COPD Patient Education

Doctors Who Treat COPD

As your COPD is diagnosed, treated and managed, you may encounter the following doctors and specialists.

General Practitioner – This doctor is involved in the daily general care of the patient. General Practitioners are typically the first healthcare provider that the patient sees and will often provide a referral to a specialist as warranted. 

Pulmonologist – Specialist physician that focuses on conditions of the respiratory tract and respiratory diseases (lung or breathing problems). Most patients with COPD will need to see this specialist. Besides treating the lungs, a pulmonologist will figure out the supplemental oxygen needs of patient, if necessary.

Thoracic Surgeon – Also known as cardiothoracic surgeons, this doctor focuses on the surgical diagnosis and treatment inside the chest (thorax). Thoracic surgeons get involved in diagnosing Chronic Obstructive Pulmonary Disease when a bronchcoscopy is necessary. Thoracic surgeons are also consulted when a patient suffering from severe COPD may need more extensive lung surgery.

 

Respiratory Therapists – These specialists are not usually MD certified, but they can be included in the patient’s care team. Respiratory therapists concentrate on treating breathing disorders such as COPD, asthma and bronchitis. They utilize mechanical ventilators and oxygen therapy to increase the lung function of the patient.

Psychiatrists/Psychologists – For the COPD patient, a psychiatrist or psychologist can assist in the smoking withdrawal symptoms or aid in smoking cessation as well as any ensuing depression.

 

How to Prepare

Having made your appointment with a healthcare provider, there are certain steps you need to take in order to maximize the benefit of your COPD doctor visit.

• Because most pulmonary screening tests require the individual to inhale and exhale deeply, do not eat a heavy meal prior to the Chronic Obstructive Pulmonary Disease exam.
• Refrain from smoking for 4-6 hours prior to the test.
• Patients may be asked to pedal a machine or walk on a treadmill to test breathing.
• Wear comfortable shoes to your doctor visit.
• Let the physician know if you are pregnant in case any x-rays are ordered.

 

Questions to Ask Your Doctor About COPD

From your initial diagnosis throughout your treatment and care, you will have questions about your COPD. This patient education guide lists questions to discuss with your doctor so you can make informed decisions about chronic obstructive pulmonary disease.

Questions About My Diagnosis

• What causes the COPD condition? Is it curable?
• Do I have emphysema?
• How do I know if I am going into respiratory failure?
• What is my prognosis?
• Does COPD affect my other vital organs?
• Is lung cancer a possibility?
• I hear that carbon monoxide is breathed in for the lung capacity test. Is that harmful?

Questions About My Treatment

• What medication will I be prescribed for my condition? What are the side effects of the drugs?
• Will I need to carry an oxygen tank?
• Will an inhaler and nebulizer help me?
• Do I need special treatments at night? Do I need special training for my treatments? Where will that be done?
• Would I be a candidate for a lung transplant?
• Will the treatments be at the hospital or at home?
• Is there a clinical trial that has newer treatments that I can participate in?

Questions About My Lifestyle and Family

• Is this hereditary? Are there special screening tests that my children should have?
• If I stop smoking, can the condition be reversed?
• Can you help me to stop smoking with medication or other methods?
• Would nicotine replacement therapy affect my condition?
• Can I go out with a portable oxygen tank? What precautions should I take?
• Can I sleep lying flat or do I need a special bed?
• Is there a special diet that would improve my condition or make it worse?
• Should I get the flu or pneumonia vaccines?
• Are there support groups that I can attend to discuss Chronic Obstructive Pulmonary Disease?

 

Common Tests or Labs to Diagnose COPD

At your first appointment, expect your physician to take your complete medical history and conduct a thorough examination. Several COPD tests and labs may also be ordered to make a proper diagnosis and monitor your ongoing condition. Below are the most common Chronic Obstructive Pulmonary Disease tests and labs ordered, why you need them, and what they can tell you about your condition.

Test Name	Why Test?	What is Normal?
Chest X-ray	Lung VisualizationHeart Chest Cavity Blood vessels Ribs Diaphragm	Lack of abnormal fluid collectionsNo cysts or masses Normal size heart No signs of inflammation Both lungs inflated
Spirometry	Measures the volume and speed that air is both breathed in and exhaled.	Forced Vital Capacity4.8L for Males 3.7L for Females   Tidal Volume 500 mL-Male 390 mL-Female   Total Lung Capacity 6 L-Male 4.7 L-Female
Arterial Blood Gases	Measures the content of oxygen, carbon dioxide and pH (for acidity).May also look at: Electrolytes Hemoglobin Lactic Acid	PaO2=80-10 mmHgPaCO2=35-45 mmHg Bicarbonate=21-27 mmol/L pH=7.35-7.45 Total CO2=25-30 mmol/L Base excess= -3 to +3 mmol/L
Oximetry	Measures the blood’s oxygen saturation	Normal is 95-100%
Electrocardiogram(ECG, EKG)	Measures the electrical activity of the heart. Both the rhythm and the intervals.	Resting heart rate is 60-100 beats/min]QRS complex (action of ventricles)=80120 T wave (ventricular recovery=160ms QT interval (prolonged one is suggestive risk of sudden death)=300-400 ms

 

Common Medications and Treatments for COPD

While there is no known cure for COPD yet, treatment plans have been devised to slow the progression of the disease and help maintain a more active life by relieving symptoms.

Living Healthy

The most crucial treatment is smoking cessation for those patients that still smoke, as this is the single worst culprit of COPD. There are many smoking cessation programs and medications.

Flare-ups of COPD symptoms are often associated with infections (viral and bacterial), as well as air pollutants. Any worsening of symptoms markedly increases a patient’s risk of death.

Thus, vaccinations are an important preventative measure. Patients with COPD should receive the following:

• Flu shot
• Pneumococcal (pneumonia) shot

Not to be overlooked is the impact lifestyle changes can have. Patients with COPD may want to seek out professionals to help them with the following:

• Exercise plan
• Nutritional advice
• Psychological counseling
• COPD management training

These programs help the COPD patient adjust to their condition and enable them to improve the quality of life.

 

Medical Treatments

Many times, some sort of medical intervention will be needed to treat the COPD patient. Treatment is specific to each individual. Side effects and warnings must be taken into consideration.

 

Treatment	What it Does	How it Works
Bronchodilator	Opens airways by relaxing surrounding musculature	Used with inhalerComes in both a short acting (4-6 hrs) and long acting (12 hrs) form.
Glucorticosteroid (steroid)	Reduces airway inflammation	Long term dosage or increased amounts have not shown increased benefitMethylprednisolone 40 mg/day X 10 days Decreases length of hospital stay
Oxygen	Increases the level of oxygen in the bloodPrevents right-sided heart failure	Typically given in Stage 4/Severe Chronic Obstructive Pulmonary Disease casesOxygen comes with a portable delivery system: Oxygen-gas cylinder Oxygen concentrators (electrically driven to concentrate oxygen in air) Liquid-oxygen devices Used with nasal cannula or face mask
Surgery	Abnormal tissue is removed so that remaining lung portions can work more efficiently	Gives relief to severe cases who had no relief from other treatmentsRemoval of damaged lung tissue through a bullectomy (removal of abnormally large air sacs) or a lung transplant