Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Chronic obstructive pulmonary disease (COPD) is comprised primarily of three related conditions,
chronic asthma, and
emphysema. In each condition there is chronic obstruction of the
air flow through the airways and out of the lungs, and the obstruction generally is permanent and may
progress over time.
While asthma features obstruction to the flow of air out of the lungs, usually, the obstruction is reversible. Between "attacks" of asthma the flow of air through the airways typically is normal. These patients do not have COPD. However, if asthma is left untreated, the chronic inflammation associated with this disease can cause the airway obstruction to become fixed. That is, between attacks, the asthmatic patient may then have abnormal air flow. This process is referred to as lung remodeling. These asthma patients with a fixed component of airway obstruction are also considered to have COPD.
Patients with COPD are often classified by the symptoms they are experiencing at the time of an increase of the symptoms of the disease. For example, if a patient is experiencing primarily shortness of breath, they may be referred to as a patient with emphysema. If the patient is primarily experiencing a cough and mucus production, he or she is referred to as having chronic bronchitis. Actually, it is preferable to refer to these patients as having COPD, since they can experience a variety of lung symptoms.
Reviewed by William C. Shiel Jr., MD, FACP, FACR on 5/13/2013
Chronic Obstructive Pulmonary Disease - SymptomsQuestion: The symptoms of chronic obstructive pulmonary disease can vary greatly from patient to patient. What were your symptoms at the onset of your disease?
Medical Author: George Schiffman, MD, FCCP
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
Symptoms of chronic obstructive pulmonary disease (COPD) in smokers include chronic cough, shortness of breath, and frequent respiratory
infections. In patients with emphysema shortness of breath is the primary symptom. In patients with
bronchitis and bronchiectasis, symptoms include chronic cough and sputum production.
Advanced COPD symptoms include cyanosis, headaches, weight loss, pulmonary hypertension, and coughing up blood.