What to Know About COPD Treatment

The most common questions about COPD treatment, answered.

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This article was sponsored by one of Canada’s leading healthcare companies. All views expressed by Dr. Marciniuk are his own

Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis, affects more than 2 million Canadians, causing lung damage and making it harder to breathe. The symptoms of COPD—shortness of breath, chronic coughing, increased mucus or phlegm—get progressively worse over time, and daily tasks can become extremely challenging. Even simple activities like walking and climbing stairs can be difficult. If you experience any of these symptoms, it’s important to be proactive and speak to your healthcare provider. While there is no cure for COPD, it can be treated and managed to improve symptoms and quality of life. Your healthcare provider can determine the best treatment plan for you. Because of the progressive nature of COPD, it’s important to continue to have ongoing treatment discussions with your healthcare provider to ensure the best possible management of the disease and help minimize its impact on your overall health.

Here, Dr. Darcy Marciniuk, a Professor of Respirology, Critical Care and Sleep Medicine, and Associate Vice-President Research at the University of Saskatchewan, Saskatoon, answers some of the most common questions about COPD treatment.

Q: When should I reach out to my healthcare provider about my symptoms?

A: It is important to be assessed by your family physician, nurse practitioner, COPD nurse-clinician, or lung specialist if you are unwell. If you are unsure about your symptoms, it’s wise to contact them at an early stage before you become very sick. But remember that regular assessments, even when you are stable and well, are vital to optimize your management and prevent issues from occurring.

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Q: I’ve been diagnosed with COPD, what should I look for to know if I need medical attention?

A: Worsening shortness of breath, increased phlegm or mucus production, or a change in mucus colour are often associated with a COPD exacerbation or ‘flare-up’—these symptoms should never be ignored or minimized. Other symptoms such as decreasing activity or chest pain should also lead to you getting assessed. And finally, you should seek medical attention any time worrisome new symptoms develop.

Q: What information about living with COPD should I tell my healthcare provider at a regular check-up appointment?

A: It is important to share how you are feeling, what you are able and not able to do, and update them on any changes in your condition since you were last assessed. They will review your medications, vaccination status, level of activity and answer any questions you may have. If you are a smoker, it is important to together discuss effective steps to becoming a non-smoker, which is the most essential step in COPD management.

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Q: I am diagnosed with COPD and am using puffers daily but feel I am getting worse. What should I do?

A: If you are feeling unwell or getting worse, you should contact your family physician, nurse practitioner, COPD nurse-clinician, or lung specialist. The medications only work when we take them as prescribed and have proper technique, and we are fortunate that our inhaled medication are generally very safe and free from life-threatening side-effects. So, this would be a good time to reassess your medication(s), although it could also be an early sign of worsening in your underlying COPD, or other condition or illness.

Q: COPD can place such a burden on my life. What do you believe is possible for COPD patients?

A: People suffering from COPD need to raise their expectations of what they can do and how they can feel. With recent advances in management, it is possible for most people with COPD to live ‘more normal’ and experience the joys that others without COPD experience. And even if you have significant COPD, you should reasonably expect to feel better and do more with current effective management.

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Q: What advice would you give to someone living with COPD who is newly diagnosed compared to someone who has had COPD for 5+ years?

A: If you have been recently diagnosed with COPD there may be an initial period of investigations and changes in medication. This could feel unsettling, but these are being done at the beginning to better understand your condition and find the best management for the long term. As time passes you will appreciate what you are able to do (rather than just what you are not able to do) and you will also likely appreciate that you are able to do more and lead a more normal life than you initially thought. The goals after this initial stage are the same as for someone who has been living with COPD for years, that is to reduce symptoms, increase activity and exercise, and prevent complications and flare-ups—our current therapies are effective in achieving those goals.

Q: I have been taught the proper techniques for using my inhalers, but the medications do not seem to work as well as they used to. Why is that, and how do I know that I am taking the right medications?

A: This is a good reason to connect with your family physician, nurse practitioner, COPD nurse-clinician, or lung specialist. The medication may indeed need to change, but it is also possible your technique needs a tune-up. Your provider will also reassess your COPD and ensure that another condition or issue has not appeared. In some instances, you may be experiencing symptoms because you are doing more—this is very good. In this case other therapies such as Pulmonary Rehabilitation may be appropriate to further improve your symptoms and COPD management.

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Q: I am interested in better managing my COPD. What resources are out there?

A: The national or provincial Lung Associations are very good resources to access and become better informed. Another rich resource my patients find very useful is the Living Well with COPD site. From my practice I know that people who are better informed are also better able to mange their condition and lead a more normal life.

Speak to your healthcare provider to determine the best treatment plan for you.

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