Chronic Obstructive Pulmonary Disease service
Information for patients
COPD is a term used to describe a number of conditions including chronic bronchitis and emphysema. Emphysema affects the alveoli (air sacs) in your lungs, and chronic bronchitis affects your bronchi (airways). You may have just one of these conditions, or more than one.
COPD is a condition where the airways become inflamed and the air sacs in your lungs are damaged. This causes your airways to become narrower (obstructed), making it harder to breathe in and out. People with COPD will have breathing difficulties, which will affect many aspects of their day-to-day life. Unfortunately the damage is permanent and can’t be repaired. However, there are many ways to help people with COPD to feel better day to day, to prevent flare ups, and to keep healthier in the long term.
The main cause of COPD is tobacco smoke. COPD usually affects people over the age of 35 who are, or have been smokers. Other causes include exposures to occupational dust, chemicals, vapours or other airborne pollutants. A small number of people may have a genetic condition called Alpha-1 antitrypsin deficiency that causes damage to your lungs and can lead to a particular type of emphysema in people who smoke. Whilst we cannot change damage that has already been done, it is important not to cause new damage. This means that although stopping smoking may be very difficult it is also very important.
The symptoms of COPD include:
- Breathlessness at rest or on activity
- Sputum/ phlegm
- Tight chest
COPD is diagnosed by taking a history and undertaking a breathing test called spirometry. This measures the size of your lungs, and measures the amount of air flowing in and out of your lungs.
- Stop smoking - Giving up will stop the on-going damage to your airways. It also means the tiny hairs in your airways can work properly, clearing mucus, bacteria and poisonous chemicals that would accumulate in the lungs.
- Pulmonary rehabilitation - It is important to stay as active as possible. Pulmonary rehabilitation usually involves a six to eight week programme of exercise which helps with breathlessness by improving strength and fitness to make better use of the lung power you have. Also, part of pulmonary rehabilitation classes are spent learning more about your lungs and what you can do to look after them when you are well or when you are ill. Our own research shows that pulmonary rehabilitation can have a huge effect; afterwards people can walk almost twice as far and feel much better, as well as being less likely to need admission to hospital in the future. People often worry that it will be hard and they won’t manage but experienced physiotherapists will make sure that your course is individually changed to make it suitable for you.
- Medications - You may be started on one or more inhalers to help relieve breathlessness and reduce exacerbations (see section below).
- Vaccinations - You should get vaccinations against flu and pneumonia to avoid getting severe infections through the winter. You should also try to stay away from people with colds, flu, sinus infections and sore throats to reduce your risk of getting an exacerbation (see below).
- Oxygen - If the level in your blood is too low when you are resting, or if the level drops when you are active you may require oxygen treatment. Oxygen is used to prevent the effects of low oxygen levels in the blood; it is possible to be very breathless without low oxygen levels, and in that case oxygen treatment will not help. Our oxygen clinics assess people fully for this if necessary. Please also see the Sheffield Home Oxygen Assessment and Review Service page (click here)
- Non-invasive ventilation (NIV) – This is a treatment which is usually given in hospital when you are unwell with an exacerbation. It involves a mask that covers your mouth or nose and is connected to a machine which pushes air into your lungs. The aim of NIV is to increase oxygen levels and to help you breathe out more carbon dioxide. Some people may be given a NIV machine to use long term at home.
Exacerbations (flare ups)
An exacerbation happens when you experience a worsening of breathlessness, increase in phlegm and or discoloured phlegm over a few days. This is also known as a ‘flare up’ and might be triggered by an infection or other cause such as change in weather or virus. It is important to start antibiotics early if you have symptoms of an infection (more cough and dark phlegm), with steroid tablets (prednisolone) too if you are especially breathless. You may be given a supply to keep at home by your GP for this but if you need to take these you should always let you GP and/or specialist nurse know as soon as possible too.
Supported discharge scheme
In Sheffield, people who have been referred to hospital because of a flare up of COPD can return home early to avoid the problems of longer hospital stays. They will be visited by a COPD Specialist Nurse who will monitor their recovery over the first few weeks after discharge. This is important to try to make sure everything is done to prevent further exacerbations, as well as to check that everything possible is being done to for the best possible day to day health and well being.
Patient Groups and Advice
- Breathe Easy group: Springs Leisure Centre 1.30pm 2nd Wednesday in every month.
- Singing for lung health: Springs Leisure Centre 12.30pm 2nd Wednesday in every month.
- British Lung Foundation: www.blf.org.uk
- Yoga for COPD: every Monday 12.15pm at Foxhill Medical Centre.
- Pulmonary rehabilitation programmes; Shirecliffe, Jordanthorpe & Springs Leisure Centre.
- Age UK: www.ageuk.org.uk
- Disability benefits helpline: 08457 123 456
- World COPD Day (Mid-November every year) www.goldcopd.org/wcd-home.html