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Chronic obstructive pulmonary disease - adults - discharge

COPD - adults - discharge; Chronic obstructive airways disease - adults - discharge; Chronic obstructive lung disease - adults - discharge; Chronic bronchitis - adults - discharge; Emphysema - adults - discharge; Bronchitis - chronic - adults - discharge; Chronic respiratory failure - adults - discharge

You were in the hospital to treat breathing problems that are caused by chronic obstructive pulmonary disease COPD. COPD damages your lungs. This makes it hard to breathe and get enough oxygen.

After you go home, follow instructions on taking care of yourself. Use the information below as a reminder.

When You're in the Hospital

In the hospital you received oxygen to help you breathe better. You may also need to use oxygen at home. Your doctor may have changed some of your COPD medicines during your hospital stay.

Keep Active

To build strength:

  • Walk until it is a little hard to breathe.
  • Slowly increase how far you walk.
  • Try not to talk when you walk.
  • Ask your health care provider how far to walk.
  • Ride a stationary bike. Ask your provider how long and how hard to ride.

Build your strength even when you are sitting.

  • Use small weights or an exercise band to strengthen your arms and shoulders.
  • Stand up and sit down several times.
  • Hold your legs straight out in front of you, then put them down. Repeat this movement several times.

Ask your provider whether you need to use oxygen during your activities, and if so, how much. You may be told to keep your oxygen above 90%. You can measure this with an oximeter. This is a small device that measures your body's oxygen level.

Talk to your provider about whether you should do an exercise and conditioning program such as pulmonary rehabilitation.

Self-care

Know how and when to take your COPD drugs.

  • Take your quick-relief inhaler when you feel short of breath and need help fast.
  • Take your long-term drugs every day.

Eat smaller meals more often, such as 6 smaller meals a day. It might be easier to breathe when your stomach is not full. DO NOT drink a lot of liquid before eating, or with your meals.

Ask your provider what foods to eat to get more energy.

Keep your lungs from becoming more damaged.

  • If you smoke, now is the time to quit.
  • Stay away from smokers when you are out, and do not allow smoking in your home.
  • Stay away from strong odors and fumes.
  • Do breathing exercises.

Talk to your provider if you feel depressed or anxious.

Stay Away From Infections

Having COPD makes it easier for you to get infections. Get a flu shot every year. Ask your provider if you should get a pneumococcal (pneumonia) vaccine.

Wash your hands often. Always wash after you go to the bathroom and when you are around people who are sick.

Stay away from crowds. Ask visitors who have colds to wear masks or to visit when they're all better.

Save Your Energy at Home

Place items you use often in spots where you do not have to reach or bend over to get them.

Use a cart with wheels to move things around the house and kitchen. Use an electric can opener, dishwasher, and other things that will make your chores easier to do. Use cooking tools (knives, peelers, and pans) that are not heavy.

To save energy:

  • Use slow, steady motions when you are doing things.
  • Sit down if you can when you are cooking, eating, dressing, and bathing.
  • Get help for harder tasks.
  • Do not try to do too much in one day.
  • Keep the phone with you or near you.
  • After bathing, wrap yourself in a towel rather than drying off.
  • Try to reduce stress in your life.

Going Home With Oxygen

Never change how much oxygen is flowing in your oxygen setup without asking your provider.

Always have a back-up supply of oxygen in the home or with you when you go out. Keep the phone number of your oxygen supplier with you at all times. Learn how to use oxygen safely at home.

Follow-up

Your hospital provider may ask you to make a follow-up visit with:

  • Your primary care doctor
  • A respiratory therapist, who can teach you breathing exercises and how to use your oxygen
  • Your lung doctor (pulmonologist)
  • Someone who can help you stop smoking, if you smoke
  • A physical therapist, if you join a pulmonary rehabilitation program

When to Call the Doctor

Call your doctor if your breathing is:

  • Getting harder
  • Faster than before
  • Shallow, and you cannot get a deep breath

Also call your doctor if:

  • You need to lean forward when sitting in order to breathe easily
  • You are using muscles around your ribs to help you breathe
  • You are having headaches more often
  • You feel sleepy or confused
  • You have a fever
  • You are coughing up dark mucus
  • Your fingertips or the skin around your fingernails are blue

References

Anderson B, Brown H, Bruhl E, et al. Institute for Clinical Systems Improvement website. Health Care Guideline: Diagnosis and Management of Chronic Obstructive Pulmonary Disease (COPD). 10th edition. www.icsi.org/wp-content/uploads/2019/01/COPD.pdf. Updated January 2016. Accessed April 9, 2018.

Global Initiative for Chronic Obstructive Lung Disease (GOLD) website. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2018 report. goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf. Accessed April 9, 2018.

Han MK, Lazarus SC. COPD: clinical diagnosis and management. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 44.

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  • COPD inhaler

    Animation

  •  

    COPD inhaler - Animation

    Inhalers of one kind or another are often the mainstay of asthma therapy. I'm Dr. Alan Greene and let's talk about how to actually use an inhaler. When someone is first handed an inhaler, their first instinct is often to put their mouth around the opening and to squeeze. But it turns out when you do it that way, you'll often end up with a lot of the medicine inside your mouth, on your tongue, on the roof of your mouth, inside the cheeks. You get less medicine down into the lungs where it is needed. It tastes bad. And if it happens to be one of the preventative kinds of medications, it could actually lead to thrush or yeast in the mouth. Something else that's worth noting. An even better way to use an inhaler is with a spacer. We especially recommend this for kids, but it's better for adults, too. And the way the spacer works, you don't have to be coordinated. You don't have to time it perfectly. You can put the spacer into your mouth and you squirt the medicine into the spacer and just breathe in and out normally for a while so the medicine keeps coming in. Now what ever you use, whether it's a straight inhaler or the spacer, there's a recent change that's worth being aware of. For a long time, asthma inhalers were propelled by CFCs (chlorofluorocarbons) that caused some problems with global warming and ozone depletion. Those have now been replaced or are being replaced with something called HFA instead. And that's great for the environment, but it is a little bit clumpier. So it's important the little place where the medicine comes out of, you may need to clean off on an albuterol kind of inhaler, whether you are using a spacer or using directly into your mouth.

  • COPD inhaler

    Animation

  •  

    COPD inhaler - Animation

    Inhalers of one kind or another are often the mainstay of asthma therapy. I'm Dr. Alan Greene and let's talk about how to actually use an inhaler. When someone is first handed an inhaler, their first instinct is often to put their mouth around the opening and to squeeze. But it turns out when you do it that way, you'll often end up with a lot of the medicine inside your mouth, on your tongue, on the roof of your mouth, inside the cheeks. You get less medicine down into the lungs where it is needed. It tastes bad. And if it happens to be one of the preventative kinds of medications, it could actually lead to thrush or yeast in the mouth. Something else that's worth noting. An even better way to use an inhaler is with a spacer. We especially recommend this for kids, but it's better for adults, too. And the way the spacer works, you don't have to be coordinated. You don't have to time it perfectly. You can put the spacer into your mouth and you squirt the medicine into the spacer and just breathe in and out normally for a while so the medicine keeps coming in. Now what ever you use, whether it's a straight inhaler or the spacer, there's a recent change that's worth being aware of. For a long time, asthma inhalers were propelled by CFCs (chlorofluorocarbons) that caused some problems with global warming and ozone depletion. Those have now been replaced or are being replaced with something called HFA instead. And that's great for the environment, but it is a little bit clumpier. So it's important the little place where the medicine comes out of, you may need to clean off on an albuterol kind of inhaler, whether you are using a spacer or using directly into your mouth.

A Closer Look

 
 

Review Date: 2/18/2018

Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. 02-25-19: Editorial update.

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