Chronic Obstructive Pulmonary Disease

WHAT YOU SHOULD KNOW:

• Chronic obstructive pulmonary disease (COPD) is a medical condition that causes breathing problems. COPD includes two main illnesses: chronic bronchitis and emphysema. COPD damages parts of your lungs called bronchiole tubes and alveoli. This can make it hard for you to breathe and do your daily activities. COPD is most often caused by tobacco smoke. It is also caused by air pollution, dust, and chemicals. You may have trouble breathing that gets worse with exercise. You may have a chronic (long-term) cough and chronic production of sputum (thick fluid from the lungs). You may also have wheezing (difficult breathing that makes a whistling sound).
  
  
• Your caregiver will diagnose you by taking a health history and doing a physical exam. Tests may include spirometry (measures how well you can breathe), a chest x-ray, and blood tests. COPD is a serious condition that gets worse over time. Lung damage from COPD cannot be reversed, but treatment may help prevent further damage. Treatment may include medicines, oxygen, and surgery. It may also include pulmonary rehabilitation. This program teaches you about your condition and how exercise and nutrition can help you be healthier. Treatment may help you breathe better and return to your normal daily activities.

AFTER YOU LEAVE:

Medicines:

• Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.
  
  
• Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.
  
  
• Bronchodilators: These help open your airways so you can breathe better. They are most often taken using one of the following devices:
  
  
  • Inhaler: This is a hand-held device that delivers medicine that you breathe in.
    
    
  • Nebulizer: This is a machine that turns liquid medicine into mist that you breathe in through a mouthpiece.
  
  
• Corticosteroids: These help you breathe better by decreasing swelling in your lungs. They may be inhaled or taken as a pill.
  
  
• Antibiotics: These are used to treat lung infections that may make your COPD symptoms worse.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

About a COPD exacerbation:

An exacerbation is when your COPD symptoms suddenly get worse. You may have a harder time breathing, your cough may get worse, and you may cough up more sputum. You may have a fever, increased heart rate, or feel sleepy. An exacerbation may be caused by a lung infection, air pollution, or other lung irritants. Sometimes the cause of an exacerbation is unknown. Your caregiver may change your treatment to help relieve your exacerbation.

How to manage COPD and help prevent exacerbations:

• Avoid cigarette smoke and other irritants. Do not smoke or breathe in smoke from other people's cigarettes. If your workplace has dust and chemicals that bother you, wear protective gear. Stay inside and avoid outdoor exercise when air quality is bad.
  
  
• Take your medicines as directed by your caregiver. This can help you have fewer and less severe exacerbations.
  
  
• Get early treatment if your symptoms are getting worse. This may help you recover faster. Create an action plan for what to do in case of an exacerbation.
  
  
• Exercise as directed by your caregiver. Exercise can help reduce breathing problems and make you feel less tired. Your symptoms may get worse if you are not active.
  
  
• Use pursed-lip breathing. Pursed-lip breathing can be used any time you feel short of breath. It can be especially helpful before you start an activity.
  
  
  • Take a deep breath in through your nose.
    
    
  • Slowly breathe out through your mouth with your lips pursed (slightly puckered). An example of pursed lips is when you pucker your lips to blow out a candle. You should make a quiet hissing sound as you breathe out through your pursed lips.
    
    
  • Try to take a long time to breathe out. It should take you twice as long to breathe out as it did to breathe in. This helps you get rid of as much air from your lungs as possible.
    
    
  • Repeat this exercise several times. Once you are used to doing pursed-lip breathing, you can do it any time you need more air.
  
  
• Keep a healthy weight. Eat several small meals each day if you have trouble breathing while you eat. Ask your caregiver for more information.
  
  
• Vaccines: To prevent influenza (flu), all adults should get the influenza vaccine. They should get it every year as soon as it becomes available. The pneumococcal vaccine is given to adults aged 65 years or older to prevent pneumococcal disease, such as pneumonia. People aged 19 to 64 years at high risk for pneumococcal disease also should get the pneumococcal vaccine. It may need to be repeated 5 years later.

For support and more information:

You may feel worried, scared, and sad if you have COPD. You may worry about your future. These feelings are normal. It may help to learn all you can about COPD. Ask your caregiver for more information. If you smoke, he can help you quit smoking. It may also help to join a support group. This is a group of people who also have COPD. Contact the following for more information about COPD and support groups:

• American Lung Association
  1301 Pennsylvania Ave. NW
  Washington , DC 20004
  Phone: 1- 202 - 785-3355
  Phone: 1- 800 - 548-8252
  Web Address: http://www.lungusa.org
  

• Smokefree.gov
  Phone: 1- 800 - 784-8669
  Web Address: www.smokefree.gov
  

CONTACT A CAREGIVER IF:

• You have a fever.
  
  
• You have trouble breathing and your medicines do not help.
  
  
• Your cough gets worse or you cough up more sputum than normal.
  
  
• The bluish tint to your skin, lips, or nailbeds gets worse.
  
  
• You have any questions or concerns about your condition or treatment.

SEEK CARE IMMEDIATELY IF:

• You are not getting enough air when you breathe.
  
  
• You become confused, dizzy, or feel like you may pass out.
  
  
• Call 911 or an ambulance if you have any signs of a heart attack:
  
  
  • Discomfort in the center of your chest that feels like squeezing, pressure, fullness, or pain, that lasts for more than a few minutes or keeps returning
    
    
  • Discomfort or pain in your back, neck, jaw, stomach, or one or both of your arms
    
    
  • Feeling sick to your stomach
    
    
  • Having trouble breathing
    
    
  • A sudden cold sweat, particularly in combination with chest discomfort or trouble breathing
    
    
  • Feeling very lightheaded or dizzy, particularly in combination with chest discomfort or trouble breathing

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Chronic Obstructive Pulmonary Disease (Discharge Care)