When Ted Koppel's wife was given a few years left to live, the couple dedicated themselves to fighting COPD
Updated 2:57 PM ET, Fri November 15, 2019
(CNN)In 2001, a doctor diagnosed Grace Anne Dorney Koppel with chronic obstructive pulmonary disease, or COPD, telling her she had just three to five years left to live.
She and her husband, long-time "Nightline" anchor Ted Koppel, held each other in bed that night and sobbed.
She was given a prescription for a treatment called pulmonary rehabilitation, as nearly two-thirds of patients report positive outcomes from the treatment, according to one study. But her doctor told her to write out her advance directives in case her death came suddenly.
"If someone in a white coat asks you that, it will slap your soul," she said. "I was not ready for that. I guess none of us are."
As lung damage increases, a gradual onset of COPD can often go unnoticed for years. By the time she visited a doctor, Dorney Koppel, a lawyer, was struggling to breathe every day and couldn't manage to walk more than a few dozen yards.
Tests showed the former smoker had lost 75% of her lung function. She needed to use a wheelchair, because even walking a short distance had become impossible.
What is COPD?
COPD is America's third most fatal chronic disease, with a five-year survival rate of 40% to 70%.
The two most common types of COPD are emphysema and chronic bronchitis, and those with the disease have airways that are partially blocked, according to Medline. Initial symptoms can include cough, sputum production and shortness of breath, especially on exertion, which limits their activity.
And the disease affects populations well beyond smokers.
It's common among construction workers as well as firefighters and first responders, and rampant among those who lived in lower Manhattan during and after the World Trade Center terror attack.
The Centers for Disease Control and Prevention has also tracked increased COPD prevalence among office workers, stemming from paper dust and fumes from photocopiers, chemicals, and oil-based ink.
Sixteen million Americans are currently diagnosed with the disease and COPD is expected to cost the country $49 billion in 2020, according to the National Institutes of Health, though millions more are thought to be undiagnosed. Each year it kills 155,000 people.
"That is more than all the Americans who died in Korea, Vietnam, Iraq and Afghanistan put together," said Ted Koppel, who covered multiple wars as a correspondent and anchor.
Since 1969, the death rate for COPD has doubled, even as the number of deaths for other chronic diseases has fallen.
Patients are concentrated in rural areas, with states such as West Virginia having some of the highest prevalence rates.
"These people are isolated by economics. They're isolated geographically," Koppel said. "And they're isolated because this is a disease that makes people ashamed if they got it through something like smoking."
A study published this year in the European Respiratory Journal showed that air pollution can age the lungs, increasing the risk for COPD. Earlier studies have shown that four in 10 Americans live in areas with air that has unhealthy levels of particulate pollution or ozone. And as the climate crisis makes air quality worse, rates of COPD are expected to climb.
In short, anyone with lungs is susceptible.
They've been fighting COPD for decades
A decade and a half beyond the life span her doctor gave her in 2001, Dorney Koppel credits pulmonary rehabilitation for her vitality, and has spent much of her life trying to help others find that same breath of life.
Pulmonary rehab is the standard care for COPD patients and includes directed exercise as well as nutrition guidance and support for those with lung diseases. But only 3.7% of Medicare-eligible COPD patients undergo the rehab, due in part to a 2010 rule change in Medicare's reimbursement policies. That change likely led to a similar procedure, cardiac rehab, being eligible for double the federal reimbursement rate of pulmonary rehab, the California Society for Pulmonary Rehabilitation says.
Dorney Koppel doesn't shake people's hands, preferring to greet new faces with an elbow bump, to avoid catching germs. "Every cold, every flu, could be fatal," she said.
Her husband, who hosted ABC's "Nightline" for 25 years, has been playing a supportive role, speaking up about the disease with the same baritone voice that delivered the news to millions of Americans every night for decades.
The couple met at Stanford in the early 1960s, where they both earned master's degrees.
Before long, Koppel was covering the civil rights movement in Selma, Alabama, in 1964, and later they moved their young family to Hong Kong, when he became an ABC correspondent covering Vietnam.
In the 1970s, and now living back stateside, Koppel took a year off from his job as an anchor to stay at home with the couple's children while Dorney Koppel finished her law degree at Georgetown University Law Center. After she graduated, she practiced law, focusing on criminal and civil litigation.