Chronic Obstructive Pulmonary Disease (COPD) is an inflammatory lung disease that makes it harder to breathe. It prevents airflow from the lungs and can cause coughing, wheezing, and mucus buildup in your airways.
COPD develops over time. The number one cause of COPD is smoking. Air pollution, secondhand smoke, and working with chemicals can also increase your risk.
How COPD affects your lungs:
While breathing, your lungs expand to pull in oxygen and contract to push out carbon dioxide. Tubes in your lungs, called bronchial tubes, allow the air to pass through and into small air sacs that help deliver the oxygen into your blood and push out the carbon dioxide. When you have COPD, your bronchial tubes and air sacs are less elastic and struggle to push air out of your lungs. They stretch out and can trap carbon dioxide in your lungs.
Some people do not experience symptoms until their COPD is severe and there has been damage to their lungs. Some symptoms are:
- Shortness of breath, especially during physical activities
- Chest tightness
- A chronic cough that may produce mucus
- Frequent respiratory infections
- Lack of energy
- Unintended weight loss (in later stages)
- Swelling in ankles, feet, or legs
People with COPD may have periods or episodes where their everyday symptoms worsen. This is called a COPD flare-up and may last several days. If the patient with COPD is a smoker, these symptoms will worsen with continued smoking.
COPD Risk Factors:
COPD is caused by long-term exposure to extreme irritants like burning fuel fumes or, most commonly, the chemicals in cigarette smoke. Pre-existing conditions like chronic bronchitis or emphysema contribute to COPD and are often caused by or worsened by the same irritants, like chemicals and cigarette smoke.
People with asthma are also likely to develop COPD. Another common cause of COPD is genetics. Alpha-1-antitrypsin deficiency is a genetic disorder that can cause COPD in some people, and providers can test for it if you develop COPD at a young age or if it runs in your family.
Other causes of COPD are exposure to air pollution, breathing in secondhand smoke, and previous respiratory infections, especially as a child.
Healthy habits can help ease the symptoms and severity of COPD. Quitting smoking is a key lifestyle change, but improvements to diet and exercise can help as well.
Quitting smoking is vital to controlling your COPD. Smoking is often the cause of COPD and makes it worse. Quitting smoking can be difficult, especially for those who have tried in the past and were unable to. But your provider can help you find nicotine alternatives and support you as you quit.
People with COPD often struggle to get enough oxygen into their bodies. Supplemental oxygen can help patients breathe better.
Supplemental oxygen is distributed through a lightweight, portable device that patients can take with them. Some patients only need supplemental oxygen at night or during activities, but others need it all the time. This treatment can greatly improve COPD patients’ quality of life.
Lots of medications for COPD come in the form of inhalers. One kind is bronchodilators. They relax the muscles in your airways to help open them up and allow air to pass through easier. They can also relieve symptoms like shortness of breath and coughing. There are short-acting and long-acting bronchodilators — short-acting ones are for before activities like exercise, and long-acting ones are for everyday use.
Another inhaled medication for COPD is inhaled corticosteroid (ICS) treatment. ICS is a long-term controlled treatment that can help prevent and control chronic symptoms. ICS is an anti-inflammatory drug that reduces swelling in your airways.
You may also benefit from combination inhalers. These use inhaled steroid treatment and bronchodilators together to treat COPD.
There are non-inhaled treatments for COPD in the form of oral medications. There is oral corticosteroid (OCS) treatment, which are steroids that come in a pill or liquid. Talk to your provider about when and if OCSs are appropriate for you to take.
There are a few other oral medications in the form of pills that can treat COPD. An example is Phosphodiesterase-4 inhibitors, which relax the airways and decrease inflammation. Theophylline is another common drug, and it can improve breathing and prevent your COPD from worsening. Antibiotics are also commonly prescribed to COPD patients who experience respiratory infections.
Your provider will work with you to find what works best for you and create a treatment plan that will help you breathe easier.
Spirometry is a test that providers use to measure the amount of air you inhale or exhale and the speed you can exhale. This helps providers determine your lung health and can help them know if your treatments are working or not. Spirometry can be used to diagnose COPD and other lung conditions like asthma or chronic bronchitis.
This test is simple. To perform it, a provider will ask you to breathe into a tube connected to the spirometer. They will put a clip on your nose to shut it so you can only breathe through the tube. They will give you instructions on how and when to breathe and write down the results.
Chest x-rays can help catch and diagnose emphysema which is a cause of COPD. Providers will also use an x-ray to rule out other potential issues like heart failure or other lung problems.
A CT scan is like a more detailed x-ray: it takes x-ray images from several different angles and can give providers more information than a simple x-ray. CT scans help providers catch and diagnose emphysema, and it can tell your provider if you might benefit from surgery for COPD.
Arterial blood gas analysis is a blood test that measures how much oxygen is getting into your blood from your lungs and how well your lungs are getting rid of carbon dioxide.
Other lab tests might be used to rule out other conditions because COPD can be hard to diagnose in the early stages.
What is a COPD Action Plan?
COPD can flare up, and exacerbations can require quick-relief medication or even urgent medical care. When this happens, it’s important to have a plan in place for you and any potential caregivers. A COPD Action Plan is a personalized, written form that lists different sets of symptoms and directions to follow if you experience symptoms or your symptoms get worse. It also explains what to do if you need to call your provider or go to the emergency room for worsening symptoms or a flare-up.
What information is on a COPD Action Plan?
A COPD Action Plan is specific to you, so it will have all the information you, a provider, or other caregiver will need to help treat your COPD. It will have:
- All of your medications and their specific names, when to take them, and their dosages
- Personal information like your provider and your emergency contact and their phone numbers.
- When your last vaccinations were and any other health conditions you might have
- Directions for which medicines to take if your symptoms are getting worse
- Symptoms that show your COPD is getting worse
- Symptoms that show you need immediate medical attention
- A quit plan for smokers
The Zones on your COPD Action Plan:
There are three color-coded zones on a COPD Action Plan that describe symptoms and what to do if you’re experiencing those symptoms. There is a green “I am doing well today” zone, a yellow “I am having a COPD flare-up” zone, and a red “I need urgent medical attention” zone.
The green zone is where you want to be. Your symptoms are mild, and you are able to go about your daily activities easily, eat well, and sleep well at night. In this zone, the actions needed are to take your daily medicine, use oxygen as prescribed by your provider, continue your regular diet and exercise plan, and avoid smoking.
The yellow zone is when your symptoms need more attention, but not hospital-level. When you’re in the yellow zone, you need to check in with yourself and your COPD Action Plan to help get your symptoms under control. The symptoms that tell you you’re in the yellow zone are:
- More breathless than usual
- I have less energy for my daily activities
- Increased or thicker phlegm/mucus
- Using quick relief inhaler/nebulizer more often
- More swelling in ankles
- More coughing than usual
- I feel like I have a “chest cold”
- Poor sleep and my symptoms woke me up
- My appetite is not good
- My medicine is not helping
To help treat this, your COPD Action Plan will tell you to continue your daily medication, take your quick-relief medication (and how often to take it), start OSC treatment, start antibiotic treatment, take oxygen as prescribed, avoid pursed-lip breathing, avoid inhaling any kind of smoke or secondhand smoke, and call your provider if your symptoms don’t get better.
The red zone is when you need to call your provider or go to the emergency room. This is when your COPD is out of control, and none of the treatments you took from the yellow zone are working. Symptoms you experience that mean you’re in the red zone are:
- Severe shortness of breath even at rest
- Not able to do any activity because of breathing
- Not able to sleep because of breathing
- Fever or shaking chills
- Feeling confused or very drowsy
- Chest pains
- Coughing up blood
If you are in the red zone, you need to call 911 immediately. There will also be instructions for you to follow while you’re waiting for emergency care.
Having a COPD Action Plan can really make a difference when you are experiencing extreme symptoms. It can be hard to keep track of different medications, when to take them and how much, what symptoms are treatable, and what symptoms are life-threatening. Keeping track of all the information you need to know about your COPD in one place is helpful, especially in emergency situations.
At EPIC, we encourage all of our patients to be able to self-manage their conditions. SELF MANAGEMENT is when the patient can treat and control their COPD on their own, without much help from their provider outside of clinical work or emergency care. This gives you more freedom in your everyday life, so it’s important for you to commit to creating and following your COPD Action Plan.
It’s also important to share your COPD Action Plan with any caregivers or your emergency contacts so they know when you might need assistance or when to go to the hospital.
Your provider will help you create your COPD Action Plan, so don’t worry, you don’t have to do it alone. Having a COPD Action Plan in place will give you confidence with managing your COPD and security in knowing there are specific instructions to help you if something does happen.
Visit your EPIC Provider and create your personalized COPD action plan today!