Treating Copd

By Author: Steven Johnson
Total Articles: 494
Comment this article

The good thing about the modern world is the improvement in the distribution of research results. Before the internet came along, the only way of keeping up with all the latest scientific work in your field was to pay a subscription. This would bring the copy of the latest printed journal to your door. So expensive were these journal subscriptions that hospital libraries would buy in all the journals and make them available to staff. If you were a doctor in practice on your own, the only good thing about this system was the subscriptions were tax deductible. But there has been a change. Although many journals are still behind pay walls, i.e. the same high subscriptions are still in place, an increasing number now make free copies available online. Sometimes this is only the abstract. A pleasing number of times, you get a full report of the research and its findings. Doctors hate this because, in some cases, you may know as much as them. After all, it's your body and if there's something wrong with it, you are motivated to find out more about your own problems.

There's an unfortunate problem called Chronic Obstructive ...
... Pulmonary Disease (COPD). This is a long-term problem with your lungs. It may start off minor, but it steadily worsens and makes it harder for you to keep breathing. At first, it sounds and feels like asthma or bronchitis. Your chest feels tight, there's that terrible wheezing, you grow short of breath and cough. For those of you who like statistics, COPD is the cause of 10% of all hospitalizations. It's the fourth most common cause of death in the US.

Because this is a really serious problem, the standard treatment in a hospital or clinic has been corticosteroids delivered intravenously. This is one of those shock and awe treatments. To be honest about it, IV lines are quite painful, inconvenient and risky. Once in place, they deliver what, by most measures, are high doses of the drug for a relatively short period of time: usually between one and two days. Overall, this leads to longer periods of stay in hospital and, for the benefit of the hospitals, justifies a higher bill. If you have one, you are relieved you have a health insurance policy. If not, you hope the credit card will absorb the bill.

There's some new research comparing the current hospital approach to simply taking a low dosage course of Prednisone. Why make the comparison? Because more people needed follow-up treatment or died using the IV delivery system as against those simply taking the tablets. Doctors argued those on the drip were the more serious cases and so more likely to die. This research does not confirm that explanation. There's now clear evidence that people taking low doses of Prednisone have better outcomes, stay in hospital for shorter times and have lower bills. Giving you major doses of corticosteroids by IV guarantees a higher risk of side effects and complications. More is not always better than less. In this case, taking Prednisone is shown the better approach and hospitals should review their procedures for the treatment of COPD. Just because you go to hospital does not means you have to have a drip. A tablet or inhaled delivery is just as good.