If you’ve recently been diagnosed with chronic obstructive pulmonary disease, you probably already know that it’s an incurable lung condition that progressively makes breathing more difficult. As time goes on, your lung function may deteriorate, and many patients find that completing everyday tasks becomes more challenging.
But as Scott Marlow, respiratory therapist at the Cleveland Clinic, says, with a little planning, “you can live a very long, effective and wonderful life with” a COPD diagnosis. A little planning and strategizing can go a long way to helping yourself breathe easier with this disease.
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This strategic approach to living with COPD starts with education, says Dr. David Beuther, a pulmonologist and associate professor of medicine at National Jewish Health in Denver. Because COPD, which encompasses both chronic bronchitis and emphysema, is often caused by smoking cigarettes, it has a stigma attached to it. Upon diagnosis, many patients “immediately jump to a lot of negative thinking. Any chronic disease can be like that, but because of the negative stigma with this disease, patients feel guilty that they did it to themselves. We need to change that conversation,” Beuther says. “That education has to talk about how the lungs work and why you get short of breath.” When patients understand how the disease works, they can be smart about working around it, he says. “There’s a lot we can do for patients to feel better day-to-day. With a little proactive work on the patient’s part, you can still travel and do things,” he says.
The lowest hanging fruit in helping yourself cope with a COPD diagnosis, Marlow says, is to quit smoking if you haven’t already. “Lung function declines exponentially faster in patients who are affected by [tobacco smoke] and develop COPD. When they quit smoking, they actually level off losing lung function to about the same as a nonsmoker. You don’t get it back, but you stop losing it as quickly,” he says.
Learning to pace yourself and breathe intentionally is another way that patients can help themselves. “Slow down and avoid rapid, shallow breathing,” Beuther says. Thinking strategically about managing your energy output can also help. For example, “maybe you have some big event with the family, so maybe that’s the day you don’t exercise or do house chores and you expect that the next [day] you’ll take it easy,” Beuther says. Asking for help with things like laundry and housework can help you manage your energy output.
Taking your medications as prescribed is another relatively easy way to keep your COPD in check. Dr. Philip Diaz, a pulmonary specialist at The Ohio State University Wexner Medical Center in Columbus, Ohio, says, “the first thing to determine is how bad is the COPD from a lung function perspective and whether the patient is on the optimal medical management. There are more choices now than in the past,” when it comes to medications, so finding the best option is key to managing the disease optimally. Similarly, if your doctor has prescribed oxygen, it’s important to use it as directed.
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Another way to help keep yourself healthier is to stay on top of annual vaccinations. Many COPD exacerbations — a worsening of the disease that results in a change to the care protocol — are caused by an infection from the flu or pneumonia, two diseases that have readily available vaccines. According to a statistical briefing from the Agency for Healthcare Research and Quality, 62.5 percent of all hospital stays related to COPD in 2008 were because of exacerbations. Those complications are avoidable in some cases, and getting routine vaccinations is one way to help keep them at bay.
You should also stay as active as you can, Marlow says, by following the pulmonary rehabilitation program you’re prescribed and getting as much physical exercise as your situation allows. Diaz says “one thing that happens with these patients is they have more trouble breathing, and then over time, they get deconditioned” because exercise causes breathlessness, which causes them to stop exercising regularly. This in turn leads to more breathlessness when the patient does engage in any physical activity — creating a cycle of decreased activity and increased breathlessness. Inactivity can lead to muscle atrophy, which magnifies the lung problems, so it’s important to stay active as consistently as possible right from the beginning, he says.
“Most patients with COPD are not exercising enough,” Beuther says. “They feel bad and so they stop doing things. Anecdotally, half the patients who can’t do things are short of breath because they’re horribly out of shape, and so we usually refer these patients to a formal pulmonary rehabilitation program, which is similar to cardiac rehab.” Using a combination of education and exercise, these programs help patients recover some of their lost capacity for physical activity. Bottom line, “you have to keep moving,” Beuther says.
Eating right is also a helpful strategy for keeping on top of your COPD and staying as healthy as you can. “You want to keep your immune system up. You want to eat a nice, balanced diet. You don’t want to be over- or underweight, because maintaining a good weight is important, too,” Marlow says. And eating more, smaller meals is another good strategy, Beuther says. “A lot of people with moderate to severe COPD will get full early because the lungs are inflated. People without COPD may feel this at Thanksgiving when we eat too much,” and the stomach expands and impinges on the space available for the lungs. Because of this, some COPD patients, particularly those with later-stage disease, can end up becoming malnourished or losing weight. On the other hand, “if you’re tremendously overweight, that can affect lung function, too, Beuther says, so he recommends eating “five or six small meals a day and monitoring your weight once a week.”
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In addition to these physical strategies, Diaz says it’s important to stay calm. “This is a condition that’s often associated with anxiety or depression. Particularly with anxiety, people have difficulty breathing when they’re anxious, so learning to appreciate that and the impact [of that anxiety] on a day-to-day basis,” is important. He says the default setting when we get anxious is to breathe faster, which is not helpful for COPD patients who often have trouble emptying their lungs fully of spent air. “It’s important to recognize this and try to relax,” he says.
In the end, a little effort can go a long way to making life with COPD easier. “It may not be fair, but you have to work a little harder to do these things,” Beuther says. He encourages patients to stay involved with friends and family and to resist the urge to withdraw from activities. “We’re trying to get people away from thinking, ‘I can’t do this and I can’t do that,'” but rather to plan ahead and think strategically to retain the highest quality of life they can despite their diagnosis.
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What Are the Best Strategies for Living With COPD? originally appeared on usnews.com
