What is COPD?
How did I get COPD?
What is happening to my lungs?
Steer clear of smoking
Be careful what you breathe
Treatment and medication
Take exercise and go to pulmonary rehabilitation
Relax and conserve energy
Eat well, drink well
Sleep well
Know what to do when things get bad
Sex
Breathing techniques
Partners and carers
What is COPD?
COPD - chronic obstructive pulmonary disease - is a name used to describe a number of conditions where people have difficulty breathing because of long-term damage to their lungs.
In the past, these may have been called: chronic obstructive airways disease; chronic obstructive lung disease; and in some cases wrongly called chronic asthma.
Everyone who has chronic bronchitis and emphysema has COPD, and many people will have a mixture of both. NB: 'Chronic' (as in COPD) means 'long term'.
COPD can affect every aspect of day-to-day life. You will probably have to make a number of changes to your lifestyle.
There are some things you should cut out and some things you should take up.
The aim of this page is to help people with COPD make their daily life more enjoyable and fulfilling.
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How did I get COPD?
The biggest single cause of COPD is cigarette smoking. Typically, COPD affects people over the age of 35 who are, or who have been, heavy smokers. It can also result from chronic severe asthma. There are other causes, but they are rare:
- Exposure to pollution in the air.
- Exposure to fumes or particles at work, e.g. welding fumes,
- coal dust.
- Alpha-1-antitrypsin deficiency, a genetic condition.
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What is happening to my lungs?
The changes that occur in your lungs when you have COPD may vary depending upon the exact nature of your disease. But the final result is obstruction (blockage) of the airways (the tubes that carry air in and out of your lungs). Obstruction happens in the airways themselves, due to inflammation and too much mucus or phlegm. Damage can also happen to the small airways and air sacs in your lungs. This leads to the lungs losing their stretchiness. This loss results in a lack of support for the airways, which can collapse, trapping air in the lungs when you breathe out.
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Steer clear of smoking
If you are still smoking, it will help a lot if you stop. If you carry on smoking, your lungs will go on getting much worse, much more quickly than if you stop. Smoking also leaves carbon monoxide in your blood. This will rapidly disappear, so your breathing may get better quickly.
Don't feel guilty about having smoked - think about how giving up will improve the rest of your life.
Giving up smoking can be very difficult - even if you are ill. If you need help with giving up, ask your Practice Nurse or GP.
For more information about stopping smoking please go here.
Another option is to call the QUIT helpline, free, on 0800 00 22 00. Or contact QUIT at Ground Floor, 211 Old Street, London EC1V 9NR.
You should also try and avoid smoky places and ask people around you not to smoke.
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Be careful what you breathe
Because your lungs are more sensitive, you need to take care about what and where you breathe:
- Try to avoid infections - stay away from people (including babies!) who have colds, flu, sinus infections or a sore throat. And ask them to stay away from you too. You should also have a flu jab every year and make sure you are vaccinated against pneumonia.
- If you know of places where there are regular traffic jams, or where there are lots of exhaust fumes (e.g. underground car parks), try to stay away.
- If you work in a dusty or smoky environment, then you might need to change departments - talk with your employer and explain the problem.
- Only use strong-smelling products (like cleaning products) when there's lots of ventilation.
- Don't go to smoky places, and ask people not to smoke around you.
- Don't use air freshener plug-ins or sprays, or scented candles.
- Try to keep the air in your house at a constant temperature.
- If you're going outside on a cold or windy day, cover your nose and mouth with a scarf.
- Don't use hair spray, and avoid perfume.
Help people to help you - they won't know unless you explain it to them. But they will want to help if they understand your problems.
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Treatment and medication
It's important that you go and see your doctor or nurse regularly so that they can check how you are. You should go even if you're feeling well. This is the only way the doctor or nurse can make sure you are taking the right medication, or see if you should be using other medicines or therapies.
Always take your medicine
If you are prescribed medicine, the doctor or nurse believes that it will help you. So you should make sure you take it as instructed. It won't get any less effective if you use it regularly, because it is designed to work this way.
You should also be sure that you use your inhaler correctly - a lot of people don't. Ask the nurse to check your technique. And if you are using other equipment, like a spacer, or a nebuliser, you should make sure you clean and maintain it properly.
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Take exercise and go to pulmonary rehabilitation
Many people with COPD stop taking exercise because it makes them breathless. But not exercising makes things worse. You can't do yourself harm by over-exertion, because breathlessness will stop you. Try to walk, even if it's just around the house or up and down the garden.
See if there are pulmonary rehabilitation classes in your area - these are individually tailored classes to help you increase your lung fitness, and can be very valuable. If there are no classes - join with your local Breathe Easy support group and campaign for pulmonary rehabilitation where you live.
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Relax, and conserve your energy
Stress and anxiety may make your symptoms worse. So make sure you talk with your friends, family or health professional - let people know how you are feeling and share your concerns. And try to avoid situations you know will worry you.
And while it's important to stay active, save your energy for when you really need it. You might not need the tips below - it depends on how serious your symptoms are - but here are things you can try if you do need to save energy:
- Organise the space around you so that what you need is near at hand.
- Keep your reliever inhaler with you.
- Sit down as much as you can - in the shower, cleaning your teeth, peeling potatoes.
- Pace yourself - slow and steady will get you there.
- Avoid unnecessary activity - put on a toweling robe instead of drying yourself with a towel.
- Try to avoid bending down - wear slip-on shoes, or use long-handled tools in the garden.
- Don't worry about getting a little breathless - if you do, take a break to get your breath back, then start again.
- If you can, sleep under a quilt rather than sheets and blankets.
- Give yourself a treat every day.
And... ask for help if you need it!
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Eat well, drink well
Having COPD means that you use up a lot of energy in breathing, which is why many people with COPD lose weight.
It's really important for you to eat a healthy diet. Eating little and often will stop you getting breathless during long meals and feeling bloated. You should aim for food that is high in protein and make sure that you are taking in enough calories.
Use fast and easy recipes. When you have the energy, cook more meals than you need and freeze them for a bad day. And if you can, share the cooking with someone else.
It's also important to drink a lot of water (unless your doctor has told you not to). It keeps the lining of the airways moist and your sputum will be thinner.
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Sleep well
It's vital to get enough rest every day. Take time to relax before going to bed. Make sure your bed is comfortable and that your medicine is where you can reach it if you need to. Some people prefer to prop themselves into a more upright position to sleep, or to sleep on their side.
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Know what to do when things get bad
Even though COPD is a long-term illness, you may still have times when your symptoms get suddenly worse. Doctors and nurses call these 'exacerbations'. It's very important that you should know what to do.
First of all, you need to know your symptoms on a daily basis, so you know when they change. This might be:
- You are coughing up more phlegm.
- A change in the colour or thickness of your phlegm.
- You have a temperature.
- You find normal activities more difficult.
- You are more breathless.
You need to make sure that you discuss with your doctor or nurse what you should do. For example, you might agree that you will:
- Have an extra supply of medicine at home, such as antibiotics.
- Have an arrangement for emergency appointments, or telephone prescriptions.
- Go directly to your hospital for treatment.
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Sex
Having an illness like COPD can upset any relationship. It will also make you feel tired. And it can also make you feel anxious and depressed. Also, COPD sufferers will experience breathlessness during sexual activity at some stage, which can be worrying. All of this means that your sex life can suffer.
Things to remember
- Avoid sex immediately after a heavy meal and after drinking alcohol.
- Some changes in your sex life are just because you're getting older - not because of COPD. Slower erections and delayed orgasms are normal in middle and later life.
- Conserve energy.
- Learn about how your disease and your medicines might affect you.
- Let your medicine work for you.
- Communicate with your partner and stay open-minded.
- Explore what you both like sexually.
- Remember that simply touching, being touched and being close to someone helps a person feel loved, special and a true partner in a relationship.
Ask your GP or nurse for advice if you have problems.
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Breathing techniques
There are various techniques for coping with breathlessness. If you practice these and use them every day, they will help you when you are active and getting breathless. They will also help you manage if you get short of breath suddenly.
Breathing control
This is helpful if you are generally short of breath. Breathing control means breathing gently, using the least effort, with your shoulders supported and relaxed. Use one of the positions below.
In a comfortable, supported position, relax your shoulders, arms and hands. Breathe in gently through your nose and breathe out through your nose or mouth. Try to feel more relaxed and calmer each time you breathe out.
Techniques for when you are more active
- Try all of these gently - don't force yourself.
- You can combine these techniques - they're all helpful for when you're short of breath.
- If you feel wheezy or tight-chested, try taking your 'reliever' inhaler. And remember, never hold your breath - you need the oxygen!
1. Relaxed slow deep breathing
Gently slow down your breathing. Breathe more deeply. Breathe in through your nose and breathe out through your mouth.
2. Pursed lips breathing
Breathe out with your lips pursed, as if you're whistling. This slows your breathing down and helps to make your breathing more efficient.
3. 'Blow as you go!'
Breathe out when you're making a big effort, for example:
- stretching your arms above your head
- reaching for something on a shelf
- bending down
- going up a step or stair
- standing up
- or during the hardest part of any action BLOW as you GO!
4. Paced breathing
This is useful when climbing the stairs (or walking). Breathe in, in time with the steps you take. Do this in a rhythm that suits you and how breathless you are. For example:
- breathe in when on the stair, and breathe out as you go up a stair (blow as you go!), or
- breathe in for one stair and out for one stair, or
- breathe in for one stair and out for two, or
- breathe in for two stairs and out for three
Positions
The best positions are the ones which need the least energy or effort. If you tense your shoulders and grip onto things when you are breathless, you're wasting energy (and oxygen).
1. To ease your breathing when standing up, lean from the hips, with your forearms resting on something at the right height (see opposite) (chairs, window sills, garden walls or kitchen work surfaces are often of a suitable height).
2. When you're standing or walking, try putting your hands on your hips, in your pockets, or stick your thumbs into your belt loops to support your arms without gripping. If you carry a shoulder bag, you can rest your arms on it.
3. Sitting uses less energy than standing up. You may find it useful to lean forwards, resting your forearms on your knees, or on the arms of a chair or table (see below).
4. Using a walking aid (walking stick, or a frame with wheels at the back and front) can help you find one of these comfortable postures when you are out and about. Most people feel better pushing a supermarket trolley - it works the same way.
5. You can rest your head and arms on pillows on a table when you're really short of breath (see below). 
6. Try lying on your side, propped up with lots of pillows.
Try all these positions and decide which ones are best for you. Different ones will suit different situations.
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Partners and carers
How will my condition affect my spouse/partner/carer?
It is inevitable that at some stage your spouse/partner/carer will feel anxious or frustrated about your breathing problems.
It is important to talk about worries together. Your partner may react by doing everything for you, but this isn't always the best approach. It is important that you remain as active as possible and continue to enjoy things together. Keeping fit will help achieve this.
What help is available for partners and carers?
The Breathe Easy network and the British Lung Foundation are a vital resource for information and support.
Partners and carers are very welcome to join Breathe Easy.
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Page last medically reviewed: June '07
