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Transcript of COPD
86 years old Definition: characterized by chronic bronchitis and/or emphysema that slowly deteriorates the lungs. Stages:
Stage 1 - Mild
Symptoms: Often minimal shortness of breath that can include cough/sputum. Isn't very severe and abnormal lung detection isn't detected.
Pulmonary Function Tests: > 80% of predicted
Stage 2 - Moderate
Symptoms: Often moderate or severe shortness of breath that can include cough, sputum, and dyspnea. First stage at which medical treatment is sought due to chronic respiratory symptoms or exacerbation
Pulmonary Function Tests: 50-80% of predicted
Stage 3 - Severe
Symptoms: More severe shortness of breath that can include cough, sputum, and dyspnea with repeated exacerbations that impact quality of life, reduced exercise capacity, and fatigue
Pulmonary Function Tests: 30-50% of predicted
Stage 4 – Very Severe
Symptoms: Appreciably impaired quality of life due to shortness of breath with possible exacerbations that could be life threatening
Pulmonary Function Tests: Less than 30% of predicted or less than 50% with chronic respiratory failure Dyspnea Scale:
0.Not troubled by breathlessness unless doing strenuous exercise
1.Troubled by breathlessness when hurrying or walking uphill
2.Walks older than people of the same age due to breathlessness or has to stop for breath when walking at a slower pace
3.Stops for breathing after walking 100 meters or only a few min.
4.Too breathless to leave the house or dress or undress themselves
Grandpa, how long have you had your lung disease?
- Asthma since age 4
- COPD for about 20 years COPD is a smoker's disease.
Alpha-1 Antitrypsin deficiency
Other environmental factors CAUSES: Chronic Emphysema:
limits air flow
bronchioles gradually destroyed
oxygen cannot reach the blood stream, carbon dioxide cannot escape Chronic Bronchitis:
overproduction of mucus from coughing (irritant)
bronchi narrowing Chronic Asthma/Bronchial Asthma
inflammation of the airways
muscle spasms around the airways Grandpa, how do you think you got your lung disease?
Asthma - hereditary; damp living conditions
COPD - greenhouses on the farm
"Probably from the eskimos" Symptoms
Cough with mucus Shortness of breath Fatigue Frequent Respiratory Infections Wheezing Chest Tightness Reduced Capacity for Physical Activity Chronic Coughing Loss of appetite Weight Loss Tests and Diagnosis Spirometer
detection before symptoms appear
tracks progression and medicine Chest x-rays
rule out other problems Arterial Blood-Gas Analysis
measure heart and lung functioning Sputum (Mucus) Examination
rule out other lung diseases CT Scan
surgery benefit Grandpa, when did you start feeling the symptoms? When were you diagnosed?
"I thought it was only asthma getting worse, but then they told me it was COPD." Progressive Disease - incurable
Permanent Damage Stages Other Complications Respiratory Infections
High Blood Pressure
(irregular beat) Lung Cancer (esp. smokers) Depression Anxiety Grandpa, how far can you walk before you have to rest?
"About 150 feet." Grandpa, how does COPD make you feel?
"I feel ugly. I feel weak. My chest is very tight. It's hard to breathe. I am tired." Grandpa, how often do you spit up mucus?
"Every hour or more." Grandpa, What things are hard for you?
"Everything. Bending over and getting dressed, esp." Medicines and Treatments Inhalers Surgery (reduction, transplant) Inhaled Steroids Antibiotics My grandpa takes:
1) 24-hour Oxygen
2) Cough Drops (as needed)
3) Albuterol (inhaled steroid) every 4-6 hours
4) Advair (inhaled steroid) twice daily
5) Low Morphine dosage twice daily
6) Mucinex once daily
7) Prednisone (oral steroid) approx. 6 mg daily
8) Ativan (anti-anxiety) once daily Oxygen Costs of COPD Higher insurance rate Medicine Hospital Visits Time Conclusion COPD is progressive and incurable.
My grandpa NEVER smoked.
COPD is painful and drawn out. Other facts:
Onset of disease occurs after age 40.
More prevelant in men than women. Sources:
Questions answered by: My grandpa, Walter Bolthouse; My mother, Nancy Gravelin
Pub Med Health. Ed. Andrew Shriber. NCBI, 9 Oct. 2009. Web. 9 Mar. 2011. <http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001153/>.
Mayo Clinic Staff. COPD. Mayo Clinic, Mar. Web. 26 Mar. 2009. <http://www.mayoclinic.com/health/copd/DS00916>.
Stages of COPD. N.p., 27 Jan. 2010. Web. 9 Mar. 2011. <http://www.copd-international.com/library/stages.htm>.
American College of CHEST Physicians. Economic Burden of COPD. CHEST, 2011. Web. 9 Mar. 2011. <http://chestjournal.chestpubs.org/content/117/2_suppl/5S.full>. Confusion