Stage 3 of COPD marks a patient's entry into "severe COPD". Symptoms you are already used to, like breathlessness, tiredness, and wheezing, persist and worsen. Your daily life will be profoundly affected by your COPD at this point, and flare-ups may require hospitalization.
1. Managing more severe shortness of breath
You’re probably familiar with being out of breath by now. In stage 3 of COPD, your breathlessness becomes even worse. That means that even light activities can now easily tire you out. Sometimes dyspnea can even become life-threatening. Because of this, your treatment plan is likely to change:
- Stage 3 patients continue to use short-acting bronchodilators. These “rescue inhalers” are great to carry around for when you're feeling out of breath.
- However, they may not be enough any more, so you will likely also be prescribed long-acting bronchodilators which are designed to offer long-lasting relief.
- Aminophylline and theophylline, which relax your airways, can also be added to your treatment plan. If you do take these drugs you might have to have blood tests to see how much medication you took and to lower your risk of suffering side effects.
- Nebulized treatment may be used in severe cases of COPD if you are unable to use inhalers. This requires a machine that delivers your medication in mist form, and which patients inhale through a mask or mouthpiece.
- Pulmonary rehabilitation, a program that combines exercise, breathing techniques, and education, is often started during Stage 2 of COPD. It can continue to be an invaluable part of your COPD management plan during Stage 3, increasing your quality of life as well as prognosis.
2. Managing your increased risk of respiratory infections
This is why it is crucial to minimize your risk, which starts with preventative steps:
- An annual flu shot becomes essential — research shows that they cut your risk of severe flu complications and death by about 50 percent.
- Pneumococcal vaccination, also called the "pneumonia vaccine", reduces your risk of developing bacterial pneumonia. Stay up to date.
- Steps that work for everyone, such as washing your hands regularly and properly, staying away from sick people, and disinfecting surfaces regularly, can also help you.
- Because you are vulnerable, ask people in your life to be mindful to avoid contact with you if they are showing signs of a respiratory infection.
Should you show signs of a lung infection, you may be prescribed a course of antibiotics, will be monitored closely, and will be admitted to hospital if necessary.
3. Coping with airway inflammation in Stage 3 COPD
As COPD progresses, the lungs become chronically inflamed and the airflow severely limited. The later stages of COPD are marked by an increased risk of more frequent exacerbations. Also called flare-ups, these are periods of time during which symptoms suddenly become worse. Airway inflammations can also increase your risk of getting lung cancer and cardiovascular disease (CVD).
To manage airway inflammation, new medications may be introduced to your COPD treatment planm and these are:
- Steroids. If you have reached Stage 3 COPD and experience flare-ups regularly, oral and inhaled steroids can really help you. You can use inhaled steroids when your symptoms are relatively stable. The oral form, on the other hand, is used when your symptoms get worse very quickly and suddenly, in which case oral steroids are typically prescribed for seven to 14 days. Use steroids for too long can induce worrying side effects like extra weight, brittle bones (osteoporosis), ankle and foot swelling, and mood swings.
- Daliresp (roflumilast), a phosphodiesterase-4 (PDE4) inhibitor, fights lung inflammation that COPD patients experience. PDE4 inhibitors should be taken once every day. This medication fights exacerbations and usually doesn't have many side effects. PDE4 helps you with airway inflammation where other therapies can't.
- Stem cell therapy is fairly new, and some COPD patients may be candidates. Stem cell therapy helps with COPD symptoms, and that includes airway inflammation.
4. Managing low oxygen levels in your blood
In stage 3 of COPD, your lowered lung function can also result in low oxygen levels in your blood. Because this can become life-threatening, your doctor might recommend for you to start oxygen therapy at home, which can be done through a mask or nasal tubes. While oxygen therapy helps raise your blood oxygen levels, it can't treat some of the more common symptoms, like shortness of breath. Oxygen can really help you when you reach stage 3, and portable devices that offer you the oxygen you need when you are out and about are also available.