COPD Exacerbations

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At this time of year many people with COPD experience an exacerbation brought on by any number of things and can mean that some patients end up on hospital (something I believe we would all wish to avoid at any time of year and especially at Christmastime).

Patient UK site has information about exacerbations, how these are treated and how to identify them. However this morning I came across this very useful article which may be helpful for some forum users and help them keep safe during the Christmas season.

The article is long but worth a read as it could help save your lungs.

[b:5cf766309e]The article reads as follows:[/b:5cf766309e]

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If you have COPD, you may be wondering about COPD exacerbation -- and that's a good thing. Because of the seriousness of an exacerbation, it's important for you to know how they develop and what you can do about them.

[b:5cf766309e]COPD Exacerbation: Defined[/b:5cf766309e]

In its simplest terms, an exacerbation is a worsening of symptoms. In more in-depth terms, a COPD exacerbation can be defined as “an event in the natural course of the disease characterized by a change in the patient's baseline dyspnea, cough, and/or sputum, that is beyond normal day-to-day variations, is acute in onset and may warrant a change in medication in a patient with underlying COPD,” according to the Global Initiative for Obstructive Lung Disease (GOLD).

[b:5cf766309e]

Causes of COPD Exacerbation: Infection, Air Pollution[/b:5cf766309e]

The top two causes of an exacerbation are infection of the airways or lungs and air pollution. In one-third of all COPD exacerbation cases, however, the cause cannot be identified.

Studies have found that smoking, lack of a pulmonary rehabilitation program, improper use of an inhaler and poor adherence to a drug therapy program are all associated with more frequent episodes of COPD exacerbation. Therefore, it is important that if you have been prescribed a treatment regimen for your COPD, you stick to the program and follow your doctor’s orders.

[b:5cf766309e]

Signs and Symptoms of a COPD Exacerbation[/b:5cf766309e]

The main symptom of an acute exacerbation of COPD is increased breathlessness which is often accompanied by the following:

* Increased cough and sputum production

* Change in the color and/or thickness of the sputum

* Wheezing

* Chest tightness

* Fever

[b:5cf766309e]

Treatment of COPD Exacerbation[/b:5cf766309e]

Often, either a hospital stay or a home-care nurse are necessary for managing an exacerbation. According to GOLD, nurse-administered home care can be a practical yet effective alternative to hospital care in certain patients with COPD exacerbation. The exact criteria used to determine who would benefit most from this approach, however, is uncertain and varies according to health care setting.

If your exacerbation of COPD cannot be managed safely at home, you will be admitted to the hospital. Once there, your treatment, as determined by your health care provider, may include the following:

* Oxygen therapy

* Glucocorticosteroids (oral, IV and/or inhaled medications that treat inflammation)

* Antibiotics (if an underlying bacterial infection exists)

* Bronchodilators

* Respiratory stimulants

* Ventilatory support - non-invasive (by mask) or invasive (by means of a tube inserted into your lungs through your mouth)

Prevention of COPD Exacerbation

Preventative strategies that may help patients with COPD prevent acute exacerbation include:

* Pneumonia and annual flu vaccine (a flu shot can decrease serious illness and death by as much as 50% for patients with COPD).

* Handwashing

* Balanced diet, sufficient amount of exercise/activity and adequate sleep

* Avoiding exposure to environmental irritants such as air pollution (pay attention to air quality alerts), extreme temperatures and cigarette smoke (including secondhand smoke).

* Avoid crowds, especially during cold and flu season

[b:5cf766309e]One Final Word[/b:5cf766309e]

COPD exacerbations are debilitating, in and of themselves. The toll they take on your body can lead to disability and even death. Paying attention to your body, taking better care of yourself and taking steps towards prevention may ultimately help you to avoid a COPD exacerbation.

For further information about COPD exacerbation, be sure to talk with your primary care provider.

Sources:

Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD)

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Keep Well and breathe good. V

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  • Posted

    Sorry forgot to embold / highlight: (as above)

    .......\"

    [b:68bc088383]Prevention of COPD Exacerbation[/b:68bc088383]

    Preventative strategies that may help patients with COPD prevent acute exacerbation include:

    * Pneumonia and annual flu vaccine (a flu shot can decrease serious illness and death by as much as 50% for patients with COPD).

    * Handwashing

    * Balanced diet, sufficient amount of exercise/activity and adequate sleep

    * Avoiding exposure to environmental irritants such as air pollution (pay attention to air quality alerts), extreme temperatures and cigarette smoke (including secondhand smoke).

    * Avoid crowds, especially during cold and flu season

    ..............\"

    Some patients with COPD are prescribed antibiotics to keep at home for those times when a lung infection strikes and accessing a doctor is more difficult (holidaying abroad or at Christmastime for example). Patients who are prescribed drugs for self medication are instructed by their GP how and when to use them for safety and health care purposes.

    For my own peace of mind I also carry and use the sanitising gel, I take it with me most everywhere I go, and apply before touching such things as supermarket trollies or just going out shopping generally if you are touching things, like railings, clothes, packaging etc.

    I've seen comment about not touching eyes, nose or mouth unless you have first washed your hands (especially when out and about) as this is three ways bacteria and viruses can be easily be transferred and cause infection.

    Keep well and warm but enjoy the season.

    V

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  • Posted

    Hi V.

    Thanks for the timely reminder re prevention of exacerbations in COPD. I was sorely tempted to avoid all medications this morning but continued in spite of how I felt. Also got another warning this morning as a friend of mine was hospitalised with a severe infection due to poor adherence to drug therapy, poor diet, lack of exercise and in general, not following Doctors orders. He regrets his folly.

    Regards,

    Robert.

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  • Posted

    [quote:f164d65708=\"waterman\"]Hi V.

    Thanks for the timely reminder re prevention of exacerbations in COPD. I was sorely tempted to avoid all medications this morning but continued in spite of how I felt. Also got another warning this morning as a friend of mine was hospitalised with a severe infection due to poor adherence to drug therapy, poor diet, lack of exercise and in general, not following Doctors orders. He regrets his folly.

    Regards,

    Robert.[/quote:f164d65708]

    Hello Robert, whilst one should always listen to the advice given by one's doctor, and whilst medication is rarely prescribed lightly, ignoring this advice and not taking medication does not and cannot cause an infection. Neither can poor diet or lack of exercise.

    Most infections are caused by viruses, although sometimes they are caused by bacteria. Germs that cause infections are often passed around in the community. Viruses can also cause infections, most commonly the respiratory syncytial virus (RSV). Other viral causes include the flu.

    Hope this clarifies things for you. :wink:

    :choc: fa

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  • Posted

    Hi Fa,

    I am a bit more confused as I wonder why I need to take a preventative steroid inhaler. I am aware that not taking medications does not cause infections but was informed by my Doc and Chest Nursing Practitioner that the use of Symbicort significantly reduced infections.

    ( Net Doctor re Symbicort. 'When budesonide is inhaled into the lungs it is absorbed into the cells of the lungs and airways. Here it works by preventing the release of certain chemicals from the cells. These chemicals are important in the immune system and are normally involved in producing immune and allergic responses that result in inflammation. By decreasing the release of these chemicals in the lungs and airways, inflammation is reduced.

    In asthma, and in chronic obstructive airways disease (COPD) such as chronic bronchitis, the airways tighten due to inflammation and can also be blocked by mucus. This makes it difficult for air to get into and out of the lungs. Budesonide is used in asthma and COPD to prevent the inflammation and excess mucus formation, and therefore help prevent asthma attacks and shortness of breath.')

    Regards,

    Robert.

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  • Posted

    Airways can become inflamed and mucous can build up in the lungs. That is why we take preventative medications. However, fa was right, the actual infection is caused by either a virus or bacteria. I hope this means we are all taking steps to avoid as many germs as we can.

    :nurse: :cracker:

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  • Posted

    [quote:d341d2f6b8=\"Anonymous\"][quote:d341d2f6b8=\"waterman\"]Hi V.

    Thanks for the timely reminder re prevention of exacerbations in COPD. I was sorely tempted to avoid all medications this morning but continued in spite of how I felt. Also got another warning this morning as a friend of mine was hospitalised with a severe infection due to poor adherence to drug therapy, poor diet, lack of exercise and in general, not following Doctors orders. He regrets his folly.

    Regards,

    Robert.[/quote:d341d2f6b8]

    Hello Robert, whilst one should always listen to the advice given by one's doctor, and whilst medication is rarely prescribed lightly, ignoring this advice and not taking medication does not and cannot cause an infection. Neither can poor diet or lack of exercise.

    Most infections are caused by viruses, although sometimes they are caused by bacteria. Germs that cause infections are often passed around in the community. Viruses can also cause infections, most commonly the respiratory syncytial virus (RSV). Other viral causes include the flu.

    Hope this clarifies things for you. :wink:

    :choc: fa[/quote:d341d2f6b8]

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  • Posted

    Apologies - not sure what happend above re my last comment, I had intended to write as below:

    Good Morning Robert, fa and Guest

    Hope you are all well and keeping warm this fine morning.

    Good comment from fa re always listening to the advice from our own personal doctors and medical advisers.

    I personally do everything I can to help my body and my lungs stay in a relatively good condition and have no doubts about those things that do help keep my general physical health and my lung health, emphysema in a stable condition. The information sourced by GOLD above helps us all do that.

    Preventative medicine does help prevent our lungs and airways from becoming inflamed. Naturally this will help avoid us developing further breathing difficulties and possibly avoid this developing into life threatening health situations.

    Exercise and healthy diet do just as they do, help build up the immune system, help the body function and operate more efficiently and effectively. I don't doubt at all that regular exercise and good diet help our bodies fight infections.

    I'm a great believer in helping myself in every which way, this makes good sense to me, that is helping myself to extend my life expectancy and an improved quality of life in the process.

    Wishing all only the very best for the Season

    :cracker:

    V

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  • Posted

    [quote:f08f07878a=\"waterman\"]Hi V.

    Thanks for the timely reminder re prevention of exacerbations in COPD. I was sorely tempted to avoid all medications this morning but continued in spite of how I felt. Also got another warning this morning as a friend of mine was hospitalised with a severe infection due to poor adherence to drug therapy, poor diet, lack of exercise and in general, not following Doctors orders. He regrets his folly.

    Regards,

    Robert.[/quote:f08f07878a]

    Hi Robert

    Glad you made a good choice re your medications. Keep up with the good diet and exercise, it will stand you in good stead throughout the winter months. Most of the time I exercise indoors in this weather, I find more lung friendly :D

    Sure do hope your friend is ok and gets well looked after during his hospital stay.

    Let us know how he is doing.

    Regards

    V

    Seasons Greetings, Wishing all, Good Health, Good Cheer for Christmas and the New Year.

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