DEAR DOCTOR K:
I have COPD. What can I do to avoid symptom flare-ups?
Chronic obstructive pulmonary disease, or COPD, is a long-term condition that makes breathing difficult. Breathing is a lot easier if you take your medicine and do any other therapy as directed.
Several types of medicines reduce the risk of flare-ups. Inhaled corticosteroids that reduce inflammation in the breathing tubes are one kind. Long-acting bronchodilators (BRONK-o-DIAL-a-tors) that keep the breathing tubes wide are another kind. A third kind are long-acting anticholinergics (AN-tie-KOLE-in-ER-jicks), which also act to keep the breathing tubes wide.
Other types of medicines are used to treat flare-ups. These include bronchodilator and anticholinergic drugs that act rapidly and do not last as long as the drugs used to reduce the risk of flare-ups.
Besides using the medicines as prescribed, there are other important things you can do to avoid symptom flare-ups:
PREVENT RESPIRATORY INFECTIONS. Sudden worsening of COPD often is triggered by a respiratory infection. Any respiratory infection — even a common cold — can cause a flare-up. Do whatever you can to avoid catching whatever is going around. That includes:
- Washing your hands frequently with soap and water or alcohol-based instant hand sanitizers.
- Staying away from people who have colds or other respiratory infections.
- Getting a flu shot every year.
- Getting vaccinated against pneumonia as needed.
You may also benefit from an antiviral medication, such as oseltamivir (Tamiflu), for reducing your risk of getting influenza during flu season. An antiviral medication can help speed the resolution of the flu, if you get it. And this, in turn, reduces your risk of a flare-up of COPD.
There is one flu medicine that you should not use, however: zanamivir (Relenza), an inhaled powder antiviral. The powder can irritate the lungs of a person with COPD.
EXERCISE REGULARLY. Aerobic exercise, which increases heart rate and breathing rate, is the most beneficial. Examples include walking and swimming. If you want something less aerobically challenging, try yoga or tai chi. Aim for at least 20 minutes of exercise per day on most days.
PRACTICE PURSED-LIP BREATHING. This technique will help you pace yourself through physical activities. Before you start moving, inhale through your nose so deeply that your abdomen expands. Then, as you begin to move, exhale through your mouth with your lips pursed to slow down the airflow. Your exhalation should last twice as long as your inhalation. You will feel pressure in your windpipe and chest as you slowly breathe out. When you finish exhaling, rest for a moment, then inhale and start the process again.
AVOID LUNG IRRITANTS. An important way to control your symptoms and prevent flare-ups is to keep your airways from becoming irritated. Many things can affect the airways, including exhaust fumes from your stove, smoke from your fireplace, dry air, and molds and mildew. If you have allergies, try to avoid exposure to whatever causes them — pollen, pet dander, house dust, mold and so on.
If you follow these tips, I think you’ll find that you have fewer episodes of severe difficulty in breathing.