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COPD: How to Achieve
Stability
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COPD: How to Achieve
Stability
What Is COPD?
Chronic obstructive pulmonary disease (COPD) refers to a group of lung disorders that make it harder for you to breathe. When you have COPD, damage to your airways and lungs causes them to become partly blocked.
The two main conditions that make up COPD are:
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Emphysema, in which the tiny air sacs in your lungs are damaged

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Chronic bronchitis, in which the tubes that carry air to your lungs get irritated and swollen

Most people with COPD have a mix of emphysema and chronic bronchitis. You might have more symptoms of one condition than the other.
When you have COPD, you may struggle to get a deep breath. Other symptoms include:
  • Wheezing
  • Thick mucus
  • Tightness in your chest
  • A cough that doesn't go away
  • Fatigue
Smoking is the No. 1 cause of COPD. You can also get it if you're exposed to air pollution, secondhand smoke, dust, or chemicals for a long time. In some cases, an inherited condition or repeated respiratory infections as a child can lead to COPD.
There's no cure, and you can't reverse the damage once it happens. But therapies for COPD can help keep symptoms at bay and slow down the disease's progress. Your treatment options depend on which lung condition you have, how serious your condition is, and your overall health.
Most people with COPD have a mix of emphysema and chronic bronchitis. You might have more symptoms of one condition than the other.
When you have COPD, you may struggle to get a deep breath. Other symptoms include:
  • Wheezing
  • Thick mucus
  • Tightness in your chest
  • A cough that doesn't go away
  • Fatigue
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Smoking is the No. 1 cause of COPD. You can also get it if you're exposed to air pollution, secondhand smoke, dust, or chemicals for a long time. In some cases, an inherited condition or repeated respiratory infections as a child can lead to COPD.
There's no cure, and you can't reverse the damage once it happens. But therapies for COPD can help keep symptoms at bay and slow down the disease's progress. Your treatment options depend on which lung condition you have, how serious your condition is, and your overall health.

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What Is Stable COPD?
COPD tends to get worse over time. But you'll likely have stretches when your symptoms stay under control for a while.
Disease stability matters because it means your condition isn't getting worse. When you have fewer flare-ups, you feel better overall. You might even have more energy.
And when your COPD is under control, damage to your lungs doesn't worsen as quickly. You're less likely to visit the hospital. You also have a lower risk of death when your COPD is stable.
Because COPD is a condition that gets worse over time, it can be hard to reach long-term stability. But it's doable for long stretches of time when you have treatment that works well.
Some research suggests that about 60% of people with mild to moderate COPD can achieve control for periods lasting at least a year.

Disease stability matters because it means your condition isn't getting worse. When you have fewer flare-ups, you feel better overall. You might even have more energy.

And when your COPD is under control, damage to your lungs doesn't worsen as quickly. You're less likely to visit the hospital. You also have a lower risk of death when your COPD is stable.

Because COPD is a condition that gets worse over time, it can be hard to reach long-term stability. But it's doable for long stretches of time when you have treatment that works well.

Some research suggests that about 60% of people with mild to moderate COPD can achieve control for periods lasting at least a year.

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Are You Having a Flare-Up?
It's not always easy to tell when you're having a COPD flare. Common signs include:
  • Feeling more out of breath than usual
  • Wheezing noises when you breathe
  • Coughing more
  • More mucus than usual, or mucus that's a different color
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What to Do When You Have a Flare-Up
  • Follow the action plan you and your doctor created.
  • Take your rescue meds and use oxygen therapy if your doctor has prescribed it.
  • Keep taking any long-acting medications you use.
  • Try pursed-lip breathing.
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When to Get Help
  • See a doctor if your symptoms keep getting worse or don't get better within two days.
  • Go to the emergency room for serious symptoms like chest pain, confusion, or trouble talking.
Treatments to Stabilize COPD
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Several treatments can help you get your COPD symptoms under control. The type you need depends on how serious your condition is. Each person's journey is different.
Some medications that can help stabilize COPD are:
Bronchodilators. These medicines are considered first-line treatments for COPD. They're usually delivered via an inhaler or nebulizer (a machine that turns liquid medicine into a breathable mist). Bronchodilators loosen tight muscles around the airways in your lungs. When those muscles relax, your airways widen so you can breathe better. Short-acting bronchodilators work right away and wear off soon. You use long-acting types daily for slower relief that lasts longer.
Corticosteroids. Steroids lessen swelling inside your airways. You usually take these drugs for short periods at times when your symptoms get worse. That's because they can cause serious side effects. You either take them as pills or in inhaled form along with other medications.
Combination medicines. Some people need a combination of drugs. You may take two or three medications in one inhaler or nebulizer.

Combination Treatments for COPD

These are some possible combinations your doctor might prescribe:

  • Inhaled corticosteroid + long-acting bronchodilator
  • Long-acting bronchodilator + different long-acting bronchodilator
  • Short-acting bronchodilator + different short-acting bronchodilator
  • Inhaled corticosteroid + long-acting bronchodilator + different long-acting bronchodilator
Biologics. Biologic medicines are a newer treatment option for people with COPD who have high levels of white blood cells called eosinophils. These medications help prevent flare-ups by targeting certain proteins involved in inflammation. You take these injected drugs as add-on medications along with other treatments.
Phosphodiesterase-4 (PDE-4) inhibitors. PDE-4 inhibitors help reduce swelling in the lungs by blocking a chemical that causes inflammation. This type of drug is generally used only for people with serious COPD. You take it as a daily pill to help prevent flare-ups.
Antibiotics. Your doctor may prescribe an antibiotic when you have a flare-up caused by a bacterial infection. Always take antibiotics for the whole time they're prescribed.
It's important to take any medicine you're prescribed exactly as your doctor recommends. If you miss doses, for example, you're less likely to get your symptoms under control.
Bronchodilators. These medicines are considered first-line treatments for COPD. They're usually delivered via an inhaler or nebulizer (a machine that turns liquid medicine into a breathable mist). Bronchodilators loosen tight muscles around the airways in your lungs. When those muscles relax, your airways widen so you can breathe better. Short-acting bronchodilators work right away and wear off soon. You use long-acting types daily for slower relief that lasts longer.
Corticosteroids. Steroids lessen swelling inside your airways. You usually take these drugs for short periods at times when your symptoms get worse. That's because they can cause serious side effects. You either take them as pills or in inhaled form along with other medications.
Combination medicines. Some people need a combination of drugs. You may take two or three medications in one inhaler or nebulizer.

Combination Treatments for COPD

These are some possible combinations your doctor might prescribe:

  • Inhaled corticosteroid + long-acting bronchodilator
  • Long-acting bronchodilator + different long-acting bronchodilator
  • Short-acting bronchodilator + different short-acting bronchodilator
  • Inhaled corticosteroid + long-acting bronchodilator + different long-acting bronchodilator
Biologics. Biologic medicines are a newer treatment option for people with COPD who have high levels of white blood cells called eosinophils. These medications help prevent flare-ups by targeting certain proteins involved in inflammation. You take these injected drugs as add-on medications along with other treatments.
Phosphodiesterase-4 (PDE-4) inhibitors. PDE-4 inhibitors help reduce swelling in the lungs by blocking a chemical that causes inflammation. This type of drug is generally used only for people with serious COPD. You take it as a daily pill to help prevent flare-ups.
Antibiotics. Your doctor may prescribe an antibiotic when you have a flare-up caused by a bacterial infection. Always take antibiotics for the whole time they're prescribed.
It's important to take any medicine you're prescribed exactly as your doctor recommends. If you miss doses, for example, you're less likely to get your symptoms under control.
Other therapies your doctor may recommend include:
Oxygen therapy
Oxygen therapy delivers extra oxygen to your lungs. This treatment can help you feel better and have more energy. It may even extend your lifespan if you have severe COPD.
You get it through a mask or tube that fits in your nose and is hooked up to an oxygen tank. The machine pulls in air, adds extra oxygen, and sends it through a tube so you can breathe it in.
Pulmonary rehabilitation
Pulmonary rehabilitation is a program that helps teach people with COPD ways to breathe better. It includes exercises, breathing training, education, and support. The program can help reduce COPD symptoms and improve your quality of life.
Most pulmonary rehabilitation programs last a few months. After that, you perform the exercises and practice the habits you learned on your own.
Oxygen therapy
Oxygen therapy delivers extra oxygen to your lungs. This treatment can help you feel better and have more energy. It may even extend your lifespan if you have severe COPD.
You get it through a mask or tube that fits in your nose and is hooked up to an oxygen tank. The machine pulls in air, adds extra oxygen, and sends it through a tube so you can breathe it in.
Pulmonary rehabilitation
Pulmonary rehabilitation is a program that helps teach people with COPD ways to breathe better. It includes exercises, breathing training, education, and support. The program can help reduce COPD symptoms and improve your quality of life.
Most pulmonary rehabilitation programs last a few months. After that, you perform the exercises and practice the habits you learned on your own.

What Do You Learn in Pulmonary Rehab?

Endobronchial valve therapy
Endobronchial valve (EBV) therapy is a procedure in which doctors place tiny, removable valves into the airways of your lungs. These valves let air out, but not in. This helps air escape from damaged and over-inflated areas of your lungs so the healthier parts can work better. EBV can improve your quality of life and may help you live longer.
Surgery
Surgery is sometimes an option for people with COPD. There are three main procedures:
  • Lung volume reduction (LVR): In this operation, a surgeon removes a damaged part of your lung. This can help the healthier parts work better.
  • Bullectomy: This is surgery to remove damaged air sacs from your lung. It may allow you to breathe easier.
  • Lung transplant: Your diseased lung is removed and replaced with a healthy lung from a donor. Some people with COPD who get lung transplants are more likely to live longer.
Vaccines
Respiratory infections can trigger COPD flare-ups and cause further lung damage. That's why it's important to stay up to date on your vaccines. Experts suggest you get shots for COVID-19, the flu, and pneumonia.
Endobronchial valve therapy
Endobronchial valve (EBV) therapy is a procedure in which doctors place tiny, removable valves into the airways of your lungs. These valves let air out, but not in. This helps air escape from damaged and over-inflated areas of your lungs so the healthier parts can work better. EBV can improve your quality of life and may help you live longer.
Surgery
Surgery is sometimes an option for people with COPD. There are three main procedures:
  • Lung volume reduction (LVR): In this operation, a surgeon removes a damaged part of your lung. This can help the healthier parts work better.
  • Bullectomy: This is surgery to remove damaged air sacs from your lung. It may allow you to breathe easier.
  • Lung transplant: Your diseased lung is removed and replaced with a healthy lung from a donor. Some people with COPD who get lung transplants are more likely to live longer.
Vaccines
Respiratory infections can trigger COPD flare-ups and cause further lung damage. That's why it's important to stay up to date on your vaccines. Experts suggest you get shots for COVID-19, the flu, and pneumonia.
Lifestyle Management for COPD
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Certain healthy lifestyle habits can help you manage your symptoms. Before you make any big changes, it's a good idea to discuss them with your doctor.
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Stop smoking
Smoking leads to as many as 80% of COPD-related deaths. Even secondhand smoke can trigger COPD. That means you should avoid being around cigarettes altogether.
If you stop smoking, you can slow down COPD lung damage. Your risk for a flare-up goes down. You'll be able to breathe easier and will have more energy. If you're having trouble quitting, ask your doctor for help.
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Avoid irritants
To avoid worsening your COPD symptoms, stay away from fumes, dust, smoke, air pollution, strong fragrances, and other chemicals that could trigger a flare-up. Stay inside when air pollution or dust levels are high. You may want to use an air filter in your home if the air quality in your area is often bad.

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Healthy lifestyle
Regular, moderate exercise along with a balanced diet could boost your lung function and help you feel better. Healthy habits can also improve your sleep and mental health.
If you're new to exercise or haven't done it in a while, start slowly. Overdoing it could actually make COPD symptoms worse. You might shoot for three to four days a week for 20-30 minutes at a time, including a combination of stretching, aerobic activity, and resistance training. Always talk with your doctor before you start an exercise program.
The foods you eat can also affect how well you breathe. A diet that includes a variety of fruits and veggies, whole grains, protein, and unsaturated fats is key. Some research has suggested that eating fewer carbohydrates and more fat may help improve breathing. That's because your body produces more carbon dioxide when it processes carbs. You exhale carbon dioxide as a waste product, and that takes more energy for people with COPD.
Also, strive to maintain a healthy weight. Health problems can result if you weigh either too much or too little. If you're overweight, breathing may be more difficult due to the extra strain on your lungs and heart. If you're underweight, you might not get enough nutrients to allow your body to fight off infections well.
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Avoid infections
Proper hygiene and other healthy habits can help you ward off respiratory infections, which can be dangerous for people with COPD. Here are some tips:
  • Wash your hands regularly with soap and water, especially after you've been around lots of people.
  • When you can't wash your hands, use an alcohol-based sanitizer.
  • Cough or sneeze into your elbow or a tissue (not your hands).
  • Avoid touching your eyes, mouth, or nose.
  • Stay away from people who are sick.
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Energy management
COPD can drain your energy, leaving you feeling tired and lethargic. Even simple tasks like getting dressed or taking a shower can be a struggle.
It might help to practice the energy management strategies known as the "5 P's":
  1. 1. Pace yourself. Take breaks when you need them, and rest before you become fatigued.
  2. 2. Plan ahead. Don't schedule too many tasks in one day.
  3. 3. Position yourself correctly. Stay upright when you stand or sit. Don't stay in one position for too long.
  4. 4. Prioritize activities. Determine what's most important and what can wait.
  5. 5. Pursed-lip breathing. Breathe in through your nose. Then breathe out for at least twice as long through your mouth, using pursed lips. This slows down your breathing so you can get more air.

Your Stop-Smoking Plan

COPD and Your Emotions
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COPD often takes a toll on your emotions. The diagnosis itself can also be hard to deal with. You may not be able to do as much as you used to, which can make you feel guilty and affect your social life. And flare-ups in which you struggle to breathe can be downright scary.
Such negative emotions can make it harder to take steps to take care of yourself properly. But there are steps you can take to help you manage these feelings.
People with COPD are more likely to deal with:
  • Anxiety. Constant worry about your condition can affect your ability to function normally.
  • Panic attacks. These are sudden episodes of severe anxiety. Panic attacks and anxiety may cause shortness of breath, which can make it even harder to breathe with COPD.
  • Depression. Clinical depression is a deep sadness that affects your daily life and doesn't go away. People with COPD who are depressed may have to visit the hospital more often due to more flare-ups.
  • Stress. A diagnosis of COPD can cause stress. Some research suggests too much stress can worsen your symptoms and lead to flare-ups.
How COPD Affects Your Life
Here are a few of the many ways COPD can affect you.
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Physical
  • Pain
  • Trouble breathing
  • Fatigue
  • Muscle weakness
  • Limits on mobility
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Emotional
  • Stress
  • Anxiety
  • Sadness or depression
  • Feelings of fear, anger, or guilt
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Relationships
  • Not being able to take part in social events
  • Missed work
  • More dependence on caregivers
  • Lack of intimacy due to physical limitations
Getting support

A good support system is important when you have COPD, especially if you also feel anxious or sad.
Don't spend too much time with people who make you feel more stressed. Instead, hang around those who encourage you. You may want to talk with a trusted family member or friend about your feelings. The simple act of sharing your emotions can often help you feel better.
You might also find a support group helpful. Others with COPD can provide management tips, emotional support, and companionship. You can find groups that meet online or in person. Ask your doctor if you need help finding one.
If you have symptoms of anxiety or depression that last for more than a couple of weeks or interfere with your daily life, talk to a mental health professional. They can help you understand why you have these feelings and how to deal with them.
Doctors can prescribe medications to improve anxiety or depression. Talk therapy may also lessen your symptoms. The important thing is not to wait to seek help.

Getting support
A good support system is important when you have COPD, especially if you also feel anxious or sad.
Don't spend too much time with people who make you feel more stressed. Instead, hang around those who encourage you. You may want to talk with a trusted family member or friend about your feelings. The simple act of sharing your emotions can often help you feel better.
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You might also find a support group helpful. Others with COPD can provide management tips, emotional support, and companionship. You can find groups that meet online or in person. Ask your doctor if you need help finding one.
If you have symptoms of anxiety or depression that last for more than a couple of weeks or interfere with your daily life, talk to a mental health professional. They can help you understand why you have these feelings and how to deal with them.
Doctors can prescribe medications to improve anxiety or depression. Talk therapy may also lessen your symptoms. The important thing is not to wait to seek help.

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