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The Definitive Guide to COPD 2018

Jun 1, 2018 3:23:15 PM / by Cory Luckner


Updated: April 4th, 2018

Chronic obstructive pulmonary disease (COPD) is an umbrella term that includes emphysema, bronchitis, and refractory asthma that affects both males and females.

In fact, COPD is the third leading cause of death in the United States. According to Lung.org, 12.7 million US adults 18 and over were estimated to have been diagnosed and close to another staggering 12 million adults in the US show signs of impaired lung function.

Often indicating a misdiagnosis. A diagnosis of COPD can come at any time at any age, however the majority of patients are 45 years and older.

It’s only when you begin to break COPD into its individual terms of bronchitis and emphysema you begin to realize the true volume of people affected.

10.1 million Americans reported a physician diagnosis of chronic bronchitis in 2011, and of the 4.7 million Americans diagnosed with emphysema 92% are 45+.

The best option at fighting the progression of this disease is to get tested at the first sign of breathlessness. The idea of “what I don’t know won’t hurt me” will actually affect you later on down the road. Especially since the prevalence of COPD increases with age.

Breathlessness should be taken seriously and should not be brushed to the side, as a common occurrence of breathlessness can indicate depleting lung function.

You may attribute your lack of oxygen to simply getting older, even if you don’t experience it every time you get up, you should still talk to your doctor about getting tested for COPD.

Often time’s patients don’t notice symptoms at the early stages of the disease, you may even go years without any noticeable shortness of breath.

COPD is a progressive disease and leaving those symptoms untreated for years will eventually catch up to you with more persistent and life altering symptoms.

During your next appointment with your doctor, ask for them to run a spirometry test. Don't worry we will cover more of that later on in the post. 

What is COPD?

COPD Patient Resources

Being honest and upfront with your doctor will allow them to provide you with the most effective treatment. But your doctor can’t be with you all the time and you may be looking for information regarding COPD.

Below are links to foundations and organizations that specialize in information regarding chronic obstructive pulmonary disease that you can use anytime to better understand such a life changing disease:

Breaking Down the COPD Umbrella Term

  • Chronic Bronchitis: This is the occurrence of inflamed airways that result in an obstruction of airflow to and from the lungs. While also producing a consistent and long-term cough with excessive mucus production.

  • Emphysema: Over time the air sacs in your lungs, medically known as the alveoli, become damaged losing their elasticity which inhibits their ability to properly fill with oxygen. Eventually the tissue between air sacs becomes damaged leading to the formation of air pockets, causing air to be trapped in the pockets limiting the flow of fresh oxygen rich air. Thus reducing the amount of oxygen that reaches your bloodstream and vital organs.

Symptoms Attributed to COPD

  • Heightened Shortness of Breath (Breathlessness); Especially during Physical Activity
  • Wheezing
  • Tightening of the Chest
  • Chronic Cough
  • Coughing up Sputum (mucus) that is Clear, White, Yellow, Greenish or Stained with Blood
  • Lack of Energy (Fatigue)

Many of these symptoms could be attributed to the common cold and flu or to simply getting older, but just because you may not feel the effects all the time doesn’t mean your body isn’t suffering.

If you experience any of the above symptoms, especially a frequent occurrence of breathlessness, you should schedule an appointment and get tested for COPD.  

Factors That Put You at Risk for COPD

  • Smoking Cigarettes, Cigars or Pipes
    • Second Hand Smoke
  • Family Genetics
  • Environmental/Workplace Pollutants
    • Dust, Fumes, and Chemicals


Tobacco Use

For the majority of COPD patients they all have one thing in common, which is they currently are or once were tobacco users.

This doesn’t mean that every person to ever smoke is diagnosed with COPD, but for 90% of patients’, frequent and long-term tobacco use is what lead to the development of chronic obstructive pulmonary disease.

In fact, 80% of COPD related deaths are attributed to smoking.

So whether you have recently been diagnosed or are occasionally experiencing the symptoms above, you should make it your number one priority to end tobacco use once and for all.

If you are having trouble quitting on your own, then talk to your doctor about a smoking cessation program.

Not only will your body thank you, but your family will cherish the additional time with you.

Environmental Pollutants

Exposure to environmental pollutants typically occur in the workplace environment over extended periods of time. People that are around chemicals, fumes, and dust day after day are at an increased risk of COPD. These pollutants once inhaled will slowly begin to deteriorate the lungs ability to function properly to a point that COPD develops. Exposure to household chemicals can cause the same end results.

Avoiding Environmental Pollutants

To reduce exposure to workplace pollutants be sure to spray chemicals and use other lung irritants in a well ventilated or outdoor area as much as possible. Whenever cleaning or vacuuming your home be sure to open all the windows to allow the lung irritating fumes and dust out, or simply ask a family member to clean for you and leave the room. 


For a small percentage of patients, their COPD can’t be attributed to years of smoking because they were never smokers nor can it be linked to exposure to environmental pollutants.

Instead the cause of their COPD is a bloodstream deficiency. COPD related Alpha-1 Antitrypsin Deficiency is caused when the bloodstream has a deficiency of the Alpha-1 Antitrypsin protein.

The lack of the Alpha-1 Antitrypsin protein leaves the lungs unprotected, eventually allowing the white blood cells to attack the lungs causing them to deteriorate.

If you experience COPD related symptoms but have never smoked nor been excessively exposed to environmental pollutants, talk to your doctor about getting tested for Alpah-1 Antitrypsin Deficiency.

COPD Terminology Definitions

With a COPD diagnosis, you must do everything you can to understand your respiratory disease. The first place to start would be to ensure that you understand the different terminology that are associated with COPD.

  • COPD: Chronic obstructive pulmonary disease, this is an umbrella term for chronic bronchitis and emphysema. Both of which cause breathing difficulties.

  • Pulmonary: Refers to anything that has to do with your lungs.

  • POC: Stands for portable oxygen concentrator. These are the latest technological advances in the medical oxygen field. POC's take air from its surrounding enviornment, and concentrates it into medical grade oxygen for you to inhale via a nasal cannula.

  • Nasal Cannula: The tubing that is connected to your medical oxygen device such as a POC (or oxygen tank), that is inserted into your nose to deliver a set dose of medical grade oxygen.

  • Pulse Flow Oxygen Delivery: This is a type of oxygen delivery. Every time you inhale through your nasal cannula, a pulse dose of oxygen is trigged on-demand and delivered according to your set pulse flow.

  • Continuous Flow Oxygen Delivery: The second type of oxygen delivery. Continuous flow is a little different than on-demand pulse flow. Instead of being trigged with each breath, continuous flow will constantly deliver a set level of oxygen in liter per minute, without interruption.

How the Lungs are Affected by COPD

COPD attacks many different parts of the lungs that result in an overall loss of lung function effectively lowering your ability to stay properly saturated, here’s how COPD affects your lungs:

  • The airways and air sacs lose their elasticity traits, leaving them unable to stretch and fill with oxygen
  • The inner walls of the air sacs become destroyed, leading to the formation of air pockets
  • Airway walls inflame and thicken
  • Airways become coated with a thick layer of mucus 

Treatment Options

There is no end all cure for COPD, but there are numerous treatment options that can be used to give you or a loved one the highest quality of life.

Smoking Cessation

The most essential step for COPD treatment to stop it from getting worse at a more rapid rate is to quit any and all tobacco use! Speak with your doctor about possible smoking cessation programs.


Typically delivered through an inhaler, bronchodilators will open up and relax the muscles around the airways that would otherwise restrict oxygen flow.

Releaving shortness of breath and coughing, you may need a short or long-term bronchodilator. A short term bronchodilator may be necessary for relief just before exercise, while the long-term bronchodilator provides relief all day.

Inhaled Steroids

For patients that experience frequent exacerbations or COPD symptom flare-ups, inhaled steroids will reduce airway inflammation while helping to prevent the occurrence of exacerbations. 

Oral Steroids

Living with moderate or severe acute exacerbations will greatly weigh down your ability to leave the house, the usage of oral steroids will help prevent them from further expediting your COPD.


COPD weakens the immune system leaving the body susceptible to respiratory infections and other viruses, causing symptoms to flare-up and get worse.

Antibiotics will provide your body with the support it needs to fight off the infections. While also fighting off acute exacerbations. 

Pulmonary Rehab Programs

All patients with COPD should be enrolled in a pulmonary rehab program. Here is where you will be equipped with the tools, knowledge, and support to live a happy and COPD friendly lifestyle.

Specialist will give you diet and exercise tips, as well as answer any of your questions or concerns. Participating in a pulmonary rehab program can result in less hospital visits, while also allowing you to participate in activities you thought you no longer could.

Oxygen Therapy

Oxygen therapy will supplement the lack of oxygen in the bloodstream by delivering it through a nasal cannula attached to the patient’s nose, giving them more energy and improving their overall mood.

Home oxygen concentrators offer high flow settings and provide an endless amount of oxygen whenever plugged into a standard wall outlet.

Portable oxygen concentrators are the latest advancement in the medical oxygen field, they provide patients the freedom to leave the house, travel and exercise.

While keeping them fully saturated at all times without the worry of running out of oxygen thanks to their rechargeable battery feature. Portable oxygen concentrators are also FAA approved for in-flight use.

Understanding the Impacts of Exacerbations

We mentioned COPD exacerbations or flare-ups a little earlier in the post. You may be wondering what exactly is an exacerbation as well as the effects it can have on your body?

A COPD exacerbation can be caused with exposure to environmental pollutants but typically stem from a respiratory infection more times than not.

Felt symptoms such as breathlessness will greatly increase during an exacerbation, and ignoring the influx of symptoms can result in further lung damage and increased hospital stays.

Frequent occurrences of exacerbations can actually lead to COPD progressing faster, here are some easy tips you can use to help reduce the occurrence of flare-ups:

  • Get a Yearly Flu Shot
  • Receive a Yearly Pneumonia Vaccination
  • Frequently Wash Your Hands with Soap and Warm Water
  • Use Hand Sanitizer When You Can’t Wash Your Hands
  • Stay Rested
    • A Tired Body is More likely to Get Sick
  • Stay Hydrated with Water to Reduce Mucus Buildup
    • Built-up mucus is an Ideal Breeding Ground for Germs
  • Avoid Crowded Areas during Peak Flu Season

Testing for Chronic Obstructive Pulmonary Disease

Doctors may lean towards COPD as the cause of your breathlessness if you are a current or ex-smoker. While on the other hand your doctor may not even consider a COPD diagnosis if you were never a smoker.

These biases often lead to patients being misdiagnosed, allowing for the disease to further progress and for patients to later realize a few years down the road that it was in fact COPD from the beginning.

For doctors to more accurately assess a diagnosis of COPD, they will recommend one or even multiple of the following testing methods:

  • Pulmonary Function Tests – You may also hear your doctor refer to this as a spirometry test, which is the most common lung function testing measure. Requiring you to only breathe into a tube connected to a spirometer device, it will measure how much oxygen your lungs can intake and how quickly your lungs can expel oxygen.

  • Chest X-ray – Doctors use this method to aid them in providing a diagnosis for emphysema, a chest x-ray may also be used to rule out other possible lung infections.

  • CT Scan – Chronic obstructive pulmonary disease puts patients at a higher risk of developing lung cancer than patients without COPD, a CT scan is commonly used to diagnose or rule out lung cancer. CT scans are also beneficial for diagnosing emphysema and to determine if surgery for COPD is the best option or not. 

  • Arterial Blood Gas Analysis – This vital tests provides doctors with an in depth look in the ability of your lungs to bring oxygen into the body and how effective they are at removing carbon dioxide from the body.

COPD Statistics:

  • Smoking is the number ONE leading cause of chronic obstructive pulmonary disease. In 80% of COPD related deaths, cigarettes were a contributing factor. Female smokers have nearly 13 times greater risk of dying from COPD than females who aren’t smokers. While male smokers have 12 times greater risk of dying from COPD than a non-smoking male.

  • Alabama and Kentucky have the highest prevalence of COPD amongst its population at 9%.

  • Overall prevalence of COPD in the United States is 6.3%.

  • Men are 7 times more likely to be diagnosed with emphysema than women.

COPD Complications

  • High Blood Pressure in the Lungs – When this occurs it is referred to as pulmonary hypertension. Pulmonary hypertension is when there is high blood pressure in the arteries that deliver blood to the lungs, also affecting the right side of your heart.
  • Heart Problems – A diagnosis of COPD automatically puts you at a heightened risk for heart disease.

  • Lung Cancer – Smokers diagnosed with chronic bronchitis are at an increased risk of developing lung cancer than smokers that aren’t diagnosed with chronic bronchitis.

  • Respiratory Infections – COPD weakens the immune system, leaving patients at an increased risk of contracting the flu, a common cold, or pneumonia. A respiratory infection can make it harder and harder to breathe eventually causing additional irreversible lung damage. Get yearly flu and pneumonia vaccinations to give your body additional protection against possible respiratory infections.

  • Depression – Coping with the life altering effects of COPD can lead to sadness and depression, often time because patients feel as if all sense of independence has been stripped from them. If you experience depression after a diagnosis or at any time during treatment, ask your doctor about steps you can take to conquer depression and if they can recommend a support group of patients with COPD that you can join.

Lifestyle Adjustments

You may think that with the diagnosis of a progressive lung disease like COPD you lose the ability to be yourself, travel, enjoy time with friends and family, or perform any hobby or activity that makes you happy.

The life you had before the diagnosis of COPD can still be enjoyed, except you will need to push yourself to make the following lifestyle adjustments in order to live an unrestricted lifestyle with an often times restrictive disease.  

Eat a Proper Diet

Farewell to the days of empty caloric snacks and meals that are loaded with cholesterol, sodium, and unhealthy amounts of fat. Instead, say hello to a diet loaded with fruits, veggies, nuts, and lean cut meats.

Eating a healthy diet is extremely essential and can have a direct impact on your overall well-being, as a diet loaded with fat will make you feel sluggish and lack energy.

Patients with COPD require up to 10 times more calories than a healthy person, but those additional calories should be extracted through fresh and healthy meal options. Proper COPD nutrition is one area that will be covered during pulmonary rehab.

Minimize Stress Levels

Stress and anxiety can lead to the occurrence of an exacerbation, leaving you to deal with the increased symptomatic pain.

A diagnosis of COPD will rightfully cause heightened stress levels, so talk to your doctor about joining a support group with patients that understand exactly what you’re going through.

Talking with people in the same situation is a great way to relieve stress as well as make new social connections, which have been shown to improve happiness. 

Hydrate for Happiness

Not only is drinking plenty of water good for bettering your health, but staying hydrated will also thin excess mucus allowing it to be easily coughed up.

A healthy daily intake of water is eight 8oz glasses of water. Talk to your doctor about other healthy caffeine free options you can drink daily to reach your designated fluid intake.

Don’t over hydrate by drinking too much water at once, instead spread it out throughout the whole day.

Exercise Regularly

Getting up and simply walking can be a tiresome task with COPD, which is why patients believe exercise is simply out of the question.

Contrary to popular belief, exercise with a chronic lung disease is actually beneficial to your health and overall treatment.

The benefits range from improved blood circulation which help the body more efficiently use oxygen to reducing stress, anxiety and depression.

Improve your COPD symptoms and help reduce the occurrence of symptomatic flare-ups with daily exercise, which you should aim to do 3-5 times per week for 20-30 minutes.

Before starting an exercise routine speak with your doctor about how often you should exercise, at the beginning you may only be able to work out for 10 minutes twice a week, but don’t give up because eventually your endurance will increase to allow you to work out longer and more often. Learn more in our Official Guide to Exercising with COPD.

See how Russell Winwood still manages to exercise and participate in marathons with stage 4 COPD all thanks to exercise on his blog: http://copdathlete.com/blog/

Reduce Sodium Intake

A diet loaded with sodium can lead to its own set of problems, edema or swelling can develop causing a rise in blood pressure.

Excess sodium can also cause fluid retention, causing the body to retain a high volume of fluids which will only impede your ability to breathe even further. Talk to your doctor about spices and herbs you can use as sodium substitutes.

Schedule Regular Doctor Appointments

Your doctor is your number one advocate, schedule regular appointments to discuss an influx of symptoms or to answer any questions or concerns you may have about your COPD.

They are also important in order to regularly monitor your lung function to check on the progression of the lung disease.

Dieting Tips

  • Choose a meal plan that is easy to prepare to reduce depleting your body of much needed energy that may be needed for other tasks.

  • Opt to take a nap before eating to give your body the chance to recoup and replenish energy before you indulge in a tasty meal.

  • If you notice drinking liquids while eating causes you to feel too full, instead hold off on the liquids until an hour after eating.

  • To reduce overeating that can impede on the diaphragms ability to work freely causing the flow of oxygen in and out of the lungs to be restricted, try eating 4-6 small meals throughout the day.

Nutritional Guidelines to Live By

  • Reduce Empty Carbohydrates – Such as sugar, cake, carbonated beverages, and candy.
  • Shoot to Eat 20-30 Grams of Fiber Daily – Bread, pasta, fruit and vegetables, nuts and seeds are incredible sources of fiber.

  • Indulge in a Protein Packed Meal – You should aim to eat at least two protein packed meals a day in order to keep your respiratory strength up. Items such as milk, eggs, cheese, meat, fish, dried beans and poultry.

  • Substitute Mono- and Poly-Unsaturated Fat – Instead of using cooking oils that are loaded with fat and cholesterol, use canola, safflower or corn oils.
    • If you are trying to lose weight then avoid these oils, but if you are looking to gain weight these are a healthy option to add to your meals.

  • Avoid Trans- and Saturated-Fats – Food items including butter, fat, lard, hydrogenated vegetable oils, fried foods, pastries and cookies, or skin from meat.

  • Enjoy Complex Carbohydrates – Fruits, vegetables, whole grain breads and pastas.
    • If your intention is to shed a few unhealthy pounds then choose fruits and vegetables for your source of complex carbs, on the other hand if you are trying to gain weight eat a combination of whole grain bread, pasta, fruits and veggies. 

Easy Exercises for COPD Patients 

When starting an exercise routine you should first discuss with your doctor about the types of exercises you should perform and ones you should avoid. The 3 most beneficial types of exercises for COPD:

  • Stretching – Improve your range of motion and flexibility by setting 5-10 minutes a day to stretch before and after exercising. Stretching is the occurrence of slowly bending and extending of the muscles. Stretching your arms and legs before you exercise will help warm the muscles up and help prevent the occurrence of an injury or muscle strain. 

  • Cardiovascular or Aerobic Exercises – The constant physical activity of these types of exercises requires the use of large muscle groups. Which will strengthen the heart and lungs improving the body’s ability to properly use oxygen. Doing aerobic exercises will help lower your heart rate and blood pressure, resulting in improved breathing. 
    • Try These Aerobic Exercises: Walking, Jogging, rowing, bicycling, skiing, water aerobics, or Jumping Rope.  
  • Strengthening – This doesn’t require you lifting hundreds of pounds, instead it just requires you to do simple contractions of the muscles until you feel them becoming tired. Upper body exercises do wonders for COPD patients, since the repeated lifting results in strengthened respiratory muscles. At first start with smaller weights so you don’t over exert yourself, over time your endurance and strength will increase allowing you to lift heavier weights.  

Breathing Exercises for Shortness of Breath   

Throughout your daily routines you may be faced with a common occurrence of breathlessness, which may also increase during times of peak physical activity.

If you are enrolled in pulmonary rehab, this is one of the many important tools you will learn. Next time you are faced with shortness of breath, try using one of the following breathing techniques to regain your breath:

  • Pursed Lip Breathing – This breathing technique is especially useful while exercising. When you feel short of breath inhale through your nose for 2 seconds with your mouth closed and exhale through your mouth with pursed lips for 4 seconds. This method allows for you to keep the airway pressure up which protects the large airways from collapsing.

  • Diaphragmatic Breathing – This breathing technique may take a little longer to grasp than pursed lip breathing, and this should be done while relaxing or laying down. Its purpose is to strengthen the diaphragm that is weakened by COPD to handle the work of breathing, otherwise the neck, shoulder and back muscles are used which can lead to unwanted pain. To start place one hand on your chest and the other on your belly, next inhale through your nose for 2 seconds and as you breathe in your belly should move outward more than your chest. Finally exhale through pursed lips while also pressing on your stomach, effectively helping your diaphragm to push air out.


The road to treatment for chronic obstructive pulmonary disease is certainly no walk in the park, but with a conserted effort to avoid lung irritants and to implement treatments you will be on your way to an improved overall quality of life.

We want to hear some of your experiences with COPD and how you make the best of your situation. Leave a comment below with some of your personal tips for living a healthy, active and social lifestyle with such a restrictive disease. You never know the benefit your comment may provide to somebody else, plus you may even learn something new from another patient! 



Cory Luckner

Written by Cory Luckner

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