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COPD (Chronic Obstructive Pulmonary Disease)

I`m Confused

01/05/2010

Question:

I was diagnosed with emphysema almost 2 yrs ago. I had quit smoking 11 yrs prior to that time and have recently heard that once you quit smoking your chances of developing emphysema from smoking are zero? I was put on oxygen at that time at 2 liters, which has not changed. When I walk my oxygen levels can get down to the low 70`s but sitting, my pulmonologist says I don`t have to use my oxygen because my levels are in the upper 90`s without oxygen. I can walk around quite a bit without feeling out of breath, but will get to that point if I really push myself hard. 

I read on this web site that if I need oxygen and my oxygen levels are low, then I am in stage four and have only a couple of years to live. So, what is going on with me? I have tried to talk with my pulmunologist, who I feel is quite intelligent and up to date with current happenings in this field, but he is of Indian descent and we have some trouble in the communication area. My last echocardiogram showed my heart to be in fairly good shape, the tech was not able to see any irregularities although the pulmonologist has stated my left ventricle has hardened. I feel good, I don`t tire too easily, no more than any 59 year old with 13 and 14 year old boys to raise and a full time job. I know I want to be in denial but I also want to fight this as hard as I can, so if you can at least put some definitive boundaries down for me maybe I will have some direction from which to fight. I don`t want to be at stage four and from what I have read I don`t know how I can be except that I use oxygen and have low levels of oxygen when I walk?? Can you please shed some light on this?

Answer:

Thank you for visiting NetWellness and for your question. The definition of COPD is a disease state characterized by airflow limitation that is not fully reversible. The airflow limitation is usually both progressive and associated with an abnormal response of the lung to noxious particles, most commonly cigarette smoke. Unfortunately, it is true that some people quit smoking and still have significant progression of disease. We don't know why this happens.

 

The stage of COPD is measured by a breathing test called spirometry and specifically the FEV1 or the amount of air that can be exhaled in one second.

 

Stage 4 disease is defined as an FEV1 less than 30% or the presence of chronic respiratory failure. The need for oxygen to support oxygen levels is defined as chronic respiratory failure. That means that without oxygen, the lungs do not support the need for oxygen by the body. When this is the case, oxygen helps people live longer.

 

Surgical treatment for emphysema can be beneficial in certain cases. Pulmonary rehabilitation also aids in symptom control and improves quality of life and can assist in determining how much people can do.

 

 Furthermore, life expectancy is a statistic and depends on more than just stage of disease, so it is incorrect to assume that all people with stage 4 disease will live a couple years. These are topics you should discuss with your pulmonologist.

For more information:

Go to the COPD (Chronic Obstructive Pulmonary Disease) health topic, where you can:

Response by:

Michael E Ezzie, MD Michael E Ezzie, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University