In this blog, we will review a few simple things that the patient and the patient’s family with chronic obstructive pulmonary disease (COPD), emphysema, and chronic asthma may use to prevent COPD exacerbations.
Many patients with COPD may have underlying chronic asthma and many are active or
former smoker. Many may have associated emphysema in conjunction with intermittent symptoms of asthmatic bronchitis. Preventing a flare-up of COPD and/or underlying asthma may further help improve quality of life and may decrease use of acute care/hospitalization.
(1) Understanding severity of disease. One needs to understand underlying severity of COPD if underlying bronchial asthma or emphysema is present or not. There are no specific COPD cures, but controlling the symptoms helps improvement of respiratory symptoms and sense of wellbeing. One may consider pulmonary function test if not done to assess underlying severity.
(2) Understanding of acute or chronic COPD symptoms. Keeping a log of regular COPD symptoms and any changes may help to seek early medical treatment for control of COPD exacerbation in the early phase rather than later. The patient may get low-grade fever, increase in cough, quantity, change in the color, and/or increase shortness of breath.
(3) Home oxygen use. A few patients with COPD may need use of oxygen either at night or on exertion or continuously. This needs to be evaluated by their physician.
(4) Emergency plan. It would be good to have an emergency plan if there is worsening of the symptoms. If someone with severe asthma and/or COPD, it may be good to have a course of antibiotic and a tapering course of prednisone handy and start it with exacerbation of symptoms in conjunction with their primary care and/or pulmonologist. If there is worsening of COPD then it would be good to call 9-1-1 and go to the Emergency Room.
(5) Anxiety symptoms. Anxiety, COPD, asthma, emphysema symptoms go hand-in-hand. With the change in respiratory symptoms and an increase in air hunger there may be fluctuation in anxiety and depression symptoms. Relaxation is the key. Slow deep breathing exercise may help.
(6) Exercise. Regular walking, breathing exercises and moderate strenuous exercise, depending on heart condition may be considered based on physician advice. This has been shown to decrease exacerbation of COPD, and clearing of respiratory secretions in the morning.
(7) Avoiding certain foods. Usually cold water, cold drinks, dairy products, ice cream, and chocolate may trigger underlying COPD/asthma. Bananas increase mucus formation. This may be good to void. Many patients notice a change once they cut down the use or discontinue it.
(8) Medications. Use of inhalers, nebulizers, oxygen, its duration frequency and maximum dose, needs to be understood. The common mistake many COPD patients make is overuse of long-acting bronchodilators in place of short-acting inhalers or nebulizer treatment. This needs to be avoided. Correct inhaler technique is the key.
I hope this may help in understanding underlying symptoms of COPD and exacerbation factors and cut down any major flare-up.