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COPD: When Symptoms Get Worse

When the symptoms of chronic obstructive pulmonary disease (COPD) get worse, it’s important not to ignore them. Your goal is to keep your lungs working as well as possible. Talk with your health care provider about whether these steps can help you control COPD.

To help control worsening symptoms of COPD, be aware of the early warning signs of change, such as more frequent symptoms or the onset of a new symptom. This could include shortness of breath, coughing, wheezing, or mucus production. Ask those close to you to watch for changes, too.

Other warning signs that you may need additional treatment include:

  • Feeling more tired

  • Feeling ill

  • Having swollen ankles

  • Needing to sleep sitting up or with more pillows

  • Becoming forgetful, confused, or sleepy

  • Slurring your speech

  • Gaining or losing weight unexpectedly

What you can do

When you notice that your COPD is acting up, the next step is figuring out ways you can help treat it. Be sure to talk with your health care provider about what is right for your condition.

Here are some symptoms you may have and steps your health care provider may recommend to help improve them:

  • Mucus. If you have more mucus or thicker or stickier mucus, your health care provider may suggest taking a mucolytic medicine to thin it or an expectorant to make it easier to cough out. Drinking at least 2 quarts of caffeine-free fluid daily may help, too. If you have an infection, sometimes indicated by yellow or green mucus, you may need an antibiotic.

  • Cough. If your cough gets worse, doesn’t bring up mucus, makes your airways spasm, or is hard to control, you may need to use an inhaled bronchodilator or inhaled steroid medicine.

  • Wheezing. You may have a medicine meant to help relieve wheezing. If you take it as directed and it doesn’t work, call your health care provider. For severe wheezing, get emergency help.

  • Shortness of breath. Your health care provider may have you use a nebulizer or inhaled treatment or try breathing techniques. If you use oxygen treatment, he or she may suggest increasing how much you use. Call your health care provider if your breathing does not improve.

Have a plan in place

Talk with your health care provider about how to handle these symptoms. The American Lung Association (ALA) suggests asking your doctor to help you come up with a three-category plan. The plan would list symptoms and what you should do in these situations:

  • When you are doing well

  • When you are having a COPD flare-up

  • When you need immediate medical attention

The ALA action plan calls these different categories green, yellow, and red zones. By having a plan in place, you'll always know what to do. 

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