COPD — chronic obstructive pulmonary disease — creeps up on you slowly. When you first begin noticing symptoms, it's easy to wave them off as a cold or a side effect of aging. As COPD gets worse, however, it will have more of an impact on your life. By the time you're in Stage II, or have moderate COPD, you'll most likely no longer be able to dismiss your symptoms so easily. If you're not diagnosed yet, you will almost certainly see a doctor, ultimately leading to diagnosis, in this stage.
1. Shortness of breath (dyspnea)
Dypnea and shortness of breath — is a symptom that almost all COPD patients experience. It can be caused by emphysema or chronic bronchitis, and is a direct result of damaged lungs and the increased effort it takes to inhale and exhale. While breathlessness isn't usually very invasive in stage I of COPD, it becomes worsen during stage II. You're especially likely to feel out of breath when you're physically active, including when you just take a short walk.
How is it treated?
There are a few different ways to battle breathlessness if you have moderate COPD, but prescription medications will be in your life at this point. They include:
- Short-acting bronchodilators, AKA "rescue inhalers", which you take when you suffer from acute dyspnea. They kick in fast — around 15 to 20 minutes — to help you with your breathlessness, and their effects can last up to six hours. Albuterol (salbutamol, Ventolin) is one example.
- Long-acting bronchodilators, which act preventatively to increase your quality of life and have effects tha tlast 12 hours or beyond, often enter the treatment picture once you have moderate COPD. You use these regardless of symptoms severity, to keep your COPD under control.
- Combined bronchodilators feature different medications in one inhaler. They include Perforomist (formoterol), Arcapta Neohaler (indacaterol), Serevent (salmeterol), and Spiriva (tiotropium bromide).
Exercise, too, can play a role in managing breathlessness. You may be afraid that working out will just increase your dyspnea, but actually, being sedentary means you'll become unfit, and daily tasks will represent even more of a strain. Talk to your doctor about exercise plans before implementing them, though!
2. A persistent cough
How is it treated?
This one's tough, as it's not clear yet. Because COPD-related coughs can be productive, antiussives aren't generally recommended, as they could interfere with sputum clearance. In some cases, you may be prescribed:
- Antibiotics, as one study showed that this reduces coughs and sputum volume.
- While research doesn't suggest that inhaled steroids make much of a difference to your cough reflex, inhaled anti-cholinergic medications might.
3. Increased phlegm production
How is it treated?
Treatment depends on the cause and symptoms. Changes in mucus can point to a flareup or infection, and thick mucus can also make it very hard to clear your airways by coughing. Depending on the exact circumstances, your doctor may suggest:
- Increasing your fluid intake to dilute the mucus and make it less difficult for you to cough it up.
- Carbocisteine, a medication that targets mucus, may be prescribed for people with thick mucus and a chesty cough.
- Your doctor can demonstrate different ways to effectively clear mucus.
- Keep using your prescription meds as instructed.
- Infections are treated appropriately — more about this now.
4. A higher risk of respiratory infections
How is it treated?
Prevention is better than cure, and all COPD patients should receive their annual flu shots and also stay up to date on pneumococcal (pneumonia) vaccination. Should you believe you have a respiratory infection, seek medical attention right away. Antibiotics will be prescribed where the infection is bacterial.
5. Fatigue
How is it treated?
There are a few ways to deal with fatigue during stage II COPD:
- Continue to exercise. It may seem counter-intuitive, but it works; research shows that more physically active people with COPD feel less tired than those who are mostly sedentary. Exercise can even increase your life expectancy. So, what workout is right for you? Both cardio abd strength exercises are good for you, as are breathing exercises. Ask your doctor before commencing a new exercise routine, as you want to make sure that your workouts help, rather than harm, you.
- Make a healthy diet a priority. Eating well makes an important contribution to your energy levels as well as your overall health.
- Do what you can to get a good night's sleep. Sleep deprivation, unsurprisingly, worsens fatigue. While your COPD symptoms can themselves interfere with your rest, now's the time to look into sleep hygiene, and to practice it.
6. Acute exacerbations or COPD flareups
Signs that you are dealing with one can include:
- Increased shortness of breath
- Changes in mucus production (you may notice more or less mucus), and changes in the color and texture of your phlegm
- Increased cough
- Confused
- Worsened fatigue and an inability to sleep
How is it treated?
Your doctor and you should come up with a management plan for exacerbations in advance. This may include:
- Steroid inhalers, such as Symbicort, which reduce inflammation and offer longer-term as well as instant relief.
- Antibiotics are prescribed if your flareup is related to a bacterial infection.
If you are suffering from a sudden worsening of your symptoms that doesn't get better with your usual medications, and you're scared, never hesitate to seek immediate medical attention; it could save your life.
The bottom line
Stage II COPD is marked by more intense symptoms than mild COPD. During this time, your chronic obstructive pulmonary disease becomes more invasive, and you will need new medications and proper support from your doctor to maximize your health and quality of life. Pulmonary rehabilitation is often a part of this, which research revealing that this integrative approach reduces symptoms, leads to increased wellbeing, and helps you life your life as fully as possible. It includes exercise, advice from a nutritionist, and education on managing life with COPD.