A patient guide to help prevent COPD exacerbations

Are you at risk of a lung attack this winter?

Living with COPD

COPD (Chronic Obstructive Pulmonary Disease) is the general term given to diseases such as chronic bronchitis and emphysema. These diseases affect the lungs and the ability to breathe, causing the airways to become permanently damaged and narrowed. People with COPD experience symptoms such as shortness of breath and coughing. These symptoms gradually worsen and can severely affect quality of life.If you are a person living with COPD, you may find that you have to slow down when doing normal daily activities such as walking up stairs, shopping or having a shower. You may also experience episodes of worsening symptoms, ‘exacerbations’, also described as ‘lung attacks’. This leaflet will help people with COPD to understand what these exacerbations are, how to recognise them, and how to help prevent them.

It is important that you take action to prevent a lung attack or exacerbation, with appropriate treatment and other simple preventative measures.

What is a ‘lung attack’ or ‘exacerbation’?

A ‘lung attack’ or ‘exacerbation’ is when your COPD symptoms become worse over a short period of time. You might experience more breathlessness, coughing and wheezing, and your phlegm/sputum could become thicker and discoloured. This worsening of symptoms may require more treatment, for example with antibiotics and/or oral steroids. Exacerbations – or lung attacks – can vary in their strength. With a small lung attack, you might even describe this as a ‘chest infection’, or mistake it for a heavy cold. However, these small lung attacks, if left untreated, can get worse.Exacerbations can be distressing and every bit as terrifying and bewildering as a heart attack. It can take a long time to recover from a COPD exacerbation. Also, if they happen repeatedly, they can lead to faster progression of the disease and cause permanent damage to the lungs. It is important that you take action to prevent a lung attack or exacerbation, with appropriate treatment and other simple preventative measures.

What causes an exacerbation?

COPD is caused by a build up of inflammation in the lungs, which increases during an exacerbation. Exacerbations are often triggered by a chest infection or a common cold enhancing the inflammation. Smoking, air pollution, and changes in the weather can also be triggers, and there are other causes which are unknown.

Don’t ignore the symptoms of an exacerbation

It is important to recognise when you are having an exacerbation and seek help from your doctor. There are often warning signs before an exacerbation, such as worsening of COPD symptoms and generally feeling unwell.If you have experienced these signs, do not ignore them. Go to your doctor for advice and treatment. Detecting an exacerbation early and taking treatment promptly can minimise the duration of exacerbations and the risk of hospitalisation.

When are you most at risk of an exacerbation?

Have you been treated with antibiotics and/or oral steroids in the previous year?Have you been hospitalized due to exacerbations in the previous year?If your answer is YES to either of these questions your risk of having two or more exacerbations within the next year is 5.72 times higher than the people who said NO.Exacerbations happen more often during the cold winter season. The number of people with COPD that are admitted to hospital is higher in winter, and especially high during Christmas and New Year.The trigger for a large number of these exacerbations is infection by a respiratory virus, particularly the virus which causes the common cold.

Signs to watch out for are: — More coughing— Thicker and

discoloured phlegm/sputum

— More breathlessness

For more information

For advice and support to prevent and manage COPD exacerbations, please visit your doctor. You can also access information from your local patient organisation.

How can you lower your risk of exacerbations?

— Visit your doctor before the winter season for advice and treatment options to prevent an exacerbation.

— Remember to take your oral and inhaled medications according to the doctor’s instructions – not only to reduce daily symptoms but to also prevent future exacerbations.

— As infections are the most common triggers of exacerbations, you should try to avoid catching them.

— Stay healthy to help you fight infections.— Practice good hygiene, wash your hands often

and avoid touching your eyes, nose or mouth.— Get a pneumococcal vaccine and a flu

vaccination every year.— Avoid anything that makes your COPD worse.

If you are still smoking, try to stop – your doctor may be able to help you.

— Be alert to the warning signs of an upcoming exacerbation.

— When you do feel like you are having an exacerbation, get help as soon as possible – acting quickly can stop it becoming as severe. Keep important phone numbers handy.