One of the main priorities in COPD treatment is keeping symptoms of the disease—such as breathlessness, coughing, and excess mucus—under control. However, this isn't always an easy thing to do, and COPD symptoms can get worse without much warning, even when you do everything right.
One of the biggest culprits of symptom flare-ups are COPD exacerbations, which are periods of elevated symptoms that can last for days, weeks, or more. In some cases, they can even lead to permanent lung damage and quicker lung function loss, which is why managing exacerbations is a vital aspect of treating COPD.
Because of this, many COPD treatment guides focus on how to prevent exacerbations, which is usually done through a combination of medication, lifestyle changes, and avoiding exacerbation triggers like illnesses and environmental irritants. However, it's also important to realize that exacerbations are not always avoidable; in fact, they are more or less an inevitable part of living with COPD.
As unfortunate as this is, it's anything but hopeless. COPD exacerbations are very treatable, and there are a variety of effective strategies and tools you can use to manage the symptoms of an exacerbation even after it has already begun.
That's why we created this practical guide about how to recover from a COPD exacerbation. In the sections below, we'll introduce you to a plethora of helpful tips and proven techniques you can use to manage exacerbations at home and get better as quickly as possible.
Whether you are experiencing an exacerbation now or you're preparing for when the next one comes, the information in this guide can help. When you learn how to be proactive about treating your COPD, you'll be better able to manage your symptoms and feel even empowered to take charge of even more aspects of your health and disease treatment.
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How to Get Over a COPD Exacerbation More Quickly
Catch it Early
If you want to limit the effects of an exacerbation and recover as quickly as possible, early detection is key. The sooner you notice the signs of an oncoming exacerbation, the sooner you can take action to bring your symptoms back under control.
In some cases, early detection and quick treatment can essentially “nip it in the bud” and prevent the exacerbation from getting significantly worse. It can also help prevent exacerbations triggered by respiratory illnesses like the cold or flu from escalating into a more serious infection like pneumonia.
In fact, research has shown that COPD patients who treat their exacerbations soon after they start recover more quickly than those who delay treatment. Patients who begin treatment promptly are also less likely to be hospitalized for the exacerbation and have a higher health-related quality of life.
Because of this, it's very important to monitor your COPD symptoms and how they change from day to day. The more familiar you are with your “baseline” symptoms, the more likely you are to notice when they start to get worse.
Here are some of the signs of a COPD Exacerbation:
- Increased shortness of breath
- Increased coughing or more sputum
- Increased fatigue
- Morning headaches
- Noisier breaths or wheezing sounds when you breathe
- Fever
- Symptoms of a cold or another respiratory illness
- Change in the color of your mucus or sputum
- Swollen ankles
- Confusion
These changes can happen suddenly without much warning, so you should always be on the lookout for flare-ups; even small up-tick in symptoms need to be carefully monitored for change. It's also important to know exactly what to do when an exacerbation strikes, as directed by your doctor and your COPD action plan.
Enact the Correct Steps in Your COPD Action Plan
We talk a lot about COPD action plans on this blog because they are just so important for managing the disease. Every person with COPD should have one of these individualized plans, which tells you precisely how to manage your COPD medications and treatments from day toy day.
While action plans are important for daily COPD management, they are perhaps even more useful for managing exacerbations. They tell you exactly what to do as soon as you notice your symptoms flare up, which gives you the opportunity to respond to a potential exacerbation quickly so you can start self-treatment at home.
The self-treatment directions in a COPD action plan often include things like reducing physical activity, taking a larger dose of medication, or starting a new medication. The exact instructions will vary from patient to patient, since they are designed to account for the severity of the disease and other individual needs.
At the start of an exacerbation, following the instructions in your COPD action plan can reduce your symptoms or prevent them from getting worse. In fact, research shows that COPD patients who follow an action plan recover from exacerbations more quickly, have fewer hospital visits, reduced shortness of breath, and a generally improved quality of life.
However, enacting your COPD action plan—while important—is not guaranteed to prevent an exacerbation from becoming more severe. It's important to talk to your doctor if your symptoms don't improve quickly, or if they continue to get worse.
Luckily, your action plan should also tell you when to notify your doctor of your symptoms, and how to know if you require more intensive medical care. When in doubt, don't hesitate to call your doctor and ask her for advice.
If you don't currently have a clear and complete COPD action plan, you should talk to your doctor about putting one together at your next visit. You could even ask your doctor to fill out this COPD action plan template (PDF link) or use it as a starting point for working out a more personalized plan.
The following sections include additional tips for using your COPD action plan to treat an exacerbation. For even more information on the topic, check out our previous guide on COPD action plans here.
Pay Close Attention to Which “Zone” You Are In
A COPD action plan isn't a singular set of instructions, but rather a collection of several sub-plans. Each of these sub-plans—which are often referred to as “zones”—corresponds to a different level of COPD symptom severity
Most action plans have 3 zones labeled by color: a green zone, a yellow zone, and red zone.
Here's an quick run-down of what each of these zones stand for:
- The Green Zone: This zone tells you how to treat your baseline symptoms, and it's the plan you'll follow on typical days.
- The Yellow Zone: This zone tells you what to do when your symptoms get worse, and usually directs you to take extra steps in addition to your usual treatment routine. Essentially, the yellow zone is your guide to managing the early signs of a COPD exacerbation.
- The Red Zone: This zone tells you what to do if you experience more severe symptoms; in many cases, this includes going to the hospital for professional medical care.
For each zone, your plan should have two important pieces of information. First, there should be clear descriptions of which types of COPD symptoms correspond to each particular zone. That way, all you have to do to determine which plan you should follow for the day is choose the zone with the description that most closely matches your current symptoms.
Second, each zone should includes a specific list of actions you need to take that day to manage your symptoms. These instructions may cover variety of different treatments and lifestyle factors, including diet, exercise, medications, and symptom management techniques.
However, you action plan can only help you if you know how to use it correctly, which is why it is so important to make sure that you thoroughly understand all the information it contains. Each part of your action plan is designed to help you manage a specific set of symptoms, and it will only be effective if you can accurately evaluate which zone to use each day.
Take Time to Rest
Getting plenty of exercise is a crucial part of managing COPD, and it's perfectly safe in most cases. However, when you're sick or coming down with an exacerbation, too much physical activity can make your symptoms worse.
Because of this, the “yellow zone” in many COPD action plans includes instructions to reduce or stop physical activity. Doing so allows your body to rest and prevents extra strain on your lungs, which are already more strained than usual because of the exacerbation.
It can be tempting to ignore this recommendation, especially if it means canceling plans or taking time off work. However, as frustrating as it might be, slowing down and taking it easy can help you recover more quickly so you can get back up on your feet ASAP.
Be Ready to Adjust Your Medications
There's a good chance that your COPD action plan will tell you to take extra medication when your symptoms flare up. It might, for example, tell you to take more of your usual medication (e.g. use your rescue inhaler more often) or it might tell you to start a new course of medication like steroids or antibiotics.
These medications can reduce both the length and severity of your exacerbation, but they're usually most effective if you start them early on. Because of this, you should make sure you have these extra medications on hand for when you need them.
For example, if your action plan says to begin a course of steroids when you feel an exacerbation coming on, ask your doctor for an extra supply to keep at home. That way, you can begin taking the medication immediately when you feel an exacerbation coming on, without having to make a trip to the pharmacy.
Know Your Treatments and What They are For
In order to self-treat an exacerbation and enact your COPD action plan, you need to have a thorough understanding of all your COPD medications. That includes the medications you take for daily COPD maintenance, as-needed inhalers, and medications specifically prescribed to treat COPD exacerbations.
You need to know more than just the name and dosage of your medicines; you should also know what each medication does and why you take it. After all, your overall health and your ability to recover from exacerbation depends on your ability to use them correctly.
The more you know about your medications, the better you will be able to manage your symptoms during an exacerbation, and the better you will be able to interpret the directions in your COPD action plan. It will also help you better communicate with your doctor about managing exacerbations and your COPD treatment plan in general.
Since you don't use them as often, you might not be as familiar with your exacerbation medicine as you are with your daily medications. That's why it's important to take the time to learn what they are and how they help.
Don't be afraid to use your doctor or pharmacist as a resource if you have any questions or concerns about any medicine you take. To help you get started, the following sections include a quick overview of each of the four main medications used to treat COPD exacerbations:
Quick-acting Bronchodilators
Quick-acting bronchodilators, also known as quick-relief or rescue inhalers, are as-needed medications that work almost immediately to open up your airways and make it easier to breathe. They are different from long-acting bronchodilators (also known as maintenance inhalers), which take much longer to work and need to be taken on a schedule every day.
During an exacerbation, you may need to use your rescue inhaler more often to keep your COPD symptoms under control. In fact, using your rescue inhaler more often is a common first sign of a COPD exacerbation.
Corticosteroids
Corticosteroids, sometimes simply called steroids, are medications that treat inflammation. They help you breathe better and reduce COPD symptoms by making your lungs less irritated and inflamed.
Because exacerbations worsen lung inflammation, corticosteroids are often prescribed to manage COPD flare-ups and exacerbations. Research shows that, in many cases, this treatment can reduce shortness of breath and even shorten the length of the exacerbation.
Antibiotics
Some exacerbations are caused by bacterial infections, which require antibiotics to cure. However, sometimes doctors prescribe antibiotics before an infection is known, in order to control bacteria in the lungs and prevent a more serious infection from taking hold.
These preventative antibiotic treatments can prevent a common cold or another illness from causing a secondary infection like pneumonia, which is a major risk during an exacerbation. In this way, antibiotics can help prevent an exacerbation from getting more severe and reduce the risk for serious complications.
Supplemental Oxygen Therapy
Supplemental oxygen is often used to treat low blood oxygen levels, known as hypoxemia, in people with COPD. People with chronic hypoxemia often need to use oxygen every day, but oxygen therapy is also used to treat temporary hypoxemia caused by COPD exacerbations.
Even if your blood oxygen levels are usually within a healthy range, exacerbations can impair your lung function to the point that they fall much lower than normal. If this happens, you might be have to use supplemental oxygen for a few days—or potentially longer—to ensure your body gets enough oxygen until you recover from the exacerbation.
Here are some additional guides to help you understand and manage your COPD medications:
- How to Take COPD Medications Correctly & Adhere to Your Treatment Plan
- 11 Tips for Saving Money on COPD Medications
Don't Delay Seeking Treatment
While self-treatment at home is enough to get over some exacerbations, it's not always possible to get better on your own. In many cases, COPD exacerbations require more extensive treatment from a doctor or an in-patient hospital stay.
Because of this, it's important to talk to your doctor if you have a flare-up that continues to get worse or doesn't start to get better after a few days. When in doubt, you can always reference your COPD action plan or call your doctor for advice.
What you shouldn't do is wait too long too get help, which could lead to much more severe symptoms and a longer recovery time. Delayed treatment can also increase your risk for permanent lung function loss, lung infections, and other complications.
During an exacerbation, you might also have a higher risk of experiencing life-threatening sympyoms that require emergency medical attention. If this happens, call 911 right away or get to an emergency room as soon as possible.
The following symptoms could be a sign that you need emergency medical care:
- Extremely severe breathlessness that doesn't go away with rest
- Breathlessness that leaves you unable to sleep or do light activity
- Unusual or severe chest pains
- Fever, shaking, or chills
- Confusion
- A bluish tint on your fingertips or lips
- Coughing up blood
To learn more about medical emergencies related to COPD, you can read our guide on the topic here.
Conclusion
If you have COPD, it's important to be prepared for handling the inevitable flare-ups and exacerbations when they come. That means knowing how to identify the signs of an exacerbation, enact a treatment plan, and knowing when it's time to get professional medical help.
With the right medications and a proper COPD action plan, you can self-treat the early stages of most exacerbations at home. Even if your symptoms end up getting worse, catching the exacerbation early and responding promptly can still limit how severe it becomes.
Even though exacerbations can be frightening and difficult to manage, remember that there are many ways to treat your symptoms and give yourself the best shot at quick recovery. By learning how to manage an exacerbation properly and taking a more active role in your health, you can take back a significant measure of control over your health and your COPD.