of COPD worldwide or cause rather, is actually biomass fuel exposure. So exposures to diesel fumes. If you had a wood borning stove while you were growing up or had frequent fires in the house with the fireplace, that can predispose you to having COPD as well.
Cheryl Martin: Now I'm sure that most people who have COPD, they are familiar with the symptoms of shortness of breath, tight chest, feeling like they can't take a full breath, and you have talked about the causes of COPD, are there ways to prevent the symptoms from happening?
Dr. Sunil Swami: Yeah, so we have a variety of medications to deal with this issue of being short of breath. And like I was saying before, you know, once these airways get narrowed, You start to trap air when you try to breathe out. So a lot of these medications are geared towards opening up the airways so you can decompress the lungs, so you feel better. In regards to the inflammation. Sometimes we give inhaled steroids to help with the inflammation within the lung to keep those small airways open and decrease the frequency of exacerbations of COPD.
Cheryl Martin: You mentioned the medicines that are available. I assume these are not over the counter or are they?
Dr. Sunil Swami: That's correct. So these medications are prescription only. So we have an algorithm based on, you know, your lab work. What caused your COPD, How short of breath you are and how many exacerbations you've had in the previous one year. And based on these data points, we form a plan for our patients and customize their care in order to help them out the best we can.
Cheryl Martin: So what can someone with COPD do to breathe better?
Dr. Sunil Swami: So if you are a smoker, the best thing you can do is to stop smoking because our lung function declines as we get older anyway. But when you start to smoke and smoke chronically, this lung function declines at an exponential rate. So if you already have airflow limitation, and you are smoking, the best thing you can do for yourself is to stop smoking now. Another point about this is that the medications that we give to help you breathe don't work as effectively if you're actively smoking. So we can give you all kinds of medications and inhalers.
But you'll continue to have lung function decline and be short of breath if you continue to smoke. So that's probably one of the most important things you can do if you are an active smoker. If you're a previous smoker and you're on the right medications for this disease, actually the best thing you can do is exercise regularly. So, regular exercise decreases mortality across all disease processes, especially COPD. But in order to exercise on a regular basis, you have to be able to breathe, and that's where these inhaled medications come into play, to improve the mortality of COPD.
Cheryl Martin: Any other top tips for reducing the number of episodes someone has? And are there ways to prevent them entirely?
Dr. Sunil Swami: So they're not. You can't prevent them entirely, but you can take measures to decrease the incidence of exacerbations. One, like I said, smoking. If you're actively smoking, this is somewhat obvious that you should stop smoking. Other things you can do aside from exercise is adhere to the regimen that your doctor has given you. And these medications have been shown to reduce exacerbations in COPD. Another thing is avoiding potential environments where you may be triggered. So very hot, humid weather, or very cold weather you'd want to avoid going outside.
If the air quality that day is poor, you may wanna avoid going outside. Avoiding other people that are sick is also an important thing to do. Along with nutrition. So if you have proper nutrition, lung function tends to stabilize in conjunction with the medication. Also an important note is vaccinations, so you need to get your age appropriate vaccinations, including vaccinations for the flu shot. And now covid have been proven to reduce exacerbation risk in COPD.
Cheryl Martin: How long can someone anticipate living with COPD and what are the factors that affect life expectancy?
Dr. Sunil Swami: Sure. So airflow limitation alone. You know, we take that data point in conjunction with a few other data points, which I'll talk about now. It's called the Bode index, B O D E. So the B stands for body mass index, and actually a lower weight or a lower BMI is associated with worse outcomes. The O is obstruction, so the degree to where you can't get the air out in a timely fashion, which we measure by lung function testing also comes into play. The D is dyspnea, and dyspnea means shortness of breath.
We have scales that will quantify how short of breath the patient is, and the last part of that index is the E or exercise tolerance, which we quantify by testing in the office. So taking all these data points together gives us an idea of the five year mortality in a COPD patient. And to give you an example, a high score of maybe seven to 10 on this index confers a 80% mortality in the next five years with COPD. So, when we treat you for COPD, we try to improve these measures because improving these measures will actually decrease your mortality over the course of five years over time. And that's actually one of the goals of treatment.
Cheryl Martin: And you've already talked about some of the key things for treating it, so any other advice for how to live a long, healthy life with COPD?
Dr. Sunil Swami: My best advice that I can give, and I've said it over and over again, is if you're actively smoking, please stop. You know, this is the one thing that you can do to improve your lung function and improve your quality of life moving forward. The other things probably most important is exercise. So, daily exercise. Adhering to the regimen that your doctor has prescribed for your COPD will help you live a long, healthy life and a good quality life. But if you continue to smoke and be sedentary, these things will work against you and you'll have problems moving forward.
Cheryl Martin: So clearly COPD may be progressive, but it is treatable.
Dr. Sunil Swami: Very treatable. Yes, and preventable.
Cheryl Martin: Great. Any other final thoughts?
Dr. Sunil Swami: You know, if you're short of breath or have a chronic cough, please come and get checked out because aside from COPD, there's a long list of diseases that can cause you to be shorter breath, and it's important to distinguish these things. So the main thing is, if symptomatic, please visit your doctor and have a full checkup.
Cheryl Martin: Dr. Sunil Swami, thank you so much for providing some great information for Living Healthy with COPD, giving those diagnosed with this great hope and encouragement. Thank you.
Dr. Sunil Swami: Thank you so much. Thanks for having me.
Cheryl Martin: You can find more shows just like this one at umms.org/podcast. That's umms.org/podcast. Thank you for listening to Live Greater, a Health and Wellness podcast, brought to you by the University of Maryland Medical System. We look forward to you joining us again.
Living Healthy with COPD
Cheryl Martin: Chronic obstructive pulmonary disease or COPD is a term used to describe chronic lung diseases like emphysema and chronic bronchitis. Now, there's some good news for people diagnosed with C O P D. You can still live a long, healthy life. Learn how. Coming up next
Welcome to the Live Greater podcast series, Information for a Healthier You from the University of Maryland Medical System. I'm Cheryl Martin.
With me as Dr. Sue Neil Swee, interventional pulmonologist at UM, Capital Region Health. We'll talk about. To do, to breathe better now and how to care for your lungs so you can keep feeling your best well into the future.. Dr. Swami, glad to have you on.
Dr. Sunil Swami: Thank you for having me.
Cheryl Martin: To start us off, Doctor, give us a quick overview of COPD, what it is and how it affects the body?
Dr. Sunil Swami: Sure. So like you said, COPD stands for chronic obstructive pulmonary disease, and what this is is inflammation in the small airways of the lung, which narrows those airways. So air can get in just fine into the lung. The problem lies where, when you have to breath out these airways prematurely close, and you trap air in the chest, which causes a sensation of feeling shorter breath. Another thing that can happen is destruction of the surrounding lung structures or the air sacks of the lung, which can be described as emphysema which can lower your oxygen level over time.
This inflammation can be caused by smoking, but you know, the prevalence of COPD worldwide or cause rather, is actually biomass fuel exposure. So exposures to diesel fumes. If you had a wood borning stove while you were growing up or had frequent fires in the house with the fireplace, that can predispose you to having COPD as well.
Cheryl Martin: Now I'm sure that most people who have COPD, they are familiar with the symptoms of shortness of breath, tight chest, feeling like they can't take a full breath, and you have talked about the causes of COPD, are there ways to prevent the symptoms from happening?
Dr. Sunil Swami: Yeah, so we have a variety of medications to deal with this issue of being short of breath. And like I was saying before, you know, once these airways get narrowed, You start to trap air when you try to breathe out. So a lot of these medications are geared towards opening up the airways so you can decompress the lungs, so you feel better. In regards to the inflammation. Sometimes we give inhaled steroids to help with the inflammation within the lung to keep those small airways open and decrease the frequency of exacerbations of COPD.
Cheryl Martin: You mentioned the medicines that are available. I assume these are not over the counter or are they?
Dr. Sunil Swami: That's correct. So these medications are prescription only. So we have an algorithm based on, you know, your lab work. What caused your COPD, How short of breath you are and how many exacerbations you've had in the previous one year. And based on these data points, we form a plan for our patients and customize their care in order to help them out the best we can.
Cheryl Martin: So what can someone with COPD do to breathe better?
Dr. Sunil Swami: So if you are a smoker, the best thing you can do is to stop smoking because our lung function declines as we get older anyway. But when you start to smoke and smoke chronically, this lung function declines at an exponential rate. So if you already have airflow limitation, and you are smoking, the best thing you can do for yourself is to stop smoking now. Another point about this is that the medications that we give to help you breathe don't work as effectively if you're actively smoking. So we can give you all kinds of medications and inhalers.
But you'll continue to have lung function decline and be short of breath if you continue to smoke. So that's probably one of the most important things you can do if you are an active smoker. If you're a previous smoker and you're on the right medications for this disease, actually the best thing you can do is exercise regularly. So, regular exercise decreases mortality across all disease processes, especially COPD. But in order to exercise on a regular basis, you have to be able to breathe, and that's where these inhaled medications come into play, to improve the mortality of COPD.
Cheryl Martin: Any other top tips for reducing the number of episodes someone has? And are there ways to prevent them entirely?
Dr. Sunil Swami: So they're not. You can't prevent them entirely, but you can take measures to decrease the incidence of exacerbations. One, like I said, smoking. If you're actively smoking, this is somewhat obvious that you should stop smoking. Other things you can do aside from exercise is adhere to the regimen that your doctor has given you. And these medications have been shown to reduce exacerbations in COPD. Another thing is avoiding potential environments where you may be triggered. So very hot, humid weather, or very cold weather you'd want to avoid going outside.
If the air quality that day is poor, you may wanna avoid going outside. Avoiding other people that are sick is also an important thing to do. Along with nutrition. So if you have proper nutrition, lung function tends to stabilize in conjunction with the medication. Also an important note is vaccinations, so you need to get your age appropriate vaccinations, including vaccinations for the flu shot. And now covid have been proven to reduce exacerbation risk in COPD.
Cheryl Martin: How long can someone anticipate living with COPD and what are the factors that affect life expectancy?
Dr. Sunil Swami: Sure. So airflow limitation alone. You know, we take that data point in conjunction with a few other data points, which I'll talk about now. It's called the Bode index, B O D E. So the B stands for body mass index, and actually a lower weight or a lower BMI is associated with worse outcomes. The O is obstruction, so the degree to where you can't get the air out in a timely fashion, which we measure by lung function testing also comes into play. The D is dyspnea, and dyspnea means shortness of breath.
We have scales that will quantify how short of breath the patient is, and the last part of that index is the E or exercise tolerance, which we quantify by testing in the office. So taking all these data points together gives us an idea of the five year mortality in a COPD patient. And to give you an example, a high score of maybe seven to 10 on this index confers a 80% mortality in the next five years with COPD. So, when we treat you for COPD, we try to improve these measures because improving these measures will actually decrease your mortality over the course of five years over time. And that's actually one of the goals of treatment.
Cheryl Martin: And you've already talked about some of the key things for treating it, so any other advice for how to live a long, healthy life with COPD?
Dr. Sunil Swami: My best advice that I can give, and I've said it over and over again, is if you're actively smoking, please stop. You know, this is the one thing that you can do to improve your lung function and improve your quality of life moving forward. The other things probably most important is exercise. So, daily exercise. Adhering to the regimen that your doctor has prescribed for your COPD will help you live a long, healthy life and a good quality life. But if you continue to smoke and be sedentary, these things will work against you and you'll have problems moving forward.
Cheryl Martin: So clearly COPD may be progressive, but it is treatable.
Dr. Sunil Swami: Very treatable. Yes, and preventable.
Cheryl Martin: Great. Any other final thoughts?
Dr. Sunil Swami: You know, if you're short of breath or have a chronic cough, please come and get checked out because aside from COPD, there's a long list of diseases that can cause you to be shorter breath, and it's important to distinguish these things. So the main thing is, if symptomatic, please visit your doctor and have a full checkup.
Cheryl Martin: Dr. Sunil Swami, thank you so much for providing some great information for Living Healthy with COPD, giving those diagnosed with this great hope and encouragement. Thank you.
Dr. Sunil Swami: Thank you so much. Thanks for having me.
Cheryl Martin: You can find more shows just like this one at umms.org/podcast. That's umms.org/podcast. Thank you for listening to Live Greater, a Health and Wellness podcast, brought to you by the University of Maryland Medical System. We look forward to you joining us again.