Understanding COPD

AMOREM’s Service Podcast serves the mission to provide quality, thoughtful, loving care to patients and support to their families and to offer education and grief support to communities served. This podcast is intended to transform the way that people view and experience serious illness and end-of-life.

In episode nine of AMOREM’s Service Podcast, Understanding COPD, Nurse Practitioner, Sarah Seaver, leads the listener through a conversation about Chronic Obstructive Pulmonary Disease, common symptoms and common ways that AMOREM care teams assist with pain management and symptom control for those who are experiencing COPD.

Seaver begins by explaining the COPD was formerly known as emphysema. Some who have been diagnosed with the illness may have also been told that they have chronic bronchitis. She explains that these key terms are all different ways to say “Chronic Obstructive Pulmonary Disorder.”

COPD is a disease process of the lungs that results from damage to the lungs. Seaver acknowledges that oftentimes, COPD stems from a history of smoking, however, this is not always the reason for developing COPD. Sometimes, the development of the illness can come from prolonged exposure to particulates or gases. She explains that individuals who work in industries like farming or welding, can often develop COPD due to the environment that they have worked in for so long.

Seaver describes that the mechanism in the lungs where oxygen and CO2 are exchanged are structures called alveoli that look similar to a bundle of grapes. When one develops COPD, this mechanism becomes damaged and loses its ability to exchange gases in a comfortable and easy manner. This damage can cause an individual to struggle with breathing and may result in an excess of mucus.

Symptoms of COPD may include things like congestion, a cough, shortness of breath, low oxygen levels and fatigue. In conversation, Seaver and the host determine that COPD can present itself as many other ailments such as asthma or bronchitis. So, she explains that the gold standard for diagnosing COPD accurately is to conduct what is called a spirometry or pulmonary function test. This simple, noninvasive, test involves an individual blowing into a tube that will measure air flow. Many times, when the test is conducted, the patient will be viewing images that look like candles being blown out or leaves blowing on a screen to assist them with blowing into the tube.  The machine that the patient is breathing into measures how much air is coming into the lungs and how much air is going out of the lungs. Many times, a patient may receive a diagnosis of COPD based on their history of smoking or based on a chest x-ray that shows emphysema, but, the best way to confirm that a patient does have COPD is to do the pulmonary function test.

In terms of palliative medicine eligibility, Seaver says that someone who is having problems with their breathing, problems with fatigue and problem with a cough that is really affecting their quality of life would be eligible for palliative medicine. This would be someone who is simply tired of being tired, someone who feels as if they cannot do the things that they used to be able to do because of their illness, someone who may be making frequent trips to the hospital and nothing that they are doing at home is working to help with their symptoms. Seaver says that these are all great cases for palliative medicine to step in and help and ensures that palliative medicine teams are not there to take the place of any other provider that a patient may be seeing- they are simply there to be an extra layer of support.

In respect to hospice eligibility, Seaver notes that they are focusing on someone who may be experiencing shortness of breath even during times of rest, that their ability to be active is extremely limited, someone whose breathing problems do not subside even when taking their prescribed medications and someone who struggles to even make it from their bed to their chair without becoming exhausted. Many comorbidities may also play into someone’s hospice eligibility who has been diagnosed with COPD.

Seaver tells that some of the best interventions for COPD symptom management include inhaled medications which can come in many different forms and from various different brands. She likes to categorize COPD medications based on what helps in the moment when someone is experiencing symptoms and what can help as a maintenance medication to prevent certain symptoms. Steroids and antibiotics can be beneficial if a patient is experiencing a significant flare up. For some patients, oxygen may also be helpful in pain control and symptom management.

Lastly, Seaver stresses again that the role of the palliative medicine team is not to take the place of any other medical professional that a patient may be seeing, they are there to empower patients to make their own decisions and to be an extra set of eyes and ears to assist in pain control and symptom management.

If you or someone that you know could benefit from AMOREM services, please visit www.amoremsupport.org or contact a team member at 828.754.0101. 

AMOREM’s Service Podcast is proudly brought to you by AMOREM, your local, nonprofit, hospice and palliative care provider. AMOREM has provided services to the community for more than 40 years, formerly as Burke Hospice and Palliative Care and Caldwell Hospice and Palliative Care, and has served the High Country for more than 10 years. To learn more or to make a referral, visit www.amoremsupport.org or call 828.754.0101 to speak with a local team member.