How to Cope with a COPD Diagnosis

A chronic obstructive pulmonary disease (COPD) diagnosis can feel overwhelming, for both patients and caregivers. What’s your next step and which treatments are right for you? Learn about the stages of COPD, from diagnosis and medication to helping a loved one deal with the disease. Plus, how much do you know about COPD?

You thought that climbing the stairs or throwing a ball with the kids was getting harder because of age. Now you know otherwise. The doctor says you have symptoms of COPD, or chronic obstructive pulmonary disease.

“An overwhelming majority of COPD patients experience shortness of breath if they exert themselves by walking or doing common household tasks,” says Jill Ohar, M.D., professor of pulmonology, critical care, allergy and immunologic disease at Wake Forest University Baptist Medical Center in N.C.

The disorder refers to a group of lung diseases that affect your ability to breathe. (The two primary conditions are emphysema and chronic bronchitis.) COPD is an incurable, chronic disease that slowly kills healthy lung tissue.
It’s diagnosed by a lung function test, a spirometry, which measures the amount of air you can breathe in and blow out, as well as how your lungs respond to medicines designed to open airways and allow more effective airflow. Most people diagnosed with COPD show lung function of just half of what it should be given their age, height and sex, Ohar says.

But by knowing what to expect and following your doctor’s COPD treatment plan, you can prevent the disease from getting worse and get back to a normal life.

Your first step is to stop smoking.

“Smoking is the No. 1 cause of COPD,” says Byron Thomashow, M.D., medical director at Columbia University/New York Presbyterian Hospital.

Not quitting, or being around secondhand smoke, is the primary reason your symptoms of COPD aren’t going away, he says. Common signs include coughing, wheezing and coughing up clear mucus. The severity of symptoms of COPD depends on your lung capacity and the disease’s stage at diagnosis.

And that breathlessness you’ve had for years? It’s to be expected.
In Treatment
Depending on how advanced your condition is, your doctor may advise you to use a short-acting bronchodilator, like prescription COPD medications Symbicort or Spiriva, or inhaled corticosteroids to manage symptoms of COPD.

Bronchodilators relax the respiratory tract’s smooth muscle. Inhaled corticosteroids are anti-inflammatory agents, which reduce swelling in your airways.

Both medicines open airways in your lungs, allowing more air to pass through. That means you can breathe easier and are less winded.

Your doctor may also advise you to get an annual flu and pneumonia shot.

“Because the respiratory system is damaged and those illnesses compromise the lung’s ability to function normally, flu and pneumonia are tough for a patient with COPD to fight off or recover from,” Ohar says.
If you don’t quit smoking, “expect a gradual increase in intensity and frequency of their symptoms of COPD,” she says.

But if you’ve kicked the habit and take your medicines (like bronchodilators and inhaled corticosteroids), your symptoms of COPD may not get worse, Thomashow says.

In fact, if your COPD was diagnosed in the early stages, you may not have to make significant lifestyle changes.

“Once you’re on medicine and possibly receiving pulmonary rehabilitation, you should be able to do everyday things, like grocery shop, take a walk and play catch with grandkids,” Thomashow says.

Here are some other steps to help maintain your quality of life:

Go to rehab. Ask your doctor about pulmonary rehabilitation, a structured exercise program that will not change lung function but will improve quality of life, decrease the need to visit your doctor and improve your ability to exercise.

Join a support group. Groups such as the “Better Breathers” club, an American Lung Association-sponsored support group, are offered through most hospitals.

Get moving. If your COPD is managed with medicines and/or pulmonary rehabilitation, activities such as regular walks, riding a bike, doing martial arts or similar aerobic activities can help improve airflow. “Aerobic exercise strengthens lungs, making them better able to breathe in air and blow it out,” Thomashow says.

Watch your weight. It’s easier to move around without getting winded if you’re at a healthy weight. Eating fresh fruits and vegetables, lean meats and fiber-filled foods helps you keep the pounds off and will take some pressure off your lungs. Talk to your doctor about your daily calorie intake and ask for a nutritional consultation, which may be done in the office or through your local hospital, to plan out a healthy weekly menu, says Thomashow.

Staying in touch with your doctor also limits COPD’s effect on your life. The following is what to expect at doctor’s visits, which may be every six months to once a year, depending on the severity of symptoms of COPD.

Review. Even if he’s been treating you for years, your doctor will review your overall medical and COPD history. Bring all medications (or a list of them) to review with your doctor – even if they’re not used to treat your COPD – so you can be sure one isn’t working against another.

Describe what’s new. Talk to your doctor about any changes in your breathing or other symptoms of COPD. Explain the amount of exercise you’re able to handle today vs. the amount you could tolerate on your last visit.

Testing for changes. Your doctor will do a breathing test to determine if your disease has progressed and to gauge the effectiveness of your COPD medication on your symptoms of COPD. This test is critical to help your doctor determine which COPD treatment, medicine or combination of drugs are best.

Describe side effects. Do you have dry mouth, a common side effect of COPD medications? Tell your doctor. They need to know all side effects your COPD medications may be causing. For example, there are mouth rinses he can prescribe or other medicines with fewer side effects.

Important reminders: Even if you quit smoking, your doctor will remind you about the importance of staying smoke-free, which includes avoiding secondhand smoke.
Caregiving
Most patients can manage symptoms of COPD with minimal support from a caregiver – usually a spouse or adult child – to make sure they stick to their COPD treatment plan and attend scheduled doctor’s visits, says Thomas Kallstrom, an associate executive director and chief operating officer of the American Association for Respiratory Care, a professional organization based in Irving, Texas.

Here’s how caregivers can help COPD patients:

Keep your ears open. Listen to “little” things the patient says about how they feel. This will help you spot any subtle changes in symptoms of COPD or if they’ve stopped taking their prescribed COPD medications.

Be watchful. Look for changes in symptoms of COPD, such as increased difficulty breathing, coughing or spitting up clear mucus. Any of these signs mean the disease may be progressing. They need to see the doctor.

Be educated. It’s important you understand COPD and how to manage it properly. Consult doctors for advice.

Be present. Attend pulmonary rehabilitation sessions or Better Breathers classes (offered at many hospitals). This will also help you learn what’s expected of the patient.
It’s particularly important for caregivers to avoid burnout or stress related to being “on call” for a COPD patient.

That’s why you should “exercise daily for at least 30 minutes, eat right, get seven to eight hours of sleep and pay attention to your own body's needs,” Kallstrom advises.

Taking a walk or practicing yoga or meditation daily and scheduling a "break" once a week to have lunch with a friend or go to a movie will relieve stress and make sure you’ve got enough energy to care for your loved one, he says.

For more information, visit our COPD Health Center.
How Much Do You Know About COPD?
Chronic obstructive pulmonary disease (COPD) is on the rise, according to the National Institutes of Health. More than 12 million people in the U.S. are currently diagnosed with it, and another 12 million may have it but don’t know.