Chronic Respiratory Illness

Julia Whitaker, MD

Most of us are aware of the poor air quality along the Front Range, which has continued to decline since 2015. Warnings that the air quality index (AQI) is elevated and unhealthy for sensitive groups are common. People with chronic lung disease are among this group of sensitive individuals. The recommendation is to minimize time spent outdoors during these times.  

Do you have shortness of breath, wheeze or a cough that produces mucus? Do you have trouble taking a deep breath? This is not a normal part of aging. These are common symptoms of Chronic Obstructive Pulmonary Disease (COPD), a treatable, largely preventable yet incurable lung disease that makes it difficult to move air in and out of your lungs.   

Over 12 million Americans have COPD with millions likely undiagnosed. It affects your quality of life and often leads to fatigue that interferes with daily living and your ability to work. COPD develops over years and can include chronic bronchitis and emphysema.   

The number one cause of COPD in the U.S. is cigarette smoking. Up to 80 percent of COPD patients are current or former smokers. Other causes are pollutants such as secondhand smoke, fuels or occupational exposures to irritants.   

A rare genetic trait can also cause COPD. More women are diagnosed with COPD likely due to smaller lung size and narrower airways. Hormones may play a role in this disparity as well. Over the past 20 years, men have seen a 32 percent decline in COPD rates whereas women’s rates have remained steady despite a drop in cigarette smoking in both groups. In 2014, the Centers for Disease Control reported chronic lung diseases as the third leading cause of death in the U.S., mainly from COPD.  

Early diagnosis and treatment are key to managing this chronic illness and slowing its advancement. Proper intervention will reduce repeated exacerbations and trips to the emergency department or hospitalizations. Diagnosis is by spirometry, a breathing device that measures your lung function. This can also help to differentiate between COPD and asthma.  

There are many steps you can take to improve your health once diagnosed with COPD. The most important step is to quit smoking as soon as possible. The less exposure to cigarette smoke in your lifetime, the less severe your symptoms will be. Also:  

• Avoid air pollutants and things you know to worsen your symptoms.  

• Heed those AQI action alerts. 

• Minimize your infection risk through vaccination and avoidance of those who are ill. Get an annual flu shot, at least one pneumonia shot and stay current on the COVID-19 vaccine. 

• Consider wearing a mask in crowded places. 

• Keep active and eat a healthy diet. 

• Warm air with low humidity is better tolerated for those with COPD so be sure to wear a covering over your nose and mouth when the thermometer dips. 

• Pulmonary rehabilitation can improve your quality of life and longevity through education, exercise, stress management and support groups, all personalized and designed to make you feel and function better. This can be prescribed by your physician along with medicines such as inhalers to treat your symptoms, such as shortness of breath or wheezing. Supplemental oxygen may also be needed over time. Living at lower elevation may correct this need.  

With early intervention and proper care, quality and length of life can be improved for those living with COPD. As Sting sang, “Every breath you take” – make each one count!  

Dr. Whitaker is a critical care specialist and the medical director of the Lutheran Medical Center Sleep Center.   

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