COPD

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In the early stages, breathing tests are the only way to diagnose COPD. If you are wondering whether it may be time to talk with your doctor or healthcare provider about COPD, go through the following COPD checklist. If your answer to any of these questions is "yes," make that appointment.

  • Have you smoked for many years?
  • Have you had several bouts of bronchitis?
  • Do you have a chronic cough and bring up mucus from your lungs?
  • Do you have a morning "smoker's hack"?
  • Do you have chest colds every winter?
  • Do your colds seem to last for weeks, instead of days?
  • Do you get out of breath during daily activities?
  • Has there been a change in your breathing?
  • To determine whether you have COPD, your doctor or healthcare provider will perform a complete physical exam and take a detailed medical history, which will include questions about family, job, habits, hobbies, current medications, and symptoms.

    The healthcare provider also may order tests to evaluate your breathing: These may include:

    • Pulmonary function tests
    • Imaging tests such as X-rays
    • Mucus culture
    • Pulmonary function tests

      Pulmonary function testing provides your healthcare provider with information about your lung function. Specifically, these tests reveal the size of the deepest breath you can take and the degree to which airflow through your bronchial tubes is obstructed.

      This section has more on:

      • Spirometry
      • Exercise tolerance test
      • Exercise for desaturation test
      • Spirometry

        Spirometry is a simple, noninvasive test that measures how fast and deep you can breathe in and out when taking as large a breath as possible. Pulmonologists (lung specialists) think that, like a blood pressure measurement, spirometry should be a part of every routine check-up with your physician. The test is a fast and relatively easy way to spot changes in lung function.

        • How it's done: A person blows very hard and fast into a tube attached to the spirometer and a computerized sensor calculates and graphs the results. The results demonstrate an individual's air flow rates, including the volume forced out within the first second, which indicates whether or not there is airway obstruction. Spirometry also records the total volume of air forced out of the lungs.
        • The test does not require any special preparation.

          Exercise tolerance test

          The exercise tolerance test evaluates the ability of the heart and lungs to provide oxygen and remove carbon dioxide from the bloodstream before, during, and after exercise.

          • How it's done: Before the test, EKG electrodes are placed on your chest to monitor your heart function. Blood pressure will be taken before, during, and after the exercise, typically a workout on a stationary bicycle or a treadmill. A pulse oximeter (device used to determine the amount of oxygen in the blood) is placed on the earlobe or fingertip to monitor blood oxygen levels. If arterial blood gas samples are to be taken during the exercise, a catheter will be placed in an artery in your arm.
          • How to prepare: Continue to take all of your medicine as you usually do. Also, dress for exercise on the day of the test. Wear tennis (running) type shoes. Avoid wearing sandals, slippers, or high heels. Wear or bring a shirt or blouse that buttons down the front.
          • The exercise tolerance test often takes three hours.

            Exercise for desaturation test

            The exercise for desaturation test evaluates oxygen needs at rest and during exercise.

            • How it's done: Patients walk on level ground or on a treadmill at a comfortable pace for a maximum of six minutes per exercise period. Several six-minute walking exercise periods may be required. Patients may be asked to wear oxygen during the testing periods if their oxygen level is found to be low, either at rest or with exercise. A pulse oximeter (device used to determine the amount of oxygen in the blood) is placed on the earlobe or fingertip to monitor blood oxygen levels.
            • How to prepare: Continue to take all of your medicine as you usually do. Also, dress for exercise on the day of the test. Wear tennis (running) type shoes. Avoid wearing sandals, slippers, or high heels. Wear or bring a shirt or blouse that buttons down the front.
            • The exercise for desaturation test takes about 15 minutes.

              The six-minute walk is a measure of how far a person can walk on the level in six minutes. It is a useful way to assess functional impairment and to quantify improvement following participation in a regular exercise program.

              Imaging tests

              The following imaging techniques are useful in diagnosing and managing COPD:

              • Chest X-ray
              • Computed tomography (CT) scan of the chest
              • Bone-density test for the diagnosis of osteoporosis, a condition commonly associated with COPD
              • Chest X-ray

                A chest X-ray can show irregularities or damage in the lungs caused by COPD and other chronic lung diseases.

                • How it's done: Getting an X-ray does not hurt. Before the test you will need to remove all clothing and jewelry from the waist up. You will be given a hospital gown to wear. During the test, you may be asked to raise your arms above your head. You will also be asked to hold your breath for a few seconds. It is important to be still while the images are being taken.
                  • How to prepare: Wear clothing that is easy to remove from the waist up.
                  • Getting an X-ray takes about 10 minutes. Most of this time is spent in preparation.

                    Bone density test

                    A bone-density test is a special type of X-ray of the lower spine, hip, and forearm that can reveal whether your bones have thinned and are thus vulnerable to fractures. This is important because osteoporosis is a side effect of some medications given to treat COPD. It is more common in the elderly, especially in post-menopausal women.

                    • How it's done: Bone-density testing does not hurt. Before the study, you will need to remove clothing that has metal or other clothing fasteners like buttons or zippers over the areas to be measured. You will lie on an imaging table. The bone-density machine will scan your lower back, hip, and forearm. The technologist will ask you to hold still during each scan.
                      • How to prepare: On the day of the test, wear loose-fitting clothing and avoid clothing that has metal or other clothing fasteners like buttons or zippers over the areas to be measured. You can be given a gown to wear if this is not possible. Also, avoid having any barium studies done two to three days before the test.
                      • The bone-density test will last about 15 minutes. Each scan takes several minutes.

                        Computerized tomography scan of the chest

                        A CT enables your doctor to see organs in the chest in two-dimensional "slices." Doctors can spot emphysema much sooner on a CT scan than on a standard X-ray.

                        • How it's done: Getting a CT scan does not hurt. Before the study, you will need to remove all clothing and jewelry from the waist up. You will be given a hospital gown to wear.
                          • The CT scanner includes a table and a doughnut shaped ring that moves over the table. You will be asked to lie still on the table. The technologist will ask you to raise your arms above your head sometimes. You also will be asked to hold your breath for 10 to 12 seconds. While you hold your breath, the scanner will move from the top of your lungs to the bottom of the lungs and back. It is important to lie still while the images are taken. You may be asked to lie on your stomach while extra pictures are taken.
                            • Young children may have trouble lying still during the CT scan. If this is the case, a child may be given medicine to make him or her sleepy first.
                              • How to prepare: Wear clothing you can remove from the waist up. You will be given a gown to wear. Avoid having any barium studies done two to three days before a CT scan.
                              • A CT scan of the chest takes about 30 minutes. This includes 15 to 20 minutes for the test and 10 minutes for preparation.

                                Mucus culture

                                Some kinds of bacteria thrive in the mucus produced in the sinuses and airways of the lungs. A culture of this mucus can help identify an infection. Lung and/or sinus infections can complicate and/or mimic some symptoms of COPD.

                                • How it's done: In this test, you will be asked to cough up phlegm into a sterile container and bring it to the laboratory, where it will be cultured.
                                • Last reviewed on 11/9/09

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