Worsening COPD is not a pretty topic. However, with your COPD diagnosis, FLASS feels you should be aware of the progression of this disease.
Thus, in our recent two blogs, we have been creating a COPD Guide. And we are following the classic 4 stages of COPD. Medical professionals have divided the stages in order of worsening COPD conditions. Meanwhile, we have also sent out some FLASS special alerts about the summer triggers that are making this season especially difficult for our patients with worsening weaCOPD. And we want to remind you that the same triggers for COPD are also dangerous to patients who have other respiratory problems like asthma, bronchiectasis or lung cancer.
This Week’s Summer Triggers: Warnings for Lung Patients
As COPD progresses, You Discover It Takes More Energy to Breathe.
The British Lung Foundation, as well as FLASS, have issued alerts about the hot weather. They stated, “If you have a long-term lung condition like asthma, bronchiectasis or COPD, you’re more at risk of the heat affecting you. And hot weather can cause your symptoms to flare up too.
Top 5 Reasons this weather could trigger your COPD include:
- Dehydration has made you feel worse.
- The strong sunshine has caused the ozone levels in the air to rise.
- Your heat-irritated tissues are now more sensitive to air pollutants. These triggers are increasing your breathing problems
- Likewise, the summer grasses and weeds are increasing our pollen levels. “If you live with asthma, COPD or another condition that makes your airways sensitive, this can mean you end up coughing, wheezing and feeling short of breath.”
- Your COPD could be worsening, regardless of the weather. This is one of the reasons you must see your healthcare specialist if you are fighting with symptoms. Worsening COPD cannot be confused with simple seasonal irritations. Your physician will know the difference. For more information on these summer COPD triggers, please read or review parts 1 and 2 of this topic.
Worsening COPD: “In Between” The Official Stages 2, 3 and 4
Worsening COPD does not always follow the exact course (four “stages”) charted by the medical professionals. This blog is dedicated the in-between times, as each stage progresses. You see, we can generalize the progression of this disease. Thus, we are empowering you to take steps that will help you cope with the condition.
Some progressions of the disease are obvious. Other symptoms of worsening COPD might take you by surprise, and you might not recognize them. We want you to recognize the signals your body sends you when your COPD is worsening. That way you will know when to come into FLASS. Then, we can help you manage your COPD with treatment and medication.
Is Your COPD Early, Moderate, Severe or Very Severe?
Experts state, “COPD can be early-stage, moderate, severe, or very severe depending on:
- your symptoms,
- the number of exacerbations you’ve had,
- and your lung function.”
Changes in Lifestyle, Medication, and Therapies Can Add More Time to Your Life or Put More “Life in Your Time” in Spite of COPD.
FLASS recommends that you become very self-aware about your condition as soon as you are diagnosed. As we stated in Part 1, in the early stages, you might excuse chronic coughing and phlegm because of your age. However, when you reach a severe stage, you could get “very out of breath just getting out of a chair.”
FLASS wants you to remember that although we have no cure for COPD, we have treatments. And those treatments improve symptoms and your quality of life. We hope you can become self –aware and listen closely to the signals your body might be sending you about your health, your breath and your quality of life.
Knowing your triggers and avoiding exacerbations “is a major part of slowing the progression of COPD,” according to Meredith McCormack, MD, an associate professor of medicine at Johns Hopkins Medicine in Baltimore.
Avoiding Exacerbations: Controlling Summer-and Other-COPD Triggers
She added, “Exacerbations are often triggered by respiratory infections which could be viral or bacterial.” As Dr. McCormack stated in our previous Part 2, “They can also be triggered by exposures, like if someone has increased exposure to pollution or secondhand smoke.”
In a review published in October 2017 in the International Journal of Chronic Obstructive Pulmonary Disease, Dr. McCormack said, “COPD exacerbations are one of the most important predictors of the progression of COPD. And a history of exacerbations is one of the most important predictors of future exacerbations”. And she added, “That’s part of why it’s so important to take steps to try to minimize the risk of exacerbations.”
The FLASS Six Signals Your COPD is Worsening
Let’s take a look at the signals of how COPD might progress, regardless of the “stage” we name it. The following are signals your body might send you. These are the little indications that your COPD is worsening.
1. Increased Shortness of Breath.
Has climbing the steps or walking up a ramp gotten more difficult? Does slight exercise leave you more short of breath than previously? “Worsening shortness of breath is a cardinal signal that your COPD is getting more severe,” says Robert A. Wise, MD the director of research in pulmonary and critical care medicine at Johns Hopkins Medicine in Baltimore. Your doctor might increase or change medication.
2. A New Whistling Sound: More Wheezing.
Did you ever wonder what causes a wheeze? It is the narrowing of your airway that adds the whistle to your breathing. When it worsens, it could be a signal of an oncoming exacerbation.
When it is very pronounced and does not go away, you must get medical attention. However, be aware that not every COPD patient gets this signal. Some COPD patients simply do not wheeze. A study in the International Journal of Chronic Obstructive Pulmonary Disease, “found that about 38 percent of people with COPD had wheezing as a symptom.” Generally, we associate more wheezing with “worse COPD symptoms, more exacerbations, and worse lung function.”
3. Changes in Phlegm.
We promised you this was not a pretty topic. However, we hope you appreciate knowing what signals should cause you to call your doctor. Phlegm isn’t pretty, but it can be a signal that your body needs more help fighting the COPD.
If you notice you are suddenly producing a larger amount of phlegm, it’s time to check in with your pulmonologist. Likewise, if the phlegm changes to yellow or green, it could be a tell-tale signal your COPD is getting worse.
4. Edema
Edema is a signal you might not realize has anything to do with your COPD. You might blame it on that one potato chip you snatched off someone else’s lunch. However, you note that this really hurts and really shows. More than puffy, this swelling is painful. Did you know that severe COPD patients often suffer from swelling of the legs, ankles, and feet? This fluid retention can show on the scales, too. It might even register as much as 5-15 pounds.
Dr. Amy Attaway of the Cleveland Clinic states, “This swelling is due to what is known as cor pulmonale, or pulmonary hypertension.” She adds, “Those conditions are caused by a combination of not enough oxygen, inflammation, and high pressure on the lung vessels and right side of the heart that can happen as a result of emphysema.” Once again, we recommend that you tell your healthcare provider. We can help. (Just the same, let’s avoid those potato chips completely. They are bad for you on any level.)
5. That Alarmingly Worsening Cough
If you are coughing more often and for longer periods of time, your pulmonologist will often want to take a chest X-ray. Take that simple, age-old test. Combined with other tests, it could show us if your COPD is worsening.
It could also reveal you are coughing from a different health issue. Please, don’t jump to conclusions or self-diagnose. Give us a call at Florida Lung, Asthma and Sleep Specialists.
6. Fatigue and Muscle Weakness and the Great Sleepies
This is a Signal that you might not recognize as a symptom of COPD: an almost chronic sense of fatigue. You feel tired most of the time. “It really comes down to the fact that your body has to work harder than someone’s who doesn’t have COPD. More of your energy is spent simply breathing,” says Dr. Attaway.
“Fatigue in COPD can also be caused by inflammation that leaks out to the rest of your body,” she says. “You can actually get muscle weakness from that.”
6A. Do You Still Feel Sleepy When You Wake Up From a Full Night’s Sleep?
As Patients Cope with COPD, Hopeful Research Continues. New Medications and Treatments are on the Horizon.
Another surprising signal might seem to come from your mind rather than your body. However, if your COPD is worsening, you might feel like you are not getting any sleep even after 9 hours in your bed. You wake to an exhausted, groggy, overwhelming sense of sleepiness. “Sometimes as COPD advances people start to have low oxygen at night,” states Dr. Attaway of the Cleveland Clinic.
This is not normal and it might indicate a more advanced level of COPD. However, it could also mean you have obstructive sleep apnea. The health professionals and doctors of FLASS can both test and treat you for both.
Did you know that sleep apnea or sleep-disordered breathing is frequently associated with COPD? With treatments for your apnea, we might be able to help you avoid exacerbations. Plus, you will not fight so much of that overwhelming grogginess when you awake in the morning.
Thus, we now close our top six signals of worsening COPD. Remember, we did not publish these to cause you undue anxiety. The doctors and staff of FLASS simply want to help you learn to read the signals your body sends you.
We are dedicated to helping you live your best life every step-or every “stage” of the way.
Thank you for reading the FLASS blog. And remember to watch out for the six signals of worsening COPD and those nagging summer triggers.