MANAGING COPD AT HOME Karla Schlichtmann, RRT
Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease. WHAT IS COPD? The airways in your lungs become inflamed and thickens. This results in the tissue where oxygen is exchanged to be destroyed. The flow of air in and out of your lungs decreases. When that happens, less oxygen gets into your body, and it becomes harder to get rid of carbon dioxide.as the disease gets worse, the shortness of breath makes it harder to remain active. COPD is also known as Chronic Bronchitis or Emphysema
C H R O N I C B R O N C H I T I S
E M P H Y S E M A
SMOKING-Top cause of COPD! Exposure to air pollution RISK FACTORS FOR COPD Breathing secondhand smoke Working with chemicals, dust or fumes A genetic condition called Alpha-1 Deficiency History of childhood respiratory infections
SYMPTOMS Chronic Cough Dyspnea/Shortness of breath while doing everyday activities Frequent respiratory infections Increased production of Mucus Wheezing Cyanosis/ bluish tone of the lips or fingernails
FACTORS THAT CAN MAKE SYMPTOMS WORSE COPD EXACERBATION Indoor pollutants Cigarette smoke, household cleaning products, strong odors, dust Outdoor pollutants Exhaust fumes, gas fumes, smog Emotions Anger, anxiety, stress Changes in temperature Extreme heat or cold, wind, humidity Respiratory infections Cold, flu, bronchitis, pneumonia
HOW TO MANAGE COPD AT HOME Medication Smoking cessation Diet NIV CPAP/BIPAP Oxygen Pulmonary Rehab (Exercise) Breathing Strategies Conserving your energy Good communication with your Doctor
MEDICATIONS
Rescue: Take as TWO CATEGORIES needed Controller: Take every day, even when feeling well
TYPES OF MEDICATION Nebulizer Propellant based Metered Dose Inhaler: MDI, Puffer Most recent is Respimat-No shaking or spacer required! Dry Powder Inhaler: DPI, Diskus, Handihaler, Ellipta
Which Inhalers Do You Have? Short Acting: relax tight muscles in airways and offer quick relief Inhaled Corticosteroids: reduce and prevent swelling Combination Medications: co ntain both inhaled corticosteroid and LABA Muscarinic Antagonist: relieve cough, sputum production, wheeze and chest tightness RESPIRATORY INHALERS
SMOKING CESSATION Inpatients will be visited by our smoking cessations team after consult has been placed by the team. There is an employee program called PiHQ (Partners in Helping you Quit) in which telephone support and medication is free for employees and/or their dependents. PiHQ@partners.org 617-724-2205 1-800 QUIT NOW
DIET -Focus on protein-containing foods and remaining physically active to maintain muscle mass -Combat shortness of breath with small frequent meals and calorie/proteindense drinks -Monitor for weight loss -Consider calcium/vitamin D supplements if on steroids
CPAP/BIPAP CPAP-Your doctor may order you to use CPAP at night. The pressure applied helps stents your airways open to improve your oxygenation. NIV/BIPAP- Your doctor may order you to use BIPAP if you are having a hard time getting rid of your carbon dioxide. Bipap helps with your ventilation (Gas Exchange.) Some of the benefits of using CPAP and BIPAP are you sleep better, you feel more alert when you are awake, you have less fatigue, takes away some of the feeling of being short of breath.
OXYGEN Oxygen is prescribed to help maintain your blood oxygen saturation level. SpO2 88% or higher is good. SpO2 87% or below means you should be evaluated for supplemental oxygen Most people purchase a portable oximeter to monitor oxygen levels at home There are many types of oxygen devices POC (portable oxygen concentrator) Stationary Concentrator Oxygen Tanks Liquid Oxygen
PULMONARY REHAB (EXERCISE) Being out of shape can make symptoms worse with COPD Recommend 3-4 times a week of 20-30 minutes of exercise Those that participate in Pulmonary Rehab or an exercise program have less symptoms, live active lives, and tend to stay out of the hospital
BREATHING STRATEGIES FIND WHAT WORKS FOR YOU! Inhale through your nose and using pursed lip breathing to exhale Smell the roses...blow out the candles Blow on your fingers Hum when you exhale Count in your head when you inhale and exhale Sit down Turn on a fan/open a window
CONSERVING ENERGY Don't do everything at once! Pace yourself Sit down to do tasks Let others help you Go slowly Take breaks Think about what clothing will be easier to take off and on
WHEN TO CALL YOUR DOCTOR Mucus changes color- Yellow, Green More mucus or trouble coughing up mucus Cough or wheezing is worse Increased shortness of breath Weight gain or increased swelling Normal activities require you to rest sooner
COPD RESOURCES COPD Foundation: www.copdfoundation.org COPD360social-online community for people with COPD Questions and answers COPD Digest Educational materials and other resources Harmonicas for Health Players Kits $15 plus shipping American Lung Association: www.lung.org Online community for people with COPD and other lung diseases Questions and answers Educational materials and other resources Better Breathers Club- local chapters to discuss topics related to COPD
HOW CAN YOU GET AHOLD OF ME Respiratory Care Consult Pager: 22978 Email: kschlichtmann@partners.org Phone: 617-724-4496