Management of your Chronic Obstructive Pulmonary Disease (COPD)

Transcription

1 Management of your Chronic Obstructive Pulmonary Disease (COPD) Your personal COPD self management plan (Please bring this plan with you at each review) Name: NHS Number: Date of Birth: GP Name: GP Practice: GP Practice Contact Number: Practice Nurse/Community Matron/ COPD Nurse: GP Out of hours: Monday Friday 6.30pm-8am. Saturday, Sunday and Bank Holidays 24 hours Telephone: Important hand held Records: Please take your COPD Record with you to your GP, Nurse or consultant appoinment. If admitted to hospital please carry this plan with you, along with your medication and inhalers.

2 What is COPD? COPD (Chronic obstructive pulmonary disease) is a name used to describe various conditions when people have difficulty breathing because of long-term damage to their lungs this includes chronic bronchitis and emphysema. In COPD the airways in the lungs are damaged, causing them to become narrower and making it harder for air to get in and out of the lungs. Cough, phlegm (sputum) and shortness of breath can be symptoms of COPD. Stopping smoking is the single most important thing you can do if you have COPD. It can slow down worsening of your COPD. It is never too late to stop. Speak to local services such as your GP, Practice Nurse, Pharmacist, Community Matron, COPD Nurse or local stop smoking service for further advice and support. Stop Smoking Service Livewell Programme Tel: wcnt.livewell@nhs.net or visit or for advice and support got to or call Smokefree Your Inhaled Medication Quick acting reliever opens your airways Your reliever is: General Health look after yourself. Vaccinations Ensure you have had your pneumonia vaccine (one off injection) and ensure you have your flu vaccine yearly. Diet Eat a balanced diet. Drink plenty of fluids. Monitor your weight. If you are overweight this can make your breathing worse. If you are losing weight, without trying, inform your GP. Exercise Pulmonary rehabilitation is an important part of your treatment. Please ask your GP/Nurse for further information about attending a programme local to you. If you are unable to attend a pulmonary rehabilitation programme keep as active as you can. If you can improve your general fitness you could improve your quality of life. Breathing exercises It is important to use breathing techniques that will help you use the least amount of effort when breathing. This will help you when you are short of breath, during flare ups and generally on a day to day basis. If you attend a pulmonary rehabilitation course, specialist physiotherapists will give you the techniques in order to do this. If not ask your GP/Nurse for further information. Feeling down? It is common for people with COPD to feel anxious and/or depressed. Please share any feelings with your GP/Nurse as there may be medication or therapy sessions that could help. Cold Weather Be aware of weather warnings and follow cold weather advice. Benefits If COPD affects your normal day to day activities you may be entitled to government support. Please seek advice from your local Citizens Advice Bureau to ensure you are receiving the correct entitlements relative to your stage of COPD. Most Importantly The information in this self management plan is only in brief. Please ask your GP/Nurse for more information on any of the topics mentioned. There is a lot more information available to help you manage your COPD as best you can. Long acting treatment helps to keep your airways open Your inhaler is: Preventer/Combined Inhaler helps to prevent flare ups (exacerbations) of your COPD Your preventer is: 2 3

3 Take your medication every day, even if you are feeling well. Rinse your mouth or gargle with water and spit after taking your preventer / combined inhaler to prevent oral thrush or a sore mouth. You are likely to experience shortness of breath, particularly on exertion and can expect to have good days and bad days. If you use a nebuliser when well It is important to understand what your normal day to day symptoms are and to know the difference between a bad day and if you are having a flare up / exacerbation of your COPD. What is an Exacerbation of COPD? An exacerbation (or flare up) of COPD is a worsening of day to day symptoms that requires changes to your treatment. YOUR USUAL SYMPTOMS How breathless are you normally? How far can you normally walk / climb stairs? How much sputum do you normally bring up? What colour is your sputum usually? Continue your usual medication Exercise is good for your overall condition Remember to pace yourself and don t overdo it Be aware of your normal day to day symptoms Avoid things that make you worse Avoid running out of medication Nebuliser Times/Day Other treatment for COPD Drug Allergies INCREASE IN SYMPTOMS FLARE UP? Increase in breathlessness? Can t walk as far as normal? New or increased cough? Changes in the amount, thickness and/or colour of your sputum? New or increased wheeze? Feeling generally unwell? HAVING A FLARE UP? If your symptoms are not improving after a maximum of 48 hours OR your symptoms are becoming worse OR you are concerned about your breathing Increase your reliever medication. Reliever Dose up to Refer to your self management treatment plan on the opposite page and start taking your standby/rescue medication or please see your GP now. puffs times/day If you improve over hours go back to your usual medication. DANGER/WARNING SIGNS Unable to talk due to breathlessness You are feeling drowsy You are agitated or confused You have a high fever You have increased ankle/leg swelling You have chest pain CONTACT YOUR GP AND ASK FOR AN URGENT CONSULTATION OR DIAL 999 FOR AN AMBULANCE IN AN EMERGENCY 4 5

4 Management of an Exacerbation of your COPD If you do not have a standby/rescue pack of Steroids and antibiotics at home, please see your GP now. If you have a rescue pack please commence as below: Continue to take your reliever Dose puffs, up to times/day Take whilst you are on treatment for your exacerbation. Steroids Antibiotics During an exacerbation it is important to rest. Eat little and often. Drink plenty of fluids. Use your breathing exercises and continue to take your reliever inhaler as advised. Date FEV1 VC or FVC FEV1 FVC / VC % Blood Pressure Pulse Rate **If your condition does not improve after a maximum of 48 hours or your symptoms get any worse please contact your GP for advice or in any emergency dial 999. **Please inform your GP when you begin your treatment for an exacerbation and order another rescue pack of your antibiotics and steroids. **If you ever cough up blood either when exacerbating or when well it is important to contact your GP. RR MRC Oxygen Level Rest Exertion Inhaler technique Yes/No Inspiratory flow If you are MORE breathless, wheezy or having trouble moving around, take a course of steroids. If you do not have steroids at home please contact your GP. If your sputum (phlegm) changes in the amount, thickness and or colour take your antibiotics in addition to your steroids as prescribed. If you do not have rescue antibiotics please contact your GP. COPD exacerbation (flare up) treatment Steroids Date Antibiotics Prednisolone Admitted to hospital Number of days in hospital Comments Antibiotics If you have been in hospital with a flare up (exacerbation) of COPD you should contact your GP or practice nurse within 2 weeks of discharge to arrange a COPD review. If you are having two or more flare ups a year requiring steriods and/or antibiotics please contact your practice nurse to discuss an earlier review. If you have had more than 2 courses of prednisolone (steroid) tablets in the last 12months you need to speak to your GP about medication to protect you against thinning bones and osteoporosis Advanced Care Planning discussed PPC Document Yes No (please tick box) 6 7

5 Useful website links regarding patient advice: The Wirral COPD and Home Oxygen Service: Victoria Central Health Centre, Mill Lane, Wallasey, Wirral, CH44 5UF Tel: Communication Sheet Please write any questions you have to ask your Doctors/Nurse/Matron below: