114: COPD Explained Clearly for Patients

Breathing out shouldn’t feel like pushing air through a straw, but for millions of people that’s the daily reality of COPD. We sit down and translate chronic obstructive pulmonary disease into plain English, starting with what the name really means and why the main problem is often getting air out, not just getting air in. If you’ve ever heard someone say they “can’t catch their breath,” we give you a clear picture of what may be happening inside the lungs.

We walk through a simple model of breathing using an upside-down tree and tiny balloon-like air sacs, then explain what changes in COPD: inflamed, narrowed airways and air sacs that lose their stretch. That combination can trap air, making each new breath feel harder than the last. We also talk about the slow burn of how COPD develops over time, why smoking is the most common cause, and how pollution, occupational dust or chemicals, secondhand smoke, and rare genetic factors can also play a role.

From there, we get practical. We cover common COPD symptoms (shortness of breath with activity, chronic cough, mucus, wheezing, fatigue), how spirometry helps diagnose airflow limitation, and what treatment can actually do. We discuss inhalers, pulmonary rehabilitation, oxygen therapy for advanced cases, and why staying up to date on flu, RSV, and COVID vaccines matters for people at higher risk. We also break down COPD exacerbations, the flare-ups often triggered by infections that can cause a step down in lung function, and why early prevention and timely care are so important.

Stick around for our post-medicine banter too. If this helped you understand your body a little better, subscribe, share it with someone who needs it, and leave a review so more people can find straightforward health education.

Transcript

Welcome To Your Checkup

SPEAKER_00 0:03

Hi, welcome to your checkup. We are the Patient Education Podcast, where we bring conversations from the doctor's office to your ears. On this podcast, we try to bring medicine closer to its patients. I'm Ed Delesky, a family medicine doctor in the Philadelphia area. And I'm Cole Ruffell, I'm a nurse. And we are so excited you were able to join us here again today. So what are we going to talk about today, Nick?

SPEAKER_01 0:26

Today we're talking about COPD, aptly known as COPID.

unknown 0:33

COPD. Just kidding.

SPEAKER_00 0:36

So we're talking about something that affects millions of people, but maybe doesn't always get explained in a way that really clicks. So, you know, we did an episode not too long ago about like what actually happens during a heart attack. So we're trying to sprinkle in some of these like very fundamental explanation teaching type episodes into our other stuff that we're mixing up. So we're trying to stay dynamic here. So we're talking about COPD. You may have heard that term before, maybe from a doctor, maybe from a family member, maybe you even have been told that you have it yourself. But what is COPD really? We're gonna break it down. Nikki, can you kick us off?

What COPD Actually Means

SPEAKER_01 1:19

COPD stands for chronic obstructive pulmonary disease, which is kind of a mouthful. So that's why we just use a little acronym. Um, so to break it down, chronic means long term. Obstructive means that something is blocking the airflow, and then pulmonary means your lungs. So in plain English, it is a long-term condition where it becomes hard to move air in and out of your lungs, and that's kind of the gist of it.

SPEAKER_00 1:55

And the issue is especially with getting air out of the lungs. So I'll take how breathing normally works.

How Healthy Breathing Works

SPEAKER_00 2:03

So if you think of your lungs, try to think of them as an upside-down tree. Your windpipe is the trunk, your airways are the branches, and at the ends are tiny air sacs like little balloons. And every time you breathe in, those balloons fill with fresh air. And oxygen transfers through and gets into the blood. Every time you breathe out, that balloon deflates and carbon dioxide leaves your body. It's really a beautiful system. It's simple, smooth, and efficient. So, what goes wrong in COPD, Nick?

SPEAKER_01 2:43

So there are two things that can happen to that tree. One are the branches are getting narrowed and inflamed. So that's like trying to breathe through through a straw instead of like a big windpipe. The second thing is the balloon loses its stretch. So it doesn't snap back the way it should. So instead of all of the air emptying fully, the air gets trapped.

SPEAKER_00 3:07

Yeah. So if you picture blowing up a balloon and then trying to blow it up again without fully letting the air out first, that's what breathing can feel like for people with COPD. You take a breath in, but then there's already air stuck inside.

Air Trapping And Narrowed Airways

SPEAKER_00 3:23

So now one feels short of breath, feels like they can't get a full breath, and breathing can even become work, where for other people it just happens automatically in the background. So, what causes COPD? The most common cause by far is smoking. Cigarettes expose your lungs to constant irritation and inflammation over years. But it's not the only cause. There can be long-term exposure to pollution, occupational exposures like dust or chemicals, secondhand smoke, and in rare cases, genetic conditions. The important takeaway here is that COPD doesn't happen overnight. It develops slowly over time. If we're to try to recognize it, Nikki, what are some common symptoms of COPD that people can notice?

SPEAKER_01 4:15

They'll often notice shortness of breath, especially with activity, a chronic cough, you might have some mucus or phlegm happening, um, wheezing, and then kind of overall feeling

Causes And Symptoms To Notice

SPEAKER_01 4:28

more tired than usual.

SPEAKER_00 4:30

And one thing to always keep an eye out, this kind of goes for beyond even COPD, is that if you're avoiding things you used to do because of your breathing, your body is trying to tell you something one way or another. There's lots of different reasons that people can have trouble breathing. COPD is one of them. So the next question is why COPD feels worse over time. So we'll think back to that trapped air. And over time, your lungs stay more inflated than they should. Your breathing muscles have to work harder. And even small activities like walking upstairs can feel exhausting. So it's it ends up not being just about oxygen, it's about the effort level of breathing, which really can become problematic. So the next question is how do we diagnose it? The main test is something called spirometry. Basically, to keep it simple, the concept of the test is measuring your breathing. One way to do that is you take a deep breath in and blow out as hard and as fast as you can, and in different time points that is measured with tubes and breathing machines. We measure how much air you can move and how quickly. If the airflow is limited in a certain pattern, that tells us COPD may be present. So, Nikki, can COPD be treated?

SPEAKER_01 5:56

It can.

SPEAKER_00 5:56

Wonderful. Can you tell us a little bit more about the treatment?

SPEAKER_01 6:00

You looked like you were gonna start talking. Yeah, so there are treatments, might not be able to completely reverse the damage that had been done, but you can absolutely improve your symptoms and your quality of life. So some things are like inhalers to help open up your airways. There is a special pulmonary rehab doing structured exercises and breathing training to help oxygen therapy in more advanced cases, um, and vaccines to prevent infections, which can worsen symptoms. And most importantly, stop smoking if applicable. It's the single most powerful step. And it's 2026. We're not smoking anymore.

SPEAKER_00 6:46

Yeah.

SPEAKER_01 6:46

So stop.

SPEAKER_00 6:47

Stop or don't. As if it's that easy. Yeah, or ask ask for help to try to stop um nicotine, hell of a drug. Um is there a COPD vaccine? A COPD vaccine? Well, yeah, this is a good bump out.

SPEAKER_01 7:02

Um obviously it's not a vaccine for COPD, but correct. Yeah, yeah.

SPEAKER_00 7:06

Um, great question, but no. Um, but like flu becomes like not like anything.

SPEAKER_01 7:13

Not for you.

SPEAKER_00 7:14

This is for them. That like flu becomes super important. Uh RSV came out in the last five-ish years, that was super important. And COVID vaccines also are very important for people with COPD. Like you are one with COPD is considered high risk. So an exacerbation, people may have heard about this. So a COPD exacerbation. This is when things with COPD and breathing suddenly get worse. People with COPD can have flare-ups called exacerbations. This may look like suddenly worse shortness of breath, more coughing, and a change in mucus color or amount. These are often triggered by infections. And this matters because each flare-up can cause a step down in lung function. So early treatment and prevention, like we were just talking about, is key. So living with COPD. If you or someone you love, it's not like a mesothelioma commercial, has COPD, here's what we would want you to know. This is a condition you can live with and live well with, and that small steps make a big difference. Staying active, using medications correctly as advised, avoiding triggers of symptoms, and keeping up with checkups can be really important. And most importantly, understanding what's happening in your body gives you control. So we have some take-home points. And to bring it all together, we will say COPD is a long-term condition

Diagnosis Treatment And Flare Ups

SPEAKER_00 8:49

that makes it hard to move air out of your lungs. Air gets trapped like a balloon that won't fully deflate. Smoking is the most common cause, but not the only one. Symptoms include shortness of breath, cough, and fatigue. And while it's not truly reversible, it is treatable and an early understanding can lead to better outcomes. In this episode, we helped explore COPD and help you understand it a little more clearly. If you want to share it with someone who might benefit, please feel free. This is free educational material we make out of the kindness of our own hearts. So please share away. Um, it is balanced and evidence-based. We're not trying to sell you anything here. But ultimately, because the more we understand our bodies, the better we can take care of them.

Memorial Day Stories And Gym Moments

SPEAKER_00 9:41

And now for the banter. Um, there's like so many good things that happen, but also like some funny things that like aren't appropriate for this venue that we can't explain. But maybe we start with the gym commentary.

SPEAKER_01 9:54

I'm curious what else is inappropriate.

SPEAKER_00 9:57

My bodily functions were like probably not something that I want to share here. But beyond that, nah, the rest of it was fine. Um, it's coming to you on Memorial Day. Shout out Memorial Day. Um it's a wet and wild one. Not really wild, but it was certainly wet. It was moist and misty, um, where we spent our time this weekend. Um we I've been having a lot of fun with those brigantine news things.

SPEAKER_01 10:29

Well, you've been yeah, Eddie's been doing some pro bono work for the city of Brigantine. Some pro bono journalism.

SPEAKER_00 10:39

Yeah, yeah, I was able to highlight the brigantine bazaar, the farmer's market, despite the rainy conditions.

SPEAKER_01 10:47

He had an exclusive interview with a local.

SPEAKER_00 10:49

Yes, the local mute, who ended up just being my brother-in-law. Um, but he was out there. Um, he was a good sport. I don't think he wanted to do it at all, but then he he was a good sport. But then he made two features. Um, one of them I have to put together, um, where he like grabbed the the bacon.

SPEAKER_01 11:08

Yeah, that's funny.

SPEAKER_00 11:09

The what was it? The preposterous pork propaganda pleasing people.

SPEAKER_01 11:17

I don't know.

SPEAKER_00 11:18

Politely.

SPEAKER_01 11:19

I forget.

SPEAKER_00 11:19

Yeah, it was very alliterative. Um, but luckily we've been able to go to the gym quite a bit, and you you're really excited to talk about this, like by gym commentary.

SPEAKER_01 11:28

Oh my god, it's so funny. So there have been two recent instances where this is now becoming a fun little gym habit that you have.

SPEAKER_00 11:39

Speaking too loud.

SPEAKER_01 11:40

You just like outwardly comments on like someone's something something that someone is doing. And so a few weeks ago, we were at the gym, and it's one of those gyms where like downstairs is the weights and stuff, and then upstairs are the treadmills and the other cardio equipment. So someone was on a treadmill that kind of overlooks the weight area that we were in, and you hear like thud, thud, thud, thud throughout the whole gym. The whole gym. And Eddie like looks up and then he's looking around. And he goes.

SPEAKER_00 12:24

I know. Whenever you think about this, you start cracking up because then the second one happened, which like people have to like edit the language a little bit, but who is so is bounding like a gazelle?

SPEAKER_01 12:52

Just like like yelling throughout the gym and like looking around.

SPEAKER_00 12:57

Hands up, looking at the sky.

SPEAKER_01 13:00

And then Friday, we're like we're at the gym, and uh someone passed some gas. So I see Eddie like I'm laying down on the bench, and Eddie's like above me and behind me, and I just see his face. It looks like he smelled a fart. I could not smell anything, but then he's like making this looking around, and then he goes kind of loudly. So funny. He goes, Oh, somebody pooped themselves.

SPEAKER_00 14:00

What there were three people around, and it wasn't either of us, and there were two other guys before, and then she starts like crying laughing like she is right now because like then she starts thinking about the gazelle comment, and she's like, How is this happening? Actually, literally using her blanket that she's wrapped in, like a babushka right now to dry her crying tears.

SPEAKER_01 14:25

It was so funny.

SPEAKER_00 14:27

Oh my god, yeah. We had a great people's behavior at the gym. Look, I I don't care for the the social contract that is apparently in place at the gym. Like, I'm gonna I'm gonna do what I want.

SPEAKER_01 14:42

Listen, if you're gonna do something that smells like you pooped yourself, then like fair game. Someone's gonna comment on it.

SPEAKER_00 14:50

I'm gonna say it out loud. I'm not gonna make anyone feel bad, but you know, I'm gonna say that I recognized it. Oh yeah, the the the first exclaim of like just disgust is yeah, no guys, this is literally how we entertain ourselves. Um, and it just happens randomly. This is not not planned humor, but I am so lucky that I can just say what comes to mind, and Nikki is just like all about it and it keeps her giggling for hours. Oh my god. Hours. So funny. Did we got um we were able to get access to a summer membership at the the beach gym?

SPEAKER_01 15:32

Yeah, beach gym. We played Rommy Cube.

SPEAKER_00 15:35

Oh my god. We're we're hit us up if you know what Romy Cube is.

SPEAKER_01 15:39

That's so fun.

SPEAKER_00 15:41

We love it.

SPEAKER_01 15:41

I just ordered one for us. Did you? Uh huh.

SPEAKER_00 15:43

Oh, that's great.

SPEAKER_01 15:44

I overnight it from Amazon. So hopefully no one steals it in between the hours of four and eight a.m.

SPEAKER_00 15:51

We um you like uh a mental puzzle like this, ergo like the puzzles that you work on, but I was resistant initially, but I'm I love that game. It's great, and it's like you could do two person and like we could just like sit somewhere and just do it together.

SPEAKER_01 16:08

Yeah, that's how we had our coffee this morning.

SPEAKER_00 16:11

It's so cute. And then like if either of us wins, we're just happy for the other person.

SPEAKER_01 16:15

Yeah.

SPEAKER_00 16:17

So that's great. I'm so excited. I love Romney Cube. And then I was able to get my cheese pocket for celebration of Memorial Day. That was terrific. What else happened this week? My goodness.

SPEAKER_01 16:32

We went to the Elks.

SPEAKER_00 16:34

We did go to the Elks Club. We did. We um We know a member.

SPEAKER_01 16:41

We know a member.

SPEAKER_00 16:42

I don't know like how much we're allowed to speak on various things because they're weird and I don't want to get anyone in trouble. But we did go there. We did. That was great. We were pretty low on the fridge. In terms of items in the fridge.

SPEAKER_01 17:03

At the beach?

SPEAKER_00 17:04

No, here. No, the beach was stocked.

SPEAKER_01 17:07

Oh, yeah, we have no food.

SPEAKER_00 17:12

I am really considering that age go cheese.

SPEAKER_01 17:16

Yeah, we have like eggs and leftover pizza from last week and condiments in the fridge. It's pretty bleak right now.

SPEAKER_00 17:26

Yeah.

TV Talk Migraine Aura And Wrap Up

SPEAKER_00 17:27

Oh, wait. Well, we haven't been talking to people, and I'm kind of excited for us to do this because um we're watching uh a hockey television show most recently. Um, but the uh, and not in the way that you think. Um, your friends and neighbors. We haven't talked about it. But we have an episode too. Yeah, we have a new episode, and it is right in line with like the rich people behaving poorly, but it is like a commentary on hedonic capitalism. And it's actually really good. It's John Ham's the guy, and well, he's the main character at least, and it's on Apple TV, which we I guess you didn't know that we had Apple TV for a while. I thought, oh wait, maybe we already did talk about this because we had the Apple TV bit. Are you gonna explain this new this new number at all?

SPEAKER_01 18:18

My glasses, I just put my glasses on. I forgot them this weekend. I wonder if well, I probably still would have had a migraine. I had a migraine aura for the first time. That was kind of scary.

SPEAKER_00 18:31

That was a little scary. Especially first time.

SPEAKER_01 18:36

Yeah. That was like definitely what it was, though. Yeah, it only lasted a couple minutes and then I had a migraine when I woke up.

SPEAKER_00 18:42

Yeah, especially after the headache. So that was that was a nice one to just be like, that was your visual disturbance. Plus you like went to the eye doctor recently and they told you you had normal healthy eyes except for a little convection problem. Yeah. So thank you for coming back to another episode of Your Checkup. Hopefully, you were able to learn something for yourself, a loved one, or a neighbor. You can find us on Threads, you can send us an email, and you can send this to a loved one or a neighbor so that they can learn something. But most importantly, stay healthy, my friends. Until next time, I'm Ed Deleski.

SPEAKER_01 19:16

I'm Nicole Rupo.

SPEAKER_00 19:17

Thank you and goodbye.

SPEAKER_01 19:18

Bye.

Medical Disclaimer And Final Reminder

SPEAKER_00 19:21

This information may provide a brief overview of diagnosis, treatment, and medications. It's not exhaustive and is a tool to help you understand potential options about your health. It doesn't cover all details about conditions, treatments, or medications for a specific person. This is not medical advice or an attempt to substitute medical advice. You should contact a healthcare provider for personalized guidance based on your unique circumstances. We explicitly disclaim any liability relating to the information given or its use. This content doesn't endorse any treatments or medications for a specific patient. Always talk to your healthcare provider for a complete information tailored to you. In short, I'm not your doctor. I am not your nurse. And make sure you go get your own checkup with your own personal doctor.