COPD What Is It? Why is it so hard to catch my breath? What does COPD feel like? What causes COPD? What is an exacerbation (ig-zas-er-bay-shun)?

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1 Attitudes and Beliefs 4 COPD What Is It? Why is it so hard to catch my breath? COPD is a disease that damages the lungs. In a healthy lung, the airways are open and the air sacs fill up with air. Then the air goes quickly out. When you have COPD, it s hard to get air through the airways and into and out of the air sacs. There are two main diseases with COPD: 1 2 Chronic bronchitis the walls of the airways become inflamed, swell, and clog with mucus. This partly or completely blocks the airway, making it hard to move air in and out of the lungs. Emphysema the walls of the tiny air sacs stretch out and break down inside. Your lungs become overinflated and the air gets trapped, making it hard to get in the next breath. Airways Normal Lungs Air Sacs Airway Chronic Bronchitis Extra mucus and pus Inflammation Air Sac Emphysema Broken air sac traps air inside and air cannot get out Original air sac What does COPD feel like? COPD may cause one or more of these signs or symptoms: Shortness of breath, especially with activity Cough Increase in mucus What causes COPD? Smoking is the most common cause of COPD. Other risk factors include family history, secondhand smoke, air pollution, and lung problems as a child. What is an exacerbation (ig-zas-er-bay-shun)? Your symptoms get worse. This can last for a few days. You may need different medicines. You may need to go to the hospital. Taking care of COPD every day The damage to your airways and lungs can be permanent. But there are things you can do to feel better and slow the damage. If you smoke, ask your doctor about a program to help you quit smoking. Exercise regularly (ask your doctor first what activities are best for you). Eat well and get enough rest. Having to clear your throat often Being very tired Do not wait for a flare-up. Take your medicines as directed. In general, avoid things that make your symptoms worse. Protect yourself from airway infections. 5

2 Attitudes and Beliefs 6 Goal1 Goal2 Goal3 Goal4 My COPD Goals What Are They? You are the most important person in controlling your COPD. Talk with your doctor to help you choose one or more goals you are ready to work on now. Stop Smoking I will ask my doctor about a program to help me quit smoking. I will think of all the reasons why I should quit and then take the steps to quit. If I slip up, I will try again. Medicine I will take my medicine(s) as directed to improve my health and prevent flare-ups. I will ask questions when I do not understand my doctor s instructions. I will learn how to use my inhaler and have my doctor check how I use it at every visit. I will get a flu shot every year. Doctor Visits I will keep my doctor appointments even when I feel fine. I will ask my doctor to test my lung function. I will ask my doctor about getting flu and pneumonia shots. Exercise I will learn pursed-lip breathing exercises. I will walk or exercise for minutes days every week if my doctor says it s okay. I will learn how to save energy by pacing myself and taking breaks. Goal5 Goal6 Goal7 Diet I will eat a balanced diet. I will drink glasses of water each day. Air Pollutants I will keep my home free of smoke, fumes, and strong smells. I will stay away from smoky places. I will stay inside as much as possible when the air quality outside is poor. I will stay away from friends who have a cold or the flu. Social Support I will talk to family and friends about how having COPD makes me feel. I will join a COPD support group. I will let my doctor know if I feel sad or down for several weeks or more. EMERGENCY: Go to the hospital right away if: a it is hard to breathe, talk, or walk; b your lips or fingernails look blue; c your heartbeat is fast or irregular. If your symptoms suddenly get worse and don t get better after taking your quick-relief medicine, call your doctor or go to the emergency room. 7

3 8 COPD Medicines How Do They Work? There are a number of treatments that may help you feel better and be more active. Talk to your doctor about what treatment is right for you. If you are still smoking, the most important thing you can do is quit. Long-term controller medicines Most are inhaled medicines that you take every day to help manage your COPD. It is important to use your controller medicines every day, even if you are feeling fine. Some long-term medicines may help to prevent flare-ups. Quick-relief (rescue) medicines Most are inhaled medicines you use when your breathing suddenly gets worse. Your doctor will tell you when and how to use a rescue medicine. Keep track of your symptoms and how your medicines help: Watch for symptoms like more shortness of breath, wheezing, or coughing than usual. Look for changes in the color of your mucus. Tell your doctor if new symptoms appear or if you have a flare-up. Avoid Exacerbations Ask your doctor how you can prevent a flare-up. Ask your doctor what to do if you have a flare-up. Patients with more severe COPD may benefit from breath training and oxygen. Taking Medicines Breath training Breath training may help you breathe easier and be less anxious about your breathing. Your doctor or respiratory healthcare professional can give you tips on breathing exercises. Oxygen If your oxygen level is low, oxygen therapy will help you live longer and feel better. Your doctor can do a simple test to determine if oxygen can help you. How can diet and exercise help? Exercise and a good diet may help increase your strength to do daily tasks. Your doctor or respiratory healthcare professional can show you the right exercises and how to do them safely. Ask them to review your diet and refer you to a nutritionist if needed. Follow your treatment plan exactly as prescribed by your doctor. Ask your doctor to help you fill out the COPD Treatment Plan on the next page. A plan can help you manage your COPD. 9

4 Taking Medicines My Treatment Plan How Do I Take Action? Your doctor will prescribe medicine based on your symptoms. If you have mild COPD, you may: Feel a little short of breath after working hard or walking quickly Cough a lot (with mucus) If you have moderate COPD, you may: Feel short of breath after working hard or walking quickly Have a tough time doing hard work or chores Need a few weeks to get better from a cold or other lung infection Cough even more, with a lot of mucus If you have severe COPD, you may: Have trouble breathing on most days Be short of breath, even at rest Need a few weeks to get better from a cold or other lung infection Not be able to do your usual activities Get tired very easily Cough even more, with a lot of mucus Taking your medicines the right way is one of the most important things you can do. Ask your doctor to help you complete the items below. Date: / / Doctor/Phone: Emergency number: How to Take Action: If you smoke, quit! When your symptoms suddenly get worse, use this quick-relief medicine: To control symptoms and prevent them from getting worse, take this daily controller medicine: Talk to your doctor about how you can prevent flare-ups, or exacerbations. Keep exercising as directed. Protect yourself from airway infections. Use pursed-lip breathing exercises. Talk to your doctor about oxygen therapy and a lung rehab program to help you breathe better. If your symptoms suddenly get worse and don't get better after taking your quick-relief medicine, call your doctor or go to the emergency room

5 Taking Medicines My Medicines How Can I Get the Most From Them? Fill out a medicine chart like the one below and talk with your doctor or pharmacist. This will help you take the right dose, at the right time. Include all medicines that you take for all reasons. Always keep your quick-relief (rescue) medicine with you. It will give you quick relief when your symptoms get worse. You may think you can stop using your long-term controller medicine once you feel fine. But your long-term medicine is the most likely reason why you feel fine. Your airways still need it every day to treat COPD and control your symptoms. Name and Strength of Medicine How Much I Take When I Take It I Take It for Dates to Refill Rx Special Instructions 12 Doctor s office contact name / phone number Pharmacy contact name / phone number 13

6 Lifestyle Sticking With My Medicines What Will Work? Taking your COPD medicines as directed by your doctor is one of the most important things you can do to stay healthy. Not taking your long-term controller medicine as directed by your doctor means: Your medicines will not work the way they should. It may be harder to take deeper breaths. You may have symptoms more often. The symptoms you have may be more severe. Simple tasks may be hard for you to do. Your lung function may get worse. I m so busy. Taking medicine gets in the way of my day. The key is to create a routine that fits your life: Try taking your long-term controller medicines with other daily habits, such as in the morning when brushing your teeth or in the evening around dinner time. Ask your doctor if there is a medicine you can take less often. A simpler medicine schedule may help you. If you forget to take your medicines often: Wear a watch. Set an alarm. Leave yourself a note on the bathroom mirror. Use the counter on your COPD medicines to help you keep track of the doses you take. Keep your long-term controller medicine in a place where you will see it daily. If you forget to refill your medicine on time: Mark a calendar with Refill on [date]. Choose a date about a week before you will run out. Make sure you have enough refills to last you until your next doctor visit. Ask your pharmacy to send you reminders to refill your prescription. Taking care of yourself can help prevent COPD flare-ups, or exacerbations. Protect yourself from airway infections. Ask your doctor if you need vaccines (shots) to help prevent flu or pneumonia. Stay away from friends or coworkers who have colds or the flu

7 Talking With My Healthcare Team My Doctor Visits How Can I Get Ready? You and your doctor are a team in treating COPD. Your doctor can help you feel better, live a more active life, and slow the damage to your lungs. To get the most from your treatment, talk openly and honestly with your doctor. I'm always going to be short of breath, so why do I need to ask my doctor questions? All questions are important. Write down your questions so you can remember them at your doctor visit. Do not be afraid to speak up if you do not understand something. Talk to your doctor about any changes in your symptoms even small changes in how you cough or how much mucus you have. Ask a family member to join you for doctor visits. They can write down your doctor s answers. If you have trouble understanding what your doctor says: Ask for written information about your medicine. Is this available in large print or another language? Ask your doctor or pharmacist to show you how to use your inhaler. Prepare before you go to your doctor s office. Check off the statements that apply to you and discuss with your doctor. Since my last visit: I have not taken my medicines as directed every day. I have coughed more than usual. I have coughed up more mucus than usual. My mucus has been different than usual (color, thickness). My breathing has been worse than usual. I have been awakened by my breathing. My COPD has caused me to miss activities. My appetite has decreased / I have lost weight. I used an antibiotic or oral steroid to treat a flare-up. I have used my fast-acting inhaler more than usual

8 Help From Others COPD Support Where Can I Go for Help? I feel like I m handling this all alone. Ask a family member or friend to support you, such as going with you to your next doctor visit. If you live with someone who smokes, ask them to quit. Ask for help keeping the air in your home clean. Ask your doctor about a COPD support group. You can find a group in your area at If you smoke, ask your doctor about a program to help you quit. If you have trouble paying for your medicines: Visit or for more information. Another option is to call Medicare or visit Have you felt down or hopeless? It s normal for people with COPD to feel down from time to time. But if you have been feeling down much of the time, talk to your doctor. For more help and information, contact one or more of these COPD resources: The National Emphysema Foundation National Lung Health Education Program The American Lung Association (includes information on local chapters and support groups) National Heart, Lung, and Blood Institute QUIT SMOKING: National Cancer Institute - Smoke Free To learn more about what may be getting in the way of taking your medicines, go to Many of the Web sites above are external to GlaxoSmithKline. GlaxoSmithKline does not have editorial control over the content of the information provided in these Web sites and therefore does not guarantee their accuracy and completeness. 19

9 About My COPD Care Record Use this chart to keep track of your doctor visits and the progress you ve made on your COPD goals. Each Visit Questions to Answer / / / / / / Symptoms in Past Week Number of days with shortness of breath at rest Number of days with shortness of breath during exercise Number of days shortness of breath interfered with usual activities Number of days with coughing and mucus Do I need help quitting smoking? Treatment Did I take my medicines as directed? Am I using my inhaler(s) the right way? Have I received my annual flu vaccine?* Do I have an up-to-date COPD Treatment Plan? Readiness Am I confident that I can follow my treatment plan? Have I scheduled my next COPD office visit? *You may also need to receive a pneumonia vaccine once (a booster may be needed after 5 years). This material was developed by GlaxoSmithKline The GlaxoSmithKline Group of Companies All rights reserved. Printed in USA. HM2193R0 April 2009

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