Rural Nashville resident Beth Hoyt, 70, and Westport resident Debora Rivera, 54, deal with the disease’s impacts daily. What they also have in common is using Columbus Regional Hospital’s Lung Institute for respiratory therapy.

“COPD is a large part of the patient population,” said Jennifer Nulph, a registered respiratory therapist at Columbus Regional. “It’s more prevalent than we’d like to see.”

Because damage to the lungs from COPD is permanent, the exercises patients perform help them manage the disease, she said.

That’s important, Nulph said, because COPD claims a lot of lives. It is the third-leading cause of death in the United States, killing more than 120,000 Americans each year, according to the National Heart, Lung and Blood Institute.

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“The sooner people seek treatment, the better they will feel; and they can possibly slow the progress of the disease,” Nulph said.

Nulph is among those who want to raise awareness of COPD and its risk factors. November is national COPD Awareness Month.

Rivera fits the typical profile of someone battling the disease. She started smoking as a teen and continued for most of her adult life. COPD is most common among current and former smokers. Rivera now hopes she can get a lung transplant.

Hoyt, who never smoked, is the rarity. However, Hoyt said she was exposed to secondhand smoke from family members and had a lot of upper respiratory infections as a child. It’s possible, but not definite, that those factors contributed to her disease, she said.

Unexpected diagnosis

Hoyt, who has asthma, suspected something else was wrong about a year ago when she felt like she couldn’t breathe and the medicine delivered from her inhaler didn’t help.“I couldn’t walk from one room to another without gasping for air,” she said. “It was a scary feeling. You think you’re going to faint.”Hoyt sought the help of doctors, but the diagnosis was difficult to determine, she said. Her history as a nonsmoker and the fact that no other family member had breathing issues had doctors looking at other causes. She was finally diagnosed with COPD on Jan. 22.

“I was shocked and terrified and scared to death. I know people with emphysema. I know people who passed,” Hoyt said.

Rehabilitation started about April and concluded in late July. She had 24 therapy sessions, each for one hour twice a week. Nulph would check her levels and pressures — such as oxygen and blood — and then put her through the paces on different exercise machines. That included a seated stepper, resembling a sitting stair climber; an ergometer, which simulated riding a bicycle while also requiring arm use; and a treadmill for walking. The goal was to exercise for at least 20 minutes on each machine.

Improving one’s physical fitness and activity level is an important way to slow the progress of COPD, Nulph said.

The rehabilitation is paying dividends.

Hoyt and her husband Bill bought recumbent bicycles and routinely ride them for exercise. On a recent Sunday they rode six miles.

“I hadn’t ridden a bike in a long time,” she said. “We’ve had a blast.”

Seeking new lease on life

Rivera has been battling COPD for longer than Hoyt, the result of years of smoking. She said she started the habit at 16 because of peer pressure and because some family members smoked, but she didn’t completely quit until March of this year.She first experienced breathing problems in the mid-1990s when she lived in Michigan. She worked for an optical lens company, grinding lenses, and she was experiencing shortness of breath. She said that was concerning considering that she was an active person who had played softball for 25 years.Rivera’s condition worsened over the years. By 2000, the year she was diagnosed with COPD, she was wearing an oxygen mask at night. Eventually she had to quit playing softball.

Rivera said she would try to quit smoking, but each attempt failed, and she would resume the pack-a-day habit.

“I knew it was taking a toll on me,” said Rivera, who began needing portable oxygen most of the time about six years ago and carries a portable oxygen distiller with her all the time now. She no longer works and receives disability benefits.

Rivera later moved to Indiana, and it was about three years ago when she first underwent respiratory therapy at Columbus Regional.

Also, three years ago was the first time she began looking into the possibility of a lung transplant. However, it wasn’t until more recently that she became serious about the idea.

She is working with Indiana University Health Methodist Hospital in Indianapolis for the lung transplant. A panel of medical professionals will decide if she’s approved for it.

In the meantime, Rivera is undergoing physical therapy sessions at Columbus Regional. One of the requirements for a transplant is that the overall health condition of the patient is good enough for the surgery to be performed, Nulph said.

A lung transplant surgery can take up to eight hours, and recovery is three to four weeks in the hospital and an additional three months at home, Rivera said.

Although the respiratory therapy sessions can be taxing, and a lung transplant will involve a lot of recovery time, Rivera is focused on the benefits that await.

“My grandson is 15, and I want to see him graduate. I want to get back into softball and have a better quality of life,” she said.

COPD awareness events

COPD risk factors, diagnosis and treatment

When: 12:15 p.m. Thursday.

Where: Room MP3 in Mill Race Center, 900 Lindsey St., Columbus.

Why: To inform people about the disease, to help those who have it, or those suspected of having COPD. Dr. Raymond Kiser will discuss the disease.

Who: Anyone is welcome to attend.

Notable: A light lunch will be served. Seating is limited so registering for the event is preferred.

To register: Call 800-699-1019.

Quarterly comprehensive health screening

When: 8 to 10 a.m. Thursday

Where: Mill Race Center, 900 Lindsey St., Columbus.

Cost: Free.

Screenings: COPD risk screening and inhaler technique, hemoglobin, balance test, advanced directives, mental health, hearing, blood pressure, height and weight, body mass index, eye pressure and glucose. Consultations with pharmacists and dietitians also available.

To sign up: Go to Mill race Center’s business office or call 812-376-9241.

About COPD

What is it?

Chronic obstructive pulmonary disease (COPD) is a lung disease that over time makes it difficult for a person to breathe. The airways that carry air in and out of the lungs are partly blocked. COPD also is referred to as emphysema or chronic bronchitis.


  • Shortness of breath doing everyday activities that used to be done with ease
  • Wheezing
  • Excess sputum
  • Coughing frequently
  • Feeling of being unable to breathe
  • Unable to take a deep breath

Who’s at risk?

Women, Caucasians, people ages 55 to 74 and current and former smokers are most likely to develop COPD.

Occurs most often in people older than 40 who are current or former smokers. Smoking is the most common cause of COPD, accounting for about 90 percent of COPD-related deaths.

Can also occur in people who have had long-term exposure to things that can irritate the lungs, such as chemicals, dust or fumes in the workplace. Secondhand smoke also may contribute to COPD.

Some people get COPD because of the genetic condition alpha-1 antitrypsin, or AAT deficiency.

Notable facts

COPD is the third-leading cause of death in the United States, claiming more than 120,000 Americans each year.

More than 12 million people have been diagnosed with COPD in the U.S., but another 12 million are likely to have COPD and don’t know it.

Indiana has one of the highest prevalence rates in the U.S. of COPD among adults ages 18 and older.

Indiana has one of the highest death rates for COPD in the U.S.

Source: National Heart, Lung and Blood Institute

About the smokeout

The American Cancer Society Great American Smokeout is always the third Thursday of November, which this year is next week.

Smokers can use the date to make a plan to quit or plan in advance and then quit smoking that day.

The Great American Smokeout event challenges people to stop using tobacco and helps people know about the tools they can use to help them quit for good.

A local awareness campaign Thursday is the High School Heroes program. Columbus high school students will visit local elementary schools to provide tobacco-awareness education. The theme this year is “Saving the 5.6,” because the previous surgeon general reported that 5.6 million children alive today will ultimately die early from smoking if more isn’t done to reduce smoking rates in the U.S.

Sources: American Cancer Society; Stephanie Womack, tobacco program coordinator for Reach Healthy Communities

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Kirk Johannesen is assistant managing editor of The Republic. He can be reached at or (812) 379-5639.