Many people assume that as they get older, it's normal to get short-winded climbing stairs, says Antonio Anzueto, MD, professor of medicine at the University of Texas Health Science Center at San Antonio.
In fact, shortness of breath can be a sign of chronic obstructive pulmonary disease (COPD), a lung condition that an estimated 12 million Americans may have without knowing it (in addition to the other 12 million who have been diagnosed).
Even if you have heard of COPD, here are some surprising facts you may not know.
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Emphysema is COPD
COPD isn't a single lung disease. It's really two diseases that cause airflow blockage and breathing problems. It includes emphysema, which makes it hard to breathe, and chronic bronchitis, which is a mucus-producing cough that doesn't go away.
Most people with COPD have both.
Roughly one-third, or 30%, of adults don't know what COPD is, according to a 2010 survey by the National Heart, Lung, and Blood Institute.
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At one time, COPD was considered a death sentence. Today, there's reason for optimism.
Once people know they have COPDin the early stages, the symptoms can be easy to ignorethey can exercise, quit smoking, and take medication to prevent further lung damage.
"With those three things together, my patients can have an absolutely normal life," says Dr. Anzueto, who is also chair of the U.S. COPD Coalition. "This can be a treatable disease."
Programs vary widely, but they usually include breathing exercises, nutritional counseling, exercise training, and tips on conserving energy and breathing easier.
Pulmonary rehab has been shown to cut hospitalizations and death, and improve quality of life for people with recent COPD flare-ups.
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Rural locations can be riskier
In one study, hospitalized COPD patients from isolated, rural areas were more likely to die from the disease than similar urban dwellers.
This may be because the disease is under-recognized in rural areas, or because hospitals in those areas lack pulmonary rehabilitation and have only a limited use of spirometry (a lung-function test).
"I recommend that patients living in rural areas discuss their breathing symptoms with their doctor and ensure that they are on the best level of treatment according to the severity of their illness," says study author Thad Abrams, MD, an assistant professor at the University of Iowa Carver College of Medicine, in Iowa City.
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Choose a hospital carefully
For many medical conditions, where you're treated can make a big difference, and the same seems to be true for COPD.
People admitted to hospitals that don't treat many COPD patients are at a higher risk of death than those at other hospitals, according to Dr. Abrams' study.
"Avoiding a hospitalization is key," Dr. Abrams says. "However, if a hospitalization is necessary, I recommend that patients with severe COPD seek out hospitals that have higher levels of pulmonary expertise and respiratory support."
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Depression is common
About 40% of people with COPD experience depressionthat's more than people with diabetes or without chronic conditions.
People with COPD may be depressed because they can't function well physically, they feel isolated or useless, or they lack control over their condition.
Either way, depression can rob people of the ability to manage COPD or stick with treatment, so getting help is key.
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Weight is tricky
Being overweight or underweight is bad for those with COPD. Emphysema can cause you to shed pounds due to muscle wasting, appetite loss, and other factors. Being underweight can interfere with day-to-day activities and is linked to a higher mortality risk, says Dr. Anzueto.
Being overweight, though, makes it harder to breathe, and may make it difficult to sleep, says Dr. Anzueto. Belly fat, in particular, is a hazard.
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Harmonica lessons might help
Breathing exercises can help you overcome shortness of breath. Why not make it fun? Some pulmonary rehabilitation programs offer harmonica classes, because playing the harmonica forces you to focus on blowing and breath control.
Another popular technique is called pursed-lip breathing, and here's how to do it: Relax your neck and shoulders. Breathe in through your nose for two counts with your mouth closed. Pucker your lips. Exhale slowly through your pursed lips for four counts. Repeat four to five times a day.
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Don't ignore symptoms
If you have a chronic cough, wheezing, shortness of breath, or chest tightness, don't ignore them. (And don't dismiss that cough as a "smoker's cough"; experts say there is no such thing.)
Evidence suggests that starting COPD treatment earlier in the course of the disease can slow its progression.
"The sooner we identify [the disease], we can start treatment, we can start interventions that can have a tremendous impact," says Dr. Anzueto.
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Lung transplants are possible
For COPD patients with severe symptoms (and who also meet specific criteria), a lung transplant may be possible. It can boost your survival rate and improve lung function, exercise capacity, and your quality of life.