What is COPD? Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases. It makes it difficult to breathe. There are two main forms of COPD: One is chronic bronchitis, which involves a long-term cough with mucus and the other is emphysema, which involves destruction of the lungs over time. Most people with COPD have a combination of both conditions. The leading cause of COPD is smoking . A person who smokes two packs per day is more likely to develop COPD than someone who smokes one pack per day.
Other risk factors for COPD are exposure to second hand smoke, air pollution and certain gases/fumes in the workplace.
One of the first symptoms is a cough with or without mucous, fatigue, dyspnea (shortness of breath) and many bouts of respiratory infections. Some other symptoms might be wheezing, and trying to catch one's breath.
The most useful test is for the doctor to listen to the lungs with a stethoscope. I do not think that many doctors have time to listen to their patients’ lungs. In the last years I am getting more involved in the physical diagnosis aspect of my patients’ health. I used to sit behind a desk (which I still do) but now I have an examination table in my office to better assess my patient’s health.
The best test for COPD is a lung function test called spirometry. This involves blowing out as hard as possible into a small machine that tests lung capacity. The results can be checked right away, and the test does not involve exercising, drawing blood, or exposure to radiation.
Many Americans die from emphysema from years of smoking. If not emphysema, then lung cancer. One of those individuals was William Griffith Wilson, also known as Bill W. I recommend the biopic film, Bill W. BILL W. is the inspirational story of Bill W, the founder of Alcoholics Anonymous. Young Bill was a hard worker and a quick learner. But there were always reasons to drink, and Bill became an alcoholic at a time when there was no support. Working with Dr. Bob Smith to organize an alcoholics’ support group in Akron, Ohio in 1935, Bill then expanded his ideas into the first 12-step recovery program. An engaging public speaker, his idea was to turn alcoholics’ interests toward others, so they wouldn’t be overwhelmed by their own difficulties. It was a truly inspirational story to watch. I teared up at many situations on the screen especially the real footage of Bill W. I am in awe of this truly gifted special man. He is one of the most engaging men of the 20th century and should never be forgotten. Next month I celebrate 31 years of sobriety
A study was published in the Annals of Internal Medicine involving COPD patients and the supplementation of Vitamin D. The supplementation was 100,000 units every 4 weeks which was equivalent to about 3,600 IU/day. The data concluded that high dose Vitamin D DID NOT decrease the incidence of exacerbations in patients with COPD. Vitamin D supplementation did decrease the exacerbation in patients with severe Vitamin D deficiency. The definition for severe was less than 10. There was a suggestion that high dose Vitamin D may exacerbate COPD in those without a severe deficiency (less than 10)
My conclusion is that the estimated daily dose is not enough. I do not consider 3,600 IU/day to be a high dose. Most of my patients take an average dose of 5,000 or greater
Until tomorrow…