For COPD Awareness Month, a top pulmonologist clears the air about chronic obstructive pulmonary disease as he shares new and emerging treatment options.

November is Chronic Obstructive Pulmonary Disease (COPD) Awareness Month—a chance to educate the public on this serious lung disease that affects 16.4 million adults in the U.S., according to the American Lung Association (ALA), and to provide resources for those diagnosed with the disease to help them live fuller, more active lives. Awareness is clearly needed: Despite being largely a preventable disease, rates of COPD are expected to grow 23% in the next 25 years, according to projections in a 2023 study in the Journal of the American Medical Association. Today, the ALA estimates that more than 300 million people worldwide could be living with COPD.

The good news? There are more effective therapies available for COPD today than even just a decade ago, offering hope for higher quality of life and breathing function for people living with this condition. To provide insight on the current COPD landscape—and share some promising developments that may be coming just around the corner—we spoke with Jordan Lee, M.D., a pulmonary critical care specialist at Queen’s Pulmonary and Critical Care Group in Honolulu, HI, and panelist for the ALA’s upcoming webinar on COPD management.

HealthCentral: How have COPD treatment options improved during the past 10 years?
Jordan Lee, M.D.: When I was first going through medical training in 2014, we would always treat COPD patients with just one or two inhalers: a long-acting muscarinic agent to relax airway muscles, as well as a long-acting beta agonist, like a bronchodilator, which also relaxes tightened muscles. Those are still very helpful but in general, we have a better understanding now when it comes to the pathophysiology of COPD and how it’s affected by chronic airway
Because of that, there’s been a shift toward triple therapy for COPD, which includes those two options, as well as inhaled corticosteroids. That’s become the gold standard because it’s hitting three different pathways in the respiratory system, leading to better breathing. This [approach] reduces symptoms and lowers the rate of COPD exacerbations in a year.

HC: What makes you most hopeful about emerging and experimental COPD therapies?
Dr. Lee: What’s fascinating right now is the use of biologic therapy, which are injectable medicines that can dampen the inflammatory process in the lungs. For example, Dupixent [dupilumab] was just approved by the FDA last year, and it’s already an exciting option, particularly for patients who have both asthma and COPD, or who have moderate-to-severe COPD alone. Biologics, in general, are showing good response rates, especially for those who don’t respond to triple therapy, so I expect this to be an area that expands with more usage and more data.

Another option that’s likely to be promising for the future is a procedure called an endobronchial valve, which is minimally invasive and addresses issues in the upper regions of the lungs. In the past, surgery would have required a more extensive, open-chest procedure—a lung volume reduction—in which damaged parts of the lungs are removed so the healthier parts can expand, and blood flow can be redistributed to those areas. While that’s still an option for some patients, use of the valve can have the same effect without being a major operation that requires much more recovery time.

HC: Is COPD reversible if you begin treatment in its earliest stages?
Dr. Lee: For the most part, those with COPD have had years of exposure to some type of damaging substance, usually cigarette smoke, which is the majority of COPD cases. But there can also be secondhand smoke or environmental toxins. Unfortunately, these patients have long-term damage that’s not reversible, although the symptoms can be managed. Unlike the liver, which has a degree of regenerative capacity, the lungs are not as resilient. Once they’re damaged, you’re kind of stuck. However, it’s true that beginning treatment as early as possible can have some effect, especially if it involves smoking cessation, so you’re not continuing to damage lung tissue.

If you have COPD, you know the main symptoms all too well: the shortness of breath, the persistent cough, the fatigue. But what about the other health issues that often show up uninvited? The truth is, COPD rarely travels alone. It often brings along other chronic conditions—known as comorbidities—that can complicate your health picture.

Understanding these connections is crucial because treating COPD isn’t just about your lungs; it’s about managing your whole health.

The Usual Suspects: Who Else Might Be at the Table?

1. Heart Disease: This is the most common and serious partner to COPD. The strain of low oxygen levels and inflammation can weaken your heart over time. Conditions like high blood pressure, heart failure, and coronary artery disease are frequent companions. Action Step: Monitor your blood pressure and report any new chest discomfort or swollen ankles to your doctor immediately.
2. The Anxiety and Depression Duo: Struggling to breathe is terrifying. It’s no wonder that feelings of panic, anxiety, and depression are common. This isn’t a “weakness”—it’s a physiological and emotional response. Action Step: Talk to your doctor about these feelings. Counseling, support groups, and sometimes medication can dramatically improve your quality of life.
3. Osteoporosis: Weakened bones are more common in people with COPD. This can be due to chronic inflammation, long-term use of corticosteroid medications, and reduced physical activity. Action Step: Ask your doctor about a bone density scan and ensure you’re getting enough calcium and Vitamin D.
4. Sleep Apnea: When COPD and sleep apnea occur together, it’s called “Overlap Syndrome.” This combination is particularly dangerous, leading to even lower oxygen levels at night. Action Step: If you snore loudly, wake up gasping, or feel exhausted despite a full night’s sleep, ask your doctor about a sleep study.

Managing COPD is a team sport, and your team captain—your primary care doctor—needs to see the whole playing field. By keeping an eye on these “other guests,” you can create a comprehensive health plan that protects more than just your lungs.

When people look at you, they see your physical self. They might notice you get winded easily. What they can’t see is the invisible weight you carry every day: the frustration, the grief for the life you once had, the anxiety about your next breath, and the loneliness that can come with a chronic illness.

This emotional burden is real, and it’s heavy. Acknowledging it is the first step toward lifting it.

Tending to Your Emotional Landscape:

1. Grieve, Then Grow: It’s normal and healthy to grieve the loss of your former abilities. Allow yourself to feel that sadness. But don’t set up camp there. The goal is to acknowledge the loss, then slowly begin building a new, fulfilling life within your current capabilities.
2. Break the Isolation Cycle: COPD can be an isolating disease. You cancel plans because you don’t feel well, and soon, people stop inviting you. Fight this cycle. Be the one to initiate contact. Invite a friend over for a cup of tea and a chat. A short, seated visit can do wonders for your spirit.
3. Find Your New Tribe: Sometimes, the people who understand you best are those walking the same path. A COPD support group (in-person or online) can be a lifeline. It’s a place to share tips, vent without judgment, and be reminded that you are not alone in this fight. Your “tribe” gets it.
4. Redefine Your Purpose: Maybe you can’t coach the soccer team anymore, but you can share your wisdom in other ways. Could you mentor a young person over the phone? Write down your family stories? Finding a new sense of purpose, no matter how small it seems, gives you a reason to get up in the morning and shifts your focus from what you’ve lost to what you still have to give.

Your mental health is the foundation upon which everything else is built. By caring for your mind and spirit with the same diligence you care for your lungs, you build the resilience needed not just to live with COPD, but to live well.

Let’s talk about a dirty little secret in COPD care: most people are using their inhalers all wrong. Studies show that up to 90% of patients don’t use their devices correctly. Think about that. You could be doing everything else right—taking your walks, eating well—but if that vital medicine isn’t getting deep into your lungs where it belongs, you’re just going through the motions.

It’s like having a key to your front door, but fumbling with the lock. You never quite get inside. The result? Poor symptom control, more flare-ups, and a feeling that your treatments “just don’t work.”

The Usual Suspects: Where Your Inhaler Routine Goes Wrong

Different inhalers have different tricks. Here’s where things often fall apart:

• The Spray-and-Pray (Metered-Dose Inhalers): The classic “puffer” requires a perfect sync between pressing the canister and breathing in slowly. A split-second mistiming, and the medicine sprays onto your tongue or the back of your throat instead of your airways.
• The Weak Suck (Dry Powder Inhalers): These devices don’t spray; they require you to breathe in forcefully and deeply to pull the powder out. A gentle, shallow breath won’t cut it.
• The Exhale Fumble: Blowing into your inhaler before you inhale can ruin the dose in a dry powder device.
• The Forgotten Hold: Not holding your breath for 5-10 seconds after inhaling means the medicine doesn’t have time to settle in your lungs.

Take Control: Become the Boss of Your Puffs

You don’t have to be part of that 90%. You can make sure every dose counts.

1. Demand a Demo. Don’t Just Nod. The next time you see your doctor or pharmacist, don’t just say “I’ve got it.” Bring your inhaler and show them your technique. Let them coach you. There’s no shame in getting it right.
2. Ask About a Spacer. If you use a metered-dose inhaler (puffer), a spacer or valved holding chamber is a game-changer. It acts like a middleman, holding the medicine in a chamber so you can inhale it slowly and deeply, with no timing required. It dramatically improves how much medicine reaches your lungs.
3. Stick to the Script. Rescue inhalers (like albuterol) are for sudden symptoms. Maintenance inhalers are for every day, whether you feel great or not. Using your maintenance meds consistently is what keeps the inflammation down and prevents bad days. Skipping them because you “feel fine” is like canceling your insurance right before a storm.

Your inhaler is one of the most powerful tools in your toolbox. But a tool is only as good as the person using it. Take the time to master it. Your lungs will thank you for it.

You know that little chirp your smoke alarm gives when the battery is low? It’s annoying, but you learn to ignore it… until it stops, and you forget about it entirely. Now, imagine that chirp is your body.

For many folks, COPD starts not with a bang, but with a series of subtle, easy-to-dismiss chirps. We’re masters at making excuses: “I’m just getting older,” “I’m out of shape,” or “It’s just a smoker’s cough.”

But what if your body is trying to sound a real alarm? Ignoring the early signs of COPD is like disconnecting that smoke alarm while a fire slowly smolders in the walls.

Decode the Chirps: Is Your Body Trying to Tell You Something?

Stop for a moment and listen. Have you noticed any of these “chirps”?

• The “I’m Just Out of Shape” Chirp: Do you find yourself catching your breath doing things that used to be easy? Taking the elevator for one flight? Avoiding a walk with your spouse? This isn’t about fitness; it’s about your lungs struggling to keep up.
• The “Morning Cough” Chirp: That daily cough that brings up phlegm isn’t normal. Writing it off as “just part of my routine” is ignoring a key early warning sign.
• The “I’m Always Tired” Chirp: Feeling constantly worn out, even after a full night’s sleep? Your body may be working overtime just to breathe, leaving no energy for anything else.
• The “Whistling Chest” Chirp: Do you or your loved ones hear a faint whistling or rattling sound in your chest when you breathe? That’s not just a quirk; it’s the sound of air struggling to move through narrowed airways.

From Chirp to Clarity: Your Next Step is Simpler Than You Think

Hearing these chirps can be scary. The fear of what the doctor might find is a powerful reason to stay put. But knowledge is power, and clarity is a gift you give your future self.

The first step isn’t scary or painful. It’s a conversation. Talk to your doctor about your symptoms. They might suggest a simple, painless test called spirometry, where you blow into a tube. It’s the gold standard for checking how well your lungs are working.

Finding out early is a game-changer. It gives you the maximum power to slow the disease’s progress, protect your lungs, and preserve your quality of life for years to come.

Don’t wait for the alarm to become a siren. Listen to the chirps. Your future self will thank you for it.

Living with COPD means you have a limited amount of energy each day, just like a fixed budget. The key to a good day isn’t about having more energy; it’s about spending the energy you have wisely. Pacing yourself is the secret weapon.

Here are some real-world, practical “life hacks” to help you stretch your breath and save your energy for the things you love.

Your Daily Energy-Saving Toolkit:

• Sit Down to Win: You’d be amazed how much energy you can save by sitting down for tasks. Get a sturdy stool for the kitchen to use while prepping food, washing dishes, or even ironing. Sit down to dress yourself—it’s safer and conserves energy.
• The Push & Slide Rule: Instead of lifting heavy objects like a laundry basket, push or slide them along the floor. Or, invest in a small, wheeled cart. Lifting heavy items requires a burst of breath-holding and effort you can’t afford.
• Breathe Smart, Work Smart: Use pursed-lip breathing during an activity, not just after. When you’re doing something exerting (like climbing stairs or vacuuming), inhale through your nose before the effort, and exhale slowly through pursed lips during the hardest part. This keeps your airways open and prevents you from getting as winded.
• Wardrobe Wisdom: Ditch the tight clothes and complicated fastenings. Opt for loose-fitting garments, stretchy waistbands, and shoes with Velcro or slip-ons. Struggling with buttons and zippers uses up precious energy before you even leave the house.
• Plan and Group: Plan your week to avoid doing multiple big tasks on the same day. If Monday is grocery day, don’t schedule a doctor’s appointment and a cleaning spree for the same day. Space out your activities to allow for recovery.

Think of these strategies not as giving in to your condition, but as outsmarting it. By working smarter, not harder, you can reclaim your independence and enjoy your day with less fatigue.

From Chirp to Clarity: Your Next Step is Simpler Than You Think

Hearing these chirps can be scary. The fear of what the doctor might find is a powerful reason to stay put. But knowledge is power, and clarity is a gift you give your future self.

The first step isn’t scary or painful. It’s a conversation. Talk to your doctor about your symptoms. They might suggest a simple, painless test called spirometry, where you blow into a tube. It’s the gold standard for checking how well your lungs are working.

Finding out early is a game-changer. It gives you the maximum power to slow the disease’s progress, protect your lungs, and preserve your quality of life for years to come.

Don’t wait for the alarm to become a siren. Listen to the chirps. Your future self will thank you for it.

You know that little chirp your smoke alarm gives when the battery is low? It’s annoying, but you learn to ignore it… until it stops, and you forget about it entirely. Now, imagine that chirp is your body.

For many folks, COPD starts not with a bang, but with a series of subtle, easy-to-dismiss chirps. We’re masters at making excuses: “I’m just getting older,” “I’m out of shape,” or “It’s just a smoker’s cough.”

But what if your body is trying to sound a real alarm? Ignoring the early signs of COPD is like disconnecting that smoke alarm while a fire slowly smolders in the walls.

Decode the Chirps: Is Your Body Trying to Tell You Something?

Stop for a moment and listen. Have you noticed any of these “chirps”?

• The “I’m Just Out of Shape” Chirp: Do you find yourself catching your breath doing things that used to be easy? Taking the elevator for one flight? Avoiding a walk with your spouse? This isn’t about fitness; it’s about your lungs struggling to keep up.
• The “Morning Cough” Chirp: That daily cough that brings up phlegm isn’t normal. Writing it off as “just part of my routine” is ignoring a key early warning sign.
• The “I’m Always Tired” Chirp: Feeling constantly worn out, even after a full night’s sleep? Your body may be working overtime just to breathe, leaving no energy for anything else.
• The “Whistling Chest” Chirp: Do you or your loved ones hear a faint whistling or rattling sound in your chest when you breathe? That’s not just a quirk; it’s the sound of air struggling to move through narrowed airways.

From Chirp to Clarity: Your Next Step is Simpler Than You Think

Hearing these chirps can be scary. The fear of what the doctor might find is a powerful reason to stay put. But knowledge is power, and clarity is a gift you give your future self.

The first step isn’t scary or painful. It’s a conversation. Talk to your doctor about your symptoms. They might suggest a simple, painless test called spirometry, where you blow into a tube. It’s the gold standard for checking how well your lungs are working.

Finding out early is a game-changer. It gives you the maximum power to slow the disease’s progress, protect your lungs, and preserve your quality of life for years to come.

Don’t wait for the alarm to become a siren. Listen to the chirps. Your future self will thank you for it.

Let’s talk about a dirty little secret in COPD care: most people are using their inhalers all wrong. Studies show that up to 90% of patients don’t use their devices correctly. Think about that. You could be doing everything else right—taking your walks, eating well—but if that vital medicine isn’t getting deep into your lungs where it belongs, you’re just going through the motions.

It’s like having a key to your front door, but fumbling with the lock. You never quite get inside. The result? Poor symptom control, more flare-ups, and a feeling that your treatments “just don’t work.”

The Usual Suspects: Where Your Inhaler Routine Goes Wrong

Different inhalers have different tricks. Here’s where things often fall apart:

• The Spray-and-Pray (Metered-Dose Inhalers): The classic “puffer” requires a perfect sync between pressing the canister and breathing in slowly. A split-second mistiming, and the medicine sprays onto your tongue or the back of your throat instead of your airways.
• The Weak Suck (Dry Powder Inhalers): These devices don’t spray; they require you to breathe in forcefully and deeply to pull the powder out. A gentle, shallow breath won’t cut it.
• The Exhale Fumble: Blowing into your inhaler before you inhale can ruin the dose in a dry powder device.
• The Forgotten Hold: Not holding your breath for 5-10 seconds after inhaling means the medicine doesn’t have time to settle in your lungs.

Take Control: Become the Boss of Your Puffs

You don’t have to be part of that 90%. You can make sure every dose counts.

1. Demand a Demo. Don’t Just Nod. The next time you see your doctor or pharmacist, don’t just say “I’ve got it.” Bring your inhaler and show them your technique. Let them coach you. There’s no shame in getting it right.
2. Ask About a Spacer. If you use a metered-dose inhaler (puffer), a spacer or valved holding chamber is a game-changer. It acts like a middleman, holding the medicine in a chamber so you can inhale it slowly and deeply, with no timing required. It dramatically improves how much medicine reaches your lungs.
3. Stick to the Script. Rescue inhalers (like albuterol) are for sudden symptoms. Maintenance inhalers are for every day, whether you feel great or not. Using your maintenance meds consistently is what keeps the inflammation down and prevents bad days. Skipping them because you “feel fine” is like canceling your insurance right before a storm.

Your inhaler is one of the most powerful tools in your toolbox. But a tool is only as good as the person using it. Take the time to master it. Your lungs will thank you for it.