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8 Steps to Help You Manage COPD Exacerbations

Reading time | 7 mins
COPD exacerbations tend to happen more in winter. Barbara Moore shares the steps she takes to reduce her risk.


Living with COPD is challenging, especially when you have a COPD exacerbation.

I’ve been through three major exacerbations that left me on a ventilator in the intensive care unit (ICU). They were terrifying not only for me, but also for my family, who never left my side.

With each hospital stay, I was taught the best coping mechanisms to manage this disease. I listened and learned from the doctors and nurses as I was schooled on the signs and symptoms of the changes in my COPD and how to best cope with them.

Exacerbation is now the first thing I think of anytime my voice is a little raspier, I have a sore throat, my breathing becomes hard, or I can’t do my exercise routine.

I’m super vigilant about COPD exacerbations. I know how fast a cold can turn into pneumonia. If my breath becomes so short that I hyperventilate, I don’t hesitate to call an ambulance. I usually wake up in the ICU on a ventilator.

What are COPD exacerbations?

COPD exacerbations involve worsening of COPD symptoms, like shortness of breath, coughing, and changes in mucus.

Most COPD exacerbations are caused by infections like the common cold or flu. And exacerbations tend to happen more often in winter, possibly due to a seasonal increase in circulating cold and flu viruses, as well as greater susceptibility to viruses due to an increase in airway inflammation.

COPD exacerbations can be serious, so it’s important to get in touch with your doctor right away if you think you might be having one. They can lead to more serious consequences like hospitalization and lung failure without prompt treatment.

Here are my top tips that help me prevent and manage COPD exacerbations:

Get vaccinated

One of the most important steps you can take to avoid a COPD exacerbation in the first place is to get your recommended vaccinations. Ignoring these shots can land you in hospital.

Be sure to get a flu shot every year. Research has shown that flu vaccines reduce the chances of being hospitalized by 38 percent. Those are very good odds.

COPD exacerbations also increase your risk for pneumonia, which can be deadly. If you have COPD, it’s a good idea to talk to your doctor about getting a pneumonia vaccine.

I get my flu shot every October and stay up to date on all other shots like pneumonia, tetanus, shingles, and any other boosters recommended by my doctor.

Talk to your doctor

We’re all different even though we have the same disease. Have a frank talk with your doctor about your COPD. Together you can create a COPD action plan. This is a set of instructions you should follow at the first sign of a COPD exacerbation. Your plan should be unique to you and may be different than mine.

Ask your doctor what makes sense for you and how and when to carry out your action plan. Be sure to include when to take meds like steroids and antibiotics and when to go to the emergency room. Regularly review your plan with your healthcare provider.

Prepare your medicine cabinet

I’ve noticed that I always seem to get sick after office hours or during the weekend. That’s why I have a standing prescription with my pharmacy.

My doctor told me that it makes sense to have prescriptions for medication in my possession. That way I have it on hand in case I get sick and need my medication right away.

Keep a record of your symptoms and appointments

Your main task now is to learn as much as you can about your COPD. I even keep a journal of my symptoms. This gives me evidence-based proof of what triggered the changes in my symptoms.

Think about what you want to track. Every day, I write down:

  • my exercise
  • my BORG Scale estimate (or my perceived exertion during exercise)
  • weather conditions
  • morning weight
  • how I felt overall throughout the day
  • any doctors’ appointments, medications, and any tests I have along with the results

I also keep a daily gratitude journal to remind me that life is better when I feel grateful.

Keeping track of all of this information encourages you to self-advocate in the future.

Remember to take your journal to your doctors’ appointments and wow them with the information you’ve gathered. It helps to optimize your 15-minute visit.

Always follow your treatments as prescribed

Not everyone is prescribed medications for COPD. Some people are prescribed medications to take regularly or every once in a while. Your doctor might also recommend oxygen therapy or pulmonary rehabilitation.

I take various inhalers three times a day. I was also prescribed a 4-month round of pulmonary rehab, and it was the best thing I ever did for myself. I learned how to pace myself through exercise and how to use pursed lips when exerting through daily tasks and my fitness routine.

My pulmonary rehab also included a class on cognitive behavioral therapy. We learned to be mindful and to stay in the moment. This is especially helpful when I become short of breath.

Soon after rehab, my doctors felt it was a good idea for me to be on continual supplemental oxygen to help my lungs keep my heart from being too overworked.

Follow your doctor’s recommendations. Take only what’s prescribed and be sure to finish all of your medication. These therapies can help improve your quality of life and reduce your risk of exacerbation and hospitalization.

Talk to your doctor if you feel you need more help managing coughing.

Take it easy

After an exacerbation is not a time to overdo it. But exercise is important for your health and may improve your quality of life. Take your time and ease back into your exercise routine. This is the time to use your supplemental oxygen, if your doctor prescribed it.

I consider an exacerbation a reason to start over again. I give myself permission to take it easy. I go slowly and gradually increase the amount of exercise I do each day.

Ask for help

Never be afraid to ask for help from friends and family. Nobody knows what you need if you don’t tell them.

Most people are more than happy to be asked for help and will do what they can to provide you with what you need.

My daughter is a social worker. The best advice she gave me was to never let anyone tell me what I need and to always make my needs the top priority. I learned then to voice my requirements by saying, “wait,” “just a minute,” “I need to sit,” and “let me catch my breath.” No one has told me that my requests were not important.

Surround yourself with people who are interested in your health and want you to be happy and healthy. If people in your circle aren’t willing to help you, it’s time to eliminate them. Find a new circle.

Eat a well-balanced diet

Nutrition is an essential part of your care plan. The food you eat can affect how you breathe.

Many people with COPD find that eating a diet with fewer carbohydrates and more fat helps them to breathe better. That’s because carbohydrates produce the most carbon dioxide, which you exhale. That means they cause you to breathe more often.

Here are a few more tips for eating with COPD:

Time your meals in a way that works for you

Some people find it easier to eat their biggest meal earlier in the day if they’re too tired to eat later. Others find it easier to have six small meals per day. I tend to feel better when I eat small meals. Sometimes I feel like I’m eating all day, but it helps me to never feel hungry or bloated.

Focus on complex carbohydrates like vegetables, fruits, and whole grains

I find ways to sneak more vegetables in my diet by adding ground veggies to pasta sauce, hamburger, stuffed chicken, and egg dishes. Fruit can be an alternative to sweets. Cut up several different ones you’ve never tried and pick at them all day instead of cookies.

Eat two servings of protein daily

Foods like eggs, lean meats, beans, cheese, fish, and poultry help to build better respiratory muscle tone.

Minimize trans and saturated fats

Eat more monounsaturated and polyunsaturated fats found in plant foods, like avocados and olive oil.

Minimize sodium and sweets

Minimize the amount of sodium you eat to reduce swelling. Swelling can increase blood pressure. Also try to cut back on sweets to reduce the amount of carbon dioxide that you breathe out and to lessen the work on your lungs and heart.

Stay hydrated

Drink plenty of water to keep mucus loose and easier to remove.

Managing COPD never gets easy. But knowing the steps I can take to help reduce my risk for exacerbation and how to handle things if I do get sick, certainly help me to feel more in control and confident.

For more information on how to manage COPD, reach out to your doctor or healthcare team.

NPS-US-NP-00674 JUNE 2020