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Could you have COPD and not know it?

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Shortness of breath could be an early sign of chronic obstructive pulmonary disease, a lung disease better known as COPD. Find out what to look for and how to protect yourself. 

Matt McMillen

By Matt McMillen

Do you ever find yourself short of breath when walking or doing other physical activities that used to come easily? Don’t ignore it or chalk it up to getting older. It may be a sign that you have chronic obstructive pulmonary disease, or COPD.

COPD is serious. The lung disease narrows the airways and makes it difficult to breathe. But the shortness of breath often starts slowly. At first, many people don’t even realize anything’s wrong. But it gets worse over time.

More than 16 million people have been diagnosed with COPD, but millions more may have it and don’t realize it, according to the American Lung Association (ALA). Excluding COVID-19, COPD was the fourth-deadliest U.S. disease in 2020, according to the Centers for Disease Control and Prevention.

“In the case of shortness of breath, people often attribute that to aging,” says Barry Make, MD, a pulmonologist at National Jewish Health in Denver. “Unfortunately, they’re not diagnosed until their COPD is more advanced and more difficult to treat, often because they are unaware that they have it.”

So don’t let yourself get caught off guard. Keep reading to learn how to slow this disease and ease its symptoms.

And if you end up with medication for any lung conditions, do yourself a favor and download the Optum Perks mobile app. The go-anywhere tool allows you to search for coupons of up to 80% off on prescription medication.

What is COPD?

COPD includes 2 diseases that frequently develop together: chronic bronchitis and emphysema.

Chronic bronchitis is inflammation in the lining of the airways that help air flow into and out of your lungs. This leads to a chronic cough and a lot of mucus, which can block airflow even more.

Emphysema damages your lung tissue. It affects tiny air sacs called alveoli, which are responsible for moving oxygen from the lungs to the bloodstream. When alveoli don’t work properly, it can feel difficult to breathe. Plus, it makes it much harder for your muscles, organs and brain to get the oxygen they need.

COPD has no cure, but there are effective treatments to help relieve symptoms. (For starters, if you smoke, you should quit now to reduce your symptoms, reduce the progression of COPD and improve your survival.)

What causes COPD?

Smoking is responsible for as many as 9 out of 10 cases of COPD, according to the ALA. Smokers are up to 13 times as likely to die of COPD than nonsmokers, the ALA says. The reason: Cigarette smoke contains toxins, or poisons, that damage your lungs over time.

Smoking cigarettes increases the likelihood of COPD in both sexes. But the risk is slightly higher for women. “The toxins in tobacco smoke seem to affect women’s lungs more than men’s lungs,” says pulmonologist Frank Coletta, MD. He’s co-director of pulmonary and critical care medicine at South Nassau Communities Hospital in Rockville Centre, New York.

Dr. Make, who has researched the differences between COPD in men and women, agrees: Women “are younger [when they get COPD] and have poorer quality of life,” he says. Women also have “more severe shortness of breath, worse lung function and more frequent COPD-related anxiety and depression.”

Aside from smoking, your environment can factor into COPD. Exposure to air pollution and secondhand smoke can put you at risk. Some industrial chemicals, which you may encounter at work, can also raise the odds of getting COPD. And finally, you may be born at risk.

There’s a rare gene mutation that causes a deficiency in a protein (called alpha-1-antitrypsin) that usually protects your lungs. Not having enough of the protein makes you more susceptible to COPD, according to the ALA.

What are the symptoms of COPD?

In addition to shortness of breath during activity, you may also experience:

  • Chronic cough, meaning a cough that lasts more than 8 weeks
  • Mucus, or phlegm, when you cough
  • Frequent respiratory infections
  • Fatigue
  • Wheezing

“In chronic bronchitis, cough and phlegm persist, are commonly worse first thing in the morning, and they are not related to an infection, cold or acute bronchitis,” says Dr. Make.

Suggested reading: 12 steps to managing winter asthma

How is COPD diagnosed?

Your doctor will review your symptoms and health history and look at whether you smoke or have done so in the past. You will undergo a lung test called spirometry, which measures how fast and how much air you can blow out. And you may also have chest X-rays and computed tomography (CT) scans of your lungs.

If you’re short of breath and on the fence about whether you should go in for these tests, then you probably should. It’s critical to get a diagnosis as early as possible, says Dr. Make. “There are ways to prevent progression, reduce symptoms and improve quality of life,” he says.

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How is COPD treated?

The goal of treatment is to prevent the disease from getting worse, to help you breathe more easily and to make it easier to exercise. These improvements will help you live longer.

If you’ve already quit smoking, then you’re ready to move on to more personalized treatment strategies, says Dr. Coletta. “We determine the degree of lung dysfunction in order to tailor interventions.”

Here are some of the treatments your doctor may recommend:

  • Bronchodilators, such as albuterol (Ventolin®), that you breathe into your lungs. These medications help relax your airways so you can breathe more easily.
  • Steroids or corticosteroids, such as prednisone (Rayos®) or hydrocortisone (Cortef®), if you experience severe worsening of your symptoms. These medications can reduce inflammation in your airways. They often come with side effects such as weight gain and increased risk of infection. So they’re taken only for short periods.
  • Antibiotics, such as doxycycline (Vibramycin®), to treat bacterial infections caused by COPD.
  • Vaccinations to help prevent flu and pneumonia.
  • Supplemental oxygen, which comes in a portable oxygen tank and allows you to go out into the community. This is only if your blood oxygen level is low.
  • Pulmonary rehabilitation, which helps you develop better breathing through exercise, weight loss and education to manage your COPD.

What can I do on my own to feel better?

Exercise will help your lungs work better. Dr. Coletta recommends walking. “It’s the easiest and the most tolerated,” he says.

Aim for 30 to 60 minutes of walking 3 times a week. Your doctor will help you determine what will work best for you and how much exercise you can do when you’re just getting started. Over time, you will likely be able to exercise more.

“Your skeletal muscles can learn to do more with less oxygen,” Dr. Coletta says.

Another essential: Stay at a healthy weight. You want to eat a nutrient-rich diet that gives you energy without excess calories. (If you take diuretics, we have a diet plan just for you.) “The last thing that someone with impaired lung function wants to do is carry around excess weight,” says Dr. Coletta. “That takes more energy and more oxygen consumption.”

Working with your doctor and taking care of yourself go a long way toward helping you breathe easier. And if you need medication to help, the Optum Perks discount card can help you pay for your prescriptions. Download our discount card here.

Additional sources
COPD background:
American Lung Association, Learn About COPD
Leading causes of death 2015–2020: Centers for Disease Control and Prevention
Conditions that contribute to COPD: Mayo Clinic, COPD Symptoms and Causes
COPD risk in women: American Lung Association, COPD Causes and Risk Factors

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