What you should be aware of
What is fact and what is fantasy in the world of CODP? There are several things patients need to be aware of when having discussions about their disease with their doctors. The chronicity, the obstruction, the treatable feature, the progression, and the prevention, has been outstanding topics in the literature for physicians. That without talking about the complications and other diseases frequently associated to this disease.
How and why it is chronic
The disease is chronic which means that it is not acute, it didn’t happen suddenly and is the result of a long time of progressive damage. With that said, we can’t not reverse it to normal as soon as we can start therapy. It’s awful to say that “damage is done” because is an over-simplification of the fact that damage can continue if we don’t take appropriate actions. What we can say is “It’s not too late” to start taking control of some domains of the disease. So, let’s be sure that we all understand that one medication, one exercise, one visit to the doctor will be enough. Let’s be sure that we understand that it started some time ago and it may take some other time to be under control.
What obstruction means
Obstruction is a kind of complicated. The reasons for this is because, in pulmonology, obstruction means any reduction in the caliber of the airway. We (the complicated-in-physiology pulmonologists) have one word that prefer not to use (occlusion) because it may imply that the airway is closed or blocked indefinitely. The latter can happen with some tumors in the space of the airways and can be an undesirable mess. Obstruction in COPD, however, is complex because the continuous contraction of the very muscles around the lung airways lead to strong/permanent contraction and it can be complicated with the excessive mucus production of some patients (like long term asthmatics and chronic bronchitis). However, not all patients produce excessive mucus (which is associated to a particular type of inflammation) which leads us to think that the main therapy for COPD should be a long acting bronchodilator (airway muscle relaxant).
Worthy to treat
The disease has been shown to be treatable. Give that “some” of the mechanisms associated to obstruction in the airways has been described, several medicines and non-pharmacological interventions have shown to be of benefit reducing the bronchospasm (obstruction) as well as improving different outcomes related to this (like power to inhale, physical and social engagement, etc.). Even more, if the patient has stopped smoking the probability to get more control is outstanding.
Oh, no! … progressive
The progression shouldn’t make us feel scared. The disease is progressive, it’s true but aging is also progressive, hair loss is also progressive, skin wrinkling is also progressive, as well as some vision changes and it doesn’t mean that the worst will happen no matter what you try. Let’s face it: rehabilitation, medications, control of other factors may help in the delay of the progression although mathematical-scientific data can’t show it sometimes.
Prevent
Prevention definitely works because if you don’t smoke or are not exposed to the factors involved in the development of the disease, you don’t develop it. So, it is key to stop smoking, to avoid risk factors, to control associated diseases (e.g. asthma) to help the physician’s efforts to put you in your best shape.
So, don’t forget it: be realistic but not unnecessarily pessimistic. Help your doctor understanding where you are and getting more of their directions for coping in the best way with your disease.
