Smoking, symptoms big COPD factors

Dear Dr. Roach: I was diagnosed with COPD a year and a half ago. I seem to be unable to get answers from my pulmonary doctor, as he is always busy.

How fast does COPD progress? I’m 78 years old, in reasonably good health and exercise regularly. I have chronic bronchitis with a slight amount of emphysema. I had been coughing a little during the day, had mucus in the morning and coughed at night for two to three hours after bedtime. After he put me on Trelegy, all of those symptoms disappeared.

My other question is what is the life expectancy of a person diagnosed with COPD? I would presume that it depends on other factors such as physical condition, exercise, weight, etc. But I would like some kind of guideline for someone in my condition. — T.J.

There are two major types of chronic obstructive pulmonary disease: chronic bronchitis, where the primary problem is productive cough; and emphysema, which is destruction of the small airways. Shortness of breath is a common feature of all types of COPD. The most prevalent cause is smoking.

I can’t answer your questions on rate of progression and overall prognosis without much more information, but it is certainly a good sign that many of your symptoms are well-controlled on treatment. The single biggest factor in rate of progression of COPD is whether you are a smoker, but not being able to exercise, being male and being very underweight are additional risk factors for faster progression. Lung function falls over time.

No medication can reverse lung damage. Inhaled steroids reduce inflammation and can slow progression somewhat. Your medication, Trelegy, is appropriate for people with severe COPD or those who do not have symptom control with a less intensive regimen.