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.
For years, you've enjoyed relaxing with a cigarette in your hand, and looked forward to your cigarette breaks at work, but now, all of that smoking has caught up with you. You're coughing, wheezing, often out of breath. Could you have chronic obstructive pulmonary disease? Let's talk about chronic obstructive pulmonary disease, or COPD, for short. COPD is a lung disease that's usually caused by smoking, although some people who smoke for years never get the condition, while a few get COPD even if they've never lit up. Most people with COPD have a combination of a cough that just won't go away, called chronic bronchitis, and lung damage, called emphysema. The symptoms of COPD can sneak up on you slowly. Over time, you'll develop a cough that lingers, day after day. You'll feel tired, and have trouble catching your breath. Only your doctor can tell for sure whether this is COPD. To test for it, you'll need to breathe or blow into a machine as hard as you can, and hold that breath, as long as you can, in a test called spirometry. You may also need to have a blood test to determine how much oxygen and carbon dioxide is in your blood. If you have COPD, the ways things stand now, you'll have it for life, as there is no cure for this disease. However, there are ways to control the condition and help you breathe more easily. The first thing you do, absolutely need to do, is stop smoking, which will help slow down the damage to your lungs. A few medicines can help relieve COPD symptoms. You may breathe in a bronchodilator medicine through an inhaler to open up your airways, or take steroids to bring down the swelling in your lungs. If you're having real trouble breathing though, call your local emergency services number. You may need to visit the hospital for oxygen or breathing assistance. You may also need to take antibiotics during flare-ups, because getting an infection can make your COPD worse. Though it may be hard to exercise when you're feeling out of breath, staying active will help keep your muscles strong. Your doctor can teach you how to breathe in a different way so that you can exercise with COPD. You can help avoid the shortness of breath, the coughing, and the wheezing of COPD by butting out, kicking your cigarette habit as soon as possible. Not smoking is the absolute best way to prevent COPD. Ask your doctor about programs and medicines that may make it easier for you to quit.
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 health care provider 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 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 with your provider about how much oxygen is safe to use and what oxygen saturation to aim for.
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 medicines.
- 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 and a COVID 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.
- Minimize going up and down the stairs.
- 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 provider if your breathing is:
- Getting harder
- Faster than before
- Shallow, and you cannot get a deep breath
Also call your provider if:
- You need to lean forward when sitting in order to breathe easily
- It is difficult to speak even a few words without being short of breath
- 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.
Dominguez-Cherit G, Hernandez-Cardenas CM, Sigarroa ER. Chronic obstructive pulmonary disease. In: Parrillo JE, Dellinger RP, eds. Critical Care Medicine. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 38.
Global Initiative for Chronic Obstructive Lung Disease (GOLD) website. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2023 report.
Han MK, Lazarus SC. COPD: clinical diagnosis and management. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 64.
National heart, lungs, and blood institute website. COPD.
Version Info
Last reviewed on: 1/20/2022
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.
