COPD

COPD stands for chronic obstructive pulmonary disease. It’s characterized by respiratory symptoms (cough and shortness of breath) and airflow obstruction. There is no cure. These symptoms are the result of damage to the lungs over many years.

  • Chronic – It doesn’t go away (long-term)

  • Obstructive – Partly blocked

  • Pulmonary – In the lungs

  • Disease – Illness

The two major forms of COPD include chronic bronchitis and emphysema, though they frequently coexist.

Chronic Bronchitis is most commonly brought on by constant irritants such as cigarette smoke. The irritated airway becomes inflamed or infected and produces excess mucus. The walls off your airways are swollen, partially blocking the airflow.

A persistent cough is common. The condition develops over time, causing shortness of breath, wheezing and coughing.

Emphysema affects the alveoli, or air sacs, of the lungs. These air sacs transfer oxygen into the blood and carry carbon dioxide out. With emphysema, the sacs become damaged, making many air sacs unable to transfer gases.

Emphysema is commonly accompanied by severe shortness of breath during exertion. Coughing and mucus are not as common with emphysema.

The Canadian Lung Health Test:

Most people with COPD aren’t diagnosed until the disease is well advanced. Answer the following questions to determine if you should be tested for COPD:

  1. Are you a smoker or ex-smoker, 40 years of age and older?

  2. Do you cough regularly?

  3. Do you cough up phlegm regularly?

  4. Do even simple chores make you short of breath?

  5. Do you wheeze when you exert yourself (exercise or go upstairs)?

  6. Do you get many colds and do your colds usually last longer than your friends’ colds? 

If you answered “yes” to any of these questions, see your healthcare professional to be assessed for COPD. Your healthcare provider may send you for a lung function test called “spirometry”.

Spirometry is the most reliable way to diagnose COPD. It’s a simple breathing test that measures the speed and amount of air you’re able to blow out of your lungs. Your healthcare provider may also refer you for other pulmonary function tests.

Things you can do to improve your symptoms:

If you smoke, QUIT! This is the first step to feeling better.

Exercise is important. Slowly increase the time you spend exercising. Talk with your healthcare provider before beginning an exercise program.

If you have trouble breathing, exercise may be the last thing you feel like doing. However, COPD exercises can help your breathing, allowing you to stay active and improve your quality of life.

Maintain proper posture. This ensures the muscles which support your spine are relaxed and do not use excess oxygen. This also allows for optimum lung expansion when you breathe.

Eat a proper diet and maintain a healthy body weight. This impacts your overall health and your recovery from illness.

Clear your lungs with controlled coughing. Coughing from deep in your lungs loosens mucus and moves it through your airways.

Keep yourself healthy. Get enough sleep and practice good infection prevention by washing your hands regularly; avoiding contact with others who are ill; and speaking to your healthcare provider about receiving an influenza and pneumonia vaccination.

Breathing Exercises. Practice S.O.S for shortness of breath and diaphragmatic breathing exercises to help manage difficult breathing.

Pursed Lip Breathing

Sameera Hasan, a respiratory therapy student at Fanshawe College, demonstrates the pursed lip breathing technique.

Instructions:

1.    Inhale thru nose
2.    Exhale thru pursed lips

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S.O.S for shortness of breath

Laura Tangelder, respiratory therapy student at Fanshawe College, demonstrates how to perform the S.O.S for Shortness of Breath technique.

Instructions:

Should you become short of breath, try to follow these steps to recover your breath:

  1. Stop what you are doing and find a comfortable position to rest, try to brace your arms on something.
  2. Get your head down - look at the floor a few feet ahead of your feet.
  3. Get your shoulders down (try to relax them).
  4. Breathe in through your mouth.
  5. Breathe out through your mouth.
  6. Breathe in and out as fast as necessary.
  7. Begin to blow out longer, but not forcibly; use pursed lips if you find it effective.
  8. Begin to slow your breathing.
  9. Begin to use your nose.
  10. Begin using your diaphragm and rib muscles to breathe. Think about having the bottom of your chest expand.
  11. Stay in position for five minutes.
  12. Remember: breathlessness is uncomfortable but not in itself harmful or dangerous.

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Diaphragmatic Breathing

This video features Andrea Martin, respiratory therapy student at Fanshawe College, demonstrating how to perform the diaphragmatic breathing technique.

Instructions:

Lying on your back:

  1. Lie on your back on a flat surface or in bed, with your knees bent and your head supported. You can use a pillow under your knees to support your legs. Place one hand on your upper chest and the other just below your rib cage. This will allow you to feel your diaphragm move as you breathe.
  2. Breathe in slowly through your nose so your stomach moves out against your hand. The hand on your chest should remain as still as possible.
  3. Tighten your stomach muscles, letting them fall inward as you exhale through pursed lips. The hand on your upper chest must remain as still as possible.

Sitting in a chair:

  1. Sit comfortably, with your knees bent and your shoulders, head and neck relaxed.
  2. Place one hand on your upper chest and the other just below your rib cage. This will allow you to feel your diaphragm move as you breathe.
  3. Breathe in slowly through your nose so your stomach moves out against your hand. The hand on your chest should remain as still as possible.
  4. Tighten your stomach muscles, letting them fall inward as you exhale through pursed lips. The hand on your upper chest must remain as still as possible.

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Lateral Chest Breathing

In this video, Andrea Martin, respiratory therapy student at Fanshawe College, demonstrates how to properly perform the lateral chest breathing exercise.

Instructions:

  1. Place your hands on the side of your lower ribs.
  2. Inhale through your nose. Your chest expands. You can feel your lower ribs expanding outwards.
  3. Exhale with the pursed lips technique, feel your ribs move in towards your body.
  4. Do this five times then relax.
  5. Repeat this procedure several times a day to improve the amount of air brought into the bottom area of your lungs.

 

 

Breathlessness, coughing, mucus, and fatigue are symptoms of COPD which can be alleviated with medication. There are five basic COPD medications which address different symptoms at different stages of the disease:

  1. Inhalers for relief and maintenance.

  2. Inhaled steroids for prevention of flare-ups.

  3. Antibiotics for fighting infection.

  4. Vaccines for flu and pneumonia prevention

  5. Supplemental oxygen to improve quality of life and prolong life (when blood oxygen levels are low).

Although there is no cure for COPD, the earlier the diagnosis the sooner a person can begin to manage his/her health and improve their quality of life.

According to a study from the Canadian Institute for Health Information (CIHI), from 2017-2018, COPD was the second most common cause of hospitalization in Canada. In 2009-2010, 772,200 (4%) Canadians, aged 35 years and older, reported being diagnosed with chronic obstructive pulmonary disease (COPD) [1]. It is estimated that 1.6 million Canadians live with it – yet it is believed that almost as many have COPD and don’t know it.

A Canadian article published in 2008, estimated that hospital admissions for COPD lung attacks averaged a 10-day length of stay at a cost of $10,000 per stay [2]. The very same article estimated the total cost of COPD hospitalizations at $1.5 billion a year.

 

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[1] Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, using data from Canadian Community Health Survey, Statistics Canada, 2009-10

[2] Mittmann, N. et al. (2008) The cost of moderate and severe COPD exacerbations to the Canadian healthcare system. Respiratory Medicine 102, 413-421.

 

General Interest Websites
The Healthline - www.thehealthline.ca

Quitting Smoking
Public Health Agency of Canada - www.phac-aspc.gc.ca
Canadian Lung Association - www.lung.ca
Physicians for a Smoke-Free Canada - www.smoke-free.ca
Smokers Helpline - Canadian Cancer Society - www.smokershelpline.ca

Ontario Government
Assistive Devices Program (ADP) - www.health.gov.on.ca/en/public/programs/adp
Home Oxygen Program - www.health.gov.on.ca/en/public/programs/adp/publications/oxygen.aspx
Respiratory products covered under ADP - www.health.gov.on.ca/en/public/programs/adp/publications/resp.aspx

Telehealth Ontario
Free Access to a Registered Nurse - 24 hours a day, 7 days a week.
1-866-797-0000     TTY: 1-866-797-0007

Associations, Organizations & Societies
American Association for Respiratory Care - www.aarc.org
American College of Chest Physicians - www.chestnet.org
Asthma Society of Canada - www.asthma.ca
Home Care Ontario - www.homecareontario.ca
The Lung Health Foundation - www.lunghealth.ca
COPD Canada - www.copdcanada.ca
Canadian Medical Association - www.cma.ca
Canadian Society of Respiratory Therapists - www.csrt.com
Respiratory Therapy Society of Ontario - www.rtso.ca