CHRONIC OBSTRUCTIVE PULMONARY DISEASE MANAGEMENT

CHRONIC OBSTRUCTIVE PULMONARY DISEASE MANAGEMENT

My Care Team My doctor is: Phone Number: Pharmacy: Phone Number: Hospital: Pulmonologist (Lung Doctor): Phone Number: Oxygen Supplier: Phone Number: Care Manager: Phone Number: 414.771.6177 Jan Bernhagen RN: Extension 133 Amy Heron RN: Extension 132 Lynn Hooper RN: Extension 124 Heike Kozlik RN: Extension 127

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) What is Chronic Obstructive Pulmonary Disease (COPD). COPD is a lung disease that makes it hard to breathe. It is caused by damage to the lungs over many years, usually from smoking. COPD is often a combination of two diseases: Chronic Bronchitis ( bron-ky-tus ) - The airway that carries air to the lungs gets inflamed and makes a lot of mucus. This can narrow or block the airways, making it hard to breathe. Emphysema ( em-fuh-zee-muh ) - In a healthy person, the tiny air sacs in the lungs are like balloons. As you breathe in and out, they get bigger and smaller to move air through your lungs. In a person with emphysema, these air sacs are damaged and lose their stretch. Less air gets in and out of the lungs, which makes you feel short of breath.

CONTRIBUTING FACTORS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE Smoking Breathing chemical fumes Dust, Coal, Foundry Dust Air Pollution Second hand smoke

Signs and Symptoms of Chronic Obstructive Pulmonary Disease (COPD) Long standing cough and phlegm Chest Pain Weight Loss Shortness of breath that gets worse when you exercise As your COPD gets worse, you may be short of breath even when you do simple things such as getting dressed or fixing a meal. It gets harder to eat or exercise, and breathing takes much more energy. People often lose weight and get weaker. At times, your symptoms may suddenly flare-up and get much worse. This is called EXACERBATION ( egg-zass-er-bay-shun ). An exacerbation can range from mild to life-threatening. The longer you have COPD, the more severe these flare-ups will be.

HOW IS CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) DIAGNOSED? To find out if you have COPD, your doctor will: Do a physical exam and listen to your lungs Ask you questions about your past health and whether you smoke or have been exposed to other things that can irritate your lungs Have you do breathing tests, including spirometry, to find out how well your lungs work Do chest x-rays and other tests to help rule out other problems that could be causing your symptoms If there is a chance you could have COPD, it is very important to find out as soon as you can. This gives you time to take steps to slow the damage to your lungs.

WHEN SHOULD I CALL MY DOCTOR? Your medicine is not working as well as it has been Your symptoms are slowly getting worse You have a cold or flu like symptoms and you develop a fever of 101 or higher that lasts longer than 2 to 3 days Breathlessness or wheezing occurs or becomes noticeably worse Your cough gets worse or lasts longer than 7 to 10 days You cough up any amount of blood Start having chest pain Have increased swelling in your legs or belly QUICK TREATMENT FOR A FLARE-UP MAY HELP KEEP YOU OUT OF THE HOSPITAL

CALL 911 WHEN Breathing stops Moderate to severe difficulty breathing occurs Severe chest pain occurs, or chest pain quickly becomes worse Cough up 0.5 cup (120ml) or more of blood MY DOCTOR: CONTACT INFORMATION PHONE NUMBER: EMERGENCY CONTACT: PLEASE KEEP THIS ALONG WITH YOUR MEDICATION LIST ON YOUR REFRIGERATOR WHERE IT IS EASILY ACCESSIBLE BY EMERGENCY PERSONEL

MEDICATION MANAGEMENT Medicine for COPD is used to: Reduce shortness of breath Control coughing and wheezing Prevent COPD flare-ups, also called EXACERBATION or keep the flare-ups you do have from being lifethreatening Most people with COPD find that medicines make breathing easier. Some COPD medications are used with devices called inhalers or nebulizers. Most doctors recommend using spacers with inhalers. It is important to learn how to use these devices correctly so you can get the full benefit from the medicine. The following are types of medications that may be used to treat your COPD: Name of Medication: Short Acting Bronchodilator: Ipratropium, Albuterol,Levalbuterol Function: Considered a good first choice for treating stable COPD

Long Acting Bronchodilator: Tiotropium, Salmeterol, Formoterol Arformoterol Helps prevent breathing problems for people whose symptoms are persistent (do not go away. Corticosteriods: Prednisone, Steroid Inhalers May be used in pill form to treat flare-ups or in an inhaled form. They are often used if you also have asthma. Other Medicines include: Expectorants (Mucinex, Guaifenesin) May make it easier to cough up mucus. Methylxanthines Generally used for severe cases of COPD. These may have serious side effects and are not usually recommended

IMPORTANT FACTS ABOUT YOUR MEDICATIONS The medications your doctor prescribed cannot make your COPD go away, but they can make you feel better and help you manage your disease. Below are some helpful tips regarding your medicine: Always take your medicine as prescribed Keep all your medications in the original container (filling a weekly pill box is ok, however, do not put the rest of your medications in a different container) Try to learn your medications. What does it look like? What is the dose? Remember that from time to time the manufacturer changes. Please clarify any changes with your Pharmacist. Do not run out of your medicine. Tell your pharmacist and doctor all of the medications you are taking, this includes all prescribed and non-prescribed medications such as vitamins and home remedies. Do not skip or increase your dose unless you are told to do so by your doctor. If you miss a dose, do NOT double up on your medications, instead, take your next dose when it is due. If you are unable to take your medications for any reasons, call your doctor or nurse immediately.

Do NOT take any over-the-counter medications until you check with your doctor. Some of these medications may interfere with your prescribed medications and could worsen your COPD. Try to get all of your medications from one pharmacy. This will decrease confusion for both you and the doctor when new medication is prescribed.

How is Chronic Obstructive Pulmonary Disease (COPD) treated? The only way to slow COPD is to quit smoking. This is the most important thing you can do. It is never too late to quit. No matter how long you have smoked or how serious your COPD is, quitting smoking can help you stop the damage to your lungs. Talk to your doctors about ways you can quit. Your doctor can prescribe treatments that may help you manage your symptoms and feel better. Medicines can help you breathe easier. Most of them are inhaled so they go straight to your lungs. It is important you know how to use your inhaler properly to get the most benefit from the medicine. A lung (pulmonary) rehab program can help you learn to manage your disease. A team of professionals can provide counseling and teach you how to breathe easier, exercise and eat well. In time, you may need to use oxygen some or most of the time. People who have COPD are more likely to get lung infections, so you will need to get a flu vaccine every year. You should also get a

pneumococcal (pneumonia) shot. It may not keep you from getting pneumonia, but if you do get pneumonia, you probably will not be as sick. There are many things you can do at home to say as healthy as you can: Avoid things that can irritate your lungs, such as smoke, pollution and air that is cold and dry Use an air conditioner or air filter in your home Take rest breaks during the day Get regular exercise to stay as strong as you can Eat well so you can keep your strength. If you are losing weight, ask your doctor or dietician about ways to make it easier to get the calories you need

THINGS TO DO TO HELP ME LIVE WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) To help you and your doctor manage your COPD, it is a good idea to keep track of your symptoms: Shortness of breath Cough Productive cough (phlegm) Wheezing Tightness in chest Weight loss Feeling sad or depressed It is also to keep track of any irritants that make your symptoms worse: Respiratory infections Exercise Changes in the weather Indoor or Outdoor pollution Exposure to cigarette smoke Exposure to things that cause allergies Chemicals or other irritants at work Worry or stress Please let your doctor know if you experience any of these symptoms.

Other Places to Get Help Organizations American Lung Association 1301 Pennsylvania Avenue NW Suite 800 Washington, DC 20004 Phone: 1-800-LUNG-USA (1-800-586-4872) 1-800-548-8252 (to speak with a lung professional) (212) 315-8700 Email: info@lungusa.org Web Address: www.lungusa.org The American Lung Assocation provides programs of education, community service, and advocacy. Some of the topics available include asthma, tobacco control, emphysema, infectious disease, asbestos, carbon monoxide, radon, and ozone. American Thoracic Society 61 Broadway New York, NY 10006-2755 Phone: (212) 315-8600 Fax: (212) 315-6498 E-mail: atsinfo@thoracic.org Web Address: www.thoracic.org The American Thoracic Society provides information for professionals and consumers about the prevention and treatment of lung disease. Its Website provides educational materials for the consumer. COPD Foundation 2937 SW 27 th Avenue Suite 302 Miami, FL 33133 Phone: 1-866-316-COPD (1-866-316-2673) Web Address: www.copdfoundation.org The COPD Foundation develops and supports programs that improve research, education, early diagnosis, and treatment of chronic obstructive pulmonary disease (COPD). They provide information to people with COPD, caregivers, and health professionals.

National Heart, Lung, and Blood Institute (NHLBI) P. O. Box 30105 Bethesda, MD 20824-0105 Phone: (301) 592-8573 Fax: (240) 629-3246 TDD: (240) 629-3255 E-mail: nhlbiinfo@nhlbi.nih.gov Web Address: www.nhlbi.nih.gov The U. S. National Heart, Lung, and Blood Institute (NHLBI) information center offers information and publications about preventing and treating: Diseases affecting the heart and circulation, such as heart attacks, high cholesterol, high blood pressure, peripheral artery disease, and heart problems present at birth (congenital heart diseases). Diseases that affect the lungs, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema, sleep apnea, and pneumonia. Diseases that affect the blood, such as anemia, hemochromatosis, hemophilia, thalassemia, and von Willebrand disease. National Jewish Health 1400 Jackson Street Denver, CO 80206 Phone: 1-800-423-8891 1-800-222-5864 (Lung Line) E-mail: lungline@njhealth.org Web Address: www.nationaljewish.org National Jewish Health is a hospital devoted to treatment, research, and education in chronic respiratory diseases. It publishes a newsletter and pamphlets; maintains the LUNG LINE, a free call-in information service for consumers; and has a patient referral center (inpatient and outpatient services). National Lung Education Program American Association for Respiratory Care 9425 MacArthur Boulevard Irving, TX 75063

QUESTIONS FOR YOUR DOCTOR Going to your doctor can be overwhelming at times and can make you nervous. You may forget what you want to ask and/or forget what your doctor tells you. Use this sheet to write your questions. Your Question 1. The Answer Your Question 2. The Answer Your Question 3. The Answer