COPD & Emphysema Treatments

The single most important step people with COPD can take to improve their health is to quit smoking. It is one of the only ways to prolong life for people with chronic lung disease.

We offer you individual sessions with pulmonary doctors to:

• Discuss smoking cessation strategies.
• Initiate medications to help you quit smoking.
• Enroll in smoking cessation programs.

To make an appointment to discuss smoking cessation, call the Division of Pulmonary, Critical Care and Sleep Medicine at 617-667-LUNG (5864). Ask to schedule a visit with a lung specialist.

You can receive free nicotine patches and counseling from a Massachusetts program called Quitworks.

If you have COPD or another lung disease, shortness of breath can impact your ability to go about your daily life. Simple activities like walking or climbing stairs can be very difficult if you cannot catch your breath.

We are happy to offer a comprehensive physical therapy program to help. Many research studies have proven the benefits of pulmonary rehabilitation in combination with other therapies.

Benefits of Pulmonary Rehabilitation

Our pulmonary rehabilitation program will help you:

• Learn more efficient breathing strategies during certain activities, such as climbing stairs.
• Manage chronic sputum production.
• Begin a supervised exercise program that includes:
  • Aerobic training such as walking or cycling.
  • Flexibility exercises.
  • Strength training.
• Increase your endurance to perform daily activities at home and in your community.

Most insurance plans cover pulmonary rehabilitation. The program is typically six to eight weeks long. You’ll experience small classes and individualized attention. You will need a doctor referral. For more information, please call 617-754-9100.

If distance prevents you from attending pulmonary rehabilitation at BIDMC, we can arrange for rehabilitation in a center that’s close to you with oversight from our BIDMC team. 

When COPD has severely damaged your lungs, they cannot deliver enough oxygen into your blood. In this situation, your doctor may recommend oxygen therapy. This treatment can:

• Improve breathing.
• Boost your energy levels.
• Help extend your lifespan.

Types of Oxygen Therapy

You may need oxygen only while sleeping or only while doing specific activities. It’s also possible that you may need it all the time. Portable systems deliver oxygen using a facemask or nose prongs (nasal cannula).

Some people may benefit from a transtracheal oxygen catheter. If your doctor suggests this method of oxygen therapy, a surgeon places a small flexible tube (catheter) into your windpipe on the lower part of your neck. The catheter delivers oxygen directly into the lungs.

Our lung care teams use many different medications — in different forms — to treat COPD. Your doctor may prescribe pills, liquids or inhaled medicine delivered directly to your lungs. We follow recommendations from the American Thoracic Society (ATS) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD). This ensures that you receive world-class care and treatment for your lung disease.

Types of Medications

You may need medication on a regular basis, or you may only need it when you have a flare-up of symptoms (exacerbation). Drug therapies can be as simple as one drug (monotherapy) or triple therapy. Triple therapy medication may include some combination of:

• Antibiotics that treat lung infections.
• Anti-inflammatory medicines, such as steroids, that reduce inflammation (swelling) in the lung airways.
• Bronchodilators that help to open the airways.
• Phosphodiesterase-4 (PDE-4) inhibitors, which reduce inflammation (swelling) and promote smooth muscle bronchodilation (relaxing the smooth muscle surrounding the lungs, which helps to widen the airways).

Our COPD Clinic can review your medicines to make sure you are taking the right type and dose. Our specialists can also advise you about any new treatments or medications that are available.

Our clinic will provide instruction on the correct use of inhalers. We’ll also provide an Action Plan for what steps to take when an exacerbation of chronic bronchitis occurs. Your Action Plan will include instruction on whether antibiotics or anti-inflammatory medications are the best choice for you.

Vaccines

It is important to receive the yearly vaccinations (immunizations) that your primary care doctor recommends. Vaccinations can protect against flu and pneumonia, as well as lessen your risk of respiratory infection. Respiratory infections can be especially serious if you have COPD. You may also need a booster vaccine for pertussis (whooping cough).

We offer medical treatments if you have alpha-1 antitrypsin (AAT) deficiency. This inherited disorder can lead to lung diseases such as emphysema. AAT is a protein that the liver makes. It protects your lungs and other body organs. When you have low levels of AAT, your lungs can break down over time.

If you have emphysema due to low AAT levels, you may benefit from infusions (medications delivered intravenously) of the AAT protein from human plasma. Over time, these infusions may slow the progression of emphysema and reduce your emphysema symptoms.

If you have COPD, you may experience breathing problems that interfere with your daily life. Robust treatment for COPD includes taking steps to minimize shortness of breath and maximize your quality of life.

Palliative care is specialized medical care for people with serious illness. Care focuses on providing relief from symptoms, pain and stress—whatever the diagnosis. The goal is to support you with COPD management and improve quality of life for both you and your family.

Palliative care offers expertise in:

• Assistance in complex medical decision-making.
• Pain and symptom management.
• Psychosocial and spiritual support.

Candidates for Palliative Care

You and your family may benefit from seeing the palliative care team if you:

• Are struggling to cope with a new serious diagnosis or with the changes of advancing illness.
• Are uncertain of how to decide which medical treatments are best for you.
• Have symptoms—such as pain or difficulty breathing—that are limiting your ability to function.
• Want more information about home-based services, including hospice.
• Want to focus your care on quality of life.

Inpatient and Outpatient Palliative Care Services

The COPD Clinic works with Palliative Care Consultation Services at BIDMC to help you and your family live as well and as fully as possible with COPD. If you’re spending time in the hospital, our palliative care consultation service can see you for a visit.

Outside the hospital, our Outpatient Palliative Care Clinic provides services for you and your family. Please call 617-667-1320 for more information.