Steps to Manage COPD

COPD, Healthy Aging, Healthy Living, Power to the Patient
on September 22, 2007

Pat Sanderson of Batavia, Ill. (pop. 23,866), smoked as much as three packs a day for 40 years before she quit last year. The benefits of quitting, she says, have been amazing.

“I have the air to sing,” says Sanderson, 60, whose diagnosis of advanced emphysema motivated her to stop smoking. “I can whistle again. I used to have a couple of sinus infections every year, and I haven’t had one since I quit smoking. My sense of taste has improved. My sense of smell has improved. I can smell everything now!”

Emphysema and chronic bronchitis are the two primary forms of chronic obstructive pulmonary disease (COPD), which causes increasing shortness of breath and is the fourth leading cause of death in America, killing more than 120,000 each year.

The disease occurs when airways that carry the breath into and out of the lungs become partly blocked, making it difficult to exhale. Sometimes first appearing as a smoker’s cough or as an inability to catch your breath, COPD can progress into a significant disability. Everyday activities such as bathing or preparing food may become difficult.

Although the disease isn’t curable, early detection can slow its progression, and careful management can help sufferers breathe easier. “You can live actively with COPD,” says Pam DeNardo, programs manager at the COPD Foundation in Miami, Fla. “You just have to learn how.”

Here are 10 ways to manage COPD.

  • Stop smoking. Because smoking causes 90 percent of COPD-related deaths, not smoking is the most important thing you can do to help your lungs. It also is important to avoid secondhand smoke, dust and strong fumes. Stay inside when the air quality is poor.
  • Attend a pulmonary rehabilitation program. Supervised exercise training can improve the ease of daily activities. Strength training for the upper body increases the strength of respiratory muscles, and aerobic exercise, such as walking and water aerobics, can lower your heart rate and blood pressure, boost energy and improve breathing. “Rehab helps you maximize the ability of the lungs to function properly,” says Dr. James Kiley, director of the National Heart, Lung and Blood Institute’s lung division. “It’s a first line of defense for patients.”Trained muscles use less oxygen than muscles that aren’t fit. After just two weeks of pulmonary rehabilitation, emphysema sufferer Joe Meeks noticed great improvements in his breathing and energy levels. “I’ve seen my oxygen level go up during exercise,” says Meeks, 60, of Muncie, Ind. “After exercise I feel so much better—for hours. It used to take me an hour to an hour and a half to carry in groceries and put them away. Now I don’t need to sit down and take breaks.”

    Ask your doctor about local rehabilitation programs and whether you qualify, or call your local chapter of the American Lung Association. Medicare and health insurance sometimes cover the cost. If pulmonary rehabilitation is not available in your area, or for additional support, call the COPD helpline at (866) 316-2673, staffed by COPD patient volunteers nationwide, or visit

    “From the website and their chat room, I learned how to make the bed by doing everything on one side first so I only had to make one trip around the bed,” says Meeks, a former smoker who is on oxygen 24 hours a day because of emphysema. “I have to make sure to breathe out when exerting, and breathe in when not exerting. So if I open a heavy door, I have to breathe out. That made things easier.”

  • Take medications as prescribed. Your doctor may prescribe medications to help open airways, clear mucus and decrease shortness of breath. Oxygen may be prescribed for chronic respiratory failure. When traveling, plan ahead to make sure you have enough medication, take along written prescriptions in case medications are lost, and ask your doctor for names of local doctors where you are traveling.
  • Practice breathing exercises. If your doctor approves, use “pursed-lip breathing” during activities such as housework or gardening. Inhale slowly through your nose for two seconds while keeping your mouth closed. Exhale gently for four seconds through pursed lips. This restores oxygen to your body more rapidly. Be sure to let all of the air out of your lungs before lifting or pushing heavy objects.Another breathing exercise is the lower rib expansion exercise. Ask your doctor if practicing this exercise will help improve your diaphragm function. If you get the go-ahead, sit in a chair with your feet on the floor, and your hands on the sides of your lower ribs. Inhale slowly through your nose, and push your hands out with your lower chest. Exhale through pursed lips, and allow your hands to move back in. Repeat 10 times.
  • Go slowly and use caution when exercising. If you can’t talk or if you become short of breath, slow down or rest. Check with your doctor or rehabilitation specialist before jogging, swimming, using free weights or weight machines, or doing sit-ups and push-ups. Exercise indoors if the weather outside is extremely hot, cold or humid.Go slowly in daily activity too. “You can’t rush,” says Tom Hurd, 69, of Algonquin, Ill. (pop. 23,276), who suffers from COPD. “Shortness of breath affects you every minute of every day. You have to learn to pace yourself. If I rush, my blood pressure goes up, my heart rate goes up, and that affects my breathing. You have to plan everything around your lessened ability to breathe.” This includes always allotting extra time, since delays can’t be recovered by running in to an appointment.
  • Maintain a healthy body weight. Ask a registered dietitian for your ideal weight, and find out how many calories you should consume each day to achieve or maintain that weight. Being overweight is taxing on the lungs, and overeating may make breathing uncomfortable. Being underweight may weaken the diaphragm and other respiratory muscles, and make you vulnerable to life-threatening infection.
  • Drink six to eight 8-ounce glasses of fluids daily. This helps keep mucus thin. If you are short of breath during or after eating a meal, try drinking only at the end of a meal. Avoid caffeine and carbonated beverages. Ask your doctor or dietician if you should limit alcohol, as excess alcohol may slow breathing and make it difficult to cough up mucus. If you have heart problems, find out if you should limit fluids.
  • Say no to salt. Excess salt makes you retain too much water, making breathing more difficult. Don’t salt your food. Read food labels to help you avoid foods with more than 300 milligrams of sodium per serving.
  • Steer clear of foods that cause gas and bloating. Foods that cause gas, which may include beans, broccoli, cabbage, and fried or spicy foods, can make breathing uncomfortable.
  • Visit your doctor for regular checkups. Also pay a visit if you are coughing up blood or colored mucus, if you have increased mucus, or if you experience increased coughing or shortness of breath. Other warning signs include swelling of the legs, ankles or feet; increased fatigue; heartburn; depression; excess anxiety; and fever. Fever usually is a sign of infection, which can be very dangerous to a person with COPD. Ask your doctor about getting a flu vaccine and a pneumonia vaccine.