How Does COPD Progress?
By Kristen Stewart | Medically reviewed by Lindsey Marcellin, MD, MPH
There's no cure for COPD, but you can work with your doctor to slow its progression. First, learn about how the chronic lung condition develops.
Few things are as scary as the inability to breathe, one of the most serious symptoms of COPD progression.
“Initially, the patient will develop a cough and possibly sputum production,” says Brian W. Carlin, MD, an assistant professor of medicine at Drexel University School of Medicine in Philadelphia and the immediate past chairman of the COPD Alliance. COPD, or chronic obstructive pulmonary disease, affects your lungs and generally gets worse over time. As the elasticity in the airways and air sacs decreases, less air is able to go in and out as you breathe. Other complications of COPD — such as thickening or inflammation of the airways and more mucus accumulation — can further restrict airflow.
The progression of COPD can vary greatly. “COPD is an exaggeration of the natural aging process of the lung,” says Richard S. Novitch, MD, director of cardiopulmonary rehabilitation at Burke Rehabilitation Hospital in White Plains, N.Y. “Each individual is different, and the illness presents differently in them.”
How COPD Progresses
Think of COPD progression in stages. Stage I, or mild COPD, appears subtly — you might notice you feel short of breath when you exercise or do strenuous tasks around the house like yard work or carrying heavy objects. Sometimes an unexplained cough is the flashing red light. Many people at this stage don’t even realize they have a medical problem and fail to mention it to their doctors, instead chalking off the symptoms to age, weight gain, or smoking.
“While many smokers think that they have a ‘normal’ smoker’s cough, there is really no such thing as a ‘normal cough,’” says Dr. Carlin. “The cough often occurs years before the development of other symptoms, such as shortness of breath.”
Exacerbations are another warning sign of COPD, according to Carlin. Many people mistakenly believe these periods of increasing shortness of breath, cough, or sputum production are bronchitis, but in reality they are likely warning signs that the condition is progressing.
Moderate or stage II COPD is where most diagnoses are made. The symptoms at this stage of COPD will start to interfere with daily activities, making them harder to ignore.
Stage III or severe COPD is impossible to dismiss. “This is when patients are usually no longer able to work and have significant quality-of-life issues,” says Meg Schneider, co-author with Kevin Felner, MD, of COPD for Dummies. At stage III, you often feel short of breath even when sitting or lying down, Dr. Schneider explains. You cough frequently and often cough up a lot of mucus. Your immune system is weak, making you more susceptible to colds and other respiratory infections, and it takes much longer to recover. Fatigue, muscle weakness, and lack of appetite are also common.
Slowing the Progression of COPD
Smoking is the No. 1 risk factor for developing COPD and worsening of symptoms, so quitting is key in trying to slow the condition’s progression. “The sooner you quit, the sooner you stop the damage to your lungs,” says Schneider.
Lighting up is not the only cause, however. Exposure over a long period of time to dust, certain chemicals or fumes, secondhand smoke, and other air pollution can also contribute to COPD, so avoiding these situations is critical.
Getting the right treatment is important, too. With mild COPD, a fast-acting inhaler can help constricted airways on an as-needed basis. Longer-acting bronchodilators (which can keep airways open) or inhaled steroids may be prescribed for stage II COPD. Stage III requires intensive treatment usually including steroids, oxygen, bronchodilators, and sometimes even surgery. Pulmonary lung rehabilitation is another option to help you stay active. Your doctor is the starting point for any of these approaches.
Finally, positive lifestyle habits can help slow COPD progression and boost your overall health. These include regular exercise, a healthy diet in order to maintain an ideal weight, and getting enough rest.
I make no apologies for posting this in full as it says all we copders need to know.