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.
Typically, after smoking 20 or more cigarettes a day for more than twenty
years, patients with COPD develop a
chronic cough, shortness of breath (dyspnea),
and frequent respiratory infections.
Emphysema symptoms of COPD
In patients affected predominantly by emphysema,
shortness of breath may be the major symptom. Dyspnea usually is most noticeable during increased physical
activity, but as emphysema progresses, dyspnea occurs at rest.
Chronic bronchitis and bronchiectasis symptoms of COPD
In patients with chronic bronchitis as well as bronchiectasis, chronic cough
and sputum production are the major symptoms. The sputum is usually clear and
thick. Periodic chest infections can cause
fever, dyspnea, coughing, production
of purulent (cloudy and discolored) sputum and
wheezing. (Wheezing is a high
pitched noise produced in the lungs during exhalation when mucous, bronchospasm,
or loss of lung elasticity obstructs airways.) Infections occur more frequently
as bronchitis and bronchiectasis progress.
Advanced COPD symptoms
In advanced COPD, patients may develop cyanosis (bluish
discoloration of the lips and nail beds) due to a lack of oxygen in blood.
They also may develop
morning headaches due to an inability to remove carbon dioxide from the blood.
Weight loss occurs in some patients, primarily (another possibility is reduced
intake of food) because of the additional energy that is required to
In advanced COPD, small blood vessels in the lungs are destroyed, and
this blocks the flow of blood through the lungs. As a result, the heart must pump with
increased force and pressure to get blood to flow through the lungs. (The
elevated pressure in the blood vessels of the lungs is called
hypertension.) If the heart cannot manage the additional work, right heart
failure also known as Cor pulmonale results and leads to swelling of the feet
Patients with COPD may cough up blood (hemoptysis). Usually
hemoptysis is due to damage to the inner lining of the airways and the airways'
blood vessels; however, occasionally, hemoptysis may signal the development of
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?