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Rising trend in women raises concern

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Chronic Obstructive Pulmonary Disease (COPD) is rising in women at an alarming rate according to the American Lung Association. COPD has historically been considered a “man’s disease”, and the rise of cases in women has been startling.

COPD is a progressive lung disease that makes it difficult to breathe.  It is the third leading cause of death in the United States behind heart disease and cancer.  There is no cure for COPD.

Why are women more susceptible to COPD?

Doctors say women’s lungs and airways are smaller than men’s, so air pollutants and cigarette smoke are more concentrated when inhaled. Estrogen also plays a role in how nicotine is broken down in the female body.

Dr. Michael Schindel, ADC pulmonologist,  says the rate of women smoking began to increase in numbers during the 1920s, so we are now seeing  more lung and smoking related diseases in women than in the prior century.

What are the symptoms of COPD?

Women are more likely to be misdiagnosed than men. In fact, when women go to their physician, they are more likely to be diagnosed with asthma than with COPD.

Symptoms of COPD are similar to asthma. They can include, tightness in chest, shortness of breath and a persistent cough that does not go away.   In fact, patients may be diagnosed with COPD if they have  two of these three conditions:

  • Asthma,
  • Chronic bronchitis (or productive cough 3 months out of the year)
  • Emphysema

At what age does COPD symptoms appear?

Dr. Schindel says he has seen patients in their 20’s with COPD; however, for most people, symptoms do not appear for 20 to 30 “pack” years.

“The reason we see it (COPD) so late is because people are born with more than adequate lung function. You have to cause a lot of damage before you see lung function begin to decline rapidly,” he said.

He also says that a quarter of COPD patients are not smokers, but they must avoid inhaling the irritant that caused the COPD in the first place.   This may include individuals who were exposed to and inhaled coal, asbestos, varnish or toxic chemicals for extended periods of time.

Body-boxHow is COPD diagnosed?

Dr. Schindel recommends a complete pulmonary function study  using a pleythysmograph or “body box” over a traditional spirometry test.  A complete pulmonary function study using the body box measures lung function using spirometry plus six more studies.  According to  ADC pulmonary function technologist, Gean Townsley, RRT, RPFT, the additional studies measure thoracic gas volumes as well as lung diffusion, giving your doctor more comprehensive information allowing for a better diagnosis.

“What your provider is looking for is how well your body takes oxygen from the air and puts it into your  bloodstream,” she said.

Patients should also discuss family history, occupational exposures, environmental irritations with their doctor.

How is COPD treated?

Fletcher Peto GraphTreatment of COPD can be complex. Many patients would benefit from pulmonary rehabilitation programs, which include exercise training, self-management education and counseling.

Central Texas patients can be referred by their doctor to the cardiac rehabilitation program at St. David‘s Medical Center.   According to the report from the American Lung Association, only 2 percent of COPD patients have access to this sort of rehab program.

Smoking cessation is the best treatment for managing COPD, along with avoiding environmental irritants.  However, Dr. Schindel emphasizes there is no one way to manage COPD symptoms.  Symptoms are different for every individual – what works for one person may not work for another.   The best thing an individual can do is to speak with their physician and formulate a plan that works best for them.

Many patients believe that once damage has been done, smoking cessation isn’t necessary.  Dr. Schindel points to the Fletcher-Peto graph. The graph shows that a patient’s lung function may continue to decline after cessation, but does so less rapidly than if they continued to smoke.

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