COPD

This lung condition is often the result of smoking, but may be caused by living or working in conditions where the air is polluted. Terms such as ‘chronic bronchitis’, or ‘emphysema’ are sometimes used to explain different stages of the disease. The airways are damaged by particles in the air that you breathe in, and become less elastic, allowing sputum to accumulate at the bottom of your lungs. This means that there is less area for fresh oxygen to pass into your blood stream, so you get breathless more easily. Also, sputum can become infected, and this can make you feel unwell, and cause more sputum to be produced, so that you get very short of breath.

To manage at home, your doctor or nurse may prescribe inhalers or tablets for day-to-day use, but also some ‘rescue medicine’ to keep for those times when you get to feel very unwell. It is important to take your rescue medicine when you need it. There is a management plan below which can help you decide when it is time to take your rescue medication. Sometimes people are not sure about when their condition has worsened, and don’t take the medication; they may need hospital treatment to get back on track if they leave it too late. Other people may take the medication too early, when there is very little evidence of infection. The medication will become less effective for them if they do this.

One of the ways COPD can be managed is through the use of Florence (Flo) text messaging. Each day the patient is asked to text a reply to a message asking about the colour of their sputum. If their reply suggests the sputum is infected, they are asked to take their temperature, and if this is high, they are asked if they are more breathless than usual. When the patient replies that all these indicators are positive, they are sent a message telling them to take their rescue medication. In addition, patients are asked to send in a reading of the oxygen in their blood, which is measured by a pulse oximeter, using infra-red. This reading gives an indication of how effective their breathing is, and as all this information is sent to the patient’s nurse or doctor, it helps to build a picture of their progress, without the need to see them face to face. Through this process, people learn how to look after themselves better, and can enjoy life more. There is a video below of a patient who has learned how to manage their worrying breathlessness. She has now stopped using Flo, but continues to use her pulse oximeter each day, which reassures her that it is OK to do her normal activities, or if the reading is low, she will take more rests until the reading improves. She now has the confidence to exercise on an exercise bike, and is able to do several community activities.

The Manage your Health app is a good source of information about managing COPD, and it includes some videos of an avatar showing, among other things, how to use an inhaler properly.There are various other apps which could be useful to you. The MyCOPD app is sometimes provided free of charge to patients (the costs being paid by the local NHS organisations). There are also a number of free apps approved by the NHS which help you make lifestyle changes. There are some below.

Skype consultations could offer a way of talking to your doctor or nurse. This may not always be suitable for you if your breathing is difficult, as the doctor or nurse may need to listen to your chest. There is a video below where a nurse is having a consultation via Skype with a diabetic patient.

Closed Facebook groups could provide support from other patients, especially as many are at home because their breathing makes it difficult to go out and meet other people. Patients with similar conditions understand the needs of other patients, and can help with ideas and friendship. There is a video below where closed Facebook groups are being used by patients with atrial fibrillation.