Misunderstandings about COPD
Chronic Obstructive Pulmonary Disease (COPD) is a common lung condition, yet many misunderstandings persist about its causes, who it affects, and how it's managed. Here are some common misconceptions about COPD:
Myth 1: Only smokers get COPD. Fact: While smoking is the leading cause of COPD, it's not the only one. Prolonged exposure to lung irritants such as secondhand smoke, air pollution, chemical fumes, and dust can also lead to COPD. Additionally, a rare genetic condition called Alpha-1 antitrypsin deficiency can cause COPD, even in non-smokers. In America, although about 80% of COPD is caused by smoking, that remaining 20% still comprises a substantial population of nonsmokers who develop the disease.
Myth 2: COPD is an older person's disease. Fact: Although COPD is more commonly diagnosed in middle-aged and older adults, it can affect younger individuals as well, especially those with genetic predispositions or significant exposure to lung irritants from a young age. Early symptoms can be mild and may be mistaken for other conditions, leading to underdiagnosis in younger populations. Second hand smoke exposure is just as important as a primary smoker, so growing up in an environment surrounded by smoke may lead to earlier onset of COPD.
Myth 3: A COPD diagnosis is a death sentence, or nothing can be done to treat it. Fact: While COPD is a progressive disease with no cure, it is treatable. With proper management, individuals with COPD can improve their quality of life, manage symptoms, and slow the progression of the disease. Treatment options include medications (like bronchodilators and inhaled steroids), pulmonary rehabilitation, oxygen therapy, and lifestyle changes such as quitting smoking and regular exercise. Furthermore, in recent years, injectable biologic medications have become available and add to the arsenal to combat the limitations that come along with significant COPD.
Myth 4: People with COPD cannot or should not exercise. Fact: Exercise is actually a crucial part of managing COPD for many individuals. Pulmonary rehabilitation programs, which include tailored exercises, can help improve breathing, increase endurance, and enhance overall physical and emotional well-being. It's important to consult with a healthcare provider to determine a safe and effective exercise plan. In many cases, health insurance will cover the cost of pulmonary rehab.
Myth 5: If you have COPD and smoke, there's no point in quitting because the damage is already done. Fact: Quitting smoking is the most important step an individual with COPD can take to manage their condition and prevent further lung damage, regardless of how long they've smoked. Quitting can slow down the progression of the disease, reduce symptoms like coughing and shortness of breath, and improve overall quality of life. Once quit, the rate of lung function decline for a person with COPD dramatically slows, assuming the natural rate of decline of someone who never smoked. While you cannot regain what has already been lost, you gain all the function that would otherwise continue to plummet if you did not quit! This is obviously only one of the many reasons to quit smoking, as doing so also dramatically reduces future heart disease and cancer risks.
Myth 6: COPD only affects the lungs. Fact: COPD primarily affects the lungs, but it can have an effect on the entire body. It can increase the risk of other health problems, including heart disease, muscle weakness, depression, and respiratory infections. Comprehensive management of COPD often involves addressing these potential co-existing conditions.
Myth 7: COPD is the same as asthma. Fact: While COPD and asthma share some similar symptoms, such as shortness of breath and wheezing, they are distinct conditions. Asthma is often characterized by reversible airway inflammation, frequently triggered by allergens or irritants. COPD, on the other hand, involves largely irreversible airflow limitation. That is not to say that lung function cannot be improved with appropriate therapies, but it still does not behave as does asthma. It is possible for someone to have both conditions, known as Asthma-COPD Overlap Syndrome (ACOS).
Myth 8: COPD is a man's disease. Fact: While COPD was historically more common in men, the rates in women have been increasing. In fact, in some regions, more women are now diagnosed with and die from COPD than men. This is partly due to increased smoking rates among women in past decades and potential differences in how women's bodies respond to tobacco smoke and other irritants.
One more thing… I have time and time again encountered patients who have been diagnosed with COPD based solely on respiratory symptoms with a history of smoking. This is not appropriate and frequently is simply incorrect. To diagnose COPD, you MUST confirm this by demonstrating airflow obstruction on a pulmonary function test (PFT). If you have not had a PFT, it cannot be said for sure that you have COPD. I quite frequently find that patients who have been told for years that they have COPD in fact have an entirely different reason for their breathing difficulties. All said, in the US, only about 20-30% of heavy smokers end up with COPD.
Best wishes for a fun filled and safe Memorial Day!
