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Those at risk for chronic obstructive pulmonary disease may wonder, “Is COPD fatal?” While there is no cure, it’s important to keep in mind that when you’re dealing with COPD signs and symptoms, various treatment approaches can help you avoid complications.
Some strategies are as straightforward as getting immunized against influenza and pneumonia. Others are more complex. For example, younger adults who have emphysema as a result of a hereditary deficiency of alpha-1 antitrypsin may be treated with alpha-1 antitrypsin augmentation therapy.
For more severe cases, the COPD care plan is likely to include a specialized exercise program called pulmonary rehabilitation has been shown to improve the ability to exercise and engage in basic daily activities with less shortness of breath. Oxygen therapy may be required for severe disease, while some people with advanced COPD may be candidates for lung volume reduction surgery or for lung transplantation.
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COPD Signs and Symptoms: Immunizations
For people with obstructive airway diseases, influenza and some types of pneumonia can be very serious and potentially life-threatening. It is extremely important that everyone in that position follow the recommended vaccination schedule or their doctor’s advice.
People with COPD should receive an influenza vaccination once a year. Flu season runs from around October and November through to March. The ideal time to get a flu shot is in October or November. (See also our post Common Cold and Flu Prevention: 15 Tips to Keep You Healthy.)
The pneumococcal vaccine protects against the bacteria that’s the most common cause of pneumonia (Streptococcus pneumoniae). The pneumococcal vaccine is available in two formulations (Pneumovax, and Prevnar 13), and is recommended for all COPD patients age 65 and older. It also may be given to patients with COPD who are younger than age 65 and have severe or very severe disease (FEV1 COPD less than 40 percent of predicted).
Unlike the flu shot, which must be given every year in the fall, pneumococcal vaccination provides protection for at least five years. It can be given at any time of the year.
Alpha-1 Antitrypsin Therapy
Alpha-1 antitrypsin is a protein that circulates in the blood. Augmentation therapy uses a concentrated form of this protein, which has been removed from donated blood and purified. This therapy cannot reverse damage that has already been done to the lungs, but it may slow down the further decline of lung function.
The therapy must be taken for life, and is very expensive. It must be administered by a healthcare professional in a doctor’s office or hospital clinic, or through home infusion services. The costs may be covered by private health insurance policies, but criteria for coverage can vary widely—before beginning therapy, check with your insurance company. For people age 65 and older, Medicare covers at least part of the cost.
A very helpful addition to drug therapy for people who have moderate, severe, or very severe COPD according to the GOLD COPD guidelines is a specialized program called pulmonary rehabilitation.
Pulmonary rehabilitation is a series of educational and structured exercises that allow people to make the most of the remaining capacity of their lungs. People with COPD who engage in these programs have less shortness of breath, an increased ability to exercise, better quality of life, and less frequent hospitalizations than similar COPD patients who do not participate in pulmonary rehabilitation
Importance of Exercise in Stemming COPD Signs and Symptoms
People with COPD signs and symptoms tend to decrease their physical activity, since shortness of breath makes exertion more and more difficult. Decreased activity can start a vicious cycle of progressive deconditioning, and this leads to worsening of symptoms and more breathlessness, with less and less physical activity.
Pulmonary rehabilitation is aimed at breaking that cycle through several core components:
- Exercise training and other therapeutic exercise (aerobic, strength and flexibility training)
- Education and skills training (such as breathing retraining)
- Secretion clearance techniques
- Prevention and management of exacerbations and pulmonary infections
- Control of irritants and allergens
- Instruction in the proper use and safety of oxygen systems
- Nutritional assessment and intervention if necessary
- Psychosocial assessment, support, panic control, and professional intervention if necessary
- Help with smoking cessation if currently smoking
- Education about medication use
- Implementation of a home treatment program follow-up
Is COPD Reversible?
Unfortunately there are no COPD cures. But COPD patients at all stages of the GOLD COPD guidelines can benefit from a pulmonary rehabilitation program—in fact, one study found that patients in the earlier stages of COPD derived greater benefits for their COPD signs and symptoms than those in the later stages. Although those with less-advanced COPD had better results, those with severe COPD also had improved ability to exercise and less shortness of breath.
This research suggests that when it comes to pulmonary rehabilitation, the earlier it is done the better—however, all of the patients were helped by the program. Other studies have found that pulmonary rehabilitation benefits are generally sustained for up to 18 months after the program ends, especially if the exercise training is maintained.
There are many pulmonary rehabilitation programs around the country. Your physician can most likely refer you to one; alternately, contact the American Lung Association (www.lungusa.org) or the American Association for Cardiovascular and Pulmonary Rehabilitation (www.aacvpr.org), which has a searchable online directory of pulmonary rehabilitation programs.
Health insurance may or may not cover pulmonary rehabilitation: You’ll need to check with your insurance carrier. The guidelines for Medicare coverage of pulmonary rehabilitation vary from state to state—check with your physician or pulmonary rehabilitation provider to obtain the guidelines in your state.
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Originally published in 2016, this post is regularly updated.