By: Allison Kauffman
About 50 percent of the participants in the Albright LIFE program have some form of COPD. That’s according to Dr. Marilyn Knaub, medical director of the Albright LIFE program. She said, “We are talking about a generation of people that we are seeing that thought nothing about smoking and didn’t know about the dangers of smoking. So, as they get older, even if they quit, they have COPD. Most have mild symptoms, but there are some that have more severe problems and need regular oxygen.”
(Dr. Marilyn Knaub)
So what exactly is COPD? It stands for Chronic Obstructive Pulmonary Disease and is a group of progressive lung diseases. According to Healthline, the most common are emphysema and chronic bronchitis. Most people with COPD have both of these conditions. Emphysema slowly destroys air sacs in your lungs, which interferes with outward air flow. Bronchitis causes inflammation and narrowing of the bronchial tubes.
Smoking is the top cause of COPD. You can also get COPD if you have regular exposure to second hand smoke. In some cases, chronic asthma can lead to COPD. And also long term exposure to chemical irritants can lead to COPD. Dr. Knaub explained, “My Dad worked in a factory and was diagnosed with COPD due to the fumes in the plant.”
When it comes to COPD, Dr. Knaub says the first thing that you want to do is make a diagnosis. The earlier you can make a diagnosis, the sooner you can help the patient. You can’t necessarily stop the progression as much, but you can slow it down, make them more comfortable and those sorts of things.”
There are four stages to COPD. Grade one is mild, grade two is moderate, grade three is severe and grade four is very sever. The four grades are based on spirometry testing. Healthline explains spirometry testing is the amount of air you can breathe out of the lungs in the first one second of a forced expiration. Dr. Knaub explained that most people aren’t diagnosed until they are in the second stage, “You need to send them for a pulmonary function test. The machine can measure how fast it takes for a deep breath and how fast it takes for them to breathe out”
As well as determining what stage they are at, you need to determine how COPD is affecting the life of a patient. Dr. Knaub said, “Can they walk? Can they go up a flight of stairs? Can they do tasks in their daily living? The treatment is based on getting them to the highest function that they can get to.”
If they have mild COPD, just stopping smoking can make a big difference. Dr. Knaub explained, “At Albright LIFE, we do counsel people. We give them medication to stop smoking if they are still smokers. We also do education. They shouldn’t be around second hand smoke. We also teach them how to use an inhaler.”
She continued, “In the LIFE program, since we see participants about once a week, we are the first ones to know if the medication is or isn’t working or if they aren’t using it properly. Inhalers are not the easiest things in the world to use. We also have Home Health that goes out to teach them in the home.” Home visits can also help determine if there are other problems going on that may trigger COPD symptoms such as allergens or second hand smoke.
Dr. Knaub said, “Since we treat the whole person, you can see how all of that can help. At some point in time they might need oxygen and we supply it here. Sometimes they need oxygen at night or with exercise. Sometimes they need oxygen all the time. “
Dr. Knaub says the LIFE program is a great place to monitor COPD, “When I worked in a private doctor’s office, I only saw people when they self-diagnosed themselves as being sick. Despite seeing them on a regular basis if they have COPD, you don’t catch the exacerbations and the things that go on as soon as they happen. So with the LIFE program, things are picked up sooner. We also have a very close relationship with patient’s families. Families feel free to call us or to write in the participant’s book that they notice something. Then they are seen in the clinic at the LIFE Center right away.”
Dr. Knaub continued, “We make sure they get their flu shots and their pneumonia shots. There are several prescription medications that can help with COPD, depending on the stage that they are at. Some people have difficulty with inhalers, so we use nebulizers, which they can take home with them. The reason people do well in this program and stay out of the nursing home as long as they do is because we have a team approach. Everybody is working together for the same participant. So if one person notices something, they can share it with the rest of the staff. If they are living with a family member, they can write in their book about concerns or needs for medication refills.”
It has also been determined that COPD and lung cancer are linked in a number of ways. Healthline reports COPD and lung cancer have several common risk factors. Smoking is the number one risk factor for both diseases. Both are more likely if you breathe second hand smoke or are exposed to chemicals or fumes in the workplace. However, having COPD doesn’t mean that you will get lung cancer, but you are at higher risk of getting it. Worldwide, it is estimated that about 65 million people have moderate to severe COPD. As more people quit smoking, the number of COPD cases could decline. However Dr. Knaub said, “We don’t yet know what impact vaping will have on a person. We also don’t have statistics on smoking marijuana. If marijuana is legalized, this could be a factor in the number of COPD cases.
Symptoms of COPD include shortness of breath, wheezing, chest tightness, chronic cough, frequent colds or flu and lack of energy. Treatment includes lifestyle changes, dietary changes, medication, inhalers and oxygen support.