TREATMENT
So far, COPD has no cure. However, changes in lifestyle and treatments can make you feel better, stay more active, and can slow the progression of the disease.
The goals of COPD treatment include:
relieve symptoms;
delay the progression of the disease;
improve exercise tolerance or your ability to stay active;
prevent and treat complications;
Improve overall health.
The general practitioner may advise you to go to a pulmonologist so that he can assist in the treatment. This doctor specializes in the treatment of people with lung disorders.
Changes in lifestyle
Stop smoking and avoid lung irritants
Quitting smoking is the most important step you can take to treat COPD. Talk to your doctor about programs and products that can help you quit.
If you have difficulty doing so on your own, consider joining a support group. Many hospitals, businesses and community groups offer classes to help you quit smoking. Ask family and friends to support you in your efforts to quit.
Also, avoid secondhand smoke and places where there is dust, chemical vapors or other toxic substances that you can inhale.
For more information on how to quit smoking, read Smoking and your heart, and Your guide to a healthy heart (in English), from the National Heart, Lung, and Blood Institute. Although these resources focus on heart health, they contain basic information on how to quit smoking. To get free help and support to quit smoking, you can call the National Cancer Institute's quit smoking helpline at 1-877-44U-QUIT (1-877-448-7848).
Other lifestyle changes
If you have COPD, especially the most severe forms, you may have trouble eating enough because of the symptoms, such as shortness of breath and exhaustion. If this happens, you may not get all the calories and nutrients you need, which can make symptoms worse and increase the risk of getting infections.
Consult with your doctor about a meal plan appropriate to your nutritional needs. This may advise you to eat smaller and more frequent meals, rest before eating and take vitamins or nutritional supplements.
Also ask what kind of activities you can perform safely. You may find it hard to stay active because of the symptoms. However, physical activity can strengthen the muscles that help you breathe and improve your overall well-being.
medicament:
Bronco-dilators
Depending on the severity of COPD, the doctor may prescribe immediate-acting bronchodilators or long-acting bronchodilators. Those of immediate action have an effect that lasts between 4 and 6 hours and should only be used when needed. The effect of long-acting bronchodilators lasts about 12 hours or more and is used daily.
Most bronchodilators are taken using a device called an inhaler. This device allows the medicine to reach the lungs directly. Not all inhalers are used in the same way. Ask your health care providers to show you the correct way to use the inhaler.
If your COPD is mild, your doctor may only prescribe an inhalable bronchodilator for immediate action. In this case, you will use the medicine only when you have symptoms.
If COPD is moderate or severe, the doctor may prescribe permanent treatment with immediate and prolonged bronchodilators.
Combination of inhalable bronchodilators and glucocorticosteroids (steroids)
In general, the use of inhalable steroids alone is not the treatment of choice. If your COPD is more severe or if your symptoms are activated frequently, your doctor may prescribe a combination of medications that include a bronchodilator and an inhalable steroid. Steroids help reduce inflammation of the airways.
The doctor may ask you to use the inhalable steroids with the bronchodilator for a trial period of between 6 weeks and 3 months to determine if adding the steroid helps relieve your breathing problems.
Vaccines:
Flu vaccine
The flu can cause serious problems in people who have COPD. The flu vaccine can decrease the risk of getting the flu. Talk to your doctor to receive this vaccine annually.
Pneumococcal Vaccine
This vaccine reduces the risk of pneumococcal pneumonia and its complications. People with COPD are more at risk of pneumonia than those without COPD. Ask the doctor if you should get this vaccine.
Pulmonary rehabilitation
Pulmonary rehabilitation is a comprehensive program that helps improve the well-being of people who have chronic respiratory problems.
Pulmonary rehabilitation may include an exercise program, training in disease management and psychological and nutritional counseling. The program aims to help you stay more active and perform your daily activities.
The rehabilitation team may consist of doctors, nurses, physiotherapists, respiratory therapists, exercise specialists and nutritionists. These health professionals contribute to the creation of a program that meets your needs.
Oxygen therapy
If you have severe COPD and low blood oxygen levels, oxygen therapy can help you breathe better. In this treatment, oxygen is administered through nasal cannulas or a mask.
You may need additional oxygen all the time or only on certain occasions. For some people with severe COPD, the use of additional oxygen for most of the day allows them to:
- perform tasks or activities with fewer symptoms;
- protect from injuries to the heart and other organs;
- sleep more at night and be more awake during the day;
- living more time.
Surgery
Surgery may benefit some people with COPD. Typically, surgery is the last resort for people who have severe symptoms and who have not improved with medication.
Surgeries for people with COPD associated primarily with external link emphysema consist of bullectomy and pulmonary volume reduction surgery (LVRS). Lung transplantation (in English) could be an alternative for people who have very serious COPD.
Bullectomy
When the walls of the alveoli are destroyed, large air-filled spaces called bullae are formed. These spaces can become so large that they interfere with breathing. In bullectomy, doctors remove one or more large bullae from the lungs.
Lung Volume Reduction Surgery
In the LVRS, surgeons remove injured tissues from the lungs. Thus the lungs work better. In carefully selected patients, this surgery can improve breathing and quality of life.
Lung transplant
During a lung transplant, doctors remove the injured lung and replace it with a healthy lung from a donor.
Lung transplantation can improve your lung function and quality of life. However, lung transplantation involves many risks, including infections and rejection of the transplanted lung.
If you have very serious COPD, ask your doctor if lung transplantation is an alternative in your case. Ask him to talk about the benefits and risks of this type of surgery.
Management of complications
Usually, COPD symptoms slowly get worse over time. However, they can also get worse suddenly. For example, a cold, the flu, or a lung infection can make symptoms worse quickly. It may take a lot more work to breathe. You may also feel chest pressure, increased cough (in English), changes in the color or amount of sputum or expectoration and fever.
Call the doctor immediately if your symptoms suddenly get worse. He may prescribe antibiotics to treat the infection and other medications, such as bronchodilators and inhalable steroids, to breathe better.
For some severe symptoms it may be necessary to receive treatment in a hospital. For more information, read Signs and symptoms.