How to Reach Your Treatment Goals with Your COPD Action Plan
Living healthily and happily with COPD is all about developing healthy lifestyle habits and learning how to keep your symptoms under control. Because it is a chronic disease with no real cure, the only way to manage it is by keeping up with daily medication and carefully following treatment goals.
That's why all COPD patients should have a personalized COPD action plan to help them keep track of their medications and other treatment goals.
A COPD action plan is a comprehensive set of instruction on how to manage and treat your COPD. It's the most important tool you have for keeping your symptoms under control and preserving the health of your lungs and the rest of your body.
A typical action plan includes all the important parts of your COPD treatment, including your medication schedule, what to do when your symptoms act up, and your diet and exercise regimen. It also helps you remember what to do in an emergency and know when to see your doctor for a problem.
In this post, we're going to help you better understand what a COPD action plan is and how you can use it to better manage your disease. We'll show you what a good action plan looks like, how to make one with your doctor, and how to put your treatment plan into action.
Crafting your COPD Action Plan
Putting together your COPD action plan is an individualized process that you and your doctor will go through together. Every patient's action plan is unique and tailored to fit their personal needs.
A good COPD action plan will give you detailed treatment instructions and clear plan for what to do if your symptoms get worse. It should take your medical history, lifestyle, symptoms, and other life factors into account.
As you and your doctor work on your action plan, it's important to have a clear picture of both your current situation and your future goals. Here are some tips to help you and your doctor better understand your condition and get on the same page.
Track Your Symptoms
Helping you manage your COPD symptoms is the most important purpose of a good COPD action plan. But in order for it to be useful and accurate, you and your doctor need to have as much information as possible about all symptoms you experience and how they fluctuate over time.
The best way to get a better understanding of your symptoms is to record them daily with a journal or a symptom checklist. This will help you remember what symptoms you had and when you had them the next time you talk to your doctor, and to track patterns and changes over time.
You should try to make your notes as detailed as you can so that you and your doctor have as much information to work with as possible. Make sure you write down any and all ailments you experience, even ones that seem small or inconsequential.
The more information you have on your condition and symptoms, the more useful your action plan will be. However, it's worth writing down your symptoms even after you have an action plan in place. It will not only make it easier to notice changes in your condition as the disease progresses, but will also help you adjust your action plan as your symptoms change.
Here are some tips for what you should include in your daily symptom diary:
- Write a list of any and all physical and psychological symptoms you experience every day, especially breathing and respiratory problems. (e.g. breathlessness, fatigue, muscle weakness, coughing, anxiety, depression, etc.)
- Record and notable changes or improvements in your symptoms compared to recent days.
- Record any changes in the frequency or severity of your cough, and note any changes in the color and consistency of any mucus you cough up.
- Keep a detailed record of any breathing issues and when they get better or worse throughout the day. Record what kinds of activities cause you to feel short of breath and your general ease of breathing from day to day.
- Keep track of how much sleep you get (in general) and any sleeping difficulties you have, such as insomnia or waking up frequently during the night.
Write down the general time and situation in which your symptoms occurred. (e.g. all day long, in the morning, after eating lunch, after exercising, after going to bed, etc.)
- Include any special circumstances surrounding your symptoms. (e.g. you were outside in the heat, your allergies were acting up, you forgot to take your daily medication, etc.)
- Keep track of your overall mood and mental state from day to day. (e.g. you felt tired, you felt motivated, you felt anxious, etc.)
- Record any prescription or over the counter medications you took that day and approximately what time you took them.
- Keep track of any exercise or physical activities you do.
- Record any smoking, tobacco, or other drug use (including alcohol).
As you start your COPD symptom diary, it may help to have a complete list of COPD symptoms on hand to help you know what to look out for. You can also use a COPD symptom checklist, like this one here, to help you remember what's important to keep track of.
Think About Your Goals
In general, it is the goal of every COPD patient to breathe easier and reduce other respiratory symptoms. However, these larger goals are difficult to reach without first breaking them down into smaller goals that are easier to act on.
For example, if you smoke cigarettes, one of your goals could be to reduce the amount of cigarettes you smoke or stop smoking altogether. You could break this goal down into even smaller steps, too, such as going to a smoking cessation counselor or joining a quit smoking program.
You should also think about your lifestyle and any areas that you need to improve. For example, you may need to lose weight, eat more fruits and vegetables, or get more exercise to keep your body strong and prevent COPD complications.
Other goals might relate directly to your symptoms and helping you breathe comfortably throughout the day. Things like always taking your medications as directed, pacing yourself during exercise, and utilizing therapeutic breathing techniques can help you reach those goals.
Once you know what you are striving for, you and your doctor can put together a treatment plan that addresses all of these goals. The following list will give you an idea of some of the major treatment goals that you should consider as you craft your COPD action plan.
General COPD Treatment Goals:
- Quitting smoking
- Improving your ability to breathe
- Getting more exercise to strengthen your body and lungs
- Eating a healthier, COPD-friendly diet
- Reducing coughing, wheezing, and other respiratory symptoms
- Reducing the number of COPD flare-ups and exacerbations you have
- Reducing your risk of COPD complications (e.g. heart attacks and osteoporosis)
- Slowing your disease from progressing further
- Working with your doctor and other medical specialists to track your symptoms and achieve your treatment goals
Consult With Your Doctor
Once you've had time to track your symptoms and brainstorm your treatment goals, it's time to sit down with your doctor to put together a comprehensive COPD action plan. Your doctor may have a standard template, like this one, to fill out, or he might put together a custom document for you to take home.
Make sure you bring your symptom diary and any other information about your medical history that your doctor may need. Your doctor will also use lung function tests, including spirometry, to determine your treatment and medication needs.
It's important for your doctor to include you in his process and thoroughly explain every part of your action plan and how to use it. Take the time to look over your treatment plan carefully and don't be afraid to ask questions or ask for clarification.
While your COPD action plan helps your doctor coordinate your medications and treatment goals, your action plan's primary purpose is to be a resource for you. It is very important that you understand your plan in its entirety and how to use it to manage your disease on a daily basis.
Depending on your condition and situation, you may have a team of doctors and specialists working to help you stay healthy. In this case, you will need to coordinate your action plan with all of your caretakers to ensure your plan is as cohesive and comprehensive as possible.
The Three Zones of Your COPD Action Plan
It's important to understand that your COPD action plan is actually split up into three distinct plans of action. From here on out, we will refer to these three plans as the green zone, yellow zone, and red zone action plans, as this is the typical way to organize them.
These three zones make up the core of your COPD action plan and tell you what to do in different situations. They tell you how manage your COPD when your symptoms are normal (green), worse (yellow), and severe (red), and how to know which zone's action plan to use.
This scheme is very useful for helping you recognize when you experience a flare-up or you need to call your doctor or seek emergency medical attention. It also helps you remember how to stay healthy and what to do when your symptoms get worse.
Think of each zone as representing a specific plan of action depending on how you feel on a particular day. It is composed of two main parts: your symptoms and the actions you should take.
The first part is a description of the symptoms and the duration of symptoms that correspond to that particular zone. This is meant to help you recognize when your symptoms fit the requirements for that zone's action plan, so you can always tell when to take the actions for that zone.
The second part is a list of actions you should take whenever you experience the symptoms that correspond to that zone. It may include things like what medication to use, how much exercise you should do, breathing techniques, mental health strategies, and other instructions for keeping yourself healthy.
For example, the green zone would include your normal, baseline symptoms and strategies for managing them on a regular basis. It would also include a list of actions to take on a regular day when your symptoms are at a typical level.
The Yellow zone should include a description of what it looks like when your symptoms flare up, and what to do to manage them and keep them from getting even worse. You would refer to the actions and strategies in this zone when you experience a minor flare up or exacerbation.
The red zone gives you instructions on what you should do when your symptoms get more severe. It will help you recognize at what point you should seek medical attention and what to do in an emergency.
The symptoms and actions that go in each zone will depend on your medical history, lung function, and your personal COPD symptoms. Since it is based on your baseline symptoms, which may be more or less severe, your green zone action plan may differ significantly from other patients, and will change as your disease progresses.
Here is an overview of the different action plan zones and when you should use them:
- Green Zone: “I am doing well today.” Use this plan when your symptoms are at a normal, baseline level, and you feel well enough to continue your usual exercise and activities.
- Yellow Zone: “I am not feeling well today or I am experience a COPD flare-up.” Use this plan when your symptoms are worse than normal, you are having difficulty breathing during your usual activities, or you notice a change in your mucus, your sleep quality, your appetite, or the frequency with which you have to use your quick-relief medications.
- Red Zone: “I need urgent medical care.” Use this plan if your symptoms become very severe, to the point that you feel shortness of breath at rest and are unable to do any physical activity. Breathing difficulties that severely interfere with sleep, fever or shaking chills, feeling confused, coughing up blood, or having chest pains are other signs that you need emergency medical care and need to follow your red zone plan.
To see an example of what an actual COPD action plan looks like, you can check out this sample plan from the American Lung Association.
Daily Treatment Goals and Instructions (Green Zone)
Your daily symptom management and treatment goals—the green zone—is one of the most important aspects of your COPD treatment plan. It contains all the medications and actions you should take on a typical-symptom day to stay healthy and keep your symptoms under control.
When your symptoms are at your usual baseline level, you should follow the actions in this plan. If you keep your COPD well-managed and minimize flare-ups, you should be able to use your green zone plan on most days.
It's a good idea to review this part of your plan regularly, even though you use it often, just to jog your memory and review your goals, medications, and treatments. It will help you stay motivated, keep on track, and remind you of any habits or treatment methods you may have gotten lazy about doing.
Your Plan for Managing Flare-ups and Exacerbations (Yellow Zone)
Generally, any noticeable increase in COPD symptoms should direct you to use your yellow zone action plan, including feeling low on energy, experiencing more difficulty breathing, worsened coughing, or changes in your sleep quality and appetite. You should also look for changes in the color and consistency of your mucus and how frequently you have to use your quick relief medications.
When your symptoms flare-up or your breathing problems get worse, your yellow zone plan will tell you exactly what you need to do to keep your symptoms under control. It should include your usual maintenance medication along with instructions on how to use your quick-relief medications effectively.
Your yellow zone action play will likely include other treatments for reducing your symptoms, such as breathing techniques and mucus clearance techniques, which we will discuss more in the following sections. It may also include stricter guidelines for using supplemental oxygen and protecting your lungs from inflammatory environments and irritants.
Your doctor may instruct you to start taking a course of antibiotics or corticosteroid medications when your symptoms get worse as part of your yellow zone action plan. You may also need to call your doctor if your symptoms don't get better within a day or two.
Your Plan For Emergencies (Red Zone)
The purpose of your red zone action plan is to remind you of what to do in an emergency. You should follow this plan when your symptoms become so severe that you have difficulty breathing at rest.
Extreme shortness of breath, severe fatigue that interferes with daily living, or being unable to do light physical activity is a sign that you need to seek immediate medical attention. Other signs include chest pain, coughing up blood, fever, chills, confusion, and symptoms that are so severe that you are unable to sleep at night.
If you experience any of these symptoms, follow your red zone action plan and call 911, or have someone else drive you to the emergency room as quickly as possible. You may also need to take a medication or adjust your oxygen prescription to help you cope until you get to the hospital.
The Components of a Good COPD Action Plan
A good COPD action plan contains everything you need to know about managing your disease on a daily basis and when your symptoms flare up. It should tell you what medications to take every day, what medications to take when your symptoms get worse, and all the actions and habits you need to do on a regular basis to keep your lungs healthy and your symptoms under control.
Many action plans also include information about your diet, exercise, and lifestyle goals related to your COPD. In these next sections, we'll explain all the different components that your COPD action plan may include as part of your green and/or yellow zone plans.
Your COPD action plan should include all of the prescription and over-the-counter medications that you need to treat your COPD. It should tell you what medication to take when your symptoms are at baseline, what medication to use as-needed (and when to use it), as well as the correct dosage and the frequency that you should take it.
Your maintenance medications help you breathe easier on a daily basis and are the cornerstone of daily COPD treatment. However, you have to take them every single day as directed by your doctor in order for them to be as effective as they can be.
On the other hand, not keeping up with your daily maintenance medications can make your symptoms worse and cause your COPD to progress faster. By keeping your symptoms minimized on a daily basis, your maintenance medicine is very important for staving off flare-ups, exacerbations, heart problems, and other serious COPD complications.
Your doctor may also prescribe quick-relief or rescue medications—in addition to your maintenance medicine—to use as part of your yellow zone action plan on days when you experience worsened COPD symptoms. These medications help reduce sudden, uncontrolled symptoms and help you breathe easier when your symptoms flare up.
Your doctor may also give you a course of steroid medication or antibiotics to use when you notice your symptoms getting out of hand. Most of the time, you will be instructed to take them if your symptoms stay worse for more than a day or two or when you notice the signs of an oncoming exacerbation.
Whenever you start a course of antibiotics, it's very important that you continue to take the entire course, even after you start to feel better. As long as you use them correctly and as directed by your doctor, antibiotics and steroid medications can help you avoid serious exacerbations and recover from flare-ups more quickly.
Your COPD action plan should also include information about any vaccines you need, including pneumonia and influenza vaccines. Most adults need another dose of the pneumonia vaccine after the age of 65, and all COPD patients should get their yearly flu shot to stave off exacerbations and infections.
Whatever medications your doctor recommends should be included in your action plan along with enough detail to help you use them reliably and consistently. If you have any questions about your medications or how to use them, talk to your doctor and ask him to clarify the instructions in your plan.
Breathing exercises like pursed lips breathing and diaphragmatic breathing are a vital part of daily COPD management for patients who struggle with shortness of breath. These breathing techniques help you control your breaths and even strengthen the muscles in your chest that you use to breathe.
Practicing breathing techniques every day can help you keep your breathing steady and under control when you exercise and do other active, daily tasks. They can also help you manage minor symptom flare-ups and get through bouts of coughing more easily.
If you deal with breathlessness and coughing often, your doctor may recommend breathing exercises as part of your everyday COPD management plan. They may also be helpful to practice when your symptoms get worse as part of your yellow zone action plan, too.
Managing Airway Congestion
Excess mucus is a common symptom that many COPD patients have to manage. If you don't take care to stay hydrated and clear the mucus out of your lungs, it can make symptoms like coughing and breathlessness worse.
If you let mucus build up in your airways, it narrows the passages that air can flow through and makes it more difficult to breathe. Mucus buildup can also trap bacteria, viruses, and irritating particles that can inflame your airways or cause infections in your lungs.
Because of this, keeping your airways clear of mucus is often an important part of managing COPD. To address this, your treatment plan may include mucus clearance techniques to use when you get excess phlegm.
The goal of mucus clearance techniques is to dislodge stuck mucus from the walls of your airways and cough it up and out of your lungs. Often a two-pronged approach of proper hydration and huff coughing can help you keep congestion under control.
Staying hydrated thins out your mucus, while coughing moves the mucus up through your airways so you can cough it up through your mouth. Your doctor may also recommend a variety of other mucus clearance techniques and aids, such as chest percussion, positional drainage, or using a special high frequency chest wall oscillation vest, as part of your COPD action plan.
If you are a smoker, then quitting should be your number one priority and included as part of your COPD action plan. Quitting smoking will help prevent further damage to your lungs, reduce flare-ups, and preserve the lung function that you still have left.
To help you quit, you may want to include a quit smoking program or therapy as part of your COPD management plan. If you are unable to quit, reducing the number of cigarettes you smoke or seeing a smoking cessation therapist can help put you on the right track to ending your addiction.
If you want help quitting smoking, check out this article, “Where to Get Help When You Decide to Quit Smoking,” from the National Cancer Institute. You can also get more information about smoking cessation and quit smoking resources from the CDC, the American Lung Association, smokefree.gov, and many other places online.
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