COPD Diagnosis Explanation

Question 1

Opening

Answer 1

WIPE

Question 2

Background history

Answer 2

Symptoms
-SOB, worse on exertion
-chronic productive cough
-wheeze
Onset
-typically in older population but can be younger if a1antitrypsin deficient)
Triggers and things that alleviate it
Smoking and occupation
FHx

Question 3

Understanding and ICE

Answer 3

Do you have any thought on what could be causing your symptoms?

Do you have any worries or concerns about your symptoms

What would you like to achieve from this conversation today

What do you understand when I say COPD?

Question 4

Explanation

-Normal physiology/anatomy

Answer 4

When you breathe in, air moves into your lungs via a branching network of airways that get progressively smaller so oxygen can enter your blood and supply your whole body

Question 5

Explanation

-What is COPD

Answer 5

However, with COPD there are 2 ways in which this process can be impaired

• emphysema is where your smallest airways collapse as they lose their elasticity
• if the airways are collapsed, air cannot move beyond that area => less oxygen enters the blood
• bronchitis is where your your larger airways get inflammed which releases mucus and this narrowing of the airway makes is harder to move air in and out of the lungs => less oxygen enters the blood
• both mechanisms can lead to feeling short of breath, productive cough, wheezy, tight chest

Question 6

Explanation

-Causes of COPD

Answer 6

There are many including

• age
• smoking, working in construction, pollution
• FHx
• genetics

Question 7

Explanation

-Problems with COPD

Answer 7

Its a lifelong condition

• exacerbations, where you experience severe symptoms that are not relieved with inhalers => can worsen lung function
• if this happens, seek urgent attention
• worsening symptoms despite following treatment plan => review current treatment to adjust it if needed
• increased susceptibility to chest infections => get flu vaccine, pneumonia vaccine

Question 8

Explanation

-Management of COPD

Answer 8

Aims of management

• no daytime or disruptive nightime symptoms
• reduce incidence of exacerbations
• to get to a point where your day to day activities are not disrupted by your symptoms
• its important to mention that COPD cannot be cured but its progressions can be slowed or stopped

A typical management plan

• lifestyle changes (smoking cessation, weight loss and exercise)
• vaccinations (flu, pneumonia)
• physiotherapy (pulmonary rehabilitation for exercises and support on how to manage symptoms)
• medications (SABA, LABA, LAMA, ICS)

Question 9

Summarise

Answer 9

So just to summarise, today we have discussed

• your experiences with COPD and how it affects you
• what should normally happen and how COPD affects your lungs
• what causes COPD and some problems that can occur and when you should talk to a doctor
• the typical treatment plan for someone with COPD

Do you have any questions?
If you have any questions after today, feel free to contact your GP, 111 or look at the NHS page on COPD.