Consider this hypothetical scenario: you have a COPD exacerbation and your shortness of breath suddenly gets much worse than usual. You call your doctor to see what you should do, and she tells you to go to the hospital right away.

If this happened, would you be ready? Would you be able to quickly gather the documents, medical equipment, and other supplies that you need?

If your answer is no, or you're not sure, then you might have a serious need for an emergency action plan. Luckily, it doesn't take much time or effort to prepare for medical emergencies, and doing so could save your life in a critical situation.

To help you get started, we've created this guide explaining how to prepare for COPD medical emergencies and unexpected hospital visits. Throughout this post, we'll go though all the different components of a good emergency action plan and walk you through the steps to make one for yourself.

We'll also explain how to recognize a variety of different COPD-related emergencies and how to know what you should do when your symptoms get worse. Then, we'll teach you how to put together a variety of practical tools that can help you respond more quickly and efficiently during a medical emergency, including:

• An emergency contact and medical info card
• An emergency grab bag with essential documents and items
• A personalized hospital care kit for basic comfort away from home

When you or someone you love has COPD, you never know when a medical emergency will strike. Whether it's because of an illness, exacerbation, or another complication, just about every person with COPD will—at some point or another—need to make a sudden visit to the hospital or emergency room.

That's why it's vital to be ready to spring into action whenever that time may come. Having a plan and a stash of supplies can make all the difference in the middle of a medical crisis, helping you to get to the hospital sooner and ensuring that you have everything you need once you are there.

Recognizing the Signs of an Emergency

The first step to handling a COPD-related medical emergency is recognizing that you have an emergency in the first place. In order to do so, you need to pay attention to your body and know how to identify the signs that you need immediate medical help.

COPD exacerbations are the most common reason for hospitalization and emergency room visits among people with COPD. Of course, not all exacerbations get that bad; some are mild enough to treat at home with medication and guidance from your doctor.

However, it's important to be aware that minor exacerbations can quickly get out of hand and become much more severe. If that happens, you might have to go to the emergency room or check into a hospital for more aggressive in-patient treatment.

That's why it's important to keep close tabs on your COPD symptoms from day to day so you can recognize any changes. If you notice your symptoms flare up and don't improve within a a couple days, that means you might need additional treatment to manage the exacerbation.

Major Signs of a COPD Exacerbation:

• Worse than usual shortness of breath
• Shortness of breath at rest
• Coughing more than usual
• Increase in sputum (mucus you cough up)
• Change in the color of your mucus or sputum
• Increased fatigue
• Fever, shaking, or chills
• Needing to use your rescue inhaler more often than usual

You should also have a COPD action plan that tells you exactly what to do whenever your symptoms get worse. It should tell you which medications to take, when you should call your doctor, and when you should call an ambulance or go to the emergency room.

If you cannot get over an exacerbation on your own, spending some time in the hospital is sometimes the only way to recover. If your symptoms get very severe or you experience breathlessness that won't go away, don't wait and seek medical care immediately.

Severe COPD Symptoms that Could Require Emergency Treatment:

• Shortness of breath that is sudden or more severe than usual
• Coughing up blood
• New chest pain
• Difficulty waking up
• Severe restlessness or anxiety
• Confusion
• Extreme weakness or fatigue
• Flu symptoms, including body ache, fever, and sore throat
• Swelling in the legs

Hypoxia is another common COPD complication that should be treated as a medical emergency. It happens when your blood oxygen saturation falls to dangerously low levels, starving your body of oxygen and potentially causing life-threatening complications.

Severe hypoxia can be fatal if you don't get immediate treatment to increase the amount of oxygen in your blood. However, even mild hypoxia can lead to serious problems like high blood pressure and cognitive decline.

Your risk for hypoxia is higher if you if you already suffer from chronic hypoxemia (blood oxygen levels that are lower than what is considered healthy). It can also cause acute respiratory failure, a life-threatening condition that can occur very suddenly, especially during severe COPD exacerbations.

There are two main types of respiratory failure that occur in people with COPD: one is the result of low blood oxygen levels (hypoxemic respiratory failure), while one is the result of too much carbon dioxide building up in your blood (hypercapnic respiratory failure). If not treated quickly, both severe hypoxia and acute respiratory failure can quickly result in severe organ damage and death.

Signs of Severe Hypoxia or Respiratory Failure

• Rapid breathing
• Racing heartbeat
• Shortness of breath at rest
• Slow heartbeat
• Irregular heartbeat
• Inability to breathe or catch your breath
• Dizziness or lightheadedness
• Inability to communicate
• Profuse sweating
• Extreme sleepiness and fatigue
• Confusion
• Blue or gray tinted skin, especially on fingertips, toes, or lips

Despite advances in COPD treatment and hospital care, people still die from treatable causes just because they don't make it to the hospital quickly enough. So if something feels wrong, don't be afraid to seek help, and never ignore the warning signs of a potential medical emergency.

How to Prepare for an Emergency

Planning ahead for a medical emergency is all about making it as simple as possible for you or someone else to respond to and get help fast. That means being able to identify the emergency immediately, promptly call for help, and quickly gather all the essential supplies and documents you need.

In the following sections, we'll show you some practical tools and strategies doing each of these things, and how to put them all together into an effective emergency action plan. That way, when emergency strikes, you will have everything you need to handle it confidently, efficiently, and with the least amount of stress.

Have a COPD Action Plan

A COPD action plan is essentially the instructions for your COPD treatment written down in a way that is easy to follow and simple to understand. If you don't have a written COPD action plan yet, ask your doctor to make one for you; you can even use a handy pre-made template like this one from the American Lung Association (PDF link).

Having a COPD action plan is important because it tells you you exactly how to treat your COPD symptoms and flare-ups in the most effective way. It also tells you how to recognize the signs that you need to seek additional medical help, either by calling your doctor or going to the emergency room.

The instructions and descriptions a COPD action plan serve as a guide to monitoring your symptoms, managing them better, and recognizing when they've gotten out of your control. In this way, a good COPD action plan can both help prevent medical emergencies and help you respond to them appropriately when they occur.

For more information, check out or guide explaining COPD action plans and how to use them from our Respiratory Resource Center.

Have a Trustworthy Mode of Communication

When you're in an emergency, a phone might be your only way to connect to the outside world. In moments like those, it's absolutely vital to have a reliable mobile phone you can use to call for help.

If you have COPD and don't have a mode of communication you can count on, it's time to get one fast. You should also make sure that you know how to use your phone and and that you feel comfortable making calls.

In case you can't use your usual phone for some reason, you should also keep something like a spare, charged cell phone battery or a separate emergency phone on hand. You can also use your car to charge up your phone battery in a pinch as long as you have the right kind of adapter for your car.

Be Prepared for Environmental Disasters

If you live in a disaster-prone area (or even if you don't), it's a good idea to plan ahead for environmental emergencies like extreme weather and natural disasters. These kinds of events, which can leave you stranded without power or a means to get supplies, are particularly dangerous for people with chronic diseases like COPD.

One of the most important things to do is make sure that you have a way to call for help if the power ever goes out. Even just an old phone with a fully charged battery can be a lifesaver in an emergency.

If you rely on an oxygen concentrator for supplemental oxygen therapy, then you should also have a backup oxygen supply that doesn't rely on electricity to work. However, you should inspect any oxygen tanks you keep in storage regularly, since some (especially liquid oxygen cylinders) can lose oxygen over time.

The American Red Cross also suggests keeping a home emergency survival kit, which includes:

• A first aid kit
• A flashlight & extra batteries
• A battery-powered radio & extra batteries
• A multipurpose tool
• An emergency document folder (we'll show you how to make your own in a section just below)
• Sanitation and hygiene products
• A 7-day supply of medication and medical equipment
• A cell phone and charger
• An emergency blanket
• Extra cash
• Maps of your local area
• In the case of a very serious disaster, a 2-week supply of water and non-perishable food.

Here are some more tips for preparing for power outages and other environmental emergencies that could affect your ability to get medical care:

• Keep a backup source of electricity, such as a gas-powered generator or a backup home battery bank.
• Ask your doctor if he can give you an extra supply of medicine to keep in case there is an emergency that leaves you unable to access or refill your prescriptions.
• Work out a plan with neighbors, family,or friends to ensure that someone can check up on you during a power outage or weather emergency. Let them know if there are any specific supplies or help you will need (e.g. assistance setting up your generator safely).
• If you use an oxygen concentrator or any other electricity-powered medical device, let your local power company know. Then, if there is a power outage, they might be able to prioritize your area as they work to get the power back on.
• Make sure your cell phone (and your emergency backup phone) is able to receive Wireless Emergency Alerts from the Federal Emergency Management Agency.
• Don't wait until the last minute if you are told you need to evacuate your home; leave and get to a safe place as early as you can.
• Anxiety and panic can make your breathlessness worse, but having a plan and supply kit ready can do wonders for helping you stay calm and collected during an environmental emergency.

Make an Emergency Contact List

The very first thing that you have to have to respond to a medical emergency is basic information about how to get the medical help you need. You should always call 911 for an immediate, life-threatening emergency, but it's also important to have an emergency contact list on hand.

Your emergency contact list should include:

• The contact information for your local hospital plus directions for how to get there
• The contact information for your primary care doctor and any other medical specialists that treat you (e.g. your pulmonologist or respiratoy therapist)
• The contact information for the person (or people) close to you who should be notified in the case of an emergency
• The contact information for each person or place should include:
• Full name of the person or place (For doctors, include the name of the medical facility they work in.)
• Full address
• Phone number{s) including area code

Having this list on hand will ensure that you can contact the hospital and get there quickly in an urgent situation. It also makes it easier for anyone who helps you in an emergency to take action and transport you to the best place for treatment.

Your emergency contact list can also help emergency and hospital personnel contact anyone they need to—such as your family or your doctor—about your condition and care. It could even help you get better treatment by allowing medical personnel to get medical records and other vital information more quickly.

Prepare an Emergency Info Folder

The purpose of an emergency info folder is to keep important documents like medical records, insurance information, and more together in an easy-to-grab package. That way, when a medical emergency strikes, you'll have everything that you and the hospital staff might need to give you the best possible care.

Essentially, your emergency grab bag should contain everything a doctor would need to get up-to-date on your health condition and treatment. It should also include any documents the hospital needs for insurance, financial, or administrative reasons, including personal ID, health insurance information, and some means of financing or payment.

Here is a list of important records you should keep in your emergency info folder:

• A copy of your emergency contact card
• A copy of your health insurance card (and any other important policy information)
• Personal identification (e.g. driver's license or passport)
• A list of all medications and supplements you take, including:
• The name of each medication and supplement
• Your regular dosage for each medication
• How frequently you take each medication
• The name and contact info for the doctor who prescribed these medications
• Important medical info and documents, including:
• A brief description of all health conditions you have
• A list of any food or medicine allergies you have
• Documentation of major treatments, operations, and noteworthy test results (e.g. x-rays, lab results, surgery reports, etc.)
• If applicable, also include any relevant documentation regarding your legal guardianship, power of attorney, or legal caretaker(s)
• A form of payment, such as: a credit card, check book, HSA card or FSA card

Make a Personalized Emergency Hospital Care Kit

Having to stay in a hospital is stressful and uncomfortable, and it can be even worse when you end up there unexpectedly. In order to keep yourself comfortable and sane, it's important to make sure you have some personal comforts to get you by.

The purpose of a hospital care kit is to act as a “go-bag” containing your emergency info folder plus anything else you might need to get by once you're in your hospital room. It's a quick way for you or a loved to grab all the basic supplies and entertainment you might need without any searching or delay.

Think of your hospital care kit like a mini travel bag that you can fill with the same types of things you might pack for a weekend away from home. In particular, consider items from the following major categories: toiletries & hygiene, clothes, medical equipment, and entertainment, and personal items that bring you comfort.

Start by choosing a bag that's small enough to grab and store easily, but big enough to hold a couple days worth of supplies (a duffel bag or gym bag will do). In order to conserve space, try to pack small, compact items; you could buy travel-sized toiletries, for example, or parse full-sized products into small baggies and containers.

Don't worry about packing for a long hospital stay; after all, you never really know how long it will be before you go home. It's better to keep your bag compact and pack just enough supplies to last until you can send someone out to fetch more.

To help you decide what to prioritize, take a moment to think about what it's like to be stuck in a hospital room, and then try to think of what little things might make it a little bit comfortable and easier to bear. The ideas that come to mind can help you narrow down your options and figure out what's most important to you.

Here are some general items you might consider including in your emergency hospital care kit:

Your emergency info folder:

• Put your emergency info folder in the same bag as your hospital care kit so everything you need for a hospital visit will all be in one place
• Make sure to keep the info up to date with any changes in your health, including changes in medication, dosage, or other treatments you use

A set of basic toiletries and personal hygiene necessities, including:

• Small bottles of shampoo, conditioner, & body wash
• A toothbrush, toothpaste, & mouthwash
• Deodorant
• A couple packages of travel tissues
• A small bottle of lotion
• Face cleansing wipes
• Chapstick
• Hand sanitizer

Comfortable, compact clothing, including:

• A couple of comfortable t-shirts
• A couple of comfortable pajama bottoms
• A few pairs of socks (ideally with non-slip bottoms)
• A few pairs of underwear
• A couple of comfortable bras (if applicable)
• A pair of slip-resistant flip flops
• Slippers

Entertainment and things to keep you busy, including:

• Books & magazines
• A compact game or set of cards
• Music & headphones
• Coloring books
• Paper and something to write or draw with
• Simple hobby supplies (e.g. for knitting, drawing, writing, etc.)
• Some spending cash (for vending machines, newpapers, etc.)
• A prepaid phone card (some hospitals do not allow cell phones)

Supplemental oxygen supplies (if you use oxygen), including:

• Oxygen mask or nasal cannula
• Humidifier bottle
• Any lubricants or lotions you normally use for comfort

Other personal items you might want to include:

• A notebook and pen for jotting down questions and notes
• An eye mask & earplugs for sleeping
• An extra phone charger & wall plug
• A soft blanket or bathrobe
• A refillable water bottle
• Photos, keepsakes, or other comfort items
• Sanitizing wipes
• Dry shampoo (for when bathing is difficult)
• Hair ties
• Tweezers
• A shaving razor
• Nail clippers
• Hair styling products and cosmetics

You should also keep in mind that, even

Being a COPD caregiver is no simple or straightforward task; it requires empathy, endurance, compassion, and creativity to fulfill the many different roles and responsibilities that the job requires. It often demands a great deal of time and self-sacrifice, while also requiring a seemly endless well of energy and patience.

This can be a heavy burden for caregivers to bear day after day, causing frustration, exhaustion, and emotional strain. As a result, many caregivers find themselves in disarray, feeling so drained and overwhelmed that they neglect their own personal needs.

This kind of burnout is detrimental to your health and well-being, and adds unnecessary suffering to an already difficult task. It can also lead to negative psychological changes—like reduced patience and poor concentration—that could affect your caregiving abilities, too.

Because of this, part of being a COPD caregiver is learning how to cope with the physical and emotional burdens of the job without draining yourself in the process. However, that's easier said than done, especially if you have a very dependent loved one or patient who needs full-time care.

It's easy to get so bogged down by worry, stress, or the weight of caregiver responsibilities that your own needs fall by the wayside. But when you put so much of your time and energy into caring for someone else, it's important to remember to care for yourself, too.

That's why we created this guide specifically to help caregivers of people with COPD find better ways to cope, stay healthy, and practice effective self-care. Inside, you'll find a variety of useful strategies for improving your own well-being, including tips for reducing stress, finding sources of support, and finding time for yourself in-between demanding caregiving tasks.

Utilizing these and the other techniques in this guide can help you stay you afloat when you feel overwhelmed and help you keep up the strength to face whatever challenges come your way. When you have the means to keep your head above water, you'll find that the hardships of being a COPD caregiver are much easier to bear.

The Sacrifice that Comes With Giving Care

Some COPD caregivers are professionals who are hired either full-time or part-time to provide care to a COPD patient (usually) in their home; these are known as “formal” caregivers. In most cases, however, people with COPD are taken care of at home by their loved ones, which are known as “informal” caregivers.

In fact, most caregivers are close family members and spouses who make huge sacrifices to be a caregiver out of necessity, compassion, or love. Some caregivers even have to leave their families, jobs, and normal lives behind in order to to be able to move in with their sick loved one and take care of them full time.

That's because taking care of someone with COPD can be a very demanding job, requiring long hours and a great deal of flexibility. A COPD caregiver never knows when they'll need to rush their patient to the hospital or provide extra care during a symptom flare-up.

In many cases, being a caregiver requires you to take on a wide variety of responsibilities that go far beyond basic care. People with advanced COPD, in particular, sometimes need intensive, full-time assistance with all the major aspects of daily life.

Here are some of the common responsibilities that come along with being a COPD caregiver:

• Providing Basic Medical Care:
• Administering COPD medications
• Sanitizing and preparing medical equipment (e.g. oxygen delivery equipment)
• Assisting with COPD treatments like breathing exercises, chest percussion, etc.
• Assisting with exercise, walking, and other physical activities
• Responding to emergencies
• Coordinating and keeping track of all aspects of COPD treatment
• Providing overnight care
• Facilitating Professional Medical Care
• Transportation to and from appointments
• Attending doctor's visits
• Advocating for their patient
• Managing medical bills and hospital visits
• Working on health insurance claims and negotiating with agents
• General Home Care
• Shopping
• Preparing meals
• Bathing and dressing
• General housekeeping responsibilities
• Providing emotional support

To learn more about what it takes to be a caretaker for someone with COPD, you can find more tips and information in this guide: How to be a Helpful Caregiver for Someone with COPD.

Being a Caregiver Can Take a Huge Toll

Being a full-time caregiver, in particular, comes with an unimaginably large weight of responsibility that can be difficult to bear. It requires a great deal of self-sacrifice and the willingness to spend day after day putting the needs of someone else first.

The physical toll of being a COPD caregiver can be huge; the responsibilities are time-consuming, ever-persistent, and sometimes physically demanding. Because of this, many caregivers fall behind on important health-related activities and suffer from poor sleep, poor diet, and lack of exercise.

Being a caregiver for a loved one with COPD can also be a very heavy mental and emotional burden. It often requires you to give empathy and compassion while putting your own worries and feelings aside, which takes a substantial amount of mental effort to keep up over time.

What's more, it can be heartbreaking to see someone you love fighting a chronic disease that causes so much suffering, physical limitation, and pain. It can be almost unbearable to watch a loved one's physical decline from a distance, but it's even harder when you're by their side every day as they struggle more and more to breathe.

Because of all these things and more, it's no wonder that COPD caregivers are vulnerable to burnout, exhaustion, depression, and a variety of other physical and psychological symptoms. In fact, the toll is so significant that it's caught the attention of researchers who have conducted extensive studies on the effects of being a caregiver for someone with COPD.

For example, one large study of 461,884 informal COPD caregivers found that suffered a wide range of problems that were directly related to their caregiver responsibilities:

• 35% had a health-related problem
• 83% had problems with their social lives and leisure time
• 38% of working-age caregivers experienced problem with their jobs or careers

Other studies have identified some more specific physical and mental impacts that caring for someone with COPD can have:

• Physical Health and Lifestyle Impacts:
• Loss of freedom
• Social isolation
• Sleep disturbance
• Fatigue
• Relationship difficulties
• Loss of intimacy

• Mental health Impacts
• Anxiety
• Depression
• Powerlessness
• Resentment
• Guilt
• Uncertainty and confusion
• General psychological distress

These difficulties for caregivers only increase with the severity of their loved one's or patients' COPD, as patients with more advanced symptoms require more care. And because COPD is a degenerative disease, people with COPD inevitably become more dependent over time, adding even more weight to the physical and mental burdens that their caregivers must bear.

Other studies have looked at some of the general needs that caregivers have with regards to their caregiver role and the hardships it brings. These studies reinforce the idea that COPD caregivers face some specific challenges that other types of caregivers do not, due to the prolonged, degenerative and unpredictable nature of COPD.

For example, COPD exacerbations are inevitable for people living with the disease, and the threat of symptom flare-ups—which can be life-threatening in serious cases—constantly looms overhead. This can cause a great deal of worry and stress for caregivers, who must always be prepared for sudden changes in their patient's or loved one's condition.

Of course, being a caregiver is about much more than just sickness and hardship and suffering—it can also be meaningful, rewarding, and a powerful act of love. Caregiving can also be an opportunity for personal development and bonding, and can even bring families closer together.

Even so, getting through the difficult parts of caring for someone with COPD isn't an easy or simple task. That's why you need a variety of personal coping strategies and sources of outside support that you can lean on when things get tough.

Coping Strategies for Caregivers

Taking care of someone with a chronic disease can be both physically exhausting and mentally draining. This is especially true if you are a full-time or primary caregiver for a loved one with COPD.

If you're not careful, you can easily get burned out or overwhelmed, which isn't good for you or the person for whom you are responsible for caring. That's why it's so important to keep sight of your own well-being and find strategies to help you balance your own needs with your care-giving responsibilities.

In the following sections, we offer some practical strategies that can help you keep strong through hardships and avoid falling into the common slump of burnout and fatigue. That way, you can keep yourself healthy and sane while continuing to be the best caregiver you can be.

Know the Signs of Burnout

The best way to avoid getting burned out and fatigued is to recognize the early warning signs. For example, you might be on the road to burnout if you notice you're feeling exhausted, overwhelmed, or struggling more than usual to cope with stress.

Here are some common signs of burnout you should watch out for:

• Feelings of dread or disillusionment regarding your work and responsibilities
• Chronic stress or anxiety
• Isolation
• Poor performance and/or productivity (in work and other responsibilities)
• Poor sleep and/or fatigue
• Intestinal issues or poor appetite
• Excessive cynicism and/or irritability (both on the job or in other aspects of life)
• Changes in appetite
• Body aches and pains
• Increased irritability, impatience, or being quick to anger
• Lack of interest in activities and recreation
• Use of drugs, alcohol, or other unhealthy habits as a coping mechanism

Burnout isn't good for you or the person you are caring for, so you should take these symptoms seriously when they occur. Don't brush them off until they gets so bad you can no longer ignore them; instead, take action to improve your situation before it gets out of hand.

As soon as you begin to feel your emotional fortitude or energy stores waning, it's time to take a step back and figure out what to do. The first step is to identify what the problem is, or what in your life you are missing: Are you doing too much? Are you losing sleep? Are you having trouble managing anxiety or stress?

Once you've defined the problem, solving it is a matter of finding some viable strategies to give yourself what you need. For example, you can improve poor health habits by figuring out how to make a bit more time in your day for self-care. If your trouble is coping with anxiety or stress, you could address it by seeking mental health counseling or participating in a caregiver support group.

You can find many other helpful ideas and solutions in this guide and in the many caregiver resources linked throughout. It may take some time to find a good set of strategies that fits into your daily routine, but the sooner you start searching and trying, the sooner you can find a balance and begin to see results.

Don't Underestimate Self Care

It's easy to get so sucked into your role as a caregiver that you start to neglect other aspects of your life. Because of this, it's important to pay attention to your own needs as well as those of your loved one or patient, and to develop a personal set of strategies for self-care.

Self-care is a broad term that can apply to just about any activity you do in the pursuit of your own health and well-being. In fact, pretty much all of the tips and strategies in this guide can be considered a form of self care.

A good self-care strategy is varied, balanced, and helps you work toward a more fulfilling and well-rounded life. You should aim to find activities that address both your physical and mental needs, in a way that helps you both maintain and improve your quality of life.

To illustrate what self-care looks like, we've provided several examples of common self-care categories below. However, these examples are far from exhaustive; self care can (and should) reach into many other categories and aspects of life that are not mentioned in this list.

Some Basic Examples of Self-Care:

• Physical Self-Care: These are activities that help you improve your physical well-being, such as exercise, healthy sleeping habits, healthy eating habits, etc. For example, setting aside time to exercise and cook healthy meals ,or staying home from work when you are sick, are both forms of physical self care.
• Emotional Self-Care: These include activities that help you manage and cope with emotions, such as relaxation exercises, emotional expression, and practicing psychological coping mechanisms. For example, taking time to journal and express your thoughts every day is a form of emotional self-care.
• Social Self-Care: This includes activities that help you connect with other people, such as keeping in touch with friends, attending social events, and nurturing both new and existing relationships. For example, scheduling some time to call and chat with a friend once a week is an example of social self-care.
• Spiritual Self-Care: This type of self care helps you find meaning and connect with your personal values and beliefs. It can include things like practicing religion, exploring your spirituality, and finding meaning in the natural world. For example, practicing mindfulness meditation or participating in a religious ceremony are examples of spiritual self care.

Don't be afraid to get creative; there is no right or wrong way to do self care as long as it helps you take care of your needs. Once you find some strategies that seem helpful and appealing to you, write them down somewhere you can find them later. That way, you'll always have your own personal self-care toolkit to reference whenever you need.

However, coming up with the strategies is the easy part; often, it's making time to actually do your self-care activities that proves most difficult. Luckily, a little creativity and flexibility can go a long way toward helping you find ways to work some self-care into your daily routine.

You can find more self-care tips and suggestions throughout this guide, and in other posts in our Respiratory Resource Center blog. You can also find a variety of ideas and examples of self-care activities from other online resources, including the ones below:

• Self-Care for the COPD Caregiver
• Taking Care of YOU: Self-Care for Family Caregivers
• Developing a Self Care Plan from ReachOut Schools

Take Advantage of Small Chunks of Time

When you're a full-time caregiver, making time for yourself can be a daunting challenge. The idea of finding time for self care and relaxation might even create more stress if you feel it's too difficult or impossible to do.

However, it's almost always possible to dig up at least a little extra time that you can use to focus on yourself. Even if all you have is a few minutes here and there, teasing them out, seizing them, and using that time wisely can make a difference in your day.

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It might help if you break down self-care activities into smaller chunks that you can slip in to smaller time slots throughout the day You could, for example, take a few minutes of quiet between caregiving tasks to read, meditate, journal, or just sit down and unwind.

For hobbies and self-care activities that take longer, you may need dedicated some larger stretches of time. Finding those hours might require more careful planning and prioritization, but remember: you are worth every bit of time and effort you put into taking care of yourself.

Make Yourself a Priority

Unless you specifically make an effort to practice self care and prioritize your own well-being, chances are that you'll fall behind. When caring for someone else absorbs so much of your time, it's just too easy put off your own needs and neglect self care.

In order to avoid this, it's important to make yourself and your self care a priority. That means truly valuing yourself and your well-being—not just mentally or theoretically, but showing it with your actions and how you plan your days.

It means showing yourself compassion, and recognizing that you deserve take care of yourself. It means believing you deserve the time to focus on your physical and mental needs, and believing you deserve the time to do things that make you feel happy and well.

Looking after yourself shouldn't be optional, and you should treat your own self-care like any other non-negotiable activity in your life. This is the true first step to successfully putting any of the strategies in this guide into practice; without it, you might never get around to using them in the first place.

Take a Break

All caregivers, even (and especially!) full-time caregivers, both need and deserve occasional breaks. In fact, taking some time off to recharge is not only good for you, but, in the long run, it can also help you be a better caregiver overall.

Unfortunately, many caregivers feel such a weight of responsibility that they feel selfish or even neglectful for spending any time away. However, if you don't get a break from that responsibility every so often, at least, you are bound to end up burned out and fatigued.

Of course, taking time off isn't always simple; in many cases, you will need to arrange for someone else to care for your patient's while you're gone. However, with a little planning, creativity, and delegation (which we'll discuss more in a later section), you're bound to be able to find another person to work in your stead.

Even if you can't get a full day off, it can be extremely refreshing just to get an afternoon or evening away. When you do, try to make the best of the time by focusing on you, letting go of any feelings of worry, stress, or responsibility for awhile.

Remember that taking some time for yourself is a necessity for your own health, and it isn't the same as abandoning your loved one or your duties. You deserve the opportunity to take care of yourself, and your loved one deserves a caregiver who isn't too burned out and exhausted to give them the care they need.

Practice Relaxation Techniques

Being a COPD caregiver often comes with a lot of stress and emotional strain. If you don't have strategies you can use to wind down, relax, and relieve that stress, it can take a huge toll on your health and well-being over time.

That's where relaxation techniques come in; they have long been the go-to recommendation from doctors and mental health professionals for coping with anxiety, stress, and other negative emotions. What's more, many relaxation techniques are quick and simple to learn, perfect for working into a busy caregiver routine.

Relaxations activities are designed to help you relax, clear your mind, and separate yourself from worries and stress. Many focus on utilizing the mind-body connection, a scientifically-supported concept regarding the ability of your mind to influence your body, and your body to influence your mind.

For example, when you feel stressed, it can cause physical reactions like muscle tension or altered immune system function. These physical effects, in turn, send signals to your brain that reinforce stress and other negative feelings. This creates a negative cycle of both physical and mental stress, but this cycle can be mitigated and interrupted by relaxation techniques and mind-body exercises.

Taking the time to focus on mental and physical relaxation can interrupt the downward spiral of stress and help you find relief. It can also give you a much-needed break from the worry, sadness, and grief that often comes with caring for someone with serious chronic disease.

Here are some examples of quick relaxation exercises you can do in 10 minutes or less:

• Practice mindfulness meditation (you can follow along with several free guided meditation sessions here)
• Do some deep breathing exercises
• Practice progressive muscle relaxation
• Do a body scan
• Take a few minutes to stretch your body and loosen up your muscles

Here are some examples of relaxation exercises that you can do in 30 minutes or less:

• Mind-body exercises like yoga or Tai Chi
• Do a longer mindfulness meditation session
• Take a 15-30 minute walk

There are many other activities that can help you relax and let go of stress, such as reading, taking a hot bath, or spending time in nature. Take some time to explore what does and doesn't work for you, and don't forget to use them in times of emotional distress!

Seek Help for Mental Health Problems

The stress and strain of being a COPD caregiver can lead to some serious emotional and psychological symptoms that you shouldn't ignore. In fact, it's quite common for caregivers to struggle with anxiety, depression, and other mental illnesses that can take a serious toll.

These mental struggles are natural and understandable, and it's okay if you're not able to able to manage them on your own. That's what counselors and psychiatrists are there for: to provide the help and support you need to regulate your emotions and develop healthy strategies for coping with whatever psychological difficulties that life and caregiving throws your way.

Give Yourself Some Credit

As a caregiver, it's easy to get so focused on the things you need to do or should be doing that you never think about how much you've already achieved. However, you shouldn't forget that you are providing a vital, admirable service that makes a huge difference in your patient or loved one's life.

People with COPD often regard their caregivers as heroes and saviors, people they (sometimes quite literally) could not live without. So give yourself some credit, and pause for a moment every so often to appreciate all the sacrifices and accomplishments you've made.

Whenever you start to feel frustrated, discouraged, or helpless—as many COPD caregivers do at times— take the time to reflect on your efforts and achievements, and remind yourself of all the good you've done so far. Doing this can help you cope better with stress and guilt, and help you keep a positive spirit when the daily strain of work and worry begins to beat you down.

How to Get Support

The burden of being a COPD caregivers is not something that anyone should have to cope with completely on their own. That's why it's important to find sources of support you can reach out to when needed, whether it's a dedicated caregiver support group, counseling, or simply a fun group activity to help you get away from the stress.

Join a COPD Caregiver Support Group

Many caregivers find that their family and friends struggle to understand what they're going through, which makes it difficult for them to provide the kind of support a caregiver needs. As a result, many caregivers end up feeling isolated and misunderstood.

That's why it's important to get support from other caregivers—people who can relate to what you are going through and understand what it's like to care for someone else with a chronic disease. You need people with whom you can share your worries, experiences, and stories, and receive personalized advice and support.

Luckily, there are a variety of different support groups specifically for COPD caregivers that offer all of these things and more. Many of these groups are remote and based online, but some places have local caregiver support groups that meet in person, too.

You might be able to find a caregiver support group in your area if you ask around your local hospitals, rehab centers, faith communities, and other organizations theat deal with healthcare, COPD and age-related diseases. You might also find more information on local groups through area-specific online forums and bulletin boards (e.g. Craigslist or Nextdoor) or via online searching tools.

Online support groups come in a variety of different formats, including:

• Phone-based support
• Online forums and chat rooms that host support sessions at specific dates and times
• Less-structured support communities that operate similarly to other social networks.

Several online support groups are run by COPD and respiratory disease advocacy organizations, such as the American Lung Association. Here are some links to some online support groups and communities for COPD caregivers and caregivers in general:

• COPD 360 Social is a large online community that is open to anyone affected by COPD, including COPD caregivers and people with the disease. You can participate in the group by following the activity feed, asking and answering questions, read the latest posts from the COPD digest, and more.
• COPD-Support offers a range of services for both COPD patients and caregivers, including an online forum (with board dedicated specifically to caregivers) and a community-driven email list.

Breathing exercises are an important part of COPD treatment, and experts recommend doing them regularly to keep your breathing muscles strong. They can also help you recover some of the breathing strength and function you lose after an illness or exacerbation weakens your lungs.



Unfortunately, practicing these techniques every day can be tedious, and it's easy to fall behind. It doesn't help that the benefits are usually subtle, and that they tend to happen so gradually that you might not notice them at all.


However, breathing exercises do help, which is why you can find special tools, known as incentive spirometers, to help you do them better. These devices are designed measure your breaths and give help you hone your breathing technique


Incentive spirometers give you real-time feedback as you breathe, allowing you to see and track your results in a way that's just not possible with unstructured breathing exercises. This can help motivate you to practice and strive for better results, whether you use it as part of your regular COPD treatment regimen or means to recover from a COPD exacerbation.


If you are interested in learning more about incentive spirometers and how they can help your lungs, then this post is for you. In the following sections, we'll explain everything you need to know about incentive spirometers and COPD, including what they are, how they work, and how to use them by following a simple step-by-step guide.


What is An Incentive Spirometer?








An incentive spirometer is a simple measurement and feedback device that can help you improve your breathing strength and ability over time. It does this by helping you practice taking long, slow, deep breaths (known in medical jargon as sustained maximal inspirations), and training you how to sustain those deep breaths for longer.


It's essentially a kind of lung exercise and recovery aid for people who struggle to breathe properly. That includes people suffering from lung injuries caused by surgery or pneumonia, and people with chronic lung diseases like asthma and COPD.


What an incentive spirometer essentially does is measure the speed and volume of the air that you inhale. It also has a simple visual mechanism that shows you exactly how quickly and deeply you are breathing in real time while you use it.


Using an incentive spirometer every day can help you strengthen your breathing muscles and improve how well your lungs function. It can increase lung capacity, reduce shortness of breath, and generally make it easier to breathe.


Incentive spirometers are particularly helpful for those who are recovering from a short-term illness like a lung infection or COPD exacerbation. These conditions often cause temporary lung function loss that can be recovered with treatment and time.


However, incentive spirometers do not necessarily work for everyone, and it's important to talk to your doctor if you are considering using one. Whether or not an incentive spirometer is right for you might depend on a variety of factors, including your specific respiratory condition, the severity of your symptoms, and the likelihood that your lung function can improve.


How Does an Incentive Spirometer Work?


There is more than one kind of incentive spirometer, but each type works in a very similar way. To help you get a better general idea of how they work, let's take a look at one of the most common incentive spirometer designs.


This type of incentive spirometer is a hand-held device made up of a handle and a mouthpiece attached to two differently-sized, clear plastic tubes. The large tube measures the volume of air you breathe in, while the smaller tube measures the air speed.









Each tube contains a movable plastic piece, called a “float,” that slides up and down as you breathe. Different spirometers have different types of floats; some look like balls, some look like small cylinders, and some have a flat, puck-like shape.


When you you inhale through the incentive spirometer, it creates an air current that blows the floats in each tube upward. How much they move depends on how fast and how deeply you inhale.


The purpose of these floats is to give you valuable visual feedback about your deep breathing technique so you can see your results and improvements. This helps you learn how to control your breathing better, and can also serve as incentive to practice and work toward better results. 


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For the larger tube, your goal is to push the puck up as high as possible by taking in deeper breaths. The markings on the side of the tube indicate how much air (in volume) you inhale.


If you or your doctor wants to set a specific volume goal, you can do this by marking a specific point along this volume measurement tube. Then, you can use that point as a benchmark to measure your progress and to motivate you to push the float up to or beyond that personal goal.


The float in the smaller tube works differently; instead of trying to push it up as high as it will go, your goal is to keep the float within a certain middle range. You can do this by controlling the speed and steadiness of your breath: the faster you breathe in, the higher the float will go.




What are the Benefits of Using an Incentive Spirometer?


If you have COPD, then using an incentive spirometer has many of the same benefits as regular COPD breathing techniques and other inspiratory muscle training exercises. However, incentive spirometers specifically focus on honing deep breathing skills, which are particularly helpful for combating shallow breathing patterns that worsen shortness of breath.


When you practice with an incentive spirometer, you are essentially training your lungs to take longer and deeper breaths. This helps to increase your lung capacity—or how much air you can breathe in to your lungs at one time—which helps your lungs work more efficiently.








Practicing with an incentive spirometer also helps you exercise specific muscles in your abdomen and chest that you use to breathe. Making these muscles stronger not only makes it easier to breathe, but can also reduce chest muscle tightness, chest pain, and fatigue.


This is an important benefit for people with COPD, who experience shortness of breath at least in part due to respiratory muscle fatigue. Tired breathing muscles can trigger quick, shallow breathing which technically requires less effort, but is also less effective at getting you the oxygen you need.


Using an incentive spirometer can help you correct this breathing pattern by helping you build up the strength and skill you need to breathe more deeply instead. It also allows you to see your improvements over time and measure your progress toward personal breathing goals.


Unfortunately, while we know that incentive spirometers work, there have not been very many studies done on incentive spirometers and COPD in particular. Fortunately, what little research that has been done shows very promising results.


One study, for example, looked at the effects of incentive spirometers on patients with mild to severe COPD. It found that participants who used incentive spirometers experienced both an increase in exercise capacity and a decrease in shortness of breath.





Another study using the Respivol incentive spirometer also found a variety of positive results for people with COPD. Those who used the device regularly for 3-6 months showed a significant increase in certain lung function measures (maximal inspiratory pressure and maximal expiratory pressure), as well as reduced shortness of breath, increased exercise tolerance, and even an increase in quality of life.


However, it's important to realize that there is no known treatment, including incentive spirometers, that can reverse any of the permanent lung damage caused by COPD. They can, however, help you breathe more efficiently, and potentially even return back to baseline after temporary lung function loss caused by an illness or exacerbation.




Where to Get an Incentive Spirometer




If your doctor recommends or approves you to use an incentive spirometer, you have a few different choices of where to get one. In some cases, you can purchase one directly from your doctor, but that can be pricier than buying one yourself.


The easiest place to purchase an incentive spirometer on your own is to go to a medical supply store, either in person or online. You might also be able to find one at your local pharmacy or in the medical section of a general store like Walmart.


If you will be buying your incentive spirometer yourself, you might still want to ask your doctor to give you a prescription for the device. You can buy them over the counter, but you will need a prescription if you want it to go through your insurance and if you want to pay for it with your FSA or HSA account.


Luckily, incentive spirometers are surprisingly inexpensive, costing less than most fast food meals. You can buy them in most places for between $6 and $20, depending on the type and brand you buy.


How to Use Your Incentive Spirometer





As we mentioned before, incentive spirometers are not all the same and come in a variety of sizes and shapes. Because of this, there is no single set of instructions for how to use an incentive spirometer that will work perfectly with every type.


It's also important to note that, while text and video instructions can certainly help, nothing can substitute for a doctor's expertise. To ensure you use your incentive spirometer correctly, you should ask your doctor to demonstrate how to use it, and then practice in front of her so she can evaluate your technique.


Bearing these things in mind, let's take a closer look at how to use the basic dual-tube spirometer we described in a previous section. This is one of the most common incentive spirometer designs that you will find in most medical supply stores, from the brands Medline, Teleflex, SPIRO-BALL, and Respivol.


Before using your incentive spirometer, make sure to position your body upright in a position that makes it easier to breathe. Ideally, you should sit up straight in a chair or on the edge of your bed.


Avoid wearing tight clothes, belts, or anything else that could restrict your ability to breathe. You might also want to clear out your airways before you begin by practicing controlled coughing or other mucus clearance techniques.








Steps to Use an Incentive Spirometer:
While sitting in a relaxed, comfortable position, hold your incentive spirometer upright in front of you.
Seal your lips around the mouthpiece.
Inhale as slowly and deeply as possible, then hold your breath for as long as you can (at least 3-5 seconds).
While breathing in, watch the float in the smaller tube, and try to keep it within the marked range (this measures your breathing speed).
You can change the position of this float by adjusting how quickly you inhale.
Increasing the speed of your breath will move the float higher, while slowing it down will cause the float to fall down lower.
While breathing in, watch the float in the larger tube and try to push it as high as possible (this measures the volume of your breath).
Note which measurement mark the float reaches at it's highest point.
The deeper breath you take, the higher the float will go.
If your spirometer has a movable indicator on the outside of the tube, you can use this to mark the maximum height.
Record this measurement for future reference and to help you keep track of your progress.
Take a few moments to rest.
Repeat these steps for another 10 to 15 breaths in order to complete one full incentive spirometer session.


If at any point you start to feel dizzy or lightheaded, you should stop and take a break to breathe normally for awhile. Once you feel better, you can continue using your incentive spirometer again.


To see these steps in action, check out this video demonstration:



Continuing to Practice




Incentive spirometers are not a one-time or occasional treatment; they only work if you use them often over an extended period of time. How long that time is depends on your particular health condition and your reason for using the incentive spirometer.


If you are using an incentive spirometer for normal COPD maintenance, then your doctor may advise you to use it long-term or indefinitely. If you are using an incentive spirometer to help your lungs recover from an exacerbation, then you might be able to stop using your incentive spirometer after several weeks or months.


Either way, you will need to use your incentive spirometer every day in order for the treatment to be effective. Your doctor will tell you often you should use it during the day based on your health and treatment goals.


In a hospital setting, doctors often recommend using an incentive spirometer very frequently; usually once every 1-2 hours for patients recovering from serious lung infections and surgeries. However, this can differ from person to person, which is why you should always follow your doctor's specific advice.


It's also a good idea to keep records of your incentive spirometry results for you and your doctor to discuss and evaluate later. Simply write down your highest volume measurement you get from each incentive spirometer session, and then you'll be able to track any changes that happen over time.


Most importantly, don't give up on your incentive spirometer if you don't notice results right away. Real improvement takes time, so it's important to practice, persevere, keep working toward your personal incentive spirometry goals.




Conclusion
Managing COPD and lung function decline is tough, but there is a wide variety of tools and treatments available to help. Tools like incentive spirometers can help you keep up with certain aspects of treatment—like breathing exercises—by providing a simple and satisfying way to practice every day.


Incentive spirometry is safe, inexpensive, and has the potential to provide a variety of breathing and exercise benefits for people with COPD. It's easy to get the hang of and, if you stick with it long enough, it can make a noticeable difference in your symptoms.


If you or someone you love suffers from COPD, consider asking your doctor if she believes that an incentive spirometer would be a helpful addition to their home treatment regimen. While not every person will see significant improvements after using an incentive spirometer, many do, and it's well worth considering giving it a try.

COPD and other respiratory diseases often come with health complications, both big and small. One of the more serious complications of COPD is acute respiratory failure, a medical emergency that occurs when you experience a sudden and serious drop in lung function.

Acute respiratory failure can be deadly, and getting immediate treatment can mean the difference between life and death. Because of this, it's vital for every person with COPD, and other chronic respiratory conditions, to be able to recognize and understand respiratory failure.

That's why, in this post, we're going to explain what respiratory failure is and how COPD can put you at risk. We'll also show you how to identify the symptoms of respiratory failure, what to do if it happens, and what you can do to minimize your risk for developing this life-threatening condition.

What Exactly is Respiratory Failure?

Respiratory failure happens when your lungs are no longer able to function well enough to meet your body's needs. This causes an imbalance of oxygen and/or carbon dioxide in your blood that can severely affect your ability to breathe.

To better understand how this happens, let's consider what healthy lungs are supposed to do: First, the air sacs (called alveoli) in your lungs absorb oxygen from the air you breathe in and transfer it to your bloodstream. Then, your heart pumps that oxygen to all the nooks and crannies of your body, where it's used as fuel for all kinds of vital functions.

When your body uses up that oxygen, it creates a waste product—carbon dioxide—that goes back into your bloodstream to get pumped back up to your lungs. Then, your lungs perform their second important duty; they take the carbon dioxide out of your bloodstream and get rid of it when you exhale.

This whole process is known as “gas exchange”, and healthy lungs can do this quickly and efficiently, even faster than your body needs. This ability is known as “respiratory capacity,” and having extra capacity allows your lungs to keep up even when you need more oxygen than usual (e.g. when you exercise) or when your lung function is reduced (e.g. when you get sick).

In the case of respiratory failure, however the opposite is true: your respiratory function gets lowered to the point that your lungs can no longer exchange gases fast enough to keep up with your body's needs. Essentially, this means that your lungs either can't absorb enough oxygen fast enough, can't get rid of carbon dioxide fast enough, or possibly even both.

As a result, one of three things happens:

• Your blood oxygen levels fall to dangerous levels, a condition known as hypoxemia
• Carbon dioxide builds up to dangerously high levels in your blood, a condition called hypercapnea.
• In some cases, both hypoxemia and hypercapnea can happen simultaneously.

If the hypoxemia or hypercapnea become severe enough, it is diagnosed as either acute or chronic respiratory failure. We'll go into more detail about the differences between the two in the next sections below.

Respiratory failure is often caused by COPD and other chronic respiratory disorders. However, it can also be caused by other serious health conditions, including pneumonia, drug overdoses, and other diseases or injuries that affect the nerves and muscles you use to breathe.

Causes of Respiratory Failure:

• Lung Conditions:
• COPD
• Cystic fibrosis
• Pulmonary embolism
• Pneumonia

• Nerve and Muscle Conditions:
• ALS
• Muscular dystrophy
• Stroke

• Spine Conditions:
• Scoliosis
• Spinal cord injuries

• Chest injuries
• Overdosing on drugs or alcohol
• Acute lung injuries from inhaling dangerous amounts of harmful fumes or smoke (e.g. breathing smoke in a house fire)

Acute vs. Chronic Respiratory Failure

There are two main types of respiratory failure: acute and chronic. Acute respiratory is severe and sudden, which chronic respiratory failure is a long-term health condition that develops gradually over time.

Chronic Respiratory Failure

The symptoms of chronic respiratory failure are, essentially, the main symptoms of moderate to severe COPD. Many people with COPD have chronic respiratory failure, and many people develop it in the later stages of the disease.

In fact, managing chronic respiratory failure is a major aspect of late-stage COPD treatment. You can live with chronic respiratory failure for years and usually manage it at home with the help of medications and your COPD treatment team.

Symptoms of Chronic Respiratory Failure

• Difficulty breathing
• Frequent shortness of breath, especially during physical activity
• Coughing up mucus
• Wheezing
• Headache
• Rapid breathing
• Fatigue
• Anxiety
• Confusion
• Bluish skin color, especially in the fingertips or lips

Acute Respiratory Failure

On the other hand, acute respiratory failure is a life-threatening medical emergency that requires immediate treatment. It can happen quickly, without much warning, and is most often caused by illness and COPD exacerbations.

Acute respiratory failure can be either hypoxemic (caused by low blood oxygen levels) or hypercapnic (caused by high blood carbon dioxide levels).

According to medical criteria, acute hypoxemic respiratory failure occurs:

• If the partial pressure of oxygen in your blood drops below 60 mmHg (91% blood oxygen saturation), OR
• If the partial pressure of oxygen in your blood drops 10mmHg or more below your usual baseline oxygen saturation.

Acute hypercapnic respiratory failure occurs:

• If the partial pressure of carbon dioxide in your blood rises above 50 mmHg, OR
• If the partial pressure of carbon dioxide in your blood rises by 10 mmHg or more above your baseline.

Acute respiratory failure often happens suddenly and begins with irregular breathing patterns like severe difficulty breathing and rapid, shallow breaths. You might also notice other symptoms in the hours and minutes before major breathing problems start, such as anxiety, fatigue, sweating, confusion, or a fast, racing heartbeat.

Symptoms of Acute Respiratory Failure:

• If caused by high carbon dioxide levels (hypercapnic respiratory failure):
• Rapid breathing
• Confusion

• If caused by low oxygen levels (hypoxemic respiratory failure):
• An inability to breathe
• Rapid and shallow breathing
• Bluish skin color, especially in the fingertips or lips
• Loss of consciousness
• Irregular heartbeat
• Racing heartbeat
• Profuse sweating
• Anxiety and restlessness
• Tiredness and fatigue

In this post, we're going to focus on acute respiratory failure, as it is one of the leading causes of death for people with COPD. In the following sections, we'll explain more about the relationship between COPD and acute respiratory failure, including how to prevent it and how to know if you are at risk.

How Does COPD Cause Respiratory Failure?

As we explained before, acute respiratory failure is caused by an imbalance of gasses in your blood, which happens when your lung's normal function gets severely and suddenly disrupted. Now, we'll take a closer look at how exactly COPD causes respiratory failure.

Essentially, COPD puts you at risk because it reduces your baseline lung function and makes your lungs more vulnerable to infection and inflammation. The lower your lung capacity, the more vulnerable your lungs are to minor respiratory ailments, which can tip the balance of gas exchange to trigger acute respiratory failure.

It works like this: lungs affected by COPD exchange gases more slowly and inefficiently than healthy lungs. This happens because the air sacs responsible for facilitating gas exchange in the lungs get damaged and destroyed by COPD.

In addition to this, the airways that carry air to and from the lungs become narrowed, inflamed, and blocked up by mucus. This makes it more difficult to both inhale enough air and to exhale air from the lungs completely. It also makes it easier for viruses and infections to multiply in your lungs and airways.

Over time, this airway obstruction can lead to lung hyper-inflation, which happens when you can't push all of the air out of your lungs when you exhale. The leftover air stays trapped inside your lungs and prevents them from collapsing completely, which eventually causes your lung tissues to stretch out and expand.

This, in turn, makes it even more difficult to breathe and exhale completely, causing more and more air to become trapped in your lungs. This puts extra strain on the muscles you use to breathe, leading to respiratory muscle fatigue and potentially respiratory muscle failure, which is another potential trigger for acute respiratory failure.

These are some of the main reasons why COPD raises your risk for hypercapnea, hypoxemia, and both acute and chronic respiratory failure. The further disease progresses, the harder it becomes for your lungs to exchange gases fast enough to satisfy your body's needs.

Eventually, the lungs become so strained that they can't keep up at times when your body needs more oxygen than usual, which is why physical activity can make you feel short of breath if you have COPD. This also means that anything that reduces your lungs ability to function—even minor things like illness or inflammation—can make it impossible for your lungs to keep up.

When this happens, it causes imbalances in the gasses in your blood, leading to hypoxemia, hypercapnea, or both. If this happens slowly and gradually, then it leads to chronic respiratory failure, which can be treated at home with medications like bronchodilators, supplemental oxygen, and other COPD treatments.

On the other hand, acute respiratory failure happens when you experience a sudden drop in respiratory function, which is an immediate, life-threatening emergency. Acute respiratory failure is more likely to happen to people who already have chronic respiratory failure, a condition known as acute-on-chronic respiratory failure.

Acute respiratory failure is usually triggered by something that puts extra strain on your lungs, such as a COPD exacerbation. Acute respiratory failure can also be caused by environmental irritants that cause lung inflammation, like air pollution and smoke, while some cases of respiratory failure have no obvious or traceable cause.

Both acute and chronic respiratory failure can significantly increase your risk of dying from COPD. In fact, research shows that acute-on-chronic respiratory failure is the number one cause of mortality in people with COPD, accounting for about 38% of all deaths.

How Do You Know if You're At Risk for Respiratory Failure?

Respiratory failure is a well-known complication of COPD, but not every person with the disease will experience it. There are a variety of factors that influence your risk for respiratory failure, including the severity of your disease.

For example, the risk is higher if you have certain medical problems, such as heart disease or asthma, in addition to COPD. Behaviors like smoking and excessive drinking can also elevate your risk.

Another risk is using supplemental oxygen incorrectly, whether through misuse of the medication or getting the wrong prescription. In rare cases, this can disrupt gas exchange severely enough to cause acute respiratory failure.

Most cases of respiratory failure, however, are triggered by COPD exacerbations. Exacerbations are essentially major symptom flare-ups that last for days or weeks at a time, causing temporary or permanent lung function decline.

Exacerbations are most likely to happen when you get sick with a respiratory illness—like pneumonia, a common cold, or the flu. If not brought under control quickly, exacerbations can limit your lung function so severely that it causes acute respiratory failure.

Other factors that may increase your risk for respiratory failure:

• Smoking
• Excessive drinking
• Breathing respiratory irritants like air pollution, noxious chemical fumes, and smoke
• Lung hyperinflation
• Malnutrition

What Should You Do if You Have Acute Respiratory Failure?

Acute respiratory failure is an extremely serious condition, and it can be deadly if you don't get immediate medical care. If you notice the signs of acute respiratory failure in yourself or someone else, you should call 911 or get someone else to drive you to the emergency room right away.

It's also a good idea to prepare for this type of situation ahead of time, since COPD symptoms can quickly become dangerous without a lot of warning. You should always keep a stash of important information and documents on hand in a place where yo can quickly grab them in an emergency.

This stash should include the addresses and phone numbers of the nearest hospitals, your doctors' contact info, and your emergency contact's info, as well as important medical records and a list of all the medications you take. Having these things available will not only ensure that you can get to the hospital fast, but it will also help doctors treat you more quickly and effectively once you arrive.

How Acute Respiratory Failure is Treated

If you go to the hospital with acute respiratory failure, the first thing that medical personnel will do is try to stabilize your breathing and ensure that your body gets enough oxygen. This usually includes administering supplemental oxygen through an oxygen mask, BiPAP machine, or mechanical ventilation.

If you need mechanical ventilation, that requires your doctor to insert a plastic tube through your mouth or nose and down into your windpipe. This tube is then attached to a breathing machine that delivers oxygen directly to your lungs to keep you stable until you can breathe again on your own.

Your doctor will then confirm the diagnosis of acute respiratory failure by measuring the levels of oxygen and/or carbon dioxide in your blood. This can be done with a simple finger pulse oximeter, or by taking a blood sample for an arterial blood gas test.

If the cause of respiratory failure is an illness or infection, your doctor will treat the underlying cause. Your doctor may also give you a variety of medications—such as steroids, antibiotics, and bronchodilators—to reduce lung inflammation and make it easier to breathe.

How to Prevent Acute Respiratory Failure

Respiratory failure is not always preventable, but there are certain things you can do to lower your risk. The next sections include a variety of practical tips to help you avoid the most common causes of respiratory failure, including exacerbations and improper supplemental oxygen use.

Avoid Exacerbations and Getting Sick

COPD exacerbations are responsible for the majority of cases of acute respiratory failure in people with COPD. Because of this, taking steps to avoid exacerbations is one of the most effective things you can do to reduce your risk for respiratory failure.

Fortunately, exacerbations are often avoidable if you follow your COPD treatment plan and do everything you're supposed to do to avoid getting sick. That includes practicing proper hygiene, getting vaccinated against pneumonia and the flu, and doing all the other things your doctor tells you to do to keep your symptoms under control.

The more illnesses and exacerbations you can prevent, the fewer chances you'll have to develop serious COPD complications like acute respiratory failure. It can also help you avoid permanent lung function loss, which can happen during severe exacerbations.

To learn more about how to prevent COPD exacerbations, read our comprehensive guide on the topic here. In the meantime, here are some helpful tips to start with.

Basic Steps to Avoid COPD Exacerbations

• Take your medications on time every day.
• Keep up with vaccinations, including yearly influenza shots and the adult Pneumonia vaccine.
• Use mucus clearance techniques to get rid of excess mucus in your lungs and airways (which can trap bacteria and cause infections).
• Always practice proper hygiene in public places (e.g. wash your hands often, avoid dirty surfaces, and avoid transferring pathogens from your hands to your nose, mouth, and eyes).
• Avoid irritants and triggers that make your COPD symptoms worse, including allergens, dust, mold, smoke, and air pollution.

Treat Exacerbations Promptly

Not all exacerbations are avoidable, even if you do your best to stay healthy. In fact, research shows that people with COPD have about one exacerbation every year on average, which increases to two every year for people with severe COPD.

Fortunately, exacerbations are not an all-or-nothing thing; some exacerbations are life-threatening, while others are mild enough to to treat at home. The trick is to catch them early and to take the proper steps to keep it under control.

Exacerbations are easiest to treat in the beginning, right when you first notice your symptoms flaring up. It's much easier to prevent the symptoms from getting worse than it is to reduce them once they're already worsened.

Here are some of the early signs of a COPD exacerbation that you should learn to recognize:

• An increase in the severity of your usual COPD symptoms, including:
• Worse coughing
• Coughing up more sputum than usual
• A change in color of your mucus or sputum
• Worsened shortness of breath
• Increased wheezing or rattling in your chest when you breathe
• Needing to use your rescue inhaler more than usual

• New symptoms, including:
• Irregular or uneven breathing
• Morning headache
• Difficulty sleeping
• Difficulty eating
• Fever

So what should you do if you feel the beginnings of an exacerbation coming on? Well, it depends on your individual COPD treatment plan and the severity of your disease.

The first thing you should do is look at your COPD action plan, which should tell you exactly what actions and medications to take when you notice your symptoms flaring up. This often includes things like reducing your physical activity, taking extra inhaler doses, or starting a preventative antibiotic or steroid regimen.

Your action plan should also tell you when you should call your doctor for extra help and treatment. For example, it might instruct you to call if your symptoms don't improve within a few days, or it might recommend calling as soon as your symptoms start to get worse.

When in doubt, don't hesitate to ask your doctor for advice or to clarify the instructions in your COPD action plan. If you don't have a COPD action plan or aren't sure whether or not you have one, you should schedule time to speak to your doctor about it ASAP.

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A COPD action plan is a vital tool that every person with the disease should have; it tells you how to treat your COPD in a variety of different circumstances and how to recognize medical emergencies like the signs of respiratory failure. That's why it's vital to work with your doctor to come up with a COPD action plan that's easy to follow and understand.

Here are some links to helpful guides and information about COPD action plans:

• Printable COPD action plan (PDF link) that you can work through with your doctor or use as an example for reference
• Another printable COPD action plan (PDF link) from Lung Foundation Australia
• Our practical guide to COPD action plans with detailed information about to use your COPD action plan to meet your health and lifestyle goals

Monitor Your Symptoms

Nicotine withdrawal is one of the most difficult challenges you will have to overcome when you first quit smoking. In fact, it's one of the main reasons that smokers tend to relapse in the first few days and weeks after quitting.

However, as long as you plan ahead, you can minimize your withdrawal symptoms and increase your chances of making it through those critical first weeks.

In this post, we're going to tell you all about nicotine withdrawal and what kinds of symptoms you can expect when you stop smoking. Then, we'll introduce you to some tools to help you cope with tobacco cravings, including strategic plans for distraction and quit-smoking medications that are scientifically proven to make it easier to quit.

In the final sections, we'll go over each type of quit-smoking medication one-by-one, including all the different forms of nicotine replacement therapy and non-nicotine medications like Chantix and Zyban. We'll go over their strengths, weaknesses, side-effects, and how to use each medication properly so you can better weigh your options and choose the ones that are best for you.

What is Nicotine Withdrawal?

Nicotine is one of the main reasons that smoking is so addictive, and it's also one of the biggest reasons that quitting smoking is so hard. Nicotine dependence is so powerful that most smokers start to get nicotine withdrawal symptoms just a few hours after their last smoke.

Soon after you quit smoking, nicotine withdrawal can cause a variety of physical and mental symptoms that make you feel worse for awhile. However, these symptoms are only temporary, and will disappear in a few weeks after your body adjusts to the change.

Nicotine withdrawal is essentially your body's reaction to no longer getting a steady supply of nicotine from smoke. Heavy smokers tend to have worse withdrawal symptoms than light smokers, and specific symptoms can vary widely from person to person.

Physical Symptoms of Withdrawal:

• Dry mouth
• Headaches
• Nausea
• Fatigue
• Sweating
• Coughing
• Digestive issues
• Increased appetite
• Difficulty staying asleep
• Weight gain

Psychological Symptoms of Withdrawal:

• Strong nicotine cravings
• Irritability
• Anxiety
• Poor mood and mood swings
• Feeling jittery or restless
• Difficulty concentrating

Nicotine withdrawal symptoms usually start within 24 hours of your last cigarette and reach their peak in about three days. While those first days can be very difficult, once you make it through, you'll be more likely to succeed in staying smoke-free.

Your withdrawal symptoms should begin to get better after just a few days, improving little by little over the course of several weeks. By the time you make it one whole month without smoking, chances are that most of your symptoms will have already disappeared.

However, everyone experiences withdrawal differently, so don't be surprised if your symptoms are different from other smokers' or follow a different timeline. For example, many ex-smokers find that their nicotine cravings stick around for longer than the other symptoms.

Fortunately, your withdrawal symptoms will go away eventually, as long as you continue to abstain from smoking. In fact, you'll find that they'll quickly be replaced with a variety of positive mood and health benefits.

But until the withdrawal wears off, you'll need some strategies for coping with the initial negative symptoms. In the next sections, we'll show you some helpful strategies and tools (including quit-smoking medications) you can use to make it through.

Make a Distraction Plan

It's much easier to ignore cravings and temptations when you have something—anything—else to focus on. That's why you should plan some activities you can use to keep yourself busy on the first day you quit and beyond.

Fun activities like hobbies, movies, and social activities with friends are a good place to start. Physical activities like walking and biking are also a great way to take your mind off your worries, and they give you the added satisfaction of doing something positive for your health.

Practicing self-care at home is another healthy way to take your mind off smoking; this includes relaxing activities like taking a bath, writing in a journal, and practicing mindfulness meditation. However, you should also find things to do outside of your home that get you away from your normal routine.

Just about anything you like to do can be an effective distraction from the desire to smoke, as long you actually remember to to do it. Unfortunately, it's easy to forget all the things you planned to do in the moments you need them the most.

Your mind isn't always is the best place to think up distractions when you're already in the middle of a tobacco craving. So, instead of leaving it up to your brain when it's busy grappling with the temptation to smoke, you should put your plan down in writing somewhere you can reference it on the fly.

First, take some time to really think about activities you like to do that could work as potential distractions from smoking. Then, take the time to write them down on paper, or type them into a document on your phone.

Just make sure you keep your plan in a place that you can access it easily whenever a sudden craving hits. That way, you'll always have a handy list of strategies to choose from, even when your brain has trouble remembering the details of your quit-smoking plan on its own.

You might want to make a few separate lists of specific distractions you can use in different settings and situations. For example, you might want a list of activities you can do at home, a list of things you can do outside the house, and a list of quick and simple strategies you can use when you're on-the-go or just don't have a lot of time.

Here are a few ideas to get you started.

Home-Based Distractions:

• Call or text a friend
• Try cooking or baking a new recipe
• Write in a journal
• Read a book or magazine
• Watch a movie or favorite TV show
• Organize a cluttered area of your home
• Finally do that deep cleaning project you've been putting off
• Prep some ingredients for a delicious home-cooked meal
• Color in a coloring book (there are plenty of adult coloring books to choose from that have much more detail than coloring books made for children)

Getting-Out-of-the-House Distractions:

• Take a quick walk (around the block, on a trail, etc.)
• Go out for coffee by yourself or with a friend
• Visit a local museum, park, library, or other public place
• Volunteer at an animal shelter or another organization
• Join a club (e.g. a sports club, a book club, or a knitting club)

Quick & Simple Distractions to Use On-the-Fly:

• Drink a glass of water or eat a quick snack
• Listen to a song that makes you feel good
• Play a quick game on your phone (e.g. a relaxing matching or puzzle game)
• Watch a short video online
• Find a quiet place to relax, breathe, or meditate for a moment
• Focus on your breaths and practice deep breathing exercises

Quit-Smoking Medications

Using a quit-smoking medication can significantly increase your chances of quitting and staying smoke-free after you quit. They can help you control cravings, reduce withdrawal symptoms, and even help prevent weight gain after you stop smoking.

There are two main types of quit-smoking medications: Nicotine replacement therapies and non-nicotine medications like Chantix and Zyban.

Nicotine Replacement Therapies

Nicotine replacement therapies are the most popular and most frequently recommended types of quit-smoking medications. They come in a variety of different forms, including patches, gum, pills, lozenges, and more; many of them are available over-the-counter, but some of them require a doctor's prescription.

Nicotine replacement medications are all designed to give you a specific dose of nicotine in a form that's much safer than inhaling it through smoke. When you use them throughout the day, they help stave off nicotine withdrawal, reducing both symptoms and tobacco cravings.

A large number of studies have shown that nicotine replacement therapies can significantly boost your chances of being able to stop smoking for good. In fact, the medications are so effective that many doctors and experts say that they should be an integral part of just about every smoker's plan to quit.

The exceptions to this are people with certain health conditions, such as heart disease and diabetes, and women who are pregnant or breastfeeding. If you have an existing health problem, make sure you talk to your doctor before starting any type of quit-smoking medication.

Here are some of the main benefits of using a nicotine replacement therapy to help you quit:

• Increases your chance of quitting smoking successfully by 50 to 70 percent
• Reduces tobacco cravings
• Prevents symptoms of nicotine withdrawal
• Reduces weight gain after quitting (however, you may gain weight after you stop using the nicotine replacement therapy)

Nicotine replacement therapy can have some negative side effects, too, and they can vary based on the type of medication you use. Some of the most common negative symptoms are nausea, stomach problems, a racing heartbeat, and difficulty sleeping.

It is also possible to overdose on nicotine when you use nicotine replacement therapy, even though it is rare. That's why you should always follow the instructions on the medication and never take more than the maximum dose.

Which type of nicotine replacement therapy works best for you will depend on your personal lifestyle and preferences. For example, you might find that certain forms of nicotine replacement medications are easier to use or fit better into your daily routine.

You should also consider using more than one type of nicotine replacement at the same time when you quit. Research shows that people who use a combination of nicotine replacement therapies are more likely to succeed in staying smoke-free than those who use just one.

However, it's still a good idea to talk to your doctor first, even if you plan to use an over-the-counter nicotine replacement therapy. He can help you explore your options, give you helpful advice about side-effects and dosage, and answer any questions or concerns you might have.

Most nicotine replacement medications come in a variety of different nicotine doses, and you can estimate how much nicotine you need based on how many cigarettes you're used to smoking every day. In general, heavier smokers need a higher dose of nicotine in order for the therapy to be effective.

Now lets take a look at the pros and cons of the different types of nicotine replacement medications.

Nicotine Patches

The nicotine patch is one of the most popular forms of nicotine therapy because it's so easy to use. All you have to do is put a sticky patch on your skin, and then you can forget about it for the rest of the day.

Nicotine patches work by releasing a slow, steady amount of nicotine that you absorb into your body through your skin. That way, you have a constant supply of nicotine throughout the day to help stave off cravings and withdrawal.

One patch lasts 24 hours, so you'll only need to use one patch every day. Because of this, however, you can't adjust the dose in response to sudden cravings; that's why many people pair the patch with another type of nicotine replacement therapy.

The patch is waterproof and resilient so it should stay stuck to your skin through showers and other normal daily activities. If it does come off, you can simply replace it with a new nicotine patch.

How to Use a Nicotine Patch:

• Place one nicotine patch on an area of dry, clean, and hairless skin (common places include the stomach, side, and upper arms).
• After 24 hours, replace with a new patch.
• You can continue using the patch for 8-12 weeks, or until your cravings and withdrawal symptoms subside (talk to your doctor if you think you need to use it longer).

Pros of Nicotine Patches

• Simple to use
• Last for 24 hours
• Can be used in combination with other nicotine replacement therapies
• Available over the counter

Cons of Nicotine Patches

• Can't adjust the dose
• Can cause skin irritation (especially if you have a skin condition such as eczema or psoriasis)
• Can cause side effects, including:
• Skin irritation and discomfort around and under the patch
• Skin tingling and itching around and under the patch
• Nausea
• Headaches
• Dizziness
• Racing heartbeat
• Muscle pain
• Difficulty sleeping

Nicotine Gum

Another option for nicotine replacement therapy is nicotine gum. This is simply a small piece of gum that releases nicotine as you chew it.

While nicotine gum is relatively easy to use, you have to chew it for an extended period of time using a stop-start technique. You start by chewing the gum until you feel a tingling sensation in your mouth, then you stop until the tingling subsides.

Then, you begin chewing again, stopping once you feel the tingling sensation once more. You have to continue repeating these steps for about thirty minutes in order to get the full nicotine dose.

This prolonged process is inconvenient for some people, but others find it satisfying to have something to do with their mouth and jaw. By engaging your mouth, like smoking does, it can satisfy oral fixation impulses and make cravings easier to resist.

How to Use Nicotine Gum:

• Avoid eating or drinking 15 minutes before using the gum (and while chewing it).
• Start by chewing one piece of gum every hour or two (you should use at least 9 pieces a day for the first 6 weeks).
• After 6 weeks, reduce the number of pieces you use per day by about half, using one piece every 2-4 hours.
• After 9 weeks, reduce your number of doses by half again, using one piece every 4 to 8 hours.
• Never swallow the gum.
• You should stop using the gum after about 12 weeks, or until your cravings and withdrawal symptoms subside (talk to your doctor if you think you need to use it longer).

Pros of Nicotine Gum

• Satisfies oral fixation by engaging your mouth and jaw
• Lower doses are available over the counter
• You can adjust the number of doses as needed to curb cravings and withdrawal symptoms

Cons of Nicotine Gum

• Must chew gum frequently throughout the day
• Must chew each piece of gum for an extended period of time
• Can leave a bad taste in your mouth
• Causes a tingling feeling in your mouth
• Can cause negative side effects, including:
• Mouth irritation
• Nausea
• Jaw pain
• Getting stuck to dental work
• Racing heartbeat

Nicotine Lozenges

A nicotine lozenge is a small tablet that releases nicotine as it dissolves slowly in your mouth. They are quick and simple to use, but you have to use them frequently throughout the day.

Nicotine lozenges usually only contain a small amount of nicotine (2 or 4 mg), and are often used in combination with other nicotine replacement therapies like the nicotine patch. You can also get mini nicotine lozenges that dissolve more quickly than regular-sized lozenges.

How to Use Nicotine Lozenges:

• Avoid eating or drinking 15 minutes before using the lozenge (and while the lozenge is in your mouth).
• Place the tablet between your cheek and your gums.
• Slowly suck on the tablet until it dissolves completely.
• For the first 6 weeks, use one lozenge every one or two hours.
• After 6 weeks, reduce your dosage frequency to one every 2-4 hours.
• After 9 weeks, reduce the number of doses again to one lozenge every 4-8 hours.
• Do not chew or swallow the tablet.
• Do not use more than 5 tablets per 6 hours or use more than 20 lozenges per day.
• You can continue using them for about 12 weeks (talk to your doctor if you think you need to use them longer).

Pros of Nicotine Lozenges

• Available over the counter
• Can adjust the frequency of your doses according to cravings and withdrawal symptoms
• Will not stick to fillings and dental appliances like nicotine gum can

Cons of Nicotine Lozenges

• Must use repeatedly throughout the day in order to be effective
• Can cause side effects, including:
• Coughing
• Heartburn
• Nausea
• Gas
• Hiccups
• Racing heartbeat
• Difficulty sleeping

Nicotine Nasal Sprays

Another type of nicotine replacement therapy comes in the form of a nasal spray. It works by squirting a nicotine-containing liquid directly into your nose, where you absorb it through your nasal lining.

With this method, nicotine absorbs into your bloodstream more quickly than most other forms of nicotine replacement therapy, including nicotine lozenges and gum. This makes it particularly useful for quickly countering sudden tobacco cravings.

How to Use a Nicotine Nasal Spray

• You will need to prepare (or prime) the spray before using a new spray bottle for the first time; to do this, simply spray the bottle several times into a sink or towel until you see a fine mist.
• To take one dose, tilt your head slightly backward and squirt one quick spray (without sniffing or inhaling) into both nostrils.
• If it begins to run out of your nose, keep your head tilted and sniff gently to keep the medication in your nostrils.
• In most cases, you should start out by using the nicotine spray once or twice per hour.
• You can continue using the nicotine nasal spray for 12-14 weeks (talk to your doctor if you think you need to use it for longer).

Pros of Nicotine Nasal Sprays:

• Works faster than most other nicotine replacement medications
• Can adjust dose frequency according to cravings and withdrawal symptoms

Cons of Nicotine Nasal Sprays:

• Only available by prescription
• Must use repeatedly throughout the day in order to be effective
• Not recommended for people with existing nasal or sinus problems
• Can trigger allergy-like symptoms (sneezing, coughing, watery eyes)
• Can cause other side effects, including:
• Nose and throat irritation
• Headache
• Racing heartbeat
• Nervousness

Nicotine Inhalers

Nicotine inhalers are small devices that you use to inhale nicotine into your mouth. This makes using a nicotine inhaler feel similar to smoking, which is a major part of its appeal.

Most nicotine inhalers look very different from the types of inhalers prescribed for health conditions like asthma. They generally have two parts: a mouthpiece and matching nicotine-containing cartridges.

When you attach the cartridge to the mouthpiece and take a puff, it turns the nicotine into a vapor that you can suck into your mouth. Despite its name, however, you do not inhale the vapor all the way into your lungs; instead, you hold the vapor in your mouth for several seconds before blowing it out.

How to Use a Nicotine Inhaler:

• The number of doses you take each day, a

One of the most difficult parts of living with COPD is coming to terms with the ways it can change your life and limit your activities. This is especially true for working adults, who often have to make difficult decisions about how to continue working—and if they should continue working—while managing their COPD.

While the answer to this question varies significantly from person to person, many people with COPD are able to continue working for many years after their COPD diagnosis. However, coping with work and a chronic disease can be a major challenge, and it only gets harder in the later, more serious stages of the disease.

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That's why we created this guide all about how to overcome those challenges and maintain a healthy, balanced work life with COPD. In it, you'll learn how to address some of the most common difficulties that people with COPD face in the workplace and how to prioritize your mental and physical well-being while keeping up with the demands of your job.

In the sections below, we cover everything from how to deal with health-related absences and minimize COPD symptoms at work to what kinds of accommodations you can request from your employer to make your job easier to manage. We also discuss how to how to evaluate and make adjustments to your work-life-health balance to make sure that it's working for you.

Whether you're a person with COPD who is currently working or considering working in the future, it's important to know your options and what kinds of difficulties you're likely face. Every person's path will be different, but everyone can benefit from strategies for coping with COPD in the workplace and making adjustments along the way.

Can You Work When You Have COPD?

It's only natural to worry about your ability to continue working and keeping your job after you've been diagnosed with COPD. Certainly, COPD symptoms can interfere with many aspects of daily life, and they can reduce or eliminate your ability to do work activities you could do before.

Of course, COPD symptoms and physical abilities vary significantly from person to person, and so does the ability to work a steady job. For instance, mild COPD symptoms might not affect your everyday life much at all, while very severe COPD symptoms can make it difficult to endure even light activities, like walking up stairs or getting ready for work.

How Does COPD Affect Your Ability to Work?

How much COPD affects your work life depends largely on the severity of your COPD symptoms and the demands of your particular job. It also depends on how, and how quickly, your COPD progresses, as well as what kinds of complications (like COPD exacerbations) you experience along the way.

For example, you might be able to work a physically-demanding job in the early stages of the disease, but it's likely to get much more difficult—and eventually too difficult—to endure those physical tasks as the disease gets worse. If you have a sedentary desk job, however, you might be able to handle the work even with moderate to severe COPD.

According to the CDC, nearly fifty percent of people with COPD reported having some kind of physical activity limitation related to their health, and nearly forty percent said they have serious difficulty walking or climbing up stairs. It's not hard to imagine how such limitations could impair your working ability in general and significantly reduce the types of physical work you can do.

Another problematic COPD symptom for working adults is fatigue, which can sap your energy and make it incredibly difficult to bear the strain of working for hours and hours day after day. This is true even for work that doesn't require any major activity; it doesn't take much to overtax yourself when you're living with chronic disease.

One study on COPD patients in Canada found that 64 percent of participants with COPD reported working at a slower pace than usual and 36 percent reported having to postpone work. A significant percentage also experienced problems with concentration (64%) and decision-making (57%) at work.

COPD can also affect your sleep, your diet, your mental endurance, and other aspects of your life that can, in turn, affect your energy level and your ability to cope with stress. This can make it especially difficult to keep up with the demands of long working hours or of fast-paced jobs.

How Common is it for People with COPD to Work?

Unfortunately, there's not a lot of detailed data about working adults and COPD, or how long COPD patients usually work after diagnosis. However, research does shed some light on a few key ways that COPD affects patients' working lives.

One study, for example, found that about 62% of US adults with COPD between the ages of 55 and 75 were still employed, and concluded that people with COPD “had an elevated risk for leaving work prior to age 65” compared to adults without chronic respiratory conditions. Other studies have found that working ability among people with COPD is strongly associated with airflow limitation and shortness of breath, as patients with more severe breathlessness are less likely to be employed.

One of the most comprehensive analyses of COPD and working ability was conducted by the CDC in 2013 and explored the types of “employment and activity limitations” experienced by adults with COPD. It found that nearly one quarter (24.3%) of adults with COPD in the US report being unable to work, compared to only 5.4% of adults without COPD.

Other studies confirm that people with COPD tend to retire earlier, on average, and are even less likely to be employed than people with other chronic health conditions like heart disease, diabetes, hypertension, and cancer. This results in an average lifetime loss of about $7,365 per person from early retirement, and—among adults still working—a loss of about $880 per year due to absences from work.

But even though employment numbers are lower than average among people with COPD, it's important to note the significant number of people with COPD who do have jobs. At least 38 percent of US adults with COPD are able to continue working beyond the age of 55, and about three quarters report that they still have the ability to work (even if they are not currently employed).

Can You Get Fired for Having COPD?

Many people with chronic diseases like COPD worry that their health problems could cause them to get fired from their job. Whether or not this can happen is a complicated questions that depends on a lot of legal definitions and case-by-case determinations.

In general, you can't be fired just for having COPD, especially if your COPD is severe enough to cause you to be disabled. However, your employer might be able to fire you if your COPD symptoms (or another medical condition) makes you unable to do your job.

Who can get fired for what reasons is a tricky issue that depends on a whole web of regulations and legal definitions. If you have questions about whether or not you can be fired for your health condition, or if you believe you've been fired unlawfully, it's best to talk to a lawyer that specializes in wrongful termination.

Should You Work with COPD?

Ultimately, whether or not you continue working is a personal decision that only you and your doctor can make. Whatever you choose to do, it's important to follow your doctor's advice and make sure that your decision doesn't interfere with your ability to take care of your health.

Is Your Current Work-Health Balance Sustainable?

All working adults can benefit from pausing once in awhile to take a good, close look at their work-life balance. This gives you the chance take stock of where you are and where you're going, and to re-evaluate your goals and expectations for your career.

This kind of self-examination is even more important for people with chronic diseases like COPD, who have to balance their working life, their personal life, and their special health needs. On top of that, they have to deal with the strain of chronic health problems that make them even more susceptible to the negative health effects of working, including mental burnout and physical fatigue.

If you are a working adult with COPD, asking yourself some key questions about your work life can help you evaluate whether or not what you're doing right now is working for you. As we go through some of these questions in the following sections, think about what your ideal work-life-health balance might look like, and consider how closely your current balance aligns with the one you'd like to achieve.

Your answers to these questions can also help you identify areas of your life that might need to change in order to establish a healthier equilibrium that's more in line with your needs. Then, in the following sections we'll introduce you to a variety of practical tools and strategies that can help you make those changes, get better support in the workplace, and maintain your ability to work as long as possible.

If you'd like to skip straight ahead to those tips now, you can do that by clicking here.

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Does your work expose you to anything that could be harmful to your lungs?

People with COPD are particularly vulnerable to respiratory irritants, which can worsen COPD symptoms and do additional damage to your lungs. That's why it's important to minimize your exposure to these hazards as much as possible—especially in places like your workplace, where you spend a great deal of time.

Unfortunately, there are many different jobs that expose you to respiratory hazards like dust, heavy air pollution, noxious chemical fumes, and smoke. Some of the more obvious culprits include jobs in fields like construction and manufacturing, but they're far from the only ones; simply working with common cleaning chemicals like ammonia and bleach, for example, can expose you to toxic fumes that are known to both cause COPD and exacerbate COPD symptoms.

Here are some additional questions to help you identify your level of exposure to respiratory hazards at work:

• Do you experience worsened respiratory irritation, coughing, or shortness of breath at work?
• Do you often handle hazardous chemicals (e.g. pesticides, solvents, adhesives, etc.) or cleaning products at work?
• Do you work around vehicles or machinery that release smoke or exhaust fumes?
• Does the air at your workplace smell like smoke or contain visible amounts of smoke, dust, or other airborne substances?
• Does your workplace provide appropriate safety equipment (e.g. dust masks, respirators, or fume hoods) in situations that could exposure to respiratory hazards on the job?

Does your job exacerbate your COPD symptoms?

Effective symptom control is a key part of COPD treatment that can even reduce your risk for serious health complications like COPD exacerbations and rapid lung function decline. That's why it can be dangerous to work a job that triggers your COPD symptoms or makes them more difficult to control from day to day.

This can happen if your work tasks require physical exertion that's beyond what you can handle or makes you feel so exhausted that it saps all your energy for the day. Even if you your job tasks themselves don't cause you any particular trouble, working in an of itself can still cause a great deal of stress and fatigue, both of which can have a particularly detrimental effect on your health if you have COPD.

Here are some additional questions to help you evaluate how your work affects your COPD symptoms:

• Are your COPD symptoms usually worse at work than they are at home?
• Does your job require you to do activities that are more strenuous than your doctor recommends?
• Do you feel significantly more fatigued or breathless on days that you work (including after work) compared to days that you do not work?
• Does work-related fatigue interfere with your ability to exercise or do other activities that are beneficial to your health?

Does your work inhibit your ability to manage your COPD symptoms?

Even if your COPD symptoms aren't a major problem at work, they're bound to affect you on the job from time to time. When they do, it's important that you work in an environment that allows you to do what you need to treat your symptoms on the job.

That means being able to use your rescue inhaler as needed and keep up with other treatments, including using supplemental oxygen and taking your medications on time. You should also be able to slow down and take rests when needed, and take other reasonable steps to minimize your symptoms at work.

Here are some additional questions to help you evaluate your ability to control your COPD symptoms on the job:

• Can you slow down or stop to rest if you feel too breathless or fatigued?
• Can you take the day off if you feel too sick to come in to work?
• Does your work schedule allow you take all of your medications and other COPD treatments on time?
• Do you ever miss medical appointments or have to delay medical treatments because of work?
• Do you forget to take your medicine more often on days that you work?
• For oxygen therapy users: Does your job prevent or discourage you from using your oxygen as needed or as your doctor prescribed?

What can you do to improve your work life?

If you answered any of the above questions unfavorably, then it might be time to make a change. What kind of change that is depends on the nature of the problem, how severely it affects you, and what kinds of options are available to you in your particular job or career.

But now that you have a better idea of what a healthy work-life balance looks like, you can start to explore what you can do to achieve a better balance for yourself. To help you get started, we've compiled a list of effective tools and techniques that people with COPD can use to improve their work lives and get the support they need to continue working sustainably with COPD.

As you read through the tips and techniques in the following sections, think about the problems you've identified in your working life so far and take note of any ideas that resonate with you. Then, take some time to consider how you can adapt those ideas into personalized solutions that can help you overcome the particular challenges you face.

Strategies for Surviving and Thriving at Work With COPD

Know How to Talk to Your Employer About Your COPD

Everyone has the right to keep their health and their medical records private, but there are many situations in which it can be beneficial to talk to your employer about your COPD. In fact, it might even be necessary to discuss your health condition if you need to request special allowances or accommodations because of your COPD.

If you do decide to tell your employer about your condition, it's important to explain your situation in an accurate and compelling way. That means knowing—and being able to present—all the relevant details about your disease, including:

• your disease diagnosis
• your symptoms, including how severe they are, how they affect your life, and how they affect your work
• your treatments, especially those that could impact your work or attendance
• potential accommodations that could help you in the workplace
• anything else that might be relevant to your job or your requests

Educating your employer about your health and the challenges it causes opens up a dialogue in which both you and your employer can work together to resolve your problems and needs. Telling your employer about your struggles might also make your employer more understanding if problems crop up in the future regarding your health condition and how it affects your work.

Remove COPD Triggers from Your Work Space

Many common, everyday substances can cause respiratory irritation, including fragrances, cleaning products, air pollutants, and more. People with COPD tend to be much more sensitive to these irritants than the average person; for some, even the mildest irritants can trigger COPD symptoms and make it harder to breathe.

These symptoms can interfere with your job performance and persist even outside of work, making it generally more difficult to keep your COPD symptoms under control. Frequent exposure to respiratory irritants can even cause additional lung damage over time and increase the frequency of COPD exacerbations.

For all of these reasons and more, respiratory irritants in the workplace can make a job miserable—and potentially even dangerous—for people with COPD. Luckily, it's usually possible to reduce sources of respiratory irritation significantly by making simple, non-disruptive changes to your working environment.

You can start by paying close attention to your COPD symptoms when you're at work and looking for patterns that might help you identify things that make your symptoms worse. As you go about your work, keep an eye (and your nose) out for potential sources of respiratory irritants, such as strong odors, noxious cleaning chemicals, and second-hand smoke.

If you notice that something in particular is bothering you, don't be afraid to speak up, but be ready to offer up reasonable solutions to the problem. If you explain your sensitivities and show consideration for your coworkers' comfort and needs, you shouldn't have too much trouble getting your employer and colleagues on board.

Here are some examples of steps you could take to reduce respiratory irritants in your workplace:

• Ask your employer to enforce policies that limit second-hand smoke in and immediately around the workplace.
• Politely ask your coworkers not to wear or bring heavily-fragranced products to work (e.g. scented lotions, candles, air fresheners, perfumes, etc.).
• Ask your employer to replace hazardous chemical cleaning products (e.g. cleaners containing ammonia and bleach) with safer cleaning products that emit fewer harmful fumes. To learn more about safer cleaning alternatives, check out our guide on Cleaning with COPD.

Ask for Air Quality Improvements at Work

If you work in an office or another indoor environment, the air quality in the building can have a major effect on your COPD. Because you spend so much time at work, it's important to make sure the air in your workplace is clean and healthy to breathe.

Unfortunately, even if you eliminate the obvious COPD triggers in your workplace, there could be other, hidden sources of indoor air pollution, such as mold, radon gas, and even common pest control products. Because these indoor air pollutants are often invisible or difficult to find, it might take some investigation to determine if—and why—your workplace's air quality is poor.

The easiest way to figure this out is to get the air tested by a professional, especially if you're still experiencing lung irritation in the workplace after removing more obvious causes. You might even be able to get a free air quality test in your workplace if you request one from your state's OSHA On-Site Consultation Program.

You could also look into your work building's cleaning and maintenance practices to see if they're doing their due diligence to keep air quality issues at bay. If their current measures aren't satisfactory, you could request that they make improvements or modifications that will make the air in the building safer or more comfortable to breathe.

Potential air quality improvements include:

• Improving the building's ventilation and air filtration system
• Using humidifiers or de-humidifiers to control the amount of moisture in the air
• Implementing measures for damp and mold control
• Testing your workplace for radon gas and (if needed) installing a radon mitigation system
• Reducing or altering the use of noxious chemicals (like pesticides) in and around the building
• Inspecting and maintaining safe emission standards for appliances and machinery that generate pollution (e.g. the building's furnace)

Though many employers are reluctant to make these kinds of changes, it might be worth reminding them that cleaner air and a healthier working environment benefits everyone, not just you. Nobody is immune to the negative effects of poor air quality in the workplace, even if the effect's aren't as obvious or immediate on people with healthy lungs.

To learn more about how to improve the air quality in your workplace, check out our guide to reducing indoor air pollution or this guide to workplace air quality from the EPA.

Prepare for Workplace Absences

When you have COPD, it's inevitable that you will miss work occasionally for doctor's appointments, exacerbations, out-patient treatments (like pulmonary rehab), and other health-related reasons. As your COPD progresses and your healthcare needs increase, you might need to take even more frequent—and more lengthy—absences from work.

Unfortunately, the ability to take leave from work—and the impact that taking leave can have on your career and finances—varies significantly from person to person. In some workplaces, taking time off work is heavily stigmatized or discouraged, making it difficult for many to take medical leave even when it should be allowed.

Employers tend to be more accommodating, however, when they know about absences ahead of time. That's why you should always let your employer know as early as possible when you know that you'll need to take time off work—except in the case of an unanticipated illness or emergency, of course.

This will ensure your employer has plenty of time to arrange for your absence and ensures that you have enough time to take all the proper steps to request leave. It also gives you a chance to get ahead on your workload or find other ways to smooth over any disruptions your absence might cause.

Here are some ideas for making your absences from work easier for yourself, your coworkers, and your employer:

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