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Several lifestyle measures are critical for improving your comfort when you suffer from chronic bronchitis and emphysema.
When taken together, chronic bronchitis and emphysema—two distinct conditions known collectively as chronic obstructive pulmonary disease (COPD)—are the fourth leading cause of death in the United States, after heart disease, cancer, and stroke. As many as 16 million Americans have been diagnosed with COPD. Experts estimate another 16 million have the condition without knowing it.
The symptoms of COPD—primarily shortness of breath and a productive cough—can be highly debilitating. Shortness of breath may be uncomfortable enough to trigger panic attacks in some sufferers. In a recent survey of 573 COPD patients, 45% of the respondents reported shortness of breath while washing, dressing, or doing light housework; about a third said they had difficulty breathing while talking or resting; 8% said they were too short of breath to leave home. COPD is also associated with frequent respiratory infections, malnutrition, weight loss, fatigue, and depression.
The survey also revealed that COPD patients tend to underestimate the severity of their illness. More than a third of those with severe symptoms characterized their condition as mild or moderate. Of these, a quarter thought that their symptoms were well controlled or even completely controlled. Surprisingly, although COPD is a progressive disorder that cannot be cured, older adults reported fewer and less severe symptoms than younger ones.
This finding is counterintuitive, but there are at least two logical explanations. First, because people often become less active with age, older adults may not require as much functional lung tissue or as great a respiratory reserve (the ability of the lungs to exchange oxygen and carbon dioxide in response to increased activity) as they did when they were younger. Second, older COPD patients tend to grow accustomed to their symptoms and may restrict their activities to avoid them. Regardless, lifestyle measures can reduce symptoms of COPD, increase stamina, and produce dramatic improvements in quality of life.
The Damaging Effects of COPD
Gradually declining lung function due to airway obstruction is the hallmark of COPD. By reducing the elasticity of the lungs and destroying the walls between the air sacs (alveoli), emphysema leads to airway collapse and reduced airflow. Chronic bronchitis is an inflammatory disease of the airways that is frequently worsened by acute bacterial infections. The inflammation causes increased mucus production and swelling of the walls of the bronchial tubes, which leads to narrower passages.
Both emphysema and chronic bronchitis decrease the ability of the lungs to take in oxygen and remove carbon dioxide and are sometimes associated with spasms of the airways. Both conditions also coexist in many COPD patients.
As COPD advances, sufferers are vulnerable to acute episodes, which are typically prompted by a viral or bacterial infection. Extremely hot or cold air temperatures and poor air quality may worsen COPD symptoms. Acute episodes of COPD are marked by increased shortness of breath, wheezing, and a cough that produces more phlegm (the color of the phlegm may also change). People in the later stages of COPD are often underweight and malnourished because eating is tiring and the work of breathing increases calorie needs by 20% to 50%.
People with COPD also typically lose muscle mass owing to inactivity, leading to general weakness as well as weakness of the muscles that control breathing. Disability and discomfort often prompt psychological problems, primarily depression. Serious potential medical complications include congestive heart failure and pulmonary embolism (a blood clot carried to the lungs).
Long-term smoking is responsible for 80% to 90% of COPD cases. Heredity, exposure to secondhand smoke and air pollution, and frequent respiratory infections during childhood may also play a role in COPD.
If you have COPD, you can improve your quality of life by following these three important steps:
- Step 1: Not Smoking
Not smoking can dramatically improve symptoms and stamina in COPD patients. However, only about 8% of smokers are able to quit on their own. You can increase your likelihood of success by talking with your doctor and enrolling in a support group. Using nicotine gum, a skin patch, a nasal spray, or an inhaler to decrease the irritability, restlessness, food cravings, and anxiety often associated with nicotine withdrawal doubles the chances of quitting successfully.
Zyban (bupropion), a medication also prescribed as an antidepressant known as Wellbutrin, may help reduce cravings and withdrawal symptoms in some people. Don’t give up. Most people try to quit several times before they succeed.
Step 2: Exercise
Exercise builds muscle strength and stamina and improves breathing ability in everyone, including those with COPD. Consequently, regular exercise may enable people with COPD to work harder and longer without triggering symptoms.
An exercise program designed to combat COPD symptoms should contain the same two elements as any exercise plan: aerobics to increase heart rate and resistance training to increase muscle strength. However, people with COPD should be supervised by a respiratory therapist, who will establish guidelines to ensure a safe, comfortable workout and provide special breathing training exercises designed to help control breathing rate, decrease the amount of energy needed to breathe, and improve respiratory muscle function. People with COPD should not exercise when the air quality is poor and should avoid airborne toxins, including secondhand cigarette smoke, at all times.
Step 3: A Healthy Diet
Good nutrition may reduce the risk of respiratory infections, which can be life-threatening in patients with COPD. However, fatigue, depression, or the side effects of medications may rob people of their motivation to eat. Up to 60% of people with COPD do not get enough calories and nutrients from dietary sources alone.
If you have COPD, you are more likely to meet your calorie and nutritional needs by:
- eating a variety of foods
- focusing on foods that contain antioxidants (vitamins C, E, and beta-carotene), which are found in deep green and yellow-orange fruits and vegetables
- limiting salt, caffeine, and alcohol
- avoiding foods that cause gas or bloating
- eating five or six small meals a day rather than a few large meals
- choosing calorie-dense foods like peanut butter
- considering taking a high-calorie nutrition supplement and/or a vitamin supplement (beta-carotene supplements are not recommended, however, because current evidence indicates they may increase the risk of lung cancer in people who smoke)
Other Treatments for COPD
When lifestyle measures are insufficient, inhaled bronchodilators, which relax and open constricted airways, can sometimes relieve COPD symptoms. If inflammation or extreme sensitivity to irritants is a problem, some physicians add an inhaled corticosteroid to the regimen.
Antibiotics should be prescribed when a bacterial infection is suspected; influenza and pneumonia vaccinations should be up-to-date; and expectorants can help loosen and expel mucus.
Supplemental oxygen is beneficial for people with advanced COPD disease who have severely impaired lung function and an abnormally low blood-oxygen concentration. Surgery may be considered in selected patients. There are two options: lung reduction, an experimental procedure, and lung transplantation. Only about 1,250 lung transplants are performed annually worldwide owing to the scarcity of donated organs.
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