November is National COPD Awareness Month. COPD stands for chronic obstructive pulmonary disease. It refers to both chronic bronchitis and emphysema. Both diseases are marked by shortness of breath and chronic cough.
COPD has no known cure. It is third after heart disease and cancer for causing U.S. deaths.
According to the National Institutes of Health, 12 million U.S. adults have a diagnosis of COPD, with 120,000 deaths annually. There may be as many as 12 million adults who have not yet been diagnosed.
More women are now dying from COPD than men every year. More than 7 million women have COPD. Millions are not yet diagnosed.
According to the American Lung Association women are more likely by 37 percent than men to have COPD. Half of the deaths from COPD happen to women.
The number of women's deaths from COPD is more than four times what it was in 1980. Since 2000 more women than men have been dying from COPD.
The American Lung Association and ADVANCE for Respiratory Care and Sleep Medicine hosted a webinar "Taking Her Breath Away: The Rise of COPD in Women," on World COPD Day, Nov. 19, 2014.
Guest speaker was Dr. MeiLan Han, associate professor of Medicine in the Division of Pulmonary and Critical Care at the University of Michigan, and report contributor.
Han said that women with COPD have 1 million emergency department visits, 9 million doctors' office visits, 100 million disability days, costing $10 billion in medical care every year. About 15 percent of COPD deaths are caused by harmful work exposures, she said.
Women's lungs and airways are smaller than men's, and we have less respiratory muscle. Women are more at risk than men for lung damage from cigarette smoke and other pollutants. They have more flare-ups from colds or other lung infections.
Due in part to gender bias in diagnosis, Han said, women are underdiagnosed and undertreated. Women's COPD is most commonly misdiagnosed as asthma.
Spirometry is underutilized, Han said. A spirometry test is done in the doctor's office on lungs, to evaluate how much you inhale, how much and how quickly you inhale.
It diagnoses asthma as well as chronic obstructive pulmonary disease, chronic bronchitis, emphysema and pulmonary fibrosis. It can evaluate the efficacy of treatment.
The patient breathes into a tube attached to the spirometer. Their nostrils are closed with a clip and they take a deep breath then breathe out as forcefully as possible into the tube for several seconds. The process takes under 15 minutes.
Han said that the goals of therapy for COPD include symptom relief, preventing progression, reducing exacerbations, and improving overall health. Other goals of therapy are to increase tolerance for exercise to maintain ability to function, and to help women live longer with better quality of life.
Treatments for COPD include vaccination for pneumonia and influenza, inhaled bronchodilator drugs, oxygen therapy, pulmonary rehabilitation, surgical interventions, the NIH reported. Surgery to reduce lung volume can extend life, or improve quality of life.
Acute exacerbations can be treated with glucocorticoids and antibiotics.
Exacerbations most commonly result from viral or bacterial lung infections, or exposure to pollutants. Left untreated, exacerbation can lead to the hospital, and lung function can decrease. Quick medical care can limit damage from an exacerbation.
Warning signs include shortness of breath, noisy breathing, anxiety from difficulty breathing, and chest breathing rather than from abdomen.
Coughing that is dry or that brings up bloody, green or yellow phlegm, a change in nail or skin color, and trouble sleeping are also warning signs.
So are not eating, unable to speak, early morning headaches, swollen ankles or legs, abdominal pain.
Han said that we need greater funding for research. We need to move ahead with tobacco control, protection from secondhand smoke, improvement of air quality and safety in the workplace. Raising awareness is a great place to start, but there is much work ahead in beating COPD.
Han encouraged us all to "speak up for the women in your life who are at risk from this disease that is taking their breath away."
COPD: START THE CONVERSATION. Nhlbi.nih.gov. Retrieved Nov. 24, 2014.
Chronic Obstructive Pulmonary Disease. Lung.org. Retrieved Nov. 24, 2014.
Chronic Obstructive Pulmonary Disease (COPD). NIH.gov. Retrieved Nov. 24, 2014.
American Lung Association Report: Women at Greater Risk of COPD. Lung.org. Retrieved Nov. 24, 2014.
American Lung Association Reinforces Awareness about High Risk of COPD in Women. Lung.org. Retrieved Nov. 24, 2014.
Taking Her Breath Away. Lung.org. Retrieved Nov. 25, 2014.
Spirometry. Mayoclinic.org. Retrieved Nov. 24, 2014.
http://www.mayoclinic.org/tests-procedures/spirometry/basics/definition/... and http://www.mayoclinic.org/tests-procedures/spirometry/basics/what-you-ca...
10 Signs of a COPD Exacerbation. WebMD.com. Retrieved Nov. 24, 2014.
Visit Jody's website at http://www.ncubator.ca
Reviewed November 25, 2014
by Michele Blacksberg RN