Today, there is a great interest in improving the identification and treatment of all stages of COPD. The reason is obvious. COPD has become the fourth most common cause of death in this country. Of greatest importance, however, is the fact that we cannot only identify and treat COPD early, but we can alter the course of the disease. We can certainly do a lot for people who already have symptoms from COPD.
Now to the new things. The popular bronchodilator, Proventil, is now available with an environmentally-safe propellant, known as HFA. This replaces the chlorinated fluorocarbons (CFC) which damage our atmosphere. It is my hope that the Federal Drug Administration (FDA) and the Environmental Protection Agency (EPA) will join forces in imposing the law which says that all CFC’s must be removed from inhalation devices by the Year 1997. The time is now!
Secondly, new drugs to combat inflammation in the lungs are under study. I have been involved in the design of a trial of a new drug, which originated in Japan and which looks quite promising in dealing with lung inflammation. It blocks the inflammatory processes in a manner quite different from cortisone-related drugs.
There is also a new emphasis on nutrition. It is very important for people to keep their weight up. A high carbohydrate diet is not bad for patients with COPD. Taking antioxidant vitamins C, E, folic acid, and the mineral selenium makes sense for all patients with COPD.
Finally, new home oxygen systems are under study. It is distinctly possible that the approach to home oxygen therapy will change and new developments which will allow patients to fill a portable device form their own concentrator right in the home. If this proves to be successful, the number of oxygen deliveries and the “hassle factor” of being sure that the oxygen is delivered on time will be diminished. Costs may also decrease.
A new health care initiative, which I have been talking about, the National Lung Health Education Program, (NLHEP), is gaining momentum. Soon, we will have a program that will encourage all smokers and anyone with cough, shortness of breath, or wheeze to see their personal physician and have a simple pulmonary function test done right in the office to measure FEV1 and FVC. “Test Your Lungs/Know Your Numbers” is the motto of the NLHEP.
Well, I must thankfully recall that five years ago on this Valentine’s Day I was “resting”, awaiting my urgent heart surgery. How the time has passed! But the five years have brought progress, not only to my own personal health, but to the field of pulmonary medicine, which I love so dearly. I think the future is bright.
I will be in touch next month.
Thomas Petty, MD