When Pam hears the pulmonologist say she has Chronic Obstructive Pulmonary Disease (COPD), she is mostly puzzled. She’s never really heard about COPD before. She quickly discovers that it is primarily a smoker’s disease and associated with two conditions—emphysema and chronic bronchitis. Emphysema is when damaged alveoli lose their flexibility, making it harder for them to expand and contract and leading to symptoms that include wheezing, shortness of breath and tightness in the chest. Chronic bronchitis is when the lining of the damaged airways swells, thickens and creates excess mucus. In an attempt to rid the lungs of the excess mucus, a persistent cough, shortness of breath or frequent respiratory infections may occur. Pam is scared when the pulmonologist mentions to her that the damage to her lungs from COPD cannot be reversed and there is no cure for COPD.
The pulmonologist informs Pam that if she follows her COPD management program, including the medications already prescribed, then she may be able to decrease the signs and symptoms associated with COPD and lead a somewhat normal life. However, if she doesn’t follow the program, she could be placed on long-term oxygen therapy, which is costly, and she may face lung volume reduction surgery (LVRS), which involves removing up to 30 percent of each lung, making the lungs smaller and allowing them to function better. Performed by either a sternotomy or a thoracoscopy, LVRS requires a 5 to 10-day stay in the hospital followed by pulmonary rehabilitation.
Internet Research: Define COPD.
Internet Research: Which body system does COPD affect?
Internet Research: Pam’s COPD Management Program includes:
Continued assessment and monitoring of her condition
If you were Pam’s pulmonologist, what would Pam’s COPD Management Program look like in each of the four areas listed below?
Assess and monitor:
Reduce risk factors:
Stabilize and manage
Manage exacerbations:
Review the Video: List a point from the video for each of the three areas: The flow of air in the body, treatment and prevention.
Alveoli: A tiny, delicate air sacs deep within the lungs, where the gas/blood exchange occurs. Oxygen from inhaled air passes through the walls of aveoli and enters the bloodstream while carbon dioxide passes out in the same way when air is exhaled.
Toxins from cigarette smoke can break the thin walls of alveoli, leaving larger, less efficient air sacs. In a smoker, this process signals the beginning of emphysema, a form of COPD.
COPD Management Program: The goal of a COPD management program is too prevent disease progression; relieve symptoms; improve exercise tolerance; improve health status; prevent and treat complications; prevent and treat exacerbations and reduce mortality.
Sternotomy: The median sternotomy involves cutting through the breastbone to open the chest. Both lungs (a bilateral approach) are reduced at the same time in this procedure.
(“Lung Volume Reduction Surgery – Diagnosis and Treatment.” Cleveland Clinic. N.p., n.d. Web. 30 Sept. 2014.)
Thoracoscopy: A minimally-invasive technique, the thoracoscopy requires 3 to 5 small incisions made on both sides of the chest, between the ribs. A videoscope is inserted through one of the incisions to allow the surgeon to see the lungs. A stapler and grasper are inserted in the other incisions and are used to remove the most damaged areas of the lung. The stapler is used to reseal the remaining lung.
(“Lung Volume Reduction Surgery – Diagnosis and Treatment.” Cleveland Clinic. N.p., n.d. Web. 30 Sept. 2014.)
Exacerbation: A worsening. In medicine, exacerbation may refer to an increase in the severity of a disease or its signs and symptoms.