Important Questions about COPD Care

How is COPD treated?
What is oxygen treatment?
When should you see a doctor?
Why is good nutrition and exercise important?
What is a respiratory rehabilitation program?

How is COPD Treated?

There is no cure for COPD. Once the lungs have been damaged, they cannot be repaired. COPD is a chronic illness that becomes progressively worse over time. However, there are things you can do that will help slow the rate at which the disease progresses, and relieve your symptoms so that you can breathe more easily and have a better quality of life. Proper treatment can prolong lifespan, reduce hospitalizations, and improve your quality of life.

Lead a smoke-free life: This includes stopping smoking and eliminating your exposure to second-hand smoke. Stopping smoking is the best way to slow the progression of COPD, lessen worsening of symptoms and avoid complications. For smoking cessation information, see General Resources under Stop Smoking.

Avoid inhaling irritants found your environment: At work be sure to use proper safety equipment that will prevent inhalation of chemical fumes and industrial dust. At home, ensure your house is properly ventilated to avoid inhalation of indoor pollution such as dust and pet dander. Avoid environmental conditions known to affect breathing such as outdoor air pollution, cold dry air, hot humid air, or high altitudes.

Be immunized against flu and pneumonia: Ask your doctor about being vaccinated for these respiratory illnesses.

Avoid Shortness of Breath: Include rest breaks as part of your daily activities and pace your activities. Seek advice from medical professionals on breathing exercises you can do to alleviate your symptoms. For information on breathing exercises, see the Canadian Lung Association's Web site under Control Your Breathing.

Properly use the medications prescribed to you by your doctor:

Bronchodilators help make breathing easier by relaxing the muscles in lung airways muscles. Medications include:

• Beta₂-agonists: Short acting beta₂-agonists are used for quick, short-term symptom relief; examples include salbutamol (Ventolin), terbutaline (brand name Bricanyl) and fenoterol (brand name Berotec). Long acting beta₂-agonists, such as proventil, formoterol, foradil, and salmeterol, take longer to work, but provide up to 12 hours of relief. Unfortunately, long-acting beta₂-agonists are not effective for some people. Beta₂-agonists come in a pill or inhaled form. Side effects include anxiety, muscle tremors, nervousness, and heart palpitation (i.e., increased or irregular heartbeat).
• Anticholinergics: Drugs such as ipratropium bromide relax the airways and protect against airway narrowing due to spasms. Anticholinergics can also be effective in reducing sputum production. They are usually the first choice for treating COPD, but sometimes are combined with beta₂-agonists. Common side effects are mild cough and dry mouth. A less common side effect associated with inhaled ipratropium is glaucoma. Early symptoms of glaucoma are red, painful eyes and foggy vision - contact your doctor immediately if you experience any of these symptoms.

What is Oxygen Treatment?

COPD symptoms can range from mild to severe. People with severe COPD who have low blood oxygen levels are sometimes given long-term oxygen therapy to prevent or slow the progression of right-sided heart failure. It is also used to prevent premature death. Oxygen can be delivered through a flexible plastic tube inserted in the nostrils. Oxygen treatment usually does not have any adverse side effects. Due to safety concerns, oxygen treatment is usually not prescribed to people who continue to be smokers.

When Should You See a Doctor?

Call your doctor immediately if you have been diagnosed with COPD and are experiencing any of the following symptoms:

• Shortness of breath or wheezing that is getting worse very quickly
• Coughing harder or more often (especially if the cough brings up sputum that is green, yellow or rust coloured)
• Coughing up blood
• Swelling in your legs or abdomen
• High fever (over 37.78 degrees Celsius or 100 degrees Fahrenheit)
• Severe chest pains
• Flu-like symptoms

Why is Good Nutrition and Exercise Important?

Nutrition

Some people living with severe COPD, especially those who have emphysema, can experience severe weight loss resulting in poor health. Being severely underweight can be life threatening. Severe weight loss can also result in a loss of muscle mass, including weakening of the muscles that are used to breathe. A proper diet is important in helping you maintain your strength and prevent your health from worsening. A diet high in protein will help rebuild muscles and recover from illness. Milk products and meat are high in protein. Vitamins and minerals from fruit, vegetables and grains are also important.

If you use water pills (diuretics), you may also experience potassium loss. Speak to your doctor about whether taking potassium pills or changing your diet to include high-potassium foods (such as milk, fresh oranges or orange juice, dried fruits, bananas, beef, potatoes and fresh pineapple) may be right for you.

A dietitian can help you determine your nutritional and caloric needs. See BC's Dial-A-Dietician Program under General Resources.

People with COPD might find it hard to breathe when they are eating because a full stomach can press on the diaphragm. Lifestyle changes that may help you to eat properly with less shortness of breath include:

• Using medications that help you breathe easier about one hour before eating
• Resting before eating and take plenty of time to eat
• Eating slowly and chewing foods thoroughly
• Breathing evenly while chewing
• Eating small frequent meals each day instead of three large ones so that your stomach is never extremely full and pushing on the diaphragm
• Avoiding or eating only small amounts of gas-forming foods which bloat the abdomen and make breathing difficult (e.g., onions, cauliflower, broccoli, melons, peas, corn, cucumbers, cabbage, brussels sprouts, turnips, raw apples and beans, except green beans
• Not skipping breakfast - drink a liquid breakfast or nutritional supplement if you have difficulty breathing in the morning

Exercise

Leg and arm exercises are often recommended for people living with COPD because they strengthen the heart and breathing muscles. Leg exercises include walking on a treadmill or exercising on a stationary bicycle. Arm exercises usually involve raising your arms over your head or raising them to shoulder height while stretching them out in front of you.

It is important to note that COPD severity will determine how much exercise a person can do.

It is also important that you consult your doctor before starting any exercise program. See the Canadian Lung Association's Web site under Exercise. In some communities, exercise is available as part of a respiratory rehabilitation program.

What is a Respiratory Rehabilitation Program?

Respiratory rehabilitation programs help you develop the skills you need to manage your COPD and improve your quality of life. This includes education on COPD, nutrition, staying healthy, and other skills to help you better cope with your disease. Respiratory rehabilitation also includes working with the rehabilitation team to develop a safe and appropriate exercise program that meets your needs. Participation in some programs may require a referral from your doctor.

For information on whether a respiratory rehabilitation program is available in your community, call the Canadian Lung Association's BreathWorks Helpline at 1-866-717-COPD (2673), or visit the BreathWorks Web site under Find Programs in Your Community.