2.3 COPD review

Chronic obstructive pulmonary disease, or COPD, describes a group of lung conditions that make it
difficult to empty air out of the lungs because the airways have become narrowed.

COPD usually develops because of long-term damage to your lungs from breathing in a harmful substance, usually cigarette smoke, as well as smoke from other sources and air pollution. Jobs where people are exposed to dust, fumes and chemicals can also contribute to developing COPD. You’re most likely to develop COPD if you’re over 35 and are, or have been, a smoker or had chest problems as a child. Some people are more affected than others by breathing in noxious materials. COPD does seem to run in families, so if your parents had chest problems then your own risk is higher.

Symptoms include:
• getting short of breath easily when you do everyday things such as going for a walk or doing
housework
• having a cough that lasts a long time
• wheezing in cold weather
• producing more sputum or phlegm than usual
You might get these symptoms all the time, or they might appear or get worse when you have an
infection or breathe in smoke or fumes. If you have COPD that has a severe impact on your breathing, you can lose your appetite, lose weight and find that your ankles swell.

The core care for COPD is:
• having treatment and support to stop smoking
• having a flu jab every year and a one-off pneumonia vaccination
• an exercise programme called pulmonary rehabilitation if your breathlessness stops you doing things
• having your own self-management plan
• taking medicine or combinations of medications to improve breathlessness and help prevent flare-ups

Your inhaler will only help if you use it correctly. Ask your pharmacist, nurse or doctor to show you how to use each type of inhaler you have and make sure they review your technique at least every year. You can watch the following video which can be helpful

CLICK HERE to view videos on how to use your inhalers

It’s important to eat a balanced diet and maintain a healthy weight. Your doctor or nurse can help you to work out what your healthy weight should be and can refer you to a dietician or local scheme to help you if necessary. If you’re overweight it will be harder for you to breathe and move around. If you’re losing too much weight because eating makes you feel breathless, or you find it difficult to shop and prepare meals, try to eat little and often. Ask your doctor or nurse about nutritional supplements

If you have COPD, being active and exercising can help you to improve your breathing, fitness and quality of life. Don’t avoid activities that make you breathless: you’ll get less fit and out of breath more easily. Regular exercise can help reverse this by strengthening your muscles. Exercise also benefits your heart and blood pressure, and makes you less likely to develop conditions such as diabetes and osteoporosis (fragile bone disease). There are many different ways to be active – find one that you might enjoy. The best way to learn how to exercise at the right level for you is to take part in pulmonary rehabilitation. Ask your doctor to refer you. There is strong evidence that people with COPD benefit from PR and exercise more generally. Remember again that it is not harmful to make yourself breathless.

Make sure you get your flu jab every year to protect you against the flu viruses likely to be going round over the winter. Vaccination reduces your risk of developing serious complications if you are exposed to flu such as pneumonia and heart problems. The NHS offers it for free to people living with long-term conditions like COPD. Your doctor should also offer you a vaccination against pneumococcal infection – a bacterial infection that can cause pneumonia and other illnesses. You only need to have this once. You can also avoid infections by staying away from people – including children – who have colds, flu, sinus infections or a sore throat. If you do get an infection, make sure you treat it quickly.

Living with a long-term condition can affect many aspects of your life. Physical symptoms such as breathlessness and coughing, feeling more tired and being less active can mean you feel stressed, anxious or depressed. The risk of anxiety and depression is greater in people with more severe COPD, people who have been admitted to hospital, and those with low oxygen levels. Treatment is available to support you. Many other people have experienced anxiety and depression and have recovered. They are both very normal reactions to living with COPD. Talk to your health care professional about medications and counselling. Don’t bottle things up – talking to someone you trust, including your health care professional, can help. It’s very important to stay active and sociable, and to learn more about COPD. This will help you to understand and cope better with your condition. You might want to get involved with a local group to meet others going through a similar experience.

Pulmonary rehabilitation or PR is a programme of exercise and education designed for people living with COPD. It’s one of the best treatments available for COPD. Ask your doctor to refer you. A course lasts about six to eight weeks and you’ll be part of a group. At each session, you’ll spend about half the time on physical exercise. This will be carefully designed to provide the right level of activity for you. You’ll also get information and tips about things like:
• breathing techniques and positions to help you when you’re out of breath
• how to manage stress
• healthy eating
• how to use your inhalers and other medicines
• what to do when you’re unwell
PR is about helping you manage your COPD better. It’s a treatment not a cure, but you’ll feel better- more confident and in control. After you’ve completed your course, it’s important to carry on exercising regularly, stay active and use the techniques you’ve learned.

myCOPD is an app for patients suffering from COPD.  It can help you perfect your inhaler technique with easy-to-follow inhaler videos and learn how to manage your COPD more independently. You can also complete online pulmonary rehabilitation classes from the comfort of your home.

You will need a registration code from your healthcare professional to be able to download the app and complete the registration process. You can request the code by completing the appropriate section on the COPD review form on this page. Alternatively you can send a message to our respiratory team by using askmyGP or by calling the practice and speaking with one of our care navigators.

We understand that downloading and using apps may be new to some people and we are here to help you get connected. One of our digital navigators will be able to talk you through how to download the app and get started using it. If you would like some help from a digital navigator please let us know using the COPD review form, contact us using askmyGP or call and speak with our care navigator team.