Dr. Tiffany DuMont and the Breathe PA team
Dr. DuMont is a pulmonologist with Allegheny Health Network and member of the Breathe Pennsylvania Board of Directors.
As a pulmonologist, I get a lot of questions from patients. Here are some common questions I hear in the pulmonary office regarding COPD. If you have any questions, please send them to Breathe PA at info@breathepa.org and we will do our best to answer them in a future blog or in the next newsletter.
They told me I had an Exacerbation. What is this?
A COPD exacerbation is defined as worsening respiratory symptoms that requires additional therapy. There are varying degrees of exacerbations. They are categorized based on the treatment needed as mild, moderate, and severe.
Ok, so I had an exacerbation… what’s the big deal? I feel better now.
COPD exacerbations can negatively affect your life, increase your chances of being hospitalized and can cause progression of your COPD. Your doctor would like to know each time you’ve had an exacerbation especially if it was moderate or severe, as it may change the category of your COPD and change the treatment plan. A prior exacerbation is a predictor of future exacerbations. Lung function, how well the lungs move air and process gases, declines as people get older. People who smoked see their lung function decline faster. Each exacerbation may cause an acute worsening of your lung function and you may not return to your prior baseline.
Come on doctor, can’t you just leave me on steroids all the time for my COPD? I feel so much better when I am on them!
This is a line I hear in the office all too much. And although I want my patients to feel their best, chronic steroids are not always the best decision. Steroids are used short term to treat COPD exacerbations but are rarely recommended for long term use for COPD. Steroids can cause multiple side effects. These side effects include, but are not limited to, high blood pressure, osteoporosis (fragile bones), high blood sugar/diabetes, weight gain, cataracts, glaucoma, easy bruising, thinning of the skin, and increased risk of infection. If you are experiencing frequent COPD exacerbations, there are alternative medications to chronic steroids. I would suggest talking to your doctor about the alternative options that exist.
If you want to learn more about your disease, have more questions, or want to meet people who are experiencing similar symptoms, join us on the Breathing in the ‘Burgh COPD Cruise on June 21. We look forward to seeing you!
References:
Walters JA, Walters EH, Wood-Baker R Oral corticosteroids for stable chronic obstructive pulmonary disease.
Cochrane Database Syst Rev. 2005
Horita N, Miyazawa N, Morita S, Kojima R, Inoue M, Ishigatsubo Y, Kaneko T. Evidence suggesting that oral corticosteroids increase mortality in stable chronic obstructive pulmonary disease. Respir Res. 2014;15:37. Epub 2014 4 3.
Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: The GOLD Science Committee Report 2019. Singh D, Agusti A, Anzueto A, Barnes PJ, Bourbeau J, Celli BR, Criner GJ, Frith P, Halpin DMG, Han M, López Varela MV, Martinez F, Montes de Oca M, Papi A, Pavord ID, Roche N, Sin DD, Stockley R, Vestbo J, Wedzicha JA, Vogelmeier C. Eur Respir J. 2019 Mar 7. pii: 1900164. doi: 10.1183/13993003.00164-2019.