Inhalers Use Various Methods to Ease COPD Symptoms

Q:  I am writing in regard to chronic obstructive pulmonary disease (COPD). I use three inhalers, but to me that seems too many. The inhalers are Serevent, Albuterol and Azmacort. Are all three necessary? Why is it hard to breathe after I eat? Are there any foods I should stay away from?

Plus, I was in a fire accident and fell from a two-story window, and my lungs collapsed. I have been on continuous oxygen since that happened. Will I ever be off oxygen again? Before, I only had to use it when I would do chores and at night when I went to bed.

A:  COPD affects 14 million people in the United States – mainly middle-aged and elderly people – and is the fourth leading cause of death. Cigarette smoking is the main cause of this disorder, but allergies, air pollution, and, in your case, smoke inhalation damage are also contributors. Inhalers don't actually "cure" the disease, but help with symptoms of shortness of breath or wheezing.

All three of your inhalers are a little different. Serevent and Albuterol are both bronchodilators, which help open up the large bronchial tubes to your lungs, but Serevent is long-acting so can be used just twice a day. People with severe COPD often feel better if they use short-acting Albuterol every four hours. Otherwise Albuterol, which acts quickly, can be saved for when your breathing gets hard, before you go walking, or if you start coughing or wheezing. Azmacort is a steroid that is supposed to decrease inflammation (swelling) of the airways. Its benefit is a bit more controversial. Some studies suggest that it may help reduce COPD exacerbations (flares) and improve overall quality of life.

More trouble breathing after eating probably has at least two reasons. Chewing and digesting food take energy, which makes your heart and lungs work harder. A full stomach presses on the diaphragm so the lungs can't expand as fully. Milk products may create more mucus, which clogs your nose and lung passages.

It is possible the extra lung damage you suffered from the fire may heal, and you could return to wearing oxygen only at night. We try to keep the oxygen blood saturation above 92% (that can be measured from your finger). Keep your spirits up – if you can live on after a fall from a second story, you're a true survivor!