So, You've Been Diagnosed with COPD: Now What?

[Thomas3.20.2010]

Now that you have been diagnosed with COPD, it is important for you to to inundate yourself with as much information about the disease as possible. Knowing what you are up against will help you better understand what to do about it.

WHEN YOU ARE DIAGNOSED WITH COPD

There are many things that you can do to make living with COPD easier:

Quit Smoking

If you smoke, the best thing you can do to prevent more damage to your lungs is to quit.

Talk with your doctor or healthcare provider about treatment options. You can take steps to make breathing easier and live a longer and more active life.

Avoid Exposure to Pollutants

Try to stay away from other things that could irritate your lungs, like dust and strong fumes. Stay indoors when the outside air quality is poor. You should also stay away from places where there might be cigarette smoke.

Visit Your Healthcare Provider on a Regular Basis

See your doctor or healthcare provider regularly, even if you are feeling fine. Be sure to bring a list of all medicines you are taking to each doctor’s visit.

Follow Treatment Advice

Be sure to take your medications and follow your provider’s advice on how to treat your disease. If you have any questions—ASK!

Take Precautions Against the Flu

Do your best to avoid crowds during flu season. It is also a good idea to get a flu shot every year, since the flu can cause serious problems for people with COPD. You should also ask your provider about the pneumonia vaccine.

Seek Support From Other COPD Patients

There are many COPD support groups offered at local hospitals and there is a very active COPD community online. Family members are also a great resource for support as you learn to live with and manage COPD.

TAKING ACTION

Once you have been diagnosed with COPD, there are many ways that you and your healthcare provider can work together to manage the symptoms of the disease and improve your quality of life. They may suggest one or more of the following options:

Medications (such as bronchodilators and inhaled steroids)

Bronchodilators are medicines that usually come in the form of an inhaler. They work to relax the muscles around your airways, to help open them and make it easier to breathe. Inhaled steroids help prevent the airways from getting inflamed. Each patient is different—your doctor or healthcare provider may suggest other types of medications that might work better for you.

Pulmonary Rehabilitation

Your healthcare provider may recommend that you participate in pulmonary rehabilitation, or “rehab.” This is a program that helps you learn to exercise and manage your disease with physical activity and counseling. It can help you stay active and carry out your day-to-day tasks.

Physical Activity Training

Your healthcare provider or a pulmonary therapist they recommend might teach you some activities to help your arms and legs get stronger and/or breathing exercises that strengthen the muscles needed for breathing.

Lifestyle Changes

Lifestyle changes such as quitting smoking can help you manage the effects of COPD.

BREATHING EXERCISES

Pursed-Lip Breathing. A technique called pursed-lip breathing can help improve lung function before starting activities or doing a strenuous task, such as lifting a heavy box. Pursed-lip breathing helps change pressure in the airways and prevents small airways from collapsing.

First, inhale through the nose, moving the abdominal muscles outward so that the diaphragm lowers and the lungs fill with air.

Exhale through the mouth with the lips pursed, making a hissing sound.

Exhalation should take twice as long as inhalation, so that pressure is experienced in the windpipe and chest, and trapped air is forced out.

Holding Breath and Coughing. A simple technique is to inhale deeply and slowly, hold the breath for 5 -10 seconds, then cough on exhalation.

CONTROLLING SECRETIONS

Fluids and Humidity. Patients with congestion and heavy sputum can benefit from maintaining good fluid intake and keeping their homes humidified.

Chest Therapy. Chest therapy involves rhythmic inhalation for three to four deep breaths followed by coughing to produce sputum. Tapping the chest may also help in loosening and raising sputum in patients with a significant amount of sputum production. Avoid chest therapy during an acute exacerbation of COPD.

When coughing to produce mucus, another method is to lean forward and "huff" repeatedly, take relaxed breaths, and huff again. Avoid forceful coughing, if possible.

PHYSICAL EXERCISE

Because COPD is not simply a lung condition, but a systemic disease that causes wasting of the muscles and bones, certain physical exercises may be very helpful.

Strengthening Exercises for the Limbs. Exercising and strengthening the muscles in the arms and legs helps some patients improve their endurance and reduce breathlessness. Exercising only one leg at a time (for example, pedaling a stationary bicycle with one leg instead of two) might benefit patients who are usually too out-of-breath to exercise, and help them increase their exercise capacity.

Walking. Walking is the best exercise for patients with emphysema. In studies of lung rehabilitation, regular exercise increased walking distance and improved breathing. Patients should try to walk 3 - 4 times daily for 5 - 15 minutes each time. Devices that assist ventilation may reduce breathlessness that occurs during exercise.

Yoga and Eastern Practices. Yoga and tai chi, two practices that use deep breathing and meditation techniques, may be particularly beneficial for COPD patients. Research is underway to determine whether yoga is helpful for COPD patients.

BREATH TRAINING

Inspiratory Muscle Training and Incentive Spirometer. Inspiratory muscle training involves exercises and devices that make inhaling more difficult in order to strengthen breathing muscles, walking capacity, and quality of life.

The use of an incentive spirometer for 15 minutes twice a day may also be helpful. It can help loosen sputum. An incentive spirometer is a small, hand-held device that contains a breathing gauge. The patient exhales and then inhales forcefully through the tube, using the pressure of the inhalation to raise the gauge to the highest level possible. A device called a peak inspiratory flow (PIF) meter measures the patient's ability to draw air into the lungs and assesses the fitness of the breathing muscles.

New guidelines released by the American College of Chest Physicians (ACCP) and American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) do not recommend the routine use of inspiratory muscle training during pulmonary rehabilitation.

DIETARY FACTORS

Because many patients with chronic bronchitis are obese and many with emphysema are underweight, assessment of nutritional status is an important part of COPD treatment. Lack of vitamins A, C, and E, and a lack of fruits and vegetables, can contribute to the development of COPD.

Protein and Fats. Patients with body wasting (cachexia) lack enough protein. Although most healthy diets emphasize proteins from fish, poultry, and lean meat, these people may benefit from foods with a higher-than-average fat content. (People should still prefer healthy fats, however, such as those found in olive oil and oily fish.) Some evidence suggests that high-carbohydrate meals may reduce exercise capacity.

Fruits, Vegetables, and Whole Grains. Healthy foods are as important for lung function as they are for health in general. Specific foods that may be important for healthy lungs are those that contain antioxidants (best obtained from fresh, deep green and yellow-orange fruits and vegetables), selenium (fish, nuts, red meat, grains, eggs, chicken, liver, garlic), plant chemicals called flavonoids (apples, onions), and magnesium (green leafy vegetables, nuts, whole grains, milk, and meats). One study found that, compared to a Mediterranean diet, which is high in fruits, vegetables, and whole grains, a Western diet high in red meat and simple carbohydrates increased the risk of COPD fivefold.

Dietary Supplements. A meta-analysis of studies in which COPD patients took supplements of N-acetyl-cysteine, an antioxidant, concluded that it was effective in preventing exacerbations, even in patients with COPD who continued to smoke. Use of inhaled steroids seems to lessen its effects, however. Additional studies are needed to confirm these findings. Other antioxidants being studied include L-carnitine and coenzyme Q10. Evidence of benefit is weak for these chemicals, though.

PSYCHOLOGICAL SUPPORT

Patients with COPD are at high risk for depression and anxiety, which can impair their outlook on life. The problem worsens along with the disease, which often requires people to limit their activities and social interactions. Psychological counseling and social supports are important for helping people improve their emotional state, cope with daily stresses, and maintain independence and social relationships.

MINIMIZING AIRBORNE CONTAMINANTS

As much as possible, patients should avoid exposure to airborne irritants, including:

Aerosol products

Hair sprays

Insecticides

Paint sprayers

Smoke from wood fires

To minimize the amount of contaminants in the home:

Avoid exposure to pollen, pet dander, house dust, and mold.

Eliminate molds and mildews resulting from household water damage.

Have furnaces and chimneys inspected and cleaned periodically.

Make sure wood-burning stoves or fireplaces are well ventilated and meet the Environmental Protection Agency's safety standards. Burn only pressed wood products labeled "exterior grade," since they contain the fewest pollutants from resins.

Ventilate by keeping windows open (weather permitting), using exhaust fans for stoves and vents for furnaces, and keeping fireplace flues open.

[elvan]

I am copying and pasting this to word and printing it out.  It will serve as a reminder to me and to others who are around me, you know, the ones who don't understand how many things I really NEED to avoid in terms of airborne irritants.  I do all of the vacuuming and dusting and I steam mop the floors, it keeps a lot of the dust down as long as I do it very regularly.  I also comb the cats to keep cat hair at a minimum.  

Windows are wide open right now, it is currently 74 degrees.  I sat outside and talked to an old friend I haven't heard from in years.  What a glorious day.  Nice breeze, sunshine, I'd say it's just about perfect.

[Thomas3.20.2010]

Lucky You, Ellen! Sounds like a beautiful day and you deserve it! It's snowing here, cold and windy! I had to call in sick because of a sinus infection and back on antibiotic (doxycycline) and prednisone! It gave me a chance to find some material that Mark will transfer here. Just a few thousand words! LOL! I actually could not access all of it! Amazing what 7 Years generates - some of it is very useful!.

 So a good day after all!

[elvan]

It was lovely, going to be colder and rainier tomorrow but no snow, high tomorrow is 63 and low of 29 tomorrow night back to 52 Sunday. This was just a perfect day.  If you post it, I will read it.  I am sure it is very useful.  

I hope you feel better, sinus infections are awful, I bought a mask in the beauty department at Walmart, that can be heated or chilled. I think the heat helps me to feel better.

[Mandolinrain]

This an excellent post Thomas! I am also going to print this out! Thank you for all this very helpful information! Wow...its great!!!

[virgomama]

I'm a over a year late in reading this, but I too copied and printed this to take home with me.  My partner has COPD and this is just a great straight forward guide to have around.  Thanks for this article.  I guess it will be a timeless piece that serves people continuously.