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Posted: Monday, April 6, 2015

The Perils of COPD

Believe it or not, chronic obstructive pulmonary disease (COPD) is the third-leading cause of death in the United States behind heart disease and cancer. It affects more than 24 million people including nearly 9 percent of the population of Tennessee. The Centers for Disease Control and Prevention (CDC) estimates that more than half of those affected by COPD – some 12 million people – don’t even realize they have it, and most patients will have lost roughly 50 percent of their lung function before they’re ever diagnosed. And while COPD typically occurs in people age 40 or older who have a history of smoking, nearly 25 percent of COPD patients have never smoked, meaning they developed the disease over time through genetic or environmental factors.

Blount Memorial thoracic surgeon Dr. Jason Budde says part of the reason COPD is so dangerous is due to the changes it causes in the lungs. “Patients who were long-term or heavy smokers typically develop changes in their lung tissue, which causes them to experience shortness of breath or other breathing difficulties,” Budde said. “While inhalation and other drug therapies can be very effective, some patients have severe changes in their lungs which result in blebs or bullae, which are large, thin pockets of lung tissue that no longer effectively exchange oxygen. These can cause several types of trouble including spontaneous pneumothorax, also known as collapsed lung, which can happen after coughing or straining. Patients who experience spontaneous lung collapse usually fall into two categories. The first and most-common is the tall, thin male between 15 and 25 years of age who has blebs or bullae in his upper lung zones. The second type is the middle-aged heavy smoker whose lungs are damaged from chronic smoking. When spontaneous pneumothorax occurs, the patient should be taken to the hospital to have a chest tube placed. Surgery often is required afterwards, usually involving removal of the bleb or bulla in combination with pleurodesis to help keep the lung inflated,” he explained. “At Blount Memorial, we perform this via the minimally invasive video-assisted thoracoscopic surgery (VATS) approach, which typically uses a single incision that is used nowhere else in East Tennessee,” he added.

Another COPD treatment involves lung volume reduction. “Lung volume reduction can be beneficial to certain patients who have heavy lung disease from smoking,” Budde said. “This involves removal of damaged lung tissue, and can help long-term breathing by removing the harmful and nonfunctioning lung tissue, and easing the crowding of functional lung tissue,” he added.

Ultimately, Budde says, patients need to know that if they have COPD, there are things that can be done to help. “With proper treatment, COPD can be a very survivable disease,” he said. “Still, it is critical for people who are exhibiting the symptoms of COPD – tightness in the chest, increased breathlessness, frequent coughing and wheezing – to consult their doctor and take a spirometry test to measure lung function. Undiagnosed symptoms can get worse quickly, so it’s important to begin treatment as soon as possible,” he explained.

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