NORTHAMPTON
YOUR GUIDE TO BETTER LIVING WITH
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
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CONTENTS
UNDERSTANDING MY CONDITION
. WHAT IS C.O.P.D?
. SYMPTONS
. DIAGNOSIS
. CRISIS
MANAGING MY DISEASE
. BETTER BREATHING
. PULMONARY REHABILITATION
. POSITIVE STEPS
. CONSERVE YOUR ENERGY & CONTROL STRESS
TREATMENT
. MEDICATION
MENTAL HEALTH & WELL BEING
. IDENTIFYING ENVIROMENTAL IRRITANTS
. SMOKING
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. EXERCISE & THE LUNGS
. WEATHER
. TRAVEL
. RELATION SHIPS
FURTHER READING
Easy breathers INFORMATION
USEFULL TELEPHONE NUMBERS
. RESTART TEAM 01604 544865
(NORTHAMPTON GENERAL HOSPITAL)
. ADVICE FOR SMOKERS WANTING TO STOP 0845 601 3116
. BENEFITS ADVICE 0800 88 22 00
. NHS DIRECT www.nhsdirect.nhs.uk
. ACTION ON SMOKING & HEALTH 02072 240743
WHAT IS COPD?
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Chronic obstructive pulmonary disease
(COPD) is the name for a collection of
lung diseases including chronic
bronchitis, emphysema and chronic
obstructive airways disease. People with
COPD have trouble breathing in and out.
This is referred to as airflow
obstruction.
Breathing difficulties are caused by
long-term damage to the lungs, usually
because of smoking.
How common is COPD?
COPD is one of the most common
respiratory diseases in the UK. It
usually affects people over the age of
35.
Around 835,000 people in the UK have been
diagnosed with COPD, but it is thought
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that there are about 2 million people
living with the disease who have not been
diagnosed. This is because many people
who develop the symptoms of COPD do not
get medical help because they often
dismiss their symptoms as a ‘smoker’s
cough’.
COPD affects more men than women.
However, according to the British
Thoracic Society, rates of COPD in women
are increasing.
The main cause of COPD is smoking. The
likelihood of developing COPD increases
the more you smoke and the longer you've
been smoking.
The effects of COPD
People with COPD have trouble breathing
in and out, known as airflow obstruction.
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Their lungs become inflamed due to
irritation, usually from cigarette smoke.
Over many years, the inflammation leads
to permanent changes in the lung. The
walls of the airways get thicker in
response to the inflammation and more
mucus is produced. Damage to the delicate
walls of the air sacs in the lungs means
the lungs lose their normal elasticity.
It becomes much harder to breathe,
especially when you exert yourself. The
changes in the lungs cause the symptoms
of breathlessness, cough and phlegm
associated with COPD.
Although any damage that has already
occurred to your lungs cannot be
reversed, you can prevent COPD from
developing or getting worse by making
lifestyle changes.
Treatment for COPD usually involves
relieving the symptoms, for example by
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using an inhaler to make breathing
easier, there are numerous types of
inhalers.
Although COPD causes about 25,000 deaths
a year in the UK, severe COPD can be
prevented by making changes to your
lifestyle.
For more on COPD
http://www.lunguk.org/you-and-yourlungs/conditions-and-diseases/copd
SYMPTOMS
You may have noticed that you started having difficulty
breathing, became tired, get chest infections or you cannot
do as much as everyone else of your age without getting
out of breath. Many people often have a cough & produce
phlegm for many years so may not notice the gradual
decline in their activity.
Listed below are the symptoms most commonly
experienced by people with COPD.
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BREATHLESSNESS this is due to a narrowing of the
airways. The airways have a muscle layer that helps to keep
them open but this is often damaged due to long exposer
to harmful substances. Therefore, the airways narrow
making it difficult to get the air in & out. The lining of the
airways can often swell, possibly to infection, or something
that has irritated them. This will lead to further narrowing
with the breathlessness worsening.
SPUTUM the airways in your lungs produce secretions to
keep them moist & to remove particles of dust that you
breathe in. Some people with COPD produce too much
sputum, this because irritation of the airways may cause
mucus glands to become enlarged & be more productive. In
addition people with COPD often tend to breathe through
their mouth in attempt to get more air. Unfortunately
when they breathe in this way, the nose is unable to
perform its important function of filtering & removing solid
particles from the air before it reaches the lungs, causing
more irritation.
COUGH the airways in your lungs have millions of tiny
hairs called ‘cilia’ which waft the sputum to the back of the
throat where it is normally swallowed. Smoking damages
these hairs& weakens the lungs ability to clear sputum.
Effective coughing helps clear sputum from the lungs.
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DIAGNOSIS
Your GP may ask you a number of questions to find out if
you have COPD, these could include:
. What symptoms you may have?
. How long have you had them?
. How far can you walk without getting short of breath?
. Do you smoke or have you in the past?
. What is/was your occupation?
. Are you prone to chest infections?
He may then send you for an x ray of your chest. It is
sometimes difficult to detect COPD from this but may help
to rule out any other problems.
You may also be referred to a consultant at the hospital for
breathing tests if they are not available at the surgery.
The best way to find out what is happening in your lungs is
to send you for a lung function test. Where you blow into a
machine called a spirometer, this will enable the doctor to
tell how well your lungs are working. Once the correct
diagnosis has been made you will then be given the
appropriate medication & advice.
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CRISIS
Sometimes COPD gets worse, you are unable to walk far,
and you may cough more & have more sputum. Health
Care Professionals may refer to these as EXACERBATIONS
You may experience an infective EXACERBATION or noninfective one. It is extremely important when you have
COPD to recognise the signs & symptoms of an
EXACERBATION & start appropriate treatment as soon as
possible.
If you notice two or more of the following symptoms, you
should seek medical advice:
. Increasingly out of breath.
. Increasing quantities of phlegm/sputum.
. Phlegm/sputum has turned persistently green.
MANAGING MY DISEASE
BETTER BREATHING
Learning about your breathing & how to have some control
over it, helps you to identify when a breathlessness attack
is going to happen & what to do about it.
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Being breathless is a frightening sensation & it is well
known that fear & anxiety contribute to breathlessness
setting up a vicious circle. With practice you should be able
to break that circle& work through episodes of
breathlessness, returning your breathing pattern to normal
in a controlled manner.
This section covers the general principles of breathing
control but may be referred to a physiotherapist for help &
more specialist advice.
QUICK TIPS TO HELP WITH BREATHLESSNESS
Try to pace yourself when you are doing something that
makes you short of breath & practice your breathing
control during rests.
. Try not to hold your breath when you are doing activities
as this will make you breathy more quickly afterwards to
compensate. Remember: Keep breathing steadily through
your activities.
. When doing everyday activities or exercise you will find it
easier to breathe out on the EFFORT part of the movement.
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. Don’t try to talk too quickly, especially when you are
talking on the telephone. Pace yourself as well as your
activities.
ROME WAS NOT BUILT IN A DAY.
BETTER BREATHING
Make sure that you are in a comfortable position e.g.
sitting with your back well supported.
Relax your shoulders consciously allowing them to drop.
Place one hand on your stomach (abdomen) & give a sniff.
The muscle you feel under your hand is called the
diaphragm.
With your shoulders relaxed, breathe in slowly through
your nose.
Try to feel the upper part of your stomach inflate while the
upper chest remains as still as possible
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As you breathe out your stomach should relax
automatically
Your breathing should be quiet & barely audible, it should
not be forced.
Continue to breathe in through the nose & gently out
through the nose/ mouth at a rate you feel comfortable
with.
You will need to practice your breathing regularly until
using your diaphragm more effectively becomes natural to
you.
Once you have mastered slow, rhythmical breathing while
relaxed, the breathing technique can be used for everyday
activities e.g. walking, stairs, lifting & bending.
PULMONARY REHABILITATION
PULMONARY REHABILITATION is a programme of care
delivered by health care specialists of different specialist
backgrounds for patients with COPD.
It consists of an education package covering many different
aspects of COPD & supervised exercise training sessions
over a given period of time.
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THE AIMS OF THE REHABILITATION PROGRAMME ARE TO:
Teach you about your chest condition & how best to
manage the symptoms.
Maximise muscle strength & endurance by providing an
appropriate exercise programme & on-going regime.
Improve emotional well-being & quality of life.
Increase confidence & independence in self chest
management & coping strategies
To find out more of the rehab course ask your GP, they will
access your suitability.
POSITIVE STEPS
To help you manage your COPD you should:
. Stop smoking
. Eat healthily.
. Take regular exercise
However, there could be other areas that you may want to
change that are not mentioned above.
SETTING GOALS
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Goal setting will help you to change the way you feel about
having COPD & may also help to raise your confidence.
The process of setting goals allows you to choose precisely
what you actually want to achieve. It helps to create long
term vision & short term motivation.
There are three key stages to making changes:
STEP ONE: Decide what you want to change, would it make
life better?
STEP TWO: Decide when to make the change, prioritise
your changes.
STEP THREE: Achieving the change, when will you know
that you have accomplished this?
IF YOU FIND IT DIFFICULT TO BEGIN TO CHANGE YOUR
BEHAVIOUR OR DO NOT KNOW WHERE TO START ASK
YOUR NURSE OR GP….IF IN DOUBT ASK!
KEEPING WELL CHECK LIST
STOP SMOKING!
ACT EARLY IF YOU FEEL YOUR BREATHING IS GETTING
WORSE.
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HAVE YOUR FLU JABS EVERY YEAR. MAKE SURE YOU HAVE
YOUR PNEUMONIA VACCINATION
TAKE AS MUCH REGULAR EXERCISE AS YOU CAN.
COVER MOUTH & NOSE WITH A SCARF WHEN OUT IN COLD
DAYS.
AVOID SUDDEN CHANGES IN TEMPERATURES.
CONSERVE YOUR ENERGY & CONTROL STRESS
CONTROL STRESS
Feeling stressed can make breathlessness much worse.
When you have trouble getting your breath, anxiety can
cause you to breathe even faster, tire your chest muscles&
lead you to panic. This cycle is common for people with
COPD but there are steps you can take to stop stress before
it over whelm you.
LEARN TO RELAX
Stress is less likely to build to anxiety if you know how to
relax yourself when you start to feel tense. Find what
works for you.
Try Yoga, prayer, meditation or listening to relaxing music.
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Some people like to get comfortable, close their eyes &
imagine themselves in a relaxing, pleasant place doing
something they enjoy. Concentrate- feel the soft breeze on
your face or the warm sand at your feet- think of whatever
relaxes you. Don’t stop till you feel relaxed. Slowly tense &
relax each part of your body. Start with your toes & work
all the way up to your scalp. Practice pursed lip &
diaphragmatic breathing.
MEDICINES
The majority of your medication may be in an inhaler but
there are many different types. The following pages will tell
you the names of the medication, how it works, when to
take them & the effects it may have on you.
If you are unsure about any of your medication, or are
having difficulty using your inhalers, contact your GP or
respiratory nurse, they will be able to help & suggest a
change of devise if need be.
All your medication comes with an information leaflet, it is
IMPORTANT that you read this. You should also inform
your GP or nurse about other medication you are taking,
this is IMPORTANT as all medicines have the potential to
react with one another. If you are using herbal or non17
prescription products you MUST consult the pharmacist to
ensure it is a safe thing to do.
Take your medicine regularly as prescribed & always
remember to order a repeat prescription in plenty of time
to prevent you from running out. If you are unsure about
any of your medication, or are having difficulty using your
inhalers, contact your GP or respiratory nurse, they will be
able to help & suggest a change of devise if need be.
All your medication comes with an information leaflet, it is
IMPORTANT that you read this. You should also inform
your GP or nurse about other medication you are taking,
this is IMPORTANT as all medicines have the potential to
react with one another. If you are using herbal or nonprescription products you MUST consult the pharmacist to
ensure it is a safe thing to do.
Take your medicine regularly as prescribed & always
remember to order a repeat prescription in plenty of time
to prevent you from running out if you are using herbal or
non-prescription products you MUST consult the
pharmacist to ensure it is a safe thing to do.
SPACER DEVICES
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Many patients are prescribed a spacer device to use with
their inhalers, these are very useful because: There is no
need to co-ordinate the pressing of the inhaler with
breathing in, plus using the spacer device enables more
medicine to reach the lungs, rather than the back of the
throat.
There is no impact of cold aerosol on the back of the throat
which sometimes makes people cough.
SHORT ACTING BRONCHODILATORS
The drugs are used to act on the muscles in the airways of
your lungs. They help to open the airways by relaxing the
muscle & are called short acting because the effect wears
off after approximately four hours.
These medications are normally in inhaler form:
Salbutamol (ventolin) . Ipratropium Bromide (Atrovent).
Terbutaline sulphate (bricany).
POSSIBLE SIDE EFFECTS
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Tremor. Nervous Tension. Headache. Palpitations.
Muscle Cramps. Flushing.
Atrovent can cause a dry mouth & can occasionally cause
urine retention & constipation.
LONG ACTING BRONCHODILATRS
These inhalers work in a similar way to the short acting
ones. They do not work as quick but their effect lasts a lot
longer, this is why you only need to take it either once or
twice a day, depending on your inhaler prescription.
These medications are: - Serevent. Oxis. Spireva.
POSSIBLE SIDE EFFECTS
Skin reactions. Tremor. Palpitations. Cramps. Local
irritation. Chest pain.
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Spireva can cause a dry mouth; also can occasionally cause
urine retention & constipation.
IMPORTANT
Please note that when taking Spiriva (Tiotropium) this will
take the place of Atrovent (Ipratropium). THEY SHOULD
NOT BE TAKEN AT THE SAME TIME
STEROID /ANTI-INFLAMMATORY INHALERS
Some patients may benefit from a steroid inhaler. These
inhalers must be taken regularly every day to achieve any
benefit as they help to reduce inflammation in the airways.
These medications are: Becotide. Flixotide. Pulmicort.
POSSIBLE SIDE EFFECTS
Hoarseness of the voice. Thrush of the mouth. Rash (rare).
Rinse your mouth after using an inhaler whenever possible.
Your GP may put you on combination Therapy:
Seretide…Purple inhaler. Symbicort…Red/white inhaler
RESCUE MEDICATION (EMERGENCY PACK)
There will be times when your condition worsens due to an
infection, the weather or pollution, so it is recommended
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that you have at home the EMERGENCY PACK, of steroids &
antibiotics. Talk to your GP or respiratory nurse about this.
Taking the above medication when the symptoms begin
will make a difference as to how you will feel sooner rather
than later.
REMEMBER PREVENTION IS BETTER THAN A CURE.
OXYGEN THERAPY
If your COPD worsens it may be necessary to have your
oxygen levels checked. If your levels are less than 93% you
may benefit from oxygen therapy.
If you are prescribed Oxygen it is important to keep it at
the prescribed dose, DO NOT increase the flow rate
yourself.
NEBULISER THERAPY
Nebulisers are sometimes used . Like all medication, follow
the dosage prescribed. It, s to treat severe exacerbations
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for a short term, they deliver the same drug but in a much
larger dose. The hospital will loan you one for the short
term if available but you can buy one at a reasonable price,
always handy to have one just in case. The nebuliser is to
be used short term only.
IDENTIFYING ENVIRONMENTAL IRRITANTS
Knowing what bothers your COPD & irritates your lungs
will allow you to avoid things that make your breathing
worse.
Some of the easiest ways to help prevent your COPD
getting worse are:
Stop Smoking, for help see your GP/nurse, there are many
new smoking cessation aides available. Tell others not to
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smoke around you or in your house because of your
condition.
Take care using hair sprays, perfume, & other type of
aerosol. Leave the room once you have used the aerosol &
try not to inhale any of it as this will affect your breathing.
Be careful of dust, wind & cold or humid weather, all these
things can make you cough or make your breathing
difficult. If you have to go out in that sort of weather limit
the time & cover your nose & mouth with a light covering,
i.e handkerchief, this will stop dust from going into your
nose & throat.
EXERCISE & YOUR LUNGS
PHYSICAL EXERCISE
People with long term lung problems as COPD may find
their lungs unable to provide enough oxygen for their
muscles to perform even simple actions like walking short
distances the lungs may struggle to keep up, which causes
breathlessness.
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Through exercise you can train your body so that more
oxygen is delivered to your muscles. Unfortunately some
COPD sufferers are afraid to exercise, this is partly due to
the fact they are worried about getting breathless, which is
untrue as gradually building up the exercise you take can
improve your breathing & feel better.
IMPORTANT: You should discuss your exercise plan with
your GP before you begin. If at any time you feel sick, get
dizzy or feel pain STOP IMMEDIATELY & see your GP/Nurse.
ACTIVITY REFERRALL SCHEME
If all the benefits of physical activity could be put
into a pill everyone would take it.
The REFERRAL SCHEME is a country wide scheme & is
available through your GP/Nurse. They can refer you into a
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tailor made exercise programme at your local leisure centre
to assist & support you with managing COPD. A qualified
instructor will then prescribe you a personal exercise
programme. Here in Northampton there is the easy
breathers exercise group which has its own professional
instructor & a respiratory nurse . More on easy
breathers later.
REMEMBER EXERCISE IS IMPORTANT TO YOU & YOUR
WELLBEING.
LIVING WITH COPD
What a daunting thought you may ask yourself? Yes at first
it may seem so, the anxiety, the doubt, the panic, & so on.
It is not as bad as you may think, if you are sensible about
your condition & take your time. Your quality of life is
down to you, do as much as you can when you can. Having
COPD need not to be the end of the world.
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There’s an old saying WHAT CANNOT BE DONE TODAY CAN
BE DONE TOMORROW, nothing is more important as your
health!
People cope with situations differently; in time you will
find your way that suits you in everyday activities. Most
people with COPD learn how to pace themselves to avoid
getting worn out throughout the day. There are self-help
groups in your area, to give you support, where you can
learn from others how to cope with daily living activities.
HELP IS OUT THERE
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The specialists involved with Pulmonary rehabilitation,
(THE RESTART TEAM in NORTHAMPTON or THE ROCKET
TEAM in KETTERING), can give you additional advice on
making your daily routine less taxing & tiring.
THE KEY IS REST WHEN YOU NEED TO & TAKE YOUR TIME!
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RELATIONSHIPS
Sexual Relations. YES, it is still possible even when you
have COPD.
Here are some suggestions that might encourage affection
& renew your pleasure during sexual activity.
Talk to your partner about your concerns & ways in which
you may be able to prevent the appearance of your
symptoms.
Build up your tolerance to effort by walking or exercising.
Never rush things.
Allow your partner to play a more active role.
Use your inhalers 30-60minsutes before sexual activity, do
your chest clearance exercises.
Keep your medication close at hand.
Try different positions which least compress your chest.
Talk to your GP if you are unable to have sexual relations.
There is no reason why you should not be able to still have
loving relationships with each other. The only caution is if
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you are breathless at rest. If this is the case then sexual
activity will cause you anxiousness. Try to start slowly &
just enjoy each other’s company in a loving atmosphere, do
not rush, or be disappointed. You as a couple will set your
own ground rules for this.
TRAVEL
If you are planning to travel it is advisable to talk to your
GP/Nurse before booking. It is a good idea to take extra
supplies of your medication with you. If you are flying
check with the airline reference adequate oxygen during
flights. It is also
a good idea to
have your
medication in
your hand
luggage for easy
access. There
are also
portable
nebulisers that
are small & compact if needed.
SELF HELP GROUPS
There are self-help groups & organisations in your area
where you can get different ideas from other sufferers as
how to cope with different circumstances that may work
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for you too or vice versa. This will give you a chance to
socialise whereas before you may have thought otherwise
due to your condition or that you felt isolated because of it.
Many groups organise trips out & social events where
everyone is equal, Speak to your GP/nurse about your local
group.
NORTHAMPTON
Easy breathers are an independent support group for
people living with & affected by a lung condition & for
those who care for them. Many people with COPD & their
carers face a daily battle to live a relative normal life.
Becoming part of easy breathers helps to strengthen the
voice of everyone living with lung disease, helping to
encourage improvement in services & making others take
COPD seriously.
The group also gives them the opportunity to make new
friends with the same complaint & at the same time learn
different ways of coping with day to day life. See how you
grow in confidence when you are in the same boat as other
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sufferers. There is no need to feel isolated anymore, come
along to one of our friendly meetings where you will be
made welcome. The group also organises trips out, social
events also fund raising.
easy breathers also have an exercise group which is held at
Danes Camp Leisure Centre every Thursday at 1pm-3pm.
Also there is an easy breathers walk group .Which are both
beneficial to the COPD sufferer.
easy breathers self-help group meet every third
Wednesday of the month at the Northampton WMC, Sheep
Street, Northampton, at 1pm to 3pm. Although there is a
light lunch available at 12 noon if pre-booked, for more
information please ring Larry Mann (chairman) 01604
638433/07719141976
COPD sufferers & those that care for them can often feel
alone, there’s no need anymore.
OTHER GROUPS
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. There is another independent group, AIRWAYS that are in
KETTERING, CORBY, and RUSHDEN & WELLINGBOROUGH.
Contact details of the above can be obtained from the
ROCKET TEAM (Kettering General Hospital) 01536 493558
breathe easy Daventry meet every third Monday of the
month, from 2pm to 3pm, at Daventry New Street Day
Centre, New Street, Daventry. NN11 4BT
Please ring the British Lung Foundation Midland office
before going to your first meeting at Daventry by
contacting them on phoning 0116 249 5780. They will give
you the groups contact details
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