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6 Tips From Doctors on Managing COPD Exacerbations

COPD exacerbationsIf you have COPD, your symptoms will sometimes vary depending on a variety of factors, many of which are out of your control. Sometimes, you will experience COPD exacerbations, which is a worsening of your symptoms. Also called flare-ups, exacerbations cause the swelling and mucus in your airways to worsen, which can cause anything from severe fatigue and breathlessness to confusion and chest pain. Exacerbations can be difficult to recover from, so if you have COPD, learning to avoid and manage exacerbations will become a part of your life.

What Causes COPD Exacerbations?

In order to offer the most helpful information to you about COPD exacerbations, it is important to be clear on what COPD exacerbations are, as well as what you can do to prevent and manage them. To gain insight, we spoke to experts in the field and asked them to explain what causes exacerbations. While most causes are environmental, many of them are out of your control, so it is important to know what you can do to try to prevent exacerbations whenever possible. For example, when we spoke to Rochelle Burnside, expert on Portable Oxygen Concentrators for BestCompany.com, she offered, “Pollution is one of the biggest factors that exacerbates COPD, and unfortunately, this problem is increasing in urban areas.” People living in larger cities or in any area with significant pollution may experience more frequent exacerbations. Highly congested areas can also be a problem because of increased exposure to smoke or scented products like perfume and cleaning products.

Anything that irritates the lungs is likely to cause an exacerbation, and Carolyn Dean, MD, ND points out that lung irritants can be natural or man-made. She says, “To name a few, things such as pollen and dust; paint fumes and scented products; lawn cuttings; chemicals such as pesticides, smoke (whether from tobacco or fireplaces); mold; air pollution; cleaning solvents and products; cooking odors” and other irritants can have a significant impact on your COPD, potentially causing an exacerbation. Look out for anything with a strong odor, as it is likely to irritate your lungs. Moreover, environmental changes can impact your COPD as well. Dean says, “Weather changes, like extreme cold, heat and/or humidity, high altitude and wind that blows in dust or pollen” can all factor in to cause potential flare-ups.

Your general health is a factor, too, as Dr. Nikola Djordjevic, MD, of LoudCloudHealth.com makes clear. Dr. Djordjevic explains, “The narrowing of the airways is caused by inflammation in the lungs, which become blocked due to excessive mucus and swelling.” This inflammation can be caused by allergies, respiratory infections including colds or flu, or even being “overstressed from too much activity and not getting enough sleep.” While there can be a variety of causes for a COPD exacerbation, J. David Gatz, MDn, Clinical Instructor and Assistant Medical Director in the Department of Emergency Medicine at the University of Maryland School of Medicine, explains that “the majority of exacerbations are triggered by an infection. Both viral and bacterial infections are common.” Additionally, he notes that “certain medications (like beta-blockers) or other medical conditions can also occasionally trigger an exacerbation,” so it is helpful to be aware of how your health, and your other health care needs, may affect your COPD.

What Can You Do to Prevent COPD Exacerbations?

Because there are so many factors that can contribute to COPD exacerbations and making your symptoms worse, it’s important to know what you can do to help prevent exacerbations before they start. Our industry experts offered a number of solutions for helping to mitigate the many potential contributing factors. It is encouraging to know that there are a good number of things that can be done to help with certain lung irritants or managing in severe weather, but unfortunately, it is impossible to eliminate every cause of COPD exacerbations.

Still, it is helpful to know what can be done when symptoms worsen. Patients living in areas with poor air quality should avoid spending time outdoors when pollution is at its highest. However, if you must go outside, wearing a face mask can help. It is also recommended that you avoid the outdoors during extreme cold or heat, though covering your face with a scarf can help during windy or particularly cold conditions. Additionally, Dean suggests keeping your home tidy by dusting and vacuuming regularly and using only natural cleaning products with minimal odors. Patients should also avoid smoke of all kinds, indoors and out, as well as use a humidifier to reduce dust and pollen in the air. Houseplants can also be helpful for reducing indoor irritants and pollutants, so feel free to keep enjoying your green thumb if you have one. Both Dean and Burnside also recommend purchasing an air purifier to help filter indoor air when opening the windows is not an option. For hot weather, Burnside says, “A good air-conditioning system is a must in hot and humid regions.”

Djordjevic also recommends taking care of your body to prevent COPD exacerbations by getting plenty of rest and sleep, as well as controlling stress with relaxing activities. Perhaps most importantly, both Djordjevic and Gatz recommend making sure health care is a top priority by ensuring you are up-to-date on your vaccinations, including influenza and pneumonia, and keeping up with any daily control medications like albuterol or glucorticosteroids. Additionally, Gatz advises that regular hand washing, especially after being out in public, helps avoid catching viruses that could cause an exacerbation.

Managing COPD Exacerbations: 6 Tips

The way you manage your COPD exacerbations will vary, depending on the severity of your symptoms. While it is important to contact your doctor when you have an exacerbation, as they can cause symptoms severe enough to warrant hospitalization, many COPD exacerbations can be managed at home. Talk to your doctor about how to best manage your particular symptoms during an exacerbation, as well as when to seek medical attention.

Djordjevic points out that there are a variety of treatment options available, based on your unique case as well as the cause of your exacerbation. Gatz advises that, while some patients can manage their symptoms on their own, other patients may need more help. Here are some of the options available to you, some of which will require the help of a medical professional.

  1. Get away from the cause of your exacerbation.
    Minimize exposure to any lung irritants or reduce contact with anything or any environments that may worsen your symptoms. Try to reduce your stress and get plenty of rest and hydration to see if your symptoms lessen.
  2. Manage your exacerbation at home.
    Some patients may be able to manage their COPD exacerbations with a prescribed inhaler and increased rest. However, Gatz advises that, “Patients should increase their use of this rescue medication as instructed by their primary physician.”
  3. See your doctor for prescribed medication.
    For example, Djordjevic suggests if your exacerbation is caused by an infection, you will likely need medication to treat the infection. For bacterial infections you may be prescribed antibiotics, while viral infections may require antiviral medications.
  4. Try supplemental oxygen therapy.
    Patients experiencing poor blood oxygen levels may require oxygen therapy to help improve lung function and oxygen levels as prescribed by their doctor, according to Burnside and Djordjevic. Supplemental oxygen can also be helpful for easing the anxiety and discomfort that comes with breathlessness.
  5. Head to the doctor.
    If none of the solutions you have been given are working as well as they should, or your exacerbation seems worse than normal, it is a good idea to see your doctor to find out what you may need. As Burnside recommends, “Many patients can work up a plan to manage flare-ups when they contact a doctor.”
  6. When in doubt, seek immediate medical attention.
    If your symptoms continue to worsen, or you feel unable to breathe, quick medical intervention is required. When the exacerbation cannot be controlled at home, Gatz suggests seeking medical attention at an emergency medical facility right away “where additional rescue medications can be given, in addition to steroids and antibiotics if needed.” COPD exacerbations can cause severe symptoms that can become life-threatening when not treated properly, so if you continue to feel worse, play it safe and go in to the ER. Extreme COPD exacerbations may require bronchodilators and ventilator support, according to Djordjevic, especially for “seniors that struggle to breathe on their own.”

Understand Your COPD Exacerbations

COPD exacerbations can be frightening, but knowing what causes them, how to prevent them and what you can do to manage them will go a long way in minimizing your anxiety. Ask your doctor about the best course of action for your particular COPD case, and ask about which treatments are right for managing your COPD exacerbations when they arise. If your doctor recommends oxygen therapy for your COPD, contact Inogen to find out how our products can help you breathe better and manage your exacerbation symptoms.

 

 

SOURCES

https://www.thoracic.org/patients/patient-resources/resources/copd-exacerbation-ecopd.pdf

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