During one of my work experience placements I was lucky enough to sit in on a practical exam for medical students. In one section of this mock test the students had to in effect discharge a patient who had been diagnosed with COPD, explaining their treatment and answering any questions the pretend patient may have had. That then was the source for the topic of this particular entry.
So what is COPD?
Well, COPD stands for Chronic Obstructive Pulmonary Disease and is an umbrella term for a variety of different illnesses. Normally the illnesses will be a combination of bronchitis and emphysema to different degrees of severity. For the most part it is people over the age of 40 that develop COPD and in the UK
Emphysema:- This is a progressive disease causing the tissues in the lungs to be damaged gradually over time. Alveoli lose their elasticity causing them to narrow. This alters the shape of the lungs reducing their effectiveness and causing shortness of breath.
Bronchitis:- This is the chronic inflammation of the bronchi and is normally diagnosed by a persistent cough that brings up phlegm.
Symptoms:
As the constituent parts of COPD are progressive the symptoms can vary massively. As such in less serious cases symptoms such as coughing and shortness of breath can be present in addition to tightness in the chest and wheezing. As the disease worsens however anxiety can result from breathlessness and especially in winter the risk of lung infections are great. Many of these infections (or exacerbations) can lead to people being hospitalised with a death rate then of 10 %.
Treatments:
Unlike other lung problems like asthma COPD is not reversible so treatment is primarily to slow the progression of the disease. A simple treatment is exercise. This is done in an attempt to keep the heart strong and the lungs active, in tandem with this physiotherapy can be used in much the same way that it is used for patients with CF: to remove mucus.
To help widen the airways nebulised or drugs in tablet form can be used. Of the many drugs used, steroids are normally the most effective. Proactive treatment is very important so at the first sign of an infection antibiotics must be given to try and reduce the damage. It’s also very important that all sufferers are vaccinated against the flu and against the most common cause of pneumonia, the pneumococcus bacteria.
Alex Butcher
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