Treatment methods

Living better with the condition

With optimised medical treatment, information and training measures, but above all motivating sports and exercise therapies, even severely ill COPD patients generally significantly increase their well-being. 
If continuous long-term oxygen therapy needs to be started, we facilitate this with an intensive knowledge transfer and support. We know that this disease is very often accompanied by depression and anxiety, and we therefore offer you help to learn how to better deal with these aspects of the disease.

The treatment of COPD and emphysema is based on four pillars:
  • Prevention
  • Drug-based treatment
  • Non-drug-based treatment
  • Device-based/surgical treatment

Conservative treatment methods

Non-invasive mask ventilation

The respiratory muscles may be chronically overloaded at an advanced stage of the disease. In addition to oxygen therapy, non-invasive mask ventilation can be provided. This takes place mainly at night to allow your respiratory muscles to recover. 

Long-term oxygen therapy

Long-term oxygen therapy may be appropriate if blood gas analysis tests at rest and stress tests have revealed chronic oxygen deficiency. This will improve the oxygen supply to your tissues and relieve your respiratory muscles. 
As many patients initially shy away from wearing the nasal cannula and feel constricted by the oxygen device, we conduct training sessions at Schoen Clinic every three weeks: One lecture answers all medical questions, a second one provides insight into social legislation (compensation of disadvantages in the Disabled Persons Act, nursing care insurance). At the third meeting, a person who has been using oxygen for many years comes to our clinic. She reports on her experiences and offers practical tips for everyday life. The exchange of experiences is deepened in the weekly oxygen groups.

Breathing therapy with COPD

Breathing therapy relieves shortness of breath, at rest as well as under stress. It also improves coughing and can lead to more targeted expectoration of thick mucus. The breathing techniques learned can also be combined with aids that prevent or reduce bronchial occlusion and improve secretion elimination.

Psychological care with COPD

The fact that COPD patients not only suffer from physical symptoms but, in many cases, the disease is also accompanied by depression and anxiety is an important aspect of the therapy for us. 
In groups and individual discussions, our psychological service helps you to accept and cope with your illness. 
Our psychologists help the chronically ill to focus their attention away from deficits and limitations. Instead, the focus is placed back on areas of life that work well in order to boost their self-esteem. The various psychotherapeutic procedures are solution-oriented and involve the relatives as much as possible. 

Quitting smoking

This is a crucial step in COPD treatment. Social education specialists and psychologists will be your side if you want to quit smoking: after all, the progression of the disease cannot be prevented without avoiding nicotine. What’s more, drugs have only a very limited effect on smokers.
In small groups of up to ten participants, patients are provided with information and encouraged to free themselves of tobacco and nicotine. The participants in the smoking cessation course are informed about nicotine replacement therapies and are given practical tips on how to handle critical situations. Experiences are exchanged and how to deal with relapses is discussed. 

Patient training

Patient training is important for all degrees of severity of the disease. Training programmes are offered on an outpatient basis by a lung specialist or as part of an inpatient rehabilitation stay. During this, you will learn, for example, how to inhale correctly or how to deal with acute relapses. Further learning content included the prevention and treatment of bronchial infections as well as positions that facilitate breathing. The goal is to better control the illness.

Prevention

We strongly recommend not smoking as the most important preventive measure. You should also pay attention to your weight because both being overweight and underweight influence the symptoms and also the course of the disease. 
You should therefore eat according to specific, differentiated criteria, which a nutritionist can work out for you. It is sensible to combine this with physical training.

Drug-based COPD treatment

Through a differentiated medical history and diagnosis of COPD, our specialists try to identify which drug combination is optimal for you. This results in corresponding therapeutic consequences. Drug-based COPD therapy is initiated according to the latest scientific findings. We check existing drug settings for their efficiency by closely monitoring their progress and, if necessary, optimise them. It is often sufficient to administer bronchodilators. We also clarify whether you need additional medication such as a cortisone preparation for inhalation or an anti-inflammatory medication. Incidentally, inhalation technology contributes to how the drugs work in many cases.

Other medications 
  • Antibiotics: Use during acute relapses when there is evidence of a bacterial infection with purulent discolouration of the sputum. The antibiotic is always taken with cortisone tablets, which are part of the five-day standard medication for the lung crisis. 
  • Alpha-1 protease inhibitor: Use in patients with pulmonary emphysema due to alpha-1 protease inhibitor deficiency. Certain criteria, such as severe deficiency or impaired lung function, must be met here. In this case, this protein can be replaced by weekly intravenous doses if the disease is not yet very pronounced.

Physical training to maintain mobility

A central component of non-drug-based COPD therapy is physical training. As the severity of the disease increases, patients put themselves under less and less strain and due to shortness of breath. This causes them to lose their physical condition and musculature. Pronounced osteoporosis (reduction of bone density) often also develops. This results from the fact that the patients exercise less overall, but also partly due to poor nutrition and the long-term intake of cortisone tablets. 

It has been shown that physical training leads to an increase in quality of life, resilience and also to a reduction in acute relapses. Many COPD patients begin exercise therapy as part of inpatient rehabilitation. However, you can also continue this at home on an outpatient basis and take part in lung sports groups in your region.

Surgical treatment methods

Surgical treatment with COPD

In the event of pulmonary emphysema, large lung bullae, which do not participate in gas exchange and therefore not in respiration, may occur. They can also compress the adjacent healthy lung tissue. 
These lung bullae are surgically removed during what is called a bullectomy. This can improve lung function and reduce shortness of breath. Before deciding on such an operation, a bronchoscopy and a high-resolution computed tomography scan of the lung should be performed in addition to the lung function tests. 

Another form of surgical treatment is lung volume reduction. Here, severely damaged parts of the lung that do not participate in gas exchange are removed. This operation helps to reduce pulmonary over-inflation, reduce shortness of breath and improve lung function. 

These procedures are not offered at our clinic. Through good preparation, we try to prepare our patients for such procedures in the best possible way.

A lung transplant may also be possible in individual cases. Schoen Clinic specialises in preparing severely ill patients for this and then supporting and building them up as optimally as possible.