Tips for Recovering From a COPD Flare-up

For people living with chronic obstructive pulmonary disease (COPD), managing and recovering from a flare-up can be part of your health and wellbeing journey. It is important to have a plan in place to support you in your recovery journey, and prevent the flare-up from becoming more severe. This article shares some handy tips and techniques to help you recover faster, so you can get back to doing all the things you love. 

What Is Chronic Obstructive Pulmonary Disease (COPD)?

Chronic Obstructive Pulmonary Disease (COPD) is a blanket term for a collection of conditions that cause a blockage, or obstruction, of the airways in the lungs. Some of the most common types of COPD include chronic asthma, chronic bronchitis, and emphysema. This collection of lung diseases is referred to as ‘obstructive’, because the condition typically blocks or partially blocks the passage of air through the lungs. They are also ‘chronic’, meaning that the illness has long-term impacts on the individual’s lung health and function, leading to a blockage of air flow that is usually irreversible or permanent. 

COPD affects around one in 40 Australians aged over 45 years, however as this is reliant on self-reported data, the prevalence may actually be higher than this. COPD is a serious illness that is a significant cause of premature death in Australia, ranking as the fifth highest cause of death, following coronary heart disease, dementia and Alzheimer disease, cerebrovascular disease, and lung cancer. It is of concern that as many as half of people living with COPD may be unaware that they have the condition. This makes it much more difficult to effectively manage their symptoms and prevent further progression of their illness. Knowing the signs and symptoms of COPD is important for the early detection and management of COPD. 

Signs and Symptoms of COPD

One of the challenges in recognising the signs and symptoms of COPD is that they can gradually develop over time, making it easy to miss the red flags. Some of the most common symptoms of COPD, like a cough and breathlessness, can at first be minor and easy to dismiss. However, over time these symptoms can worsen until ordinary tasks of your daily life become difficult and cause excessive exertion or fatigue. 

Other common signs that you may be experiencing COPD are wheezing, fatigue, coughing up sputum or phlegm and vulnerability to chest infections. Some people living with COPD also experience cyanosis, a blue tinge to the skin caused by poor oxygen supply. People with COPD may feel respiratory exhaustion disproportionate to the physical demands of the activity they are participating in. If you or someone you love has been experiencing any of these symptoms, it is important to seek medical advice as soon as feasible. Early detection and management of COPD can prevent further illness progression or complications, and may even be lifesaving.

How Does COPD Affect Lung Health and Function?

Our lungs are among our most important organs, playing an essential role for our respiratory and cardiovascular function, and general health and wellbeing. They are located in our chest, protected by our ribcage, and are composed of spongy tissue that receives air inhaled from our environment via the trachea and two bronchi, one for each lung. The bronchi in our lungs each separate into smaller tubes called bronchioles, which are then separated into miniscule air sacs called alveoli. These tiny alveoli support the exchange of oxygen and carbon dioxide that happens when we breathe. The lungs work with the rest of the respiratory organs to deliver oxygenated blood to the heart where it is pumped around the body, and also removes carbon dioxide from the body by drawing it out of the bloodstream into the alveoli where it is breathed out. 

COPD can affect the health and functionality of the lungs in a few different ways. For people with emphysema, the bronchi and alveoli become damaged and weak, limiting their ability to deliver oxygen to the blood. Over time this can reduce the amount of oxygen available in the body, leading you to feel weak and breathless after minor exertion or even at rest. 

In cases of chronic bronchitis, which means inflammation of the bronchi, an excessive amount of fluid is produced in the lungs. Whilst a small amount of fluid is normal in the lungs, too much can cause a persistent cough, often producing phlegm or mucus. 

Asthma describes a condition where the breathing tubes are inflamed or constricted as a result of factors like cold weather, irritants or physical exertion. Asthma and COPD can often present with very similar symptoms, and it can be easy to mistake one for the other. However, it is important to know if your breathing difficulties are being caused by asthma or COPD, as the management strategies and risks will be different. It is also possible to have both asthma and COPD, so be sure to talk to your doctor who can perform lung function tests to determine the cause of your breathing difficulties.

People with COPD may start to experience lung damage and difficulty breathing that is very mild at first, causing doubt about whether it is serious. If you suspect you may have COPD, it is important not to wait until your symptoms are severe before seeing medical assistance and advice.

What Are the Risk Factors for COPD?

COPD can affect anyone, however there are certain risk factors that you can avoid to reduce the likelihood of your or a loved one developing the condition. Smoking cigarettes is by far one of the greatest modifiable risk factors for developing COPD. As many as 25% of smokers will develop COPD, and people who were once smokers remain at an elevated risk of developing COPD. If you are a current or previous smoker, it is important to watch for signs of breathlessness or other COPD symptoms to enable early detection and management.

COPD can also be caused or exacerbated by environmental factors, such as prolonged exposure to irritants or pollutants. This can include wood or grain dust from industrial settings, or living in an area with high air pollution. There are also some genetic factors, such as alpha-1-antitrypsin deficiency, which can cause emphysema even in people with no other risk factors. Being aware of the risk factors for COPD can help you to make lifestyle changes that reduce your risk, such as not smoking, keeping physically active, eating a healthy diet, limiting your exposure to pollution and irritants and following your COPD action plan.

Getting Diagnosed and Treatment Options for COPD

The sooner you seek diagnosis and treatment if you suspect you may have COPD, the better. In most cases, a COPD diagnosis will be made using a breathing test called a spirometry. This test can be done by your general practice surgery, or at a laboratory by a respiratory specialist. Your doctor may also recommend other diagnostic tests and tools such as a chest x-ray, computed tomography (CT) scan, blood tests and lung volume tests to help paint a clearer picture of your lung health and function. 

There is no cure for COPD currently available, and because damaged lung tissue does not repair itself, COPD is not reversible. However, with early diagnosis, effective management including lifestyle changes and treatment options, there is plenty you can do to alleviate your symptoms, slow the disease progression, prevent hospitalisation and increase your life expectancy. Treatment options will depend on your unique circumstances, the type of COPD you are diagnosed with, and other personal factors. Common types of treatment for COPD may include:

Bronchodilator Medication

This type of medication helps treat COPD conditions such as asthma by relaxing the muscles of the lungs and widening the airways that can become constricted. It is usually administered using an inhaler or puffer, ideally with a spacer for optimum absorption. You can find out more about how to use inhalers and spacers via the Lung Foundation Australia website.

Expectorants

Expectorants work by thinning out the mucus and secretions that can build up in the lungs of people with COPD. This acts like a ‘decongestant’, making the phlegm in the lungs less ‘sticky’ and easier to cough up. This can help reduce the discomfort and breathing difficulties posed by a buildup of fluid in the lungs and airways. 

Oxygen Therapy

Over time, COPD can lead to reduced oxygen availability in the bloodstream and throughout the body. Our body can handle low oxygen levels for a short time, however long-term low oxygen levels can have serious health risks. People with COPD and chronic low oxygen availability may undergo oxygen therapy, which delivers oxygen to your body via a nasal tube, face mask or a tube in your trachea or windpipe. Oxygen therapy helps increase the oxygenated blood supply to your body.

Corticosteroids

This type of medication can alleviate COPD symptoms by reducing the swelling and inflammation of the lung tissue. Due to the potential side effects of corticosteroids, these are usually delivered through an inhaler to minimise any risks.

Pulmonary Rehabilitation

This type of treatment is personalised to each person following an assessment. Treatment strategies in pulmonary rehabilitation vary, and often include education, supervised exercise and support to transition into a maintenance program at the end of your rehabilitation program.

Chest Infection Treatment

Chest infections can be a serious risk for people living with COPD. Because the lungs are already facing challenges to optimal function, treating existing chest infections with medication like antibiotics is important. It is also essential to prevent chest infections from occurring where possible, such as by being vaccinated for conditions like pneumonia, influenza and COVID-19.

Lung Volume Reduction Surgery

In a small number of cases of COPD, surgical removal of some of the damaged lung tissue can help. Removing damaged tissue can sometimes allow for healthy lung tissue to expand and contract more effectively, improving breathing and other symptoms of COPD.

Regular, Ongoing Monitoring

Managing COPD is a lifelong journey, and it is important not to get complacent in noticing changes to your symptoms. Having a trusted medical professional who knows your history is important to effectively manage your COPD long-term, including the timely identification and treatment of any flare-ups. 

What Is a COPD Flare-Up?

Anyone who lives with COPD can be at risk of a flare-up. A flare-up describes a period where your COPD symptoms worsen, and this can be severely debilitating and even lead to hospitalisation. The best way to treat a flare-up is to prevent it from happening in the first place, however sometimes there are factors outside of our control that can cause a flare-up.

Some factors that can ‘trigger’ or lead to a flare-up may include exposure to pollutants such as dust or smog, smoke exposure, or a recent respiratory infection such as influenza. Unknown triggers can also cause flare-ups, and may be specific to you, so it is important to have a written COPD Action Plan that lists your individual triggers and how to manage them.

Knowing the signs to help you recognise a flare-up and start recovering is essential for your long-term wellbeing and COPD management. Signs and symptoms that you may be experiencing a flare-up include less energy for your normal activities than usual, loss of appetite, insomnia, more coughing, breathlessness or wheezing than normal, requiring more of your reliever medicine than usual, and a greater amount or different colour of sputum being produced. Keeping a written, up-to-date COPD Action Plan that your loved ones and health care team can access can be a lifesaving document to help manage flare-ups when they occur.

Your Recovery Action Plan: How to Bounce Back From a COPD Flare-up

Managing a chronic health condition is a lifelong journey, and the better you understand your COPD, including the signs, symptoms and triggers for flare-ups, the better. Knowing when your symptoms are becoming worse, indicating a flare-up, is crucial to enable you to act fast, recover quickly, and avoid ending up in the hospital. Regular monitoring of your symptoms and their severity, using a tool such as a symptom diary, can help you, your loved ones and your care team to know when your symptoms worsen or change. You should also track how your symptoms change during a flare-up, so that you have historical data to help inform treatment options in the future. 

Once you have determined that your symptoms are worsening, you should seek medical assistance quickly. You should also practice extra caution when experiencing a flare-up, avoiding any activities or irritants that may further aggravate your health. This may include avoiding strenuous exercise and reducing your physical activity, practising controlled breathing and increasing your medication if previously discussed with your doctor. 

Because each person who lives with COPD is unique, it is important that you and your medical professionals maintain a personalised COPD Action Plan. This should include regular, day-to-day management strategies, but also have a dedicated section to guide you in self-managing any flare-ups. Make sure that this plan is also regularly updated, at least once every six months, and after every individual flare-up. As soon as you suspect a COPD flare-up, refer to your COPD Action Plan for guidance on how to recover. 

The Action Plan may include general tips like increasing your fluid intake and eating small amounts of nourishing food, as well as specific strategies that have been tailored to you and your condition. It will also include details for any medication or rehabilitation that needs to be undertaken in light of a COPD flare-up. This document should be easily accessible and it is also a good idea to make copies to give to your primary health care professionals and close loved ones. COPD Action Plans are critical in knowing when to increase medication, or when a flare-up is serious and requires urgent medical care. If you live with COPD and do not have a current, updated Action Plan, follow the below steps to create this potentially life-saving document. 

1. Talk to Your Doctor and Request Support in Plan Creation.

The first step in creating your COPD Action Plan is to talk to your doctor and request their support in creating the plan. Your plan should include clear instructions for managing your COPD when you are stable, but also for when you experience a mild to moderate or severe flare-up. Information around daily medicines, oxygen use, other members of your treatment team, and results from past lung function tests can also be added to help give a more comprehensive picture.

2. Tailored Instructions to Guide When Experiencing Mild to Moderate Flare-Up.

Specific instructions should be tailored to help guide you when you are experiencing a mild to moderate flare-up. This should give you easy to understand guidance on when and how much to increase your reliever medication dose, when and if to take additional medications such as steroids or antibiotics, and when to seek urgent treatment if the flare-up becomes more severe. 

3. Additional Medication Prescriptions From Your Doctor.

Your doctor should provide prescriptions for any additional medication that is required to manage a flare-up and include this in your COPD Action Plan documentation. This step is important to avoid delays in urgent treatment and medication when a flare-up takes place.

4. Plans Should Be Signed by Your Doctor.

All COPD plans should be signed and dated by your doctor so that you and anyone else reading the plan knows it is up to date and accurate.

5. Ask Your Doctor to Explain the Entire Plan.

Once finalised, you should ask your doctor or other trusted medical professional to explain the entire plan to you, and any loved ones who help you manage your COPD. This conversation should include confirming the signs of a flare-up to watch for and the actions you should take. It is important that you and your loved ones understand this plan and know how to enact it.

6. The Final Step Is to Ensure Your COPD Action Plan Is Regularly Used and Updated.

Keep your Action Plan somewhere visible and easy to locate in your home, such as on your fridge. You should also bring it with you to any medical appointments, including during any hospitalisations. Making copies or digitising it to keep on a smartphone or tablet can also help make sure it is within reach when and if you need it. Ensure you always bring a copy with you when travelling or away from home, in case a flare-up happens when you least expect it.

Have a Loved One Suffering From COPD?

If you have a loved one who has suffered from a COPD flare-up before, Homage has Care Professionals that are able to care and look after them in the comfort of their own homes. Our trained professionals are also able to provide companionship, nursing care, night caregiving, home therapy and more, to keep your loved ones active and engaged.

Need some assistance with care for yourself or your loved one? Find out how Homage can help!