Living with COPD
Managing flare-ups (exacerbations)
Although your treatment plan will incorporate as much as possible to reduce or slow down impaired lung function, symptoms can go through patches (flare-ups) which are worse than normal. Acute exacerbation can last for a few days or even weeks, and if not treated effectively (and quickly) can result in lung failure.
A respiratory infection, other inflammatory triggers or even air pollution can bring on exacerbations. If you experience a sustained increase in coughing, an increased difficulty in breathing or notice a change in the mucus you bring up with coughing, seek prompt medical attention.
A medical professional may administer supplemental oxygen or prescribe antibiotics and or/ steroids. It may also be possible that you will be hospitalised for further medical care. Inhaled steroids or long-acting bronchodilators can help to lower the risk of exacerbations in the future.
COPD as a condition will worsen over time, so flare-ups are likely to happen. There’s little way around this. Once diagnosed and a treatment plan implemented your doctor will ensure that you understand what to do when exacerbations happen. In milder instances, your treatment plan and medications will be able to help provide some relief. In severe cases, medical intervention is essential.
Lifestyle changes and diet
As much as your treatment plan will help to alleviate symptoms, flare-ups and discomforts as you manage your condition, there is plenty you can do to help yourself.
One thing is for certain, your lungs are weakened and will never be in their best condition again. Any triggers or causes that overtax their function or result in exacerbations should be avoided as best you can, especially in the earlier stages of the disease.
On the plus side, there is quite a lot you can do by making changes to your lifestyle in order to improve your quality of life. These can include:
- Maintaining a nutritious diet: What you put into your body matters and can make all the difference. A diet which avoids highly processed foods, or those that contain high amounts of sodium (which can retain water and cause breathing strain) and calories is important (in some cases more calories may be needed). Your body needs nutrients. If you are losing weight as a result of the disease, speak to your doctor or a nutritionist about developing a diet plan that will best ensure you get all the benefits of healthy and balanced meals daily. Nutrient-rich foods such as vegetables, fruits, protein, grains and dairy should be included in your daily diet plan. If you are overweight, you may likely be encouraged to lose weight as a means to significantly improve your breathing capacity. Plenty of non-caffeinated liquids are important to help alleviate discomforts associated with increased mucus production. Your doctor may recommend that you limit caffeinated drinks as they can interfere with many medications you may be taking, as well as increase water loss. Tips your doctor may give you regarding your eating habits can include swapping out 3 big meals a day for 5 or 6 smaller ones, clearing your airways through specifically designed exercises including postural drainage, controlled coughing and/or chest percussion) at least an hour before consuming a meal and drinking any beverages after a meal (instead of at the same time) so that you feel less full while eating. A fuller stomach can make it more difficult for your lungs to expand and thus affect your breathing, making you feel short of breath each time you eat.
- Manage / treat other chronic conditions carefully: It is important to ensure that if you have any other chronic conditions, you work closely with your doctor to effectively treat them. Poorly treated conditions such as diabetes or heart disease can have a devastating effect on your overall health.
- Adjust your living conditions: One thing is for certain, your energy levels are likely to deplete as the condition progresses. Unless you have help, you can take steps to de-clutter your living environment in such a way that makes cleaning and performing household tasks easier. During the more advanced stages, you will likely need help with these daily requirements in the home, as your energy levels will be significantly low. You can also use an air filter in your home, making your personal space healthier for you.
- Be more mindful of your body (breathing): You can learn techniques which may help you to breathe a little easier. A doctor or respiratory therapist can help you with relaxation techniques and breathing positions which will help provide relief when you experience shortness of breath symptoms. You can also learn ways to help alleviate the effects of coughing, especially when there is excess mucus production. Drinking plenty of water and using humidifiers will help to clear your airways and passages, making breathing a little easier and more comfortable.
- Keep your medical appointments: Ensure that you keep all appointments with your doctor and other specialists. The disease is a flexible one and going through changes is inevitable. It is important that your doctor is able to routinely monitor any changes in your lung function, as well as keep track of any infections that may occur, needing prompt treatment.
- Carry your emergency contact information: As the disease progresses, it may become increasingly difficult for you to be able to inform others of your disease and what you need. It is a good idea to be prepared for potential flare-ups and emergency situations where you may be unable to take the appropriate course of action yourself. Carry emergency contact information with you at all times and keep something in your home where it can be easily seen or found, such as on the refrigerator. This information must include any medications and dosages you currently take, as well as all emergency numbers a person assisting you can contact in order to get you the best medical care necessary in a problematic or life-threatening situation.
- Find relief in support: A progressive disease which shortens your life expectancy can be immensely distressing for any individual. It can bring on emotional rounds of sadness, hopelessness and even anxiety. You may find some comfort in joining a support group in your area and talking to others who experience the same things you do. Talk to your doctor about organisations or councillors you may be able to get in touch with as a way to help you cope on an emotional level. As much as you are going through adjustments and changes in your life, those who love and care for you the most will be affected too. Counselling can help you deal with others too.
You may think that exercise isn’t good for your condition. Think again. A given with this disease is that as it progresses you will get weaker. As much as you can do to slow down the process and build up strength will be hugely beneficial to your quality of life. A little each day can go a long way in helping to stay strong. The less you do, the less you will be able to do, and the more your muscles will weaken as things progress. Muscles that are weaker need more oxygen. A healthy dose of exercise is the best thing for this and will help build strength that will make daily / routine activities (such as shopping and cooking) a lot easier.
Your doctor will be able to best advise how much exercise activity you will need as you manage your condition at each stage. Some exercise activities you may benefit from include:
- Walking: Understandably, exercise and the risk of not being able to breathe is intense for many with COPD. If you’re fearful of exercising or are not all that active to begin with, walking is a great starting point. It’s a simple activity which can be done anywhere and it can be increased gradually at your own pace. You can add as little as 30 seconds to your walk each day as you slowly build strength. A slow pace is all you need to get started, so you need not feel that you have to accomplish a lot quickly. Take your time getting comfortable with this activity and ensure to keep your doctor in the loop with your activity levels and frequency too. Stretching (or warming up and cooling down) properly before and after a walk is also important.
- Biking: Riding a stationary bike is a good activity to take up as well. Once you gradually build strength you can even consider outside riding as well and enjoy some lovely scenery at the same time. You’ll need to be mindful of shortness of breath symptoms. You can stop and rest at any time for a few minutes when needed. Pushing yourself will not serve your purpose of building strength and will compromise your breathing.
- Tai Chi: The gentle, flowing movements of this exercise is a great activity for suffers of COPD. A workout helps tone muscles and build strength in the heart and lungs. If you find yourself feeling emotionally overwhelmed as a result of your illness, this activity easily alleviates stress and helps you to relax.
- Weights: Basic things like reaching a high shelf or carrying heavy objects will become increasingly difficult things to do as the disease progresses. A good way to build strength the muscles need for such activities is with weight training exercises. Light dumbbells (hand weights) and stretchy bands can be used to regularly do arm curls and forward arm raise exercises. The exercises will help to strengthen your upper arms and shoulders.
- Leg work: Strengthening muscles in your legs will make exercise activities such as walking a whole lot easier. Working these muscles will also enable you to go further (walk for longer) as you build strength. Calf raises and leg extensions are good exercises to do.
- Easy breathing: The diaphragm is a key breathing muscle in your body and you can learn to ‘exercise it’ at least 3 to 4 times a day for 5 to 10 minutes at a time. Choose a comfortable chair to sit in or lie down with your knees bent up and place one hand on your chest. Place your other hand below your rib cage. Now take a deep breath, inhaling through your nose. You will feel your abdomen rise, raising your one hand (the one below your rib cage). Purse your lips and exhale (also known as pursed lip breathing). Your stomach muscles should tighten. Take care not to move the hand on your chest throughout. You will also need to learn to be conscious of your breathing during exercise. The nose is a natural air filter so it is important to be aware of only inhaling through your nose (mouth closed) and exhaling through your mouth (for twice as long as the time you take to breathe in). When your breath increases in pace and becomes shallow or you begin to pant, stop and rest for a few minutes. It is important to rest so that you do not over exert yourself and restrict your lungs from the natural process of getting air (and carbon dioxide) out of the body.
Other exercise activities mild stage COPD suffers can benefit from include water aerobics and rowing. Once the disease progresses and the use of oxygen becomes necessary, exercise need not stop altogether. Your doctor may even recommend using oxygen during exercise. You should be able to perform most exercises with oxygen. Many are small and light-weight tanks which can easily be used when mobile. Some oxygen units also come with extra-long tubing which is convenient when at home.
Try and get yourself into an exercise routine that you can commit to. Once a habit, 20 to 30 minutes at least 3 times a week will do you the world of good. A little cardio combined with strength training is all you need.
Knowing when not to exercise is just as important as starting an exercise routine. Your symptoms will range from mild and familiar to increasing in intensity and frequency. Pay attention to your coughing or wheezing symptoms. Are you coughing up more mucus than usual? Has your shortness of breath become worse lately? Keep your doctor in the loop of any changes, however subtle, and seek medical attention if any change concerns you or doesn’t improve.