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What about oxygen/nebuliser?

Some people with COPD develop low blood oxygen levels called hypoxemia. Just because you feel breathless does not mean that you are short of oxygen, if you have normal levels oxygen has no benefit if you are breathless.

Great care has to be taken with oxygen therapy. Too much oxygen can actually be harmful if you have COPD. The long term use of oxygen at home may be beneficial for some people. Blood tests will be carried out by a specialist service check your blood gas levels before oxygen can be prescribed. Normally, you will only be considered for oxygen if you do not smoke. Oxygen therapy is not effective if you continue to smoke and there is a serious risk of fire.

Nebulisers are used routinely in hospital and you may have them if you are cared for by the Early Supported Discharge nurses when you are having an exacerbation at home.

Nebulisers just deliver much bigger doses of the medicines in your inhaler. Some people will be able to do more with the bigger doses of drugs but many find they just get more side effects. Advances in inhaled drugs mean that nebulisers are used less frequently these days.

Specialist services carry out assessments for this equipment as it cannot be prescribed (although the drug can) and it is not suitable for every one.

You should only use a nebuliser if supplied by a specialist service following assessment. You should not buy your own.

What is COPD?

COPD stands for chronic obstructive pulmonary disease. This is a term used for a number of conditions including chronic bronchitis and emphysema. COPD leads to damaged airways in the lungs, causing them to become narrower and making it harder for air to get in and out of the lungs making it harder to breathe. Chronic means long term. See the British Lung Foundation for more information.

What causes COPD?

The most common cause of COPD is smoking. Some occupational factors such as exposure to dust and fumes usually at work can cause airway narrowing. There are some rare genetic causes of COPD.

How do I know if I might have COPD?

Symptoms of COPD are a cough, breathlessness, usually on exertion, producing phlegm or sputum and having frequent chest infections especially in the winter. You will be over the age of 35 and will probably have smoked or be a current smoker.

Is there a cure for COPD?

There is no cure for COPD, but there are medications to help symptoms and education, self management and exercise programmes to help reduce the effect the disease can have on your life. Stopping smoking is the single most important thing you can do. Locala Stop Smoking Service.

How will my condition affect my family and I?

Some people with COPD may reduce their activities to avoid becoming breathless. But by reducing activity levels you become less fit and therefore get breathless even sooner when you try to do any activity. Having COPD may mean that you have to adapt your lifestyle but keeping as fit as possible is important and will help you to remain positive.

It is inevitable at some stage you and your spouse/partner/carer/family will feel anxious or frustrated about your breathing problems. It is important for you to talk about worries together. Care and support from family and friends can do a lot to relieve anxiety and depression. The BLF's Breathe Easy support network offers information and advice to people with COPD and other lung conditions.

What should I do when I am breathless?

If possible stop what you are doing, sit down or lean against something of a suitable height and try to slow your breathing down.

Your reliever inhaler can but used but this is likely to be more effective once you have a little more control of your breathing pattern.

It is important you remember that it is normal for a person with COPD to be breathless with some activity, there may be things that you do that ALWAYS make you short of breath but this is not going to hurt you, neither should you stop doing things.

There are some breathing exercises you can practice for coping with breathlessness. If you use these every day, they will help you when you are active and getting breathless. You may be referred to a pulmonary rehabilitation programme.

What is pulmonary rehabilitation?

Pulmonary rehabilitation is an exercise and education programme run by physiotherapists and nurses which is run in this area twice a week for 8 weeks in a community setting. You will be encouraged to exercise safely building up your stamina gradually. There are education and discussion sessions around the sort of problems most people with COPD have.

Pulmonary rehabilitation has been shown over a number of years to make a considerable difference in the way people think about and manage their disease and how much they are able to do.

Being breathless much of the time can make you feel a variety of emotions, you may feel anxious and frightened about being short of breath, you may feel very frustrated that you can't do all you want to or that you are dependent on others.

Can I still live a normal life?

Yes, but you may have to make some changes that best suit you and your needs. Things may become a little more difficult as the disease progresses or if you are having an exacerbation. It's always a good idea to inform your family and friends of your capabilities so they don't worry when you are breathless. As your disease progresses you may wish to make some choices about the kind of treatment you would wish to have in an emergency and where you might like to be if you are very unwell. Your health care professional can help you with these decisions when appropriate, for more information see End of Life Care.

Why do I have to stop smoking?

Smoking causes damage your lungs. Stopping smoking will slow down the progression of COPD, reduce the chances of infection and may reduce symptoms.

How will I be diagnosed?

If you think you may have COPD you should see your GP. COPD is confirmed by a breathing test called spirometry. This is a breathing test blowing into a machine which measures your lung capacity. You may have this test in the surgery or you may be referred to the hospital. If this confirms you have COPD you will need a chest xray and some blood tests.

What treatment for COPD will I be given?

Treatment for COPD is mostly given via inhalers rather than pills.

The type of inhaler you are given depends on how severe your disease is and how many symptoms you are having, for more information follow the links or ask your health care professional. Patient.co.uk

It is very important you understand what your inhalers, and other medications if you have them, do for you and how to use them.

There are some tablets used to treat COPD and you will be given antibiotics and/or steroids to treat any infections.

COPD patients are commonly offered a self management or exacerbation plan. This is a short booklet explaining the disease and its treatment which your health care professional will discuss with you. You may given some antibiotics and steroids called a rescue pack to keep at home to help you treat any infections quickly.

There are some surgical procedures such as lung volume reduction and in rare cases transplant but these are only suitable for a few patients.

What is an exacerbation?

An exacerbation or a flare up is a worsening of your symptoms that doesn't go away and lasts for at least two days. This may be caused by an infection. This is different to your normal day to day symptoms and comes over hours and days rather than weeks or months. It is important to recognise the symptoms because the earlier you spot them the sooner you will be able to start appropriate treatment.

Although your symptoms may vary from day to day, it is a good idea to establish what you would consider normal everyday symptoms for YOU when having good days. Knowing how far you can walk and what colour your sputum is when you are well will help you spot when you are having an exacerbation or flare up.

If you think you are getting a flare up of your symptoms please refer to your emergency care plan if you have been given one.

If you don't have an self management/emergency care plan you should contact your GP or Health Care professional.