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Step-by-step: managing COPD flare-ups

By Louis Neipris, M.D., Staff Writer, myOptumHealth

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If you have a chronic lung disease like COPD, you most likely have to see your doctor more often. You may have even been to the emergency room or had to stay in the hospital recently.

It's important to know the early symptoms of lung infections or flare-ups so you can get help and avoid serious illness. Also, doing all you can to manage chronic lung disease will help improve your health and cut hospital stays. Take these steps to stay healthy.

1. Assess your symptoms regularly. Be familiar with your COPD symptoms and know when they're getting worse so you can get help right away. Some people with COPD get sudden attacks or flare-ups when their symptoms suddenly get worse. Symptoms of a COPD flare-up include:
   • Increased shortness of breath
   • Coughing - and possibly wheezing - more
   • Coughing up more mucus and it may be a darker color
2. Try these self-care steps to avoid flare-ups and stay healthy:
   • Smoking. We know you've heard this before, but if you smoke, get advice on quitting. It's never too late to quit. Quitting can help slow the progress of the disease. Quitting a tobacco habit can be tough. Some people try to quit "cold turkey" - just stopping on their own without any help. But quitting for good often takes support from your doctor, along with nicotine replacement therapy or other medicine.
   • Vaccines. Make sure your immunizations are up to date. Getting the flu can lead to serious worsening of COPD. That's why getting the flu vaccine every fall is so important. The best time to get the seasonal flu vaccine is during October and November. You may also need the pneumococcal vaccine, which protects against a type of pneumonia.
   • Inhaler instruction. Learn how to use your inhalers the right way. If you use a metered dose inhaler or dry powder inhaler, proper technique is essential. Time the "puff" with breathing in. Your doctor should watch you use your inhaler and correct your technique if needed.
   • Medications. Make sure you take your medications correctly. Medicines for COPD include those to help you breath, and possibly corticosteroids and a drug to thin the mucous.
     • Bronchodilators. These are usually given as an inhaler. They help open up the airways to make breathing easier.
     • Corticosteroid. Inhaled steroids are often prescribed along with a bronchodilator to reduce inflammation.Oral prednisone is sometimes used for a COPD flare-up but is usually not given long-term.
     • Oxygen. Low-flow oxygen helps some people with COPD. By testing your blood oxygen level, your doctor can tell if oxygen therapy would help you feel better.
     • Antibiotics. These may be prescribed if you have a bacterial infection that is making your COPD worse. Take them as directed.
   • Feelings. Tell your doctor if you are feeling down. Depression is common in people with COPD, but it may not be obvious to the doctor. Depression is a treatable condition.
   • Activities and exercise. Discuss your ability to do your daily activities. If buttoning your shirt is a challenge, your doctor needs to know about it. Ask if you would benefit from pulmonary rehab, a program of supervised exercise for people with COPD. Daily exercise, even if it's walking more at home, gardening or other light activities, may help you keep up your strength and energy level. Ask your doctor about a safe activity level.
   • Eating well. A well-rounded diet is an important part of keeping up your strength and health. You may need to eat a handful of small meals a day if you are not able to eat regular-sized meals. Ask your doctor about seeing a nutritionist if you need help setting up a healthy diet.
3. Know when to see your doctor. Create a COPD action plan with your doctor. Your "action plan" is a set of instructions on what to do if your symptoms get worse, such as if you become more short of breath, or have more or thicker sputum. You should know how often to use your inhaler and when to call the doctor.

View the original Step-by-step: managing COPD flare-ups article on myOptumHealth.com 

SOURCES:

• Chronic Obstructive Pulmonary Disease.org. What is chronic obstructive pulmonary disease? Accessed: 07/07/2009

• National Lung Health Education Program. Treatment of COPD and asthma. Accessed: 07/07/2009

• American Thoracic Society. How can I stay healthy? Accessed: 07/06/2009

• Rust R. Obstructive lung disease. In: Rakel RE. Rakel: Textbook of Family Medicine. 7th ed. Philadelphia, PA: Saunders Elsevier; 2007.

• Global Initiative for Chronic Obstructive Lung Disease. Pocket guide to COPD diagnosis, management, and prevention. Accessed: 07/07/2009

• National Guideline Clearinghouse. VA/DoD clinical practice guideline for management of outpatient chronic obstructive pulmonary disease. Accessed: 07/07/2009

• National Heart Lung and Blood Institute. COPD: are you at risk? Accessed: 07/07/2009

• Hunter MH, King DE. COPD: management of acute exacerbations and chronic stable disease. American Family Physician. 2001;64:603-612.