Dr. Philip Diaz
Chronic obstructive pulmonary disease, most commonly known at COPD, has become the third-leading cause of death in the U.S. However, according to Dr. Philip Diaz of The Ohio State University Wexner Medical Center, the disease isn’t necessarily a death sentence.
Diaz has been practicing medicine since completing his fellowship in 1992 and currently serves as a professor of medicine, directing the COPD program as well as pulmonary rehabilitation at the medical center.
COPD is a disease so common there are over three million new cases each year in the U.S. alone. The disease refers to a long-term lung illness, which includes both emphysema and chronic bronchitis. The early warning signs of COPD include shortness of breath with activity, persistent cough with or without phlegm production, and tightness in the chest. Diaz says people diagnosed with asthma, which can have similar symptoms, shouldn’t be too concerned about COPD.
“Unlike asthma, COPD is progressive and, while both are common and there can be an overlap, there is only some evidence to suggest someone with asthma may be more at risk for COPD, but primarily if they smoke,” Diaz says.
Exposure to smoke inhalation damages the bronchial tubes and air sacs of the lungs, making the large majority of COPD cases related to cigarette smoking. While it’s uncommon to develop COPD from secondhand smoke, some occupations that have a risk of dust exposure and other factors can contribute to possible development of the chronic condition.
“You don’t have to be actively smoking to get COPD; the disease can develop years after someone has quit smoking, but 20 pack years is considered the threshold for getting COPD.”
A pack year refers to the number of cigarettes smoked per day over the course of a year. So, someone who smokes a pack a day for 20 years, or 20 pack years, is statistically more likely to have COPD.
The most important thing to know about COPD is that even if your doctor sees something on a chest x-ray, you shouldn't be satisfied until they have also checked your lung function.
“People come to see me with a COPD diagnosis but haven’t had lung function tests done. Those, as well as spirometry tests, can tell you your vital capacity, how much you can breathe out in one second, and much more,” says Diaz.
The tests are also predictive based on age, sex and height.
“There have been advancements in good therapies and some of the inhaled perspective." - Dr. Philip Diaz
There are four stages of COPD: early, moderate, severe and very severe. Life expectancy varies from stage to stage, especially because COPD is one of the most variable diseases, and can stabilize even in stage four.
“You have to look at the whole person, not just the lungs, to determine the stage and prognosis of COPD,” Diaz says. “Someone with stage four COPD could live anywhere from three to five years - and sometimes less than six months, but we’ve seen people live 10 or more years if they are otherwise healthy.”
While there’s currently no cure for COPD, there are several ways to manage the disease. If you are a smoker, it’s very important to stop immediately. Like any disease, the earlier you can catch and prevent it from progressing, the better. There are also medications, inhalers and exercise therapies to help manage the symptoms – even surgery in advanced cases. Diaz suggests pulmonary rehabilitation, an eight- to 12-week program, that is often covered by insurance and can make a world of difference for a COPD patient.
No one can be sure of what the future holds for patients with COPD, and Diaz indicates no magical cure is around the corner. However, there is hope for new methods to manage the disease.
“There have been advancements in good therapies and some of the inhaled perspective. Stem cell therapy has been advertised but has yet to be proven,” Diaz says. “I wouldn’t advise these therapies to someone unless they’re involved in a formal research study.”
There are myths you may have heard about COPD, like: “it’s the same for everyone,” “It’s a form of cancer” and “It always gets worse.”
This simply isn’t true.
“COPD is extremely variable, and can be stable for long periods of time,” Diaz says.
He also notes it is unusual to develop COPD before a person is in their 40s and 50s, but early onset COPD (defined as under the age of 55) is much more likely to be found in a woman than a man. Like most things in life, how you cope with it can affect your quality of life just as much the disease itself.
Diaz was named to the Castle Connolly list of Regional Top Doctors for the third time in 2018 and feels the most important part of his job is educating his patients, and allowing them to participate fully in their own care.
It’s a lot to take in, but COPD is not a death sentence. With early detection, education and advancements in treatments, living life to the fullest is still possible with the support of a professional like Diaz, whose mission is to support individuals to make good decisions and achieve the best quality of life possible.
Mallory Grayson is a contributing writer. Feedback welcome at feedback@cityscenemediagroup.com
