What Is a COPD Flare-up?

If you’re living with chronic obstructive pulmonary disease, you can control it with the help of the right kind of food, exercise, and plenty of sleep. No matter how careful you are, though, your COPD may act up from time to time.

When you have a flare-up like this, you may hear a doctor or nurse call this an “exacerbation.”

A flare-up can make you feel sick. A bad one could put you in the hospital and might make your COPD more severe. So the fewer you have, the better.

Awareness is key with COPD flare-ups. You know how you feel on a typical day with your breathing and how much you cough.

If you get an infection in your lungs or if something else irritates them -- secondhand smoke, for instance -- you might be headed for a flare-up.

Signs of a COPD Flare-up

You might be more short of breath or wheeze and cough more than you usually do. Other symptoms include:

  • Fatigue
  • Fever
  • Scratchy throat or other signs of a cold
  • Coughing up more mucus than usual, or it turns green, tan, or bloody
  • Swollen ankles
  • Confusion
  • Unusual sleepiness

What to Do When Flare-ups Happen

Ideally, your doctor has given you instructions for what to do, and has set you up with an inhaler and a rescue pack of drugs. If so, follow the instructions.

Here are some tips to help you judge how severe your flare-up is and what action to take:

  • Mild -- You’re more breathless than you usually are, but you aren’t coughing up any more than usual. In this case, use your inhaler.
  • Moderate -- The inhaler isn’t helping, or you’re coughing up more than usual. Take your rescue-pack medicine and call your doctor.
  • Severe -- You keep getting worse despite the medicine, or you have a fever. Call your doctor’s office at once. If you can’t wait for the doctor, call 911.

Signs of an Emergency

Some flare-ups are so serious that you should call 911 right away. Here are some signs of this:

  • You have chest pains.
  • Your lips or fingers turn blue.
  • You’re very short of breath.
  • You can’t think clearly, or you’re upset.
  • You’re drowsy.

Continued

Flare-up Triggers

These are some of the things that can make your COPD worse and spark a flare-up:

  • Smog and other kinds of air pollution
  • Cigarette or cigar smoke
  • Strong fumes from perfume and other scented products
  • Cold air or hot, humid air
  • Ragweed and other pollens that trigger allergies

Tips to Prevent Flare-Ups

Because infections or other triggers that irritate your lungs generally cause flare-ups, you need to protect yourself against things like that.

Start with your lifestyle, because a healthier body has the best chance to fight off germs. Eat nutritious food. Exercise. Get plenty of sleep. Also:

  • Wash your hands often. They pick up germs from things you touch. Try not to touch your eyes, nose, or mouth, because that can help germs get into your body.
  • Get a flu shot every year. Also, ask your doctor about a shot to protect against pneumonia.
  • Carry your own pen with you. That way, if you need to fill out paperwork at the doctor’s office or other places, you won’t handle the same pen as other people.
  • Show up for all of your medical appointments. Do that even if you feel OK.
  • Stay away from crowds when you can. That’s especially important during cold and flu season.
  • Try to avoid perfumes or the odors of household cleaning products. Buy unscented products whenever you can.
  • Avoid secondhand smoke. And if you smoke -- the cause behind many cases of COPD -- ask your doctor for help in quitting.
  • Be careful outdoors. If cold air bothers you, pull up your scarf around your mouth and nose, and breathe through your nose. During hot, humid weather, stay inside with air conditioning.

Have a Plan

No matter how careful you are, your COPD may act up sooner or later. Be prepared. Ask your doctor to help you work out an action plan to guide you.

Your plan should fit what you personally need, and will depend on what symptoms you have. To get an idea of what it might look like, you can see a blank form for plan on the Canadian Lung Association website, in the sections that covers COPD. You plan should spell out things such as:

  • What your special flare-up medicine is and when to use it
  • If you have an inhaler or oxygen, when to use it or use it more
  • How you’ll know it’s time to call the doctor or call 911

Remember, when you start feeling bad, you have to take it seriously.

Flare-ups are a leading cause of disability in people with COPD. But if you take the right precautions, you can go on about your business.

WebMD Medical Reference Reviewed by William Blahd, MD on November 20, 2016

Sources

SOURCES:

British Lung Foundation: “Managing COPD Flare-Ups.”

Canadian Lung Association: “Chronic Obstructive Pulmonary Disease (COPD): Flare-ups”; “Chronic Obstructive Pulmonary Disease (COPD): Triggers.”

Canadian Respiratory Guidelines: “2013 CTS COPD Action Plan.”

COPD Foundation: “Staying Healthy and Avoiding Exacerbations.”

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