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Just Breathe

Living with COPD

One of the first things Susanne Carter noticed was a general heaviness in her chest. At 66, the active and longtime Colorado Springs resident realized her energy just wasn’t up to par. Rushing to get ready for an appointment, working in the garden, and even walking up her long, sloping driveway after getting the mail left her seriously out of breath.

"I was a smoker for 40 years,” she says, “and since I take blood pressure medication, I thought it might be something with my heart, so I was seeing a cardiologist for a while.”

Susanne and her husband, Ray, spent part of each year in Arizona, where some of their children live, and she began to notice she felt much better there. “Every time we’d come home from Arizona, I felt worse than the last time I came home.”

About three years after those initial symptoms, Susanne learned she had COPD, or Chronic Obstructive Pulmonary Disease. The disease has changed her life.
COPD is a life-threatening and progressive lung disease, or group of lung diseases, characterized by blocked airflow that makes breathing difficult. Emphysema and chronic bronchitis are the two most common conditions associated with COPD.

Timothy Rummel, MD, with Pulmonary Associates and based out of Memorial Hospital, says tobacco use is by far the most common cause of the disease, but there are several others, including a genetic cause in non-smokers called Alpha I-antitrypsin, chronic asthma and a chronic scarring disease of the bronchial tubes called Bronchiectasis. “We also see what’s called crossover syndrome, where people have asthmatic syndromes as well as COPD features. Those folks may start off initially as having a bronchitis attack. Also, we’ll see some cases of patients with COPD who have it induced by either air pollution or industrial and occupational causes.”

Corinne Preston, Nurse Practitioner with Penrose-affiliated Colorado Springs Pulmonary Consultants, says, “Most people develop symptoms and are then diagnosed around the fifth or sixth decade of life. Females tend to have more severe disease than males, even with the same smoking history.”

There is no known cure for COPD, and as Dr. Rummel points out, current treatments are aimed at managing and slowing progression of the disease.

“Over the past year we’ve seen two new inhalers hit the market,” says Preston. “One is geared toward exacerbation reduction and the other to reduce air flow obstruction. There are several others in the works; however, none of them will reverse or cure COPD.”

COPD can also affect the heart, says Dr. Rummel, because “when you have COPD with progressive destruction of lung tissue, you actually lose a big portion of the vascular bed of the lung, so the heart has to work a lot harder to pump blood through the lungs. This ends up producing, in more advanced cases, Cor pulmonale, which is where the right side of the heart fails because it’s trying to push blood through thick lungs, and patients get a lot of fluid retention.”

Living with COPD in the Pikes Peak region may bring its own set of challenges, as Susanne discovered. “This is a tough environment for patients with COPD,” says Dr. Rummel. “The lung disease is harder to compensate for when you’re at 6,000 feet. You try to mimic sea level by giving oxygen, but there is something else about our low barometric pressure that makes it hard to tolerate COPD here. We will see more patients with Cor pulmonale heart component because of our altitudes.”

Corinne Preston says exercise as part of a comprehensive program can help those with COPD. “Pulmonary Rehabilitation, specifically, has been shown to improve patient symptoms and reduce flair-ups and hospitalizations.”

“The lungs are a passive organ,” explains Rummel, “so exercise is really recommended for patients with COPD mainly to maintain and improve their fitness. They may have airflow limitation based on their COPD, but they still can improve the fitness of their muscles and heart and lung-oxygen delivery through an exercise program.”

Last fall, Susanne Carter and her husband made the difficult decision to leave their Colorado Springs home and move permanently to Arizona. Ten years after learning she has COPD, Susanne is doing well but says she has definitely slowed down. She quit smoking, is on several medications including two inhalers, and carries a rescue inhaler she used 4-6 times a week in Colorado but has not needed in Arizona since January. For things like trips to the zoo with her grandchildren, Carter uses a motorized cart.

“I don’t wear my oxygen in the house at all,” she says. “If I exert - rushing, changing a bed, etc., I’ll put it on for a half hour and rest, but otherwise I can do just great without it. I keep the portable charged and in the car just in case, but if I walk slowly I don’t get too short of breath.”