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Short of Breath, Short of Facts

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed on page 14 in the November 1-2, 2008 issue of
The Mississauga News under the feature: Health, Wellness & Beauty, Medicine Matters.
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

When we talk about wheezing and shortness of breath, most people think of Asthma, mostly because we generally don't pay attention to diseases with long names. Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death. We tend to refer to it in the simpler form of COPD, which includes the entities of emphysema and chronic bronchitis. The majority of COPD is caused by smoking. What's more, you are at risk for developing the disease whether you smoked in the past or currently still smoke. Only a very small group of non-smokers develop the disease for other reasons. What is distressing is that the rate at which women are developing and dying of COPD has doubled in less than eight years. It is reflecting the alarm sounded in the 1980's, about skyrocketing smoking rates among teenage girls.

COPD is important to recognize because it tends to co-exist with other diseases such as heart failure, depression, osteoporosis and several metabolic disorders. COPD causes the lung airways to become constricted and blocked. This will cause symptoms such as cough, often associated with production of phlegm. Simple chores can cause you feeling short of breath, and in some people, an audible wheezing can be heard during exhertion. The ability to clear minor cold viruses and their effects is prolonged, and colds last much longer. Many COPD sufferers minimize their symptoms because they tend to be afflicted with other more distressing symptoms such as chest pain, and many people believe that these symptoms are a part of normal ageing, but these signs may in fact be indicative of an underlying mechanism that can be treated. If you are someone with a history of smoking, and experience either cough, phlegm, frequent chest colds, and/or breathlessness at any time, discuss this with your doctor.

The diagnosis depends on a clinical suspicion and examination of the chest. It is often confirmed with a breathing test called spirometry. We often do blood testing, chest x-ray and heart tests to complete the evaluation. COPD often exists with other medical entities. Depression seems to be a common disorder among COPD sufferers.

COPD is not curable, but its severity and progression can be modulated. Smoking cessation is the obvious prevention, since many more smokers die of COPD than of lung cancer. The symptoms are treated with inhaled medications delivered through various puffing devices. Solbutamol or Ventolin does not last long, but is able to open up spastic lung airways. Tiotropium bromide or Spiriva is another medication which can keep the airways open for much longer periods of time. At times, it is also necessary to add various steroid medications to the mix in the hopes of controlling lung inflammation and mucus.

Both Trillium Health Centre and Credit Valley Hospital have pulmonary rehabilitation centres focused on educating and improving the lives of people afflicted with COPD. The Lung Association also runs a toll-free number to help educate the general public at 1-866-717-COPD (2673). The sooner COPD is suspected and diagnosed, the longer and more normalized survival can be.

Related resources:

Chronic Obstructive Pulmonary Disease: What is COPD? From Ontario Lung Association. More than 750,000 Canadians suffer from this disease. COPD affects 3.9 per cent of men and 4.8 per cent of women ... COPD is expected to be the 3rd leading cause of death worldwide by 2020.

What Is COPD? from National Heart, Lung, and Blood Institute, NIH. COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to breathe. COPD can cause coughing that produces large amounts of mucus, wheezing, shortness of breath, chest tightness, and other symptoms. Cigarette smoking is the leading cause of COPD.

Chronic obstructive pulmonary disease from Wikipedia, the free encyclopedia. COPD is a disease of the lungs in which the airways become narrowed.

COPD (Chronic Obstructive Pulmonary Disease) from Medline Plus. Coughing up mucus is often the first sign of COPD. Chronic bronchitis and emphysema are common COPDs.

Frequently Asked Questions. Who is at greatest risk for COPD? What are the symptoms of COPD? How is COPD diagnosed? What are the treatments for COPD? How can I prevent my COPD from getting worse? What medications are used to treat COPD? When is oxygen therapy used for COPD? When is surgery recommended? What should I do if my symptoms suddenly get worse?

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