Living with COPD

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Lung function and age play a very important role in establishing the prognosis. However, more information is required in order to establish a more individualised prognosis, as well as multi-dimensional assessments, such as those taken into account in the BODE index; weight (body mass index), the degree of obstruction, the feeling of breathlessness (dyspnoea), and exercise capacity.

The frequency and severity of the decompensations have a very important role in the prognosis, as it leads to a worsening of the clinical situation, as well as due to the risk during the periods of exacerbations.

Some recommendations that help patients live with COPD are the following:

do not smoke

Give up smoking. It is the starting point and cornerstone of COPD treatment. Giving up smoking is the only way to slow down the progression of the disease, regardless of how long ago the diagnosis was made and the severity of the COPD. The sooner you give up smoking the greater is the benefit.

Chemicals, pipette

Irritant substances. Certain elements that are in the air that we breathe can cause irritation in the bronchial tree. It is almost impossible to avoid all irritant substances, but it is important to try to avoid environments contaminated with tobacco smoke, sprays, paints and solvents, dust, gases and traffic contamination, domestic animal hair, insecticides, lacquers, strong air fresheners and perfumes.

Thermometer, Optimum body temperature,

Climate. Cold and changes in temperature can be a problem for people with COPD. All the rooms of the home should be maintained at the same temperature between 19˚C and 21˚C.

Heating, radiator

Heating. Some heating systems can dry the air and the dry atmosphere can affect some individuals with COPD. It is advised to maintain a humid environment of 45%. Excessive humidity in the home can also be a problem for those with COPD. Mould, dust, mites and bacteria depend on the humidity in order to develop and can cause respiratory irritation.

apple

Diet. It is important to maintain a healthy and balanced diet. Maintain an appropriate weight, both overweight and excessively thin or malnourishment have an unfavourable influence on the progression of the disease.
Drinking abundant liquids helps to keep the respiratory tract clean or with less dense mucous. The best drink is water, with a quantity of approximately 1.5 litres per day being necessary.
It also important to prevent constipation, therefore it is advised to follow a diet rich in fruit and vegetables and increase the consumption of wholemeal cereals.

Vaccines, calendar, calendar vaccination

Vaccines. Each year, except by medical contraindication, the vaccine should be administered against influenza, as this can cause worsening of the disease. Although the vaccine does not preventing catching the flu, at least it is less severe.

Apart from this vaccine, it is also advised to have a pneumococcal vaccine every 5 years, if over 65 years-old, in order to be protected against a type of pneumonia.

Both vaccines can be given together.

take part in regular physical exercise

Exercise. With COPD, it is likely that you do not to want to perform exercises for fear that it may trigger more breathlessness or cause some damage. The problem is if no activity is practised, physical shape is lost and the muscles become weak, which can have an effect on daily activities.

In this sense, it is advised to take regular exercise in order to improve the symptoms of breathlessness and fatigue, as well as to strengthen the arms, legs, trunk, the heart and physical shape in general.

The exercise recommended will vary depending on the situation, preferences, and symptoms of each patient. In general activities such as walking, swimming, riding a bicycle or static cycling, conveyer belt, dancing, etc., can be practised.

Before starting any type of activity or exercise program, you should talk to the health professional about the most suitable type of exercise.

To feel breathless or short of breath during exercise is normal, as breathing will return to normal after stopping the activity. With time, and if you practice regularly, this feeling will decrease and you will have more tolerance on exertion.

It is important to keep to your own rhythm on exercising, and if you reach a stage in which you are too breathless to speak, then decrease it or have a short rest.

Sexuality, sex, masculine, feminine

Sexuality and relationships. On occasions, patients with COPD may feel that is better to avoid sexual relationships as it may be too “dangerous” for their health. However, these relationships, like the other physical activities, are not dangerous for respiratory disease. It should be known that small increases in heart and respiration rates are normal during this activity, without being dangerous.

Man sleeping 7-8 hours

Sleep. Many people with COPD have difficulties in breathing during the night due to a decrease of oxygen in the blood. It also causes as decrease in the cough reflex, which leads to retaining bronchial secretions.

  • If you wake up with a feeling of breathlessness, sit on the edge of the bed and lean forward.
  • Leave medication near to the bed, in case it is needed.
  • Sleep a little more supported in bed.

COPD, together with other factors, such as obesity, smoking, and alcohol consumption, among other things can, in some people, lead to a sleep disorder called Sleep Apnoea-Hypopnoea Syndrome (SAHS).

This can produce symptoms such as excessive drowsiness during the day (the individual falls asleep involuntarily and when carrying out usual activities), a feeling of not having rested during the night, snoring, morning headaches, irritability, attention and memory problems. If you have any of these symptoms it is advised to consult the chest disease specialist.

Man with respiratory support

Oxygen therapy. COPD can occasionally lead to the lungs having difficulty in capturing the oxygen of the air and transporting it to the blood, which then leads to having low oxygen levels in the blood (chronic respiratory failure). The levels of oxygen in the blood are measured by means of arterial blood gases.

Oxygen therapy is a treatment that enriches the air that is breathed with supplementary oxygen. In this way a suitable concentration of oxygen for the body can be obtained. However, this does not mean that the breathlessness and fatigue is eliminated.

travel, ariplane

Leisure and travel. To have COPD does not mean giving up leisure or travel. For this reason it is advised to maintain relationships and interest in carrying out leisure and social activities, as well as sharing these activities with other people, like going to relaxation classes, listen to music, or travel.

Other diseases

The term "comorbidity" refers to the presence of two or more simultaneous diseases in the same person. The comorbidities of COPD may be as a consequence of the respiratory that affects the whole body (restriction of oxygenation in all the tissues) or due to the direct impact of common triggering factors: smoking affects the airways at the same time that it increases cardiovascular risk.

Among the most common morbidities, are highlighted:

  • Ischaemic heart disease. It is associated with smoking.
  • Osteoporosis. It is more common in smokers.
  • Diabetes. The presence of diabetes is significantly higher in patients with COPD than in the general population.
  • Sleep disorders. The prevalence is similar to the general population, but the risk is higher in patients with COPD.
  • Gastroduodenal reflux. It is more common in patients with COPD, and some studies associate it with cough and with a higher risk of decompensations.
  • Anxiety and depression. They are common in COPD and are undervalued.

Information for the carer or the people that live with the patient

Living with COPD can involve difficult times in the family environment and on occasions, significant changes in normal and leisure activities may need to be faced.
People with COPD must try to maintain a good family climate. This can be helped by sharing their fears and feelings about the diseases with them, as it should not be the responsibility of your carer.

Some useful advice for the carer:

  • Over-protection. Try not to be over-protective, as it can make the patient feel like an invalid.
  • Try to be positive. There will be bad days; but don’t be discouraged.
  • Search for information about COPD. A useful resource are patient associations.
  • Seek advice. If you think that you need some type of support, it is recommended to contact a social worker in your health centre.
  • Take time for yourself. Do things that help stop thinking of the disease. Take a rest with some leisure activity, outside the home.
Substantiated information by:
Núria SeijasNurse — Hospital at HomeNéstor SolerPneumologist — Pneumology Department

Published: 20 February 2018
Updated: 20 February 2018

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