COPD: Now What?

You will find that you and your doctor, as well as his/her staff, get to be quite a team. 

At the beginning of your disease, you may find you are short of breath or do a lot of coughing. Walking or exercising may be affecting you. If you are a smoker, you may be wondering if that is what is affecting you. Or are you wondering about the altitude, working too much, etc. You don’t like going to doctors, but you find that your shortness of breath and/or coughing isn’t going away. Maybe you’ll go to a doctor because you might need an antibiotic. You will call your regular doctor if you have one, if not, check with friends or people from work, maybe you will go to the ER. This doctor may be a doctor of General Medicine; a doctor of Internal Medicine; or even a Physician’s Assistant.

Be prepared for your appointment. Take your check list.

• List what you are seeing the doctor for. Type of illness, when did it start? What are you experiencing? What makes it better? What makes it worse? Does it affect other areas of your body?
• When did you begin noticing your shortness of breath? What makes it better, what makes it worse? Do you still smoke?
  Do you do alcohol or drugs?
• Is there pain? With one being the lowest and ten being the highest, how would you rank your pain?
• List of medications that you are on. These should be prescriptions, as well as OTC (over the counter medications).
• List of your allergies to medications, food, environmental, and other.
• List of family medical history, including all of their illnesses, etc.
• List of any surgeries you may have had.
• List of your past medical history.
• List of shots you had and dates that you had them.
• When did you eat last?
• Have you had unplanned weight loss or weight gain?

Your doctor may schedule a spirometry, where you breathe into a machine so that he/she can see how your lungs are performing, the output of your lungs and even your inhalation. This may be done in a booth or sitting in your chair. You may be tested before and after doing a nebulizer treatment with albuterol. How this procedure is done, depends on what is available where you live. They may recommend you going to a bigger hospital where they have more intense testing. This can also help your doctor to discern whether you have COPD or asthma.
Your doctor might request an x-ray and/or a CT scan.

A six-minute walk is often done, so that they can monitor your O2 (oxygen) readings while you are walking. You will walk at a pace that is comfortable to you for as long as you can go, up to 6 minutes. This can help determine if you need oxygen, while walking. An ABG (arterial blood gas) may be done too. This reads the PH levels of oxygen and CO2 (carbon dioxide) in your blood. It tells how well you move oxygen into your blood and remove carbon dioxide from your blood. Regular blood work will also be done and should be monitored to see how you are doing overall and how medications etc. are affecting you.

Do others in your family have COPD, such as parent or grandparent?

Mention this to your doctor. Maybe it’s time to have your doctor test you for Alpha-1, which is the genetic form of COPD and can also affect your liver.

Once your doctor is able to read all of your tests, he/she should set up an appointment to go over everything thing with you. You may be prescribed medications, such as a rescue inhaler and possibly another medication to help you with your breathing.

Most doctors and organizations declare that there are four stages of COPD, these are called the Gold Stages. Stage 1 is mild, stage 2 is moderate; stage 3 is severe; and stage 4 is very severe. Some places will say there are 5 stages, with stage 5 being CHF (congestive heart failure). The Mayo Clinic goes with 3 stages: mild; moderate and severe. Your stage is determined by your spirometry test, age, weight, etc.

COPD is the 3rd leading cause of death. Smoking is the biggest cause of COPD. However, if you don’t smoke or never did, COPD can also be caused by pollution, chemicals, and other dangerous things that you may have breathed in.

COPD is non-reversible, but you can slow the progression of your disease.

How? By quitting smoking if you smoke, exercise, proper nutrition, regular doctor appointments, medications as directed and oxygen when needed. Be sure to discuss any additional OTC medications, exercise and diet that you are wanting to do with your doctor and get his/her opinion. You doctor is an important person in your overall treatment and health.

Remember that you too are an intricate part of your health. You have a right to your records and to take part in deciding your care. Doctors are very busy, go prepared. Make a list of things that you want to discuss with your doctor. Your list should now only have 2 or 3 things to discuss. Ask too about pulmonary rehab, this is a wonderful program where they show you how to breathe, exercises you should do and more. It’s an excellent program. Smaller hospitals and communities may not have this program. Maybe there is a Better Breathers Club where you are, if so, do go. Support is a wonderful thing. If you can’t find it where you are, there are some good groups online.

If you don’t feel your doctor is helping or doing what he/she should do, find another doctor and get a second opinion.

If you don’t have a pulmonologist ask your doctor will refer you to one. A pulmonologist is a doctor specialized in lungs. If you are in a small town, you might have to travel to him/her.

Always remember, things are different in other countries, even in different parts of the United States. Differences might be in names of medications, stages of COPD, types of doctors available, stages, treatments etc. Never judge another and their treatment, never push your treatment at them or even degrade them for those things. Things might be different where they are at.

As your COPD progresses, you will likely encounter other physical limitations. Eventually, you will get new medications and treatments. Oxygen is something people often want to know about. Once your oxygen level reaches 88% when breathing room air at rest or PAO2 is less than 55% you will qualify for oxygen. Some people are diagnosed needing oxygen at night only. Oxygen is a medication. Once you are on oxygen, your settings should be as prescribed. Don’t increase this without an okay from your doctor or respiratory therapist. It can be harmful. Also, no smoking with oxygen, it can cause fire, an explosion, and more. Yes it has happened, too often.

Always remember, you have a life to live.

It can seem that COPD dictates your life and even that of your family. COPD is a family disease as well that does affect everyone. However, remember to live your life to the fullest. Take charge of your life, don’t let COPD take charge. That can be hard, but it can be possible. There may be things you can do and other things you can’t. Find what works for you. You have COPD, but it does not have you.