Early screening for COPD important for anyone who smokes cigarettes
By Laura Hunt, M.D.
COPD is a term you may have heard of, but not be entirely familiar with. It stands for Chronic Obstructive Pulmonary Disease and it is a broad category of diseases that includes emphysema and chronic bronchitis.
Almost 100 percent of the time it is caused by cigarette smoking.
But don’t let this alarm you if you have been a long-term smoker. It just needs to be a warning to you that if you have frequent shortness of breath or a constant cough, you need to get it checked out. Anyone who smokes or who has smoked and develops these symptoms would be a candidate for COPD and early screenings.
In its early stages, symptoms might not even be prevalent yet, so it is important for all smokers to be screened.
If you are a smoker or were a smoker, it’s never too early to come have your lungs tested. We do a pulmonary function test or PFT where a patient does a series of maneuvers of blowing and holding their breath. We use a computer to measure how well you can exhale, the stiffness of your lungs and also how well your lungs are putting oxygen into the bloodstream.
By doing these simple tests, we can tell a patient what percentage of lung function they have left. This tells us how to categorize them and choose medications if need be. Mild, moderate and severe COPD have different regimens.
We like to repeat these screenings at least once a year, which helps us be certain the diagnosis is correct and that there isn’t something else going on.
I think smokers should also have a chest X-ray once a year. It is also important for that population to have a pneumonia vaccine, a yearly flu shot, and be proactive when they get a respiratory infection. It’s important to get those treated quickly to avoid hospitalization.
Where do I start?
These basic tests are offered here at Williamson Pulmonary and Sleep Medicine and in Williamson Medical Center as well. All smokers should have these tests. Primary care physicians have a fair amount of knowledge about COPD and early screening for it, so occasionally they will start inhalers and other basic treatments.
There has been an abundance of new medications that have come out in the last few years, so we recommend that primary care physicians go ahead and send patients to a pulmonologist just to see if there are any new treatments available for them.
Too late to quit?
It is never too late to quit smoking. We can’t entirely reverse the damage to your lungs from years of smoking, but lung function can improve as much as 10 percent if you stop smoking.
What happens when you smoke is that the components and chemicals in the tobacco cause destruction of the air sacs in your lungs. This is what leads to emphysema. In addition, the irritation from the chemicals and the smoke cause the lungs to produce too much mucous, which paralyzes your lungs’ defense system.
OK, so how do I do it?
Nobody ever said quitting smoking was going to be easy, but it can be done. There are a number of smoking cessation counseling programs, including one at Williamson Medical Center, and even medications to help with it. There are inhalers available that literally help increase the size of the windpipe and decrease the amount of mucous. We have oxygen therapy for more advanced cases.
Quitting not only will give you a slight increase in your lung function, but that alone will make you feel better. Many people can completely get rid of their cough, excess mucous and wheezing. Even if you have some daily limitations with shortness of breath, if you quit smoking, you can limit things like having to quit your job or go on oxygen therapy. It doesn’t matter if you are 80 years old, it is worth quitting. You will have less illness and feel better overall.
Laura Hunt, M.D., is a board-certified pulmonologist at Williamson Pulmonary and Sleep Medicine in Franklin. Her office can be reached at 615-790-4159.
Posted on: 6/17/2013