COPD Care in Southlake, TX

We confirm COPD with spirometry rather than assuming it, choose an inhaler based on your symptoms and flare history, and make sure you can actually use it. Then we build a written plan for the bad weeks, because that is what keeps people out of the hospital.

Confirming the diagnosis

A great many people carry a COPD label without ever having had a breathing test, and a meaningful number of them do not have COPD.

Spirometry before and after a bronchodilator establishes whether obstruction is present and how much of it reverses. We also look for the things that mimic COPD: heart failure, anemia, deconditioning, and asthma, which is treated differently.

If you have a significant smoking history we check whether you qualify for lung cancer screening with low-dose CT, since the criteria overlap almost entirely with the people who develop COPD. Details on our preventive screening page.

We also check alpha-1 antitrypsin once in anyone diagnosed with COPD, particularly if you are young, never smoked heavily, or have a family history. It is a genetic cause that is easy to miss and changes management.

Treatment

We start with long-acting bronchodilators, a LAMA or a LABA, and combine the two when symptoms warrant.

Inhaled corticosteroids are not for everyone with COPD. They help patients who flare frequently and those with higher blood eosinophil counts, and they raise pneumonia risk in others. We use the eosinophil count and your flare history to decide rather than adding one reflexively.

Roflumilast and azithromycin have roles in specific patients who keep flaring despite optimal inhalers.

Quitting smoking

This is the only treatment that changes the trajectory of the disease, and it works at any age.

We prescribe rather than advise. Varenicline is the most effective single agent. Combining a patch with a short-acting nicotine product works well. Combining medication with counseling roughly triples quit rates over willpower alone. Relapse is normal and is not a reason to stop trying.

Pulmonary rehabilitation

If you take one thing from this page, take this. Pulmonary rehab improves breathlessness, exercise capacity and quality of life more than most drugs, and it reduces admissions after a flare.

It is covered by Medicare and most commercial plans, it is chronically underused, and we refer for it actively rather than waiting for you to ask.

Your flare plan

Every patient leaves with written instructions: daily medications, what a flare looks like for you, when to start a rescue course, and when to go to the emergency department.

For people who flare regularly we provide a rescue pack to keep at home with clear instructions about when to open it. Starting treatment on day one rather than day four is often the difference between managing at home and being admitted.

Vaccines and the rest of the body

Flu, COVID, pneumococcal, RSV and Tdap. Respiratory infections cause most COPD flares and vaccination prevents a meaningful share of them.

COPD raises cardiovascular risk independently, so we manage it alongside heart disease prevention. Osteoporosis is common in this group from steroids and inactivity, and depression is common and under-treated.

Oxygen

We test rather than guess. Home oxygen improves survival in people who meet criteria on resting oxygen saturation or blood gas, and it does not help people who do not meet them.

Lung care is followed through our chronic condition management program. See our primary care Southlake practice overview.