Gasping for Air

Living with COPD

/ Author:  / Reviewed by: Joseph V. Madia, MD

"I couldn't breathe, I could barely walk, and felt like I was going to collapse or pass out when I did."

"I can't stand but for a couple minutes, or walk very far that I am not gasping for breath."

"Everything feels like it’s a hill I have to climb, but don’t have the energy, and breath to do it. I am really trying to have a more positive attitude, maybe I need a swift kick in the butt!"

All of these individuals - writing on a patient support forum  - are talking about what it's like for them to live with chronic obstructive pulmonary disease, or COPD.

What is COPD?

COPD makes it hard to breath and damages the lungs. 

Most of the people living with the disease are or were smokers. Exposure to air pollution and other lung irritants can also contribute to this respiratory (breathing) disease.

In the United States, the term COPD describes two main conditions—emphysema and chronic bronchitis.

While there are a number of different treatments for the disorder, it's a leading cause of disability in this country.

So what does COPD do?

Breathing is an extremely complex operation, involving a number of organs - windpipe, bronchial tubes or airways, lungs, air sacs and blood vessels.

Without getting too complicated, just think of your lungs and air sacs as balloons. They fill up when you breathe in and deflate when you breathe out. COPD damages the lungs and narrows the airways makes it hard to breathe fully.

Less air flows in and out of the lungs for a number of reasons:

  • The airways and air sacs harden and lose their ability to expand - inflate and deflate
  • The walls between the air sacs are destroyed
  • The walls of the airways become thick and inflamed
  • The airways make more mucus than usual, which tends to clog them

What are chronic bronchitis and emphysema?

COPD causes chronic (ongoing) inflammation in the bronchi (airways) of the lungs. This is called chronic bronchitis.

When the air sacs in the lungs are damaged, this is called emphysema.

Both of these conditions can - and often - happen at the same time in people with COPD.

When the bronchi are always inflamed, they get swollen and irritated. This causes the lining to thicken as lots of thick mucus forms in the airways, making it hard to breathe.

In emphysema, the walls between many of the air sacs are damaged or destroyed so they no longer function properly.

What are the symptoms of COPD?

You may not even notice the first signs of COPD. These come in the early stages and don't affect daily activities.

Here are symptoms of COPD you shouldn't ignore:

  • Coughing daily over a long period of time
  • Coughing up phlegm (mucus)
  • Getting breathless when you're moving, climbing stairs or walking long distances
  • Hearing wheezing or rattling sounds when you breathe
  • Having colds or flu often

Coughing is the most common first sign of COPD. And smokers may pass this off as "just a smoker's cough."

While coughing and having trouble breathing can signal COPD, these are also symptoms of other diseases, such as asthma or lung cancer.

So if you have a cough that lasts weeks or months, don't ignore it - get it checked out.

Who has COPD?

COPD is a very common respiratory disease. More than 12 million people are living with it in the United States. In addition, many more people  have COPD disease and don't even know it.

COPD is usually diagnosed in middle-age or older people. It's not contagious.

How is COPD diagnosed?

A simple lung function test called spirometry is the easiest and best way to diagnose COPD. It tests lung capacity and offers immediate results. The person being tested simply blows into the testing device.

 COPD can also be diagnosed by:

  • Listening to the lungs with a stethoscope
  • Taking pictures of the lungs with X-rays or CT scans
  • Measuring blood gases (oxygen and carbon dioxide) with a blood test

What happens when you have COPD?

COPD is a progressive disease, meaning it gets worse over time. Predicting how quickly COPD progresses varies from person to person and can't really be predicted.

Early symptoms such as coughing and struggling with breathing get worse as COPD progresses.

People living with the disease may have severe attacks, known as exacerbations, where they are suddenly not able to breathe.

In time, though, COPD can get so bad, that virtually every aspect of daily life is affected - everything from walking, bathing and eating to taking care of yourself. And advanced COPD can lead to death.

There is no cure for COPD, and damage to the lungs can't be reversed. So all treatments are designed to limit further lung damage and relieve symptoms.

How is COPD treated?

There are two main types of medicines that help treat COPD - bronchodilators (inhalers) and steroids.


  • These medicines are inhaled using a special device
  • They work to decrease shortness of breath by opening (dilating) the airways
  • Short-acting bronchodilators work quickly (15-20 minutes)
  • These are sometimes called "rescue inhalers" for severe shortness of breath
  • Long-acting bronchodilators work over hours to keep the airways open

Short-Acting Bronchodilators

Here are common short-acting inhaled bronchodilators your doctor may prescribe:

Long-Acting Bronchodilators

  • Spiriva
  • Serevent
  • Foradil

Long-Acting bronchodilator and anti-Inflammatory medications

Two medications that are used to manage COPD in one device help with breathing and inflammation:

  • Advair
  • Symbicort


Steroids are used to open the airways and reduce inflammation. They can be inhaled or taken in pill form.

Inhaled corticosteroids:

  • Asmanex
  • Flovent
  • Pulmicort
  • QVAR

Corticosteroid pills:

These are usually prescribed if symptoms are getting worse or you need to be hospitalized. Long-term use of these medications carry very serious side effects, so they aren't used often. These medications are available under a number of brand names.

Changing lifestyles

In addition to medications, people living with COPD are urged to make important lifestyle changes, including quitting smoking and staying active.

These are the best things you can do to keep the disease from advancing.

A number of organizations, including hte American Thoractic Society and National Heart Lung and Blood Institute, are excellent sources of information for both patients and their loved ones.

Review Date: 
June 9, 2011