Nearly 15 million Americans have Chronic Obstructive Pulmonary Disease (COPD), and it is the third most common cause of death in the U.S.
Although there's no cure, there are many things you can do to slow the progression, including learning more about it. Candace Bromley discusses what you need to know about COPD.
Selected Podcast
COPD and The Lourdes Chronic Care Center
Featured Speaker:
Candace Bromley, Physician Assistant
Candace Bromley is a Physician Assistant at the Lourdes Chronic Care Center/COPD program.Transcription:
Melanie Cole: Nearly 15 million Americans have chronic obstructive pulmonary disease and although there's no cure, there are many things you can do to slow the progression, including learning more about it. Here to help us with that today is Candace Bromley. She's a physician assistant and the lead of the Lourdes Chronic Care Center and COPD program. What is COPD for the listeners that are not quite sure?
Candace Bromley, Physician Assistant: COPD is a degenerative lung disease. It’s caused by repeat exposure to an irritating substance. For most people, this is cigarette smoke over the course of the lifetime, but it can also be dust, metal filings and particulates or fumes from your workplace exposures. The other way COPD develops is asthma, which is chronically uncontrolled, where a lot of irritation and inflammation builds up from years of frequent bronchitis and exacerbation.
Melanie: You've mentioned some of the risk factors in your answer of what it is. Is there a genetic component if a parent has COPD or if you were exposed to second-hand smoke as a child? Are there certain risk factors you'd like to mention?
Candace: There's one specific genetic abnormality they've discovered which is antitrypsin deficiency and there is a specific blood test for that. Anyone who has been diagnosed with COPD should have that blood test once in their life. Exposure to second-hand smoke will also increase your risk for COPD just like personal smoking will.
Melanie: What are some of the symptoms? How would someone know if they're starting to experience lung damage in the form of COPD?
Candace: To diagnose COPD, one element is a daily cough with sputum production and the other elements are shortness of breath, which you primarily notice when you're trying to lift or carry things or when you're trying to walk up an incline or stairs.
Melanie: When do you go see a doctor about some of those things because some of those things can also be allergies or they can be asthma? When is it time to see a doctor and find out that this is what it is?
Candace: The earlier the better. If you see your doctor, they can do a quick and easy test called lung function test where you blow and it measures your lung capacity. It has very limited risk and if your lung function test comes back abnormal and has the COPD pattern, the first thing to do is to quit smoking, but also you could be started on the right treatment from the start and help decrease your flare-ups, which will help preserve your lung function. Once your lung function is lost, you can't regain it, so it’s imperative that you're diagnosed as soon as possible.
Melanie: Such an important point. As I said in the intro, there's no cure, but there are things you can do to slow the progression as you’ve just stated. Speak about some of the treatments and when is oxygen required and are there medications? If you can't fix an already diseased lung, what are some of the treatments?
Candace: The most important thing is that somebody with COPD has a rescue inhaler and that is albuterol. It’s available in different branded names and also in nebulizer form. Because people with COPD can have flare-ups, chest tightness, and wheezing that hit them very suddenly, they need to be able to have the inhaler to reverse their symptoms and to keep them out of the hospital. The second part of inhaler treatment is a controller inhaler and this is a medicine that lasts anywhere from 12 to 24 hours. They help decrease the feeling of shortness of breath and help patients actually do more without having to stop and rest, but the even more important element is that it reduces the number of flare-ups you have per year when you take it every day. That means that instead of having five hospitalizations in a year, then you can reduce that by half, and that saves your lung function and it improves your quality of life because you're at home living your life instead of being held up in a hospital bed.
Melanie: That’s great information. Tell us about the Chronic Care Center at Lourdes.
Candace: The Chronic Care Center at Lourdes is designed to help keep patients out of the hospital. We try to make it easy to get in; you're going to have a same day or next day appointment if you're not feeling well. We follow patients very intensively for about six weeks after they come out of the hospital to make sure that we're keeping them on the right track. If they start to backslide, we can catch it very quickly and make adjustments to their medications. The most important thing, which is probably the less glamorous side, is the education. So many patients are diagnosed with COPD by someone going ‘take this inhaler and see if it works’ and they may not have the time to really educate the patient on how to use it correctly, about when you should be changing your treatment, when we need to be stepping up the inhaler and the aggressive of treatment, and that’s what we really like to focus on. We get to know the patient and educate them and help them really take control of their COPD, to help them know their body, have emergency medications in the home that they can start when they start to feel that or COPD is flaring up and they can nip at exacerbation before it gets really bad. The main thing is to feel that you're in control of your COPD and to have the tools at home to help control it. Just like patients when they're diagnosed with diabetes get diabetes education and insulin training. I think patients who are first diagnosed with COPD deserve the same respect and knowledge base that they should be able to feel they really have all the tools to manage their disease and that improves your quality of life.
Melanie: What a great answer. Tell us about your team.
Candace: In our office, I have two medical assistants who help do the spirometry and measure lung function and we coordinate and do education. We help people quit smoking by trying to make a tailored program, which is going to help them. We want to make sure that people feel comfortable coming to us. We’re very realistic and we’ll work with you. We really want to make sure that you don’t feel that we’re going to yell at you. We want to keep trying different things and we want to see patients be successful, quitting smoking, staying out of the hospital and just growing and becoming stronger and independent again.
Melanie: Thank you so much for being with us today. This is Lourdes Health Talk. For more information on the Chronic Care Centers at Lourdes Medical Center, please visit lourdesnet.org. That’s lourdesnet.org. This is Melanie Cole. Thanks so much for tuning in.
Melanie Cole: Nearly 15 million Americans have chronic obstructive pulmonary disease and although there's no cure, there are many things you can do to slow the progression, including learning more about it. Here to help us with that today is Candace Bromley. She's a physician assistant and the lead of the Lourdes Chronic Care Center and COPD program. What is COPD for the listeners that are not quite sure?
Candace Bromley, Physician Assistant: COPD is a degenerative lung disease. It’s caused by repeat exposure to an irritating substance. For most people, this is cigarette smoke over the course of the lifetime, but it can also be dust, metal filings and particulates or fumes from your workplace exposures. The other way COPD develops is asthma, which is chronically uncontrolled, where a lot of irritation and inflammation builds up from years of frequent bronchitis and exacerbation.
Melanie: You've mentioned some of the risk factors in your answer of what it is. Is there a genetic component if a parent has COPD or if you were exposed to second-hand smoke as a child? Are there certain risk factors you'd like to mention?
Candace: There's one specific genetic abnormality they've discovered which is antitrypsin deficiency and there is a specific blood test for that. Anyone who has been diagnosed with COPD should have that blood test once in their life. Exposure to second-hand smoke will also increase your risk for COPD just like personal smoking will.
Melanie: What are some of the symptoms? How would someone know if they're starting to experience lung damage in the form of COPD?
Candace: To diagnose COPD, one element is a daily cough with sputum production and the other elements are shortness of breath, which you primarily notice when you're trying to lift or carry things or when you're trying to walk up an incline or stairs.
Melanie: When do you go see a doctor about some of those things because some of those things can also be allergies or they can be asthma? When is it time to see a doctor and find out that this is what it is?
Candace: The earlier the better. If you see your doctor, they can do a quick and easy test called lung function test where you blow and it measures your lung capacity. It has very limited risk and if your lung function test comes back abnormal and has the COPD pattern, the first thing to do is to quit smoking, but also you could be started on the right treatment from the start and help decrease your flare-ups, which will help preserve your lung function. Once your lung function is lost, you can't regain it, so it’s imperative that you're diagnosed as soon as possible.
Melanie: Such an important point. As I said in the intro, there's no cure, but there are things you can do to slow the progression as you’ve just stated. Speak about some of the treatments and when is oxygen required and are there medications? If you can't fix an already diseased lung, what are some of the treatments?
Candace: The most important thing is that somebody with COPD has a rescue inhaler and that is albuterol. It’s available in different branded names and also in nebulizer form. Because people with COPD can have flare-ups, chest tightness, and wheezing that hit them very suddenly, they need to be able to have the inhaler to reverse their symptoms and to keep them out of the hospital. The second part of inhaler treatment is a controller inhaler and this is a medicine that lasts anywhere from 12 to 24 hours. They help decrease the feeling of shortness of breath and help patients actually do more without having to stop and rest, but the even more important element is that it reduces the number of flare-ups you have per year when you take it every day. That means that instead of having five hospitalizations in a year, then you can reduce that by half, and that saves your lung function and it improves your quality of life because you're at home living your life instead of being held up in a hospital bed.
Melanie: That’s great information. Tell us about the Chronic Care Center at Lourdes.
Candace: The Chronic Care Center at Lourdes is designed to help keep patients out of the hospital. We try to make it easy to get in; you're going to have a same day or next day appointment if you're not feeling well. We follow patients very intensively for about six weeks after they come out of the hospital to make sure that we're keeping them on the right track. If they start to backslide, we can catch it very quickly and make adjustments to their medications. The most important thing, which is probably the less glamorous side, is the education. So many patients are diagnosed with COPD by someone going ‘take this inhaler and see if it works’ and they may not have the time to really educate the patient on how to use it correctly, about when you should be changing your treatment, when we need to be stepping up the inhaler and the aggressive of treatment, and that’s what we really like to focus on. We get to know the patient and educate them and help them really take control of their COPD, to help them know their body, have emergency medications in the home that they can start when they start to feel that or COPD is flaring up and they can nip at exacerbation before it gets really bad. The main thing is to feel that you're in control of your COPD and to have the tools at home to help control it. Just like patients when they're diagnosed with diabetes get diabetes education and insulin training. I think patients who are first diagnosed with COPD deserve the same respect and knowledge base that they should be able to feel they really have all the tools to manage their disease and that improves your quality of life.
Melanie: What a great answer. Tell us about your team.
Candace: In our office, I have two medical assistants who help do the spirometry and measure lung function and we coordinate and do education. We help people quit smoking by trying to make a tailored program, which is going to help them. We want to make sure that people feel comfortable coming to us. We’re very realistic and we’ll work with you. We really want to make sure that you don’t feel that we’re going to yell at you. We want to keep trying different things and we want to see patients be successful, quitting smoking, staying out of the hospital and just growing and becoming stronger and independent again.
Melanie: Thank you so much for being with us today. This is Lourdes Health Talk. For more information on the Chronic Care Centers at Lourdes Medical Center, please visit lourdesnet.org. That’s lourdesnet.org. This is Melanie Cole. Thanks so much for tuning in.
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