How to Avoid Hospitalization Due to COPD Flare-Ups and Exacerbations
Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases in the world. It’s estimated that about 16.4 million people in the United States alone have COPD and millions more are either undiagnosed or at high risk of contracting it. Despite this fact, many people are woefully unaware of what causes this disease and how it should best be managed.
In short, COPD is an umbrella term that denotes two conditions: chronic bronchitis and emphysema. While the symptoms and pathogenesis of these two diseases are slightly different, they are both primarily caused by cigarette smoking. However, in rare instances, someone who has never smoked can contract COPD through something called alpha-1 antitrypsin deficiency (AAT deficiency).
One of the symptoms of COPD that’s particularly vicious is something called an exacerbation. This is similar to an asthma attack in that it causes respiratory symptoms such as breathlessness, chest pain, and sputum production to suddenly become worse, oftentimes requiring you to seek immediate medical attention. In this post, we will help you better understand COPD flare-ups and exacerbations, as well as how to avoid being hospitalized as a result.
If you have any questions or concerns, feel free to leave them in the comment section so we can address them.
What’s the Difference Between a Flare-Up and an Exacerbation?
Generally speaking, the terms “COPD flare-up” and “COPD exacerbation” are used interchangeably. They both refer to respiratory symptoms becoming worse due to environmental causes, infections, or any number of other things. However, when it comes to discussing these symptoms, it’s important to be precise not only about what’s causing them but how severe they are as well.
A mild COPD exacerbation is one that could lead to increased discomfort but is unlikely to cause any serious long-term consequences. These can typically be treated with short-acting bronchodilators (SABD) or “rescue inhalers” which work to quickly open up the airways allowing you to breathe better. Moderate COPD exacerbations should be supplemented with oral corticosteroids which suppress inflammation and antibiotics which can help fight inflammation.
The final type of exacerbation is a severe exacerbation, sometimes called an “acute” exacerbation. This type of exacerbation requires immediate medical attention and can even be life-threatening if it’s not treated appropriately. Ideally, the best way to prepare for this type of exacerbation is to have an action plan and ensure you always have someone on hand to either take you to the hospital or call an ambulance.
Why it’s so Important to Avoid Hospitalization With COPD
According to the American Journal of Respiratory and Critical Care Medicine, COPD is responsible for $72 billion a year in direct healthcare expenditures. The majority of these costs come from hospital visits which range from 4.5 to 8.8 days on average. Around two-thirds of all COPD hospitalizations are due to COPD exacerbations, and the majority of COPD exacerbations are caused by infections — specifically viral infections.
The primary reason it’s important to avoid hospitalization for COPD is because of the risks for your health. According to another study by the aforementioned medical journal, after testing over 2 million patients, the 1-year readmission rate was 64.2% and the 1-year mortality rate was 26.2% both of which were significantly higher than rates among the general COPD population. Readmission and mortality rates are also much higher among patients who were hospitalized with severe exacerbation of COPD.
The second most important reason to avoid hospitalization due to COPD is cost. Frequent or long-term admissions can pose a significant financial burden on people with COPD which can also lead to stress, anxiety, and even depression. In our last post, we highlighted some key ways that you can avoid unnecessary financial costs due to COPD so check it out if you’re interested in learning more.
Have a Plan to Deal With Exacerbations
First and foremost, if you want to avoid hospitalization due to COPD exacerbation, you need to have a plan of action before an emergency occurs. An action plan is a sort of written outline that you will follow in order to accomplish a certain goal. This way, if you notice your COPD symptoms starting to worsen, you can refer to your sheet instead of worrying about making difficult decisions at the moment.
In order to prepare your COPD action plan, you should first consult your doctor. He/she will likely already have a template that you can fill out to make this process a little easier. On this action plan, you will need to create an “action” for every symptom you experience. For example, if the symptom is a gradual decrease in your blood oxygen levels, you might make a note to increase your oxygen flow setting or contact your doctor. If you experience sudden shortness of breath, you might make a note to use your rescue inhaler.
Another important thing to know about your COPD action plan is that it should not be private information. You should make it a priority to go over your plan with friends and family, especially if they spend a lot of time with you. This way, if you are in a situation where you are unable to act out your action plan, they will be able to help. In this post, we discuss how you can prepare for medical emergencies and hospital visits with COPD, so check it out if you want to know more.
Change Up Your Diet
Diet can be a very difficult topic to discuss in this day and age. Most people have access to more types of food than ever before and there is a near endless list of diets that people swear by. As a result, it can feel like an insurmountable task trying to find something that keeps you happy and healthy. The good news, however, is that many years of research have been dedicated to COPD diets, so you shouldn’t have to do much scrambling to make sense of it all.
Generally speaking, COPD patients should maintain a diet that’s high in protein, fiber, and fat, but low in carbohydrates. The reason for this is that the metabolism of carbs produces the highest amount of carbon dioxide in the body while the metabolism of fat produces the least. Adequate protein ensures your respiratory muscles stay strong and efficient, and fiber helps to control blood glucose levels and reduce cholesterol in the blood.
Another reason to keep your diet healthy, natural foods rather than processed ones is because weight management is vital to COPD management. Most often, people tend to become underweight after contracting COPD due to a loss of appetite or other factors. Sometimes, people experience a loss of appetite because consuming food is more physically exerting than it was previously, and bloating can contribute to breathing difficulties. COPD patients who are underweight may find that they lack the energy or endurance to make it through the day.
On the other hand, being overweight with COPD can contribute to breathing problems as well. While it is less common for a COPD patient to become overweight than underweight, the problems associated with it can be just as severe. Simply put, having a higher body mass index (BMI) can be obstructive to your breathing by putting more strain on your lungs when you inhale. However, some studies have found mixed results when it comes to being overweight/obese with COPD.
Be Consistent With Your Exercise Routine
Consistency is unbelievably important when it comes to treating COPD and preventing exacerbations. For example, your diet is much more likely to benefit you if you keep up with your goals week in and week out. But if you do well one week then cheat the next, you’re going to put yourself at a much higher risk of COPD complications like exacerbations. This works pretty much the same way when it comes to your exercise routine.
Oftentimes, exercise specialists will talk about getting into a “routine.” In other words, you do the same exercise each day for an allotted period of time. By doing so, it will be much easier to track your progress and catch yourself when you fall back on your plan. This works well for most people who want to commit to an exercise routine, but it’s especially useful for COPD patients who benefit more from consistent moderate exercise rather than high-intensity exercise.
Avoid Getting Sick
Lung infection is both the number one cause of severe COPD exacerbation and the number one cause of hospitalization due to COPD. With that being said, staying healthy and avoiding infection (especially lung infections) is vital. One of the best things you can do right now to avoid getting sick is to quit smoking or avoid second-hand smoke if you live around smokers.
It’s been known for quite some time that smoking reduces the immune response in the body and also makes the smoker more likely to have exaggerated responses to viral infections. During influenza outbreaks and with the current situation we face involving COVID-19, smokers have a much lower survival rate when compared to the general population. Not to mention that smoking and second-hand smoke can trigger COPD exacerbations even if an infection isn’t present.
Another thing you can do to avoid getting sick is to be more conscious of your daily habits. For example, do you wash your hands frequently throughout the day? Do you take care to avoid places that are unclean or unsanitary? Do you stay away from people who exhibit symptoms of the cold or the flu? Do you clean surfaces in your home like door handles, coffee pot handles, or faucet handles? Are you following all the precautions recommended by the World Health Organization (WHO) in order to prevent contracting the novel coronavirus?
Last but certainly not least, you should be getting the doctor-recommended eight hours of sleep each night in order to avoid getting sick. According to WebMD, sleep deprivation suppresses the immune system and puts you at a higher risk of contracting colds, the flu, and other ailments. This is an especially difficult topic for many COPD patients because respiratory symptoms can make it difficult to maintain a healthy sleep schedule. In this post, we take a look at some actionable tips to improve your sleep if you have COPD.
Avoid Environmental Triggers
It can be a scary world out there for anyone who values their lung health. From wildfire smoke to car exhaust and pollen, it’s easy to feel like no place is safe. The Environmental Protection Agency (EPA) even reports that indoor air can be two to five times more polluted than outdoor air. Fortunately, it’s not all grim news for COPD patients who want to avoid exacerbation triggers. Just by following a few simple steps, you’ll be well on your way to avoiding the most common triggers.
Despite summer ending last week, we are still in the midst of wildfire season. As a result, COPD patients need to be aware of when they go outside, especially when it concerns exercising outdoors. Air quality index (AQI) is the measurement we use to determine how safe outdoor air is to breathe. Each day before you go outside, be sure to check AirNow.gov for the AQI in your area. If the AQI is above 100, this is a sign that the air quality is too poor for people with lung diseases like COPD, asthma, or pulmonary fibrosis.
Another thing you should be wary of is seasonal allergies. Contrary to popular belief, allergies are a reality during all times of the year as opposed to only being active during certain seasons. In September and October, allergens like ragweed are typically at their peak. According to WebMD, if you get allergies in the spring, you are about 75% likely to have reactions to ragweed. So, if you’re outside this trying to enjoy the fall colors and cool weather this year, just be aware that allergies are still a reality.
The final airborne COPD exacerbation triggers we’d like to talk about are the ones found in your home. Like we mentioned earlier, indoor air can potentially be more dangerous than outdoor air. This is because the air in your home is extremely concentrated, so if you track things in like dust, allergens, or smoke, it will likely start to build up in one area of your home unless you take the time to clean regularly. While it may not seem that important, taking the time to vacuum, dust, and wipe down surfaces every day can go a long way to preventing COPD exacerbations. What’s more, it will help you get your daily exercise.
Use a Reliable Portable Oxygen Machine
Last but certainly not least, having a reliable portable oxygen device that you can take anywhere will put you in the best position to avoid COPD exacerbations and hospitalization. For the vast majority of COPD patients, supplemental oxygen therapy is a medical necessity. Not only does it stabilize your lung condition, but it also ensures your blood oxygen levels are normal, which in turn saturates every organ in your body with the oxygen it needs to function properly.
For the foreseeable future, portable oxygen concentrators are your best bet for reliable portable oxygen. Unlike oxygen tanks or liquid oxygen tanks, portable oxygen concentrators are electronic devices. So, instead of having to go out of your way constantly to have your tanks refilled by an oxygen specialist, you simply need to carry batteries with you. Fortunately, these batteries are lightweight and don’t take up very much space in your backpack or handbag.
Currently, the best portable oxygen concentrator on the market is the Caire FreeStyle Comfort. It weighs in at only 5 pounds and it offers 5 different flow settings that you can adjust on the fly as needed. One of the unique features of the FreeStyle Comfort is its ergonomic design which keeps the device comfortably at your side rather than jostling around as some other concentrators do.
Another portable oxygen concentrator we’d like to recommend is the Inogen One G5. While this POC came out last year, it’s still very relevant and a great choice for anyone who needs a reliable 24/7 medical oxygen supply. The Inogen One G5 has one more pulse flow setting than the FreeStyle Comfort and it weighs slightly less at just 4.7 pounds. Inogen is one of the top brands in the medical oxygen industry and they take pride in customer satisfaction.
In rare instances, your doctor may require you to use a continuous flow concentrator. If this is the case, we recommend the Respironics SimplyGo portable oxygen concentrator. This unit is twice as heavy as the Caire FreeStyle Comfort, but since it puts out a continuous flow of oxygen, it can be used with your CPAP or BiPAP machine if you have sleep apnea or another related sleeping disorder. If you’re looking for affordable portable oxygen concentrators, don’t hesitate to visit our online oxygen store.
Unfortunately, exacerbations and flare-ups are a reality for COPD patients. But that doesn’t mean that you can’t take steps to reduce your risk of experiencing hospitalization due to an exacerbation. Above all, following your treatment plan as closely as possible and preventing sickness like the cold or flu will be your best bet if you want to avoid hospital visits.
If you would like to learn more about managing chronic respiratory conditions such as COPD, stay tuned to our blog. We aim to equip our readers with the knowledge they need to combat breathlessness, chest pain, and fatigue in their daily lives, as well as learning how to cope with the mental aspects of chronic disease like anxiety and depression. Feel free to leave a comment below if you have any questions or concerns.