10 Questions to Ask Your Healthcare Provider About COPD

What is COPD?

When you ask this question, you're likely to learn that COPD is an incurable yet preventable and treatable lung disease that also affects other systems in your body. The disease is progressive, meaning that it generally gets worse over time. To date, there are no medications that are proven to increase survival in COPD.

Studies suggest that only smoking cessation, oxygen therapy (used for 15 hours or more a day) and pulmonary rehabilitation can slow COPD's progression.

What causes COPD?

Although smoking is the number one cause of COPD, your healthcare provider will probably explain to you that there are other risk factors to consider as well. Some of these risk factors are common, while others are not as common. These may include age, genetics, and occupational exposure to dust, fumes, and toxic chemicals.

Being aware of risk factors for the disease can help with earlier diagnosis and prompt treatment since patients who know the risk factors may question their own COPD symptoms before they're diagnosed.

How can I have COPD if I've never smoked?

Contrary to popular belief, smoking is not the only cause of COPD. Your healthcare provider will confirm that never smokers can also develop the disease. In fact, some studies suggest that between 25% and 45% of people diagnosed with COPD have never smoked.

What is my prognosis?

Although no one can accurately predict your life expectancy after a COPD diagnosis, the prognosis of the disease depends upon several factors—most importantly, whether or not you still smoke.

If you continue to smoke after your diagnosis, your lung function will decline more rapidly and the disease will progress much faster than if you were to quit completely. Other factors associated with COPD life expectancy are your degree of airway obstruction, your level of dyspnea, your body mass index (BMI), and your exercise tolerance.

A study published in the International Journal of Chronic Obstructive Pulmonary Disease suggested the following comparative life expectancy rates:

• Never smokers with no lung disease have a life expectancy of 17.8 additional years.
• Current smokers with no lung disease have a life expectancy of 14.3 years
• Current smokers with stage 1 COPD have an average life expectancy of 14 years.
• Current smokers with stage 2 COPD have a life expectancy of 12.1 years.
• Current smokers with stage 3 or 4 COPD have a life expectancy of 8.5 years.

Why should I quit smoking if I already have COPD?

You may be wondering why you should quit smoking when you've smoked for decades and the damage to your lungs has already been done.

Medical experts agree that quitting is the first-line treatment for COPD irrespective of whether you've smoked for 30 years or one. In fact, some studies suggest that lung function will improve (and even normalize) after smoking cessation, declining at the same rate as non-smokers of the same sex, age, height, ​and weight.

What are spirometry tests?

Spirometry is a pulmonary function test that is used to diagnose COPD and determine its severity. Ideally, your healthcare provider should thoroughly explain the results to you in a way that you can understand them. Unfortunately, this does not always happen.

There are three values measured in spirometry that are critically important to making a COPD diagnosis: your forced vital capacity (FVC), your forced expiratory volume in one second (FEV1) and the ratio of your FEV1 to your FVC (FEV1/FVC). Monitoring your results over time helps your practitioner determine if your COPD is improving, staying the same, or getting worse.

What COPD stage am I in?

According to the Global Initiative for Obstructive Lung Disease, COPD is divided into four stages: mild, moderate, severe, and very severe. Your healthcare provider will use your spirometry results to determine which stage of the condition you're in.

Still, no matter what stage your official diagnosis says, the disease affects everyone differently. How good you feel and how much activity you can tolerate depends upon a number of factors, including whether or not you continue to smoke, how much exercise you do and the type of diet you consume.

Will I have to be on oxygen?

Not everyone with COPD needs supplemental oxygen. Your healthcare provider will measure the amount of oxygen in your blood by taking blood from an artery in your wrist and sending it to the lab for analysis or by using a device called a pulse oximeter.

The general goal of COPD treatment is to keep your oxygen saturation level above 88%. If it consistently drops below this (a state referred to as hypoxia), the current treatment guidelines recommend the use of oxygen therapy.

Can I prevent COPD from worsening?

Ask your healthcare provider what you can do to keep your disease from worsening. As we talked about earlier, smoking cessation is the number one priority if you smoke. But, quitting smoking is only the first step. Incorporating other important lifestyle changes is also essential.

In addition, you may be advised to get a personal trainer, avoid fumes and second-hand smoke, invest in clean air equipment, get vaccinated, and lose weight.

Can surgery help me live longer?

Surgical intervention is an option for a small group of patients who meet very specific criteria.

There are three types of lung surgery your healthcare provider may discuss with you once your symptoms are severe enough and you've reached the most advanced stages of the disease: bullectomy, lung volume reduction surgery, and lung transplant.

Having a lung transplant may improve your quality of life and allow you to perform more activities, but it has not been shown to increase 10-year survival rates in people with COPD.

With that said, five-year survival rates for people who undergo lung transplants are in the range of 54%, while one- and three-year survival rates average 80% and 65% respectively.