Download Chronic Obstructive Pulmonary Disease A Patient

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Chronic Obstructive Pulmonary Disease
A Patient Information Booklet
Acknowledgements for information in this booklet go to:
The Australian Lung Foundation, State of Queensland.
COPD-X Plan – Australian and New Zealand Guidelines for the management of COPD. David K McKenzie,
Michael Abramson, Alan J Crockett, Nicholas Glasgow, Sue Jenkins, Christine McDonald, Richard
Wood-Baker, Peter A Frith on behalf of The Australian Lung Foundation. The COPD-X Plan:
Australian and New Zealand Guidelines for the management of Chronic Obstructive Pulmonary
Disease, 2010.
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www.health.act.gov.au | www.act.gov.au | Enquiries: Canberra 13ACT1 or 132281 | Publication No 11/1282
Contents
How the lungs work
2
Understanding COPD medications and devices
4
Smoking and COPD
7
Working together with your healthcare team
8
Protecting against chest infections
9
Exercise/Pulmonary Rehab
10
Nutrition
11
Home oxygen
12
You are not alone!
13
A Patient Information Booklet 1
How the lungs work
How the lungs work
Each time you breathe in, air rushes in through your nose and mouth, and
travels down your windpipe. The windpipe divides into two smaller tubes
(bronchi) that lead to the right and the left lung. Within each lung these tubes
divide and become smaller and smaller – and lead to tiny air sacs (alveoli). It
is in these sacs where an exchange between oxygen and carbon dioxide takes
place. The oxygen you get from breathing in moves from the air sacs into the
bloodstream; and the carbon dioxide moves back into the air sacs from the
bloodstream ready to be exhaled.
Throat (pharynx)
Windpipe (trachea)
Lung
Voice (larynx)
Bronchi and
Bronchioles
(Picture courtesy of “Better living with COPD – a
patient guide” Australian Lung Foundation 2008)
Air sacs at the base of the
small airways where gas
exchange takes place.
(Picture courtesy of “Better living
with COPD – a patient guide”
Australian Lung Foundation 2008).
2 Chronic Obstructive Pulmonary Disease
COPD stands for Chronic Obstructive Pulmonary Disease. It is a chronic
condition of the lungs where the small airways are damaged. Damage to the
airways means they become narrower, making it harder for air to get in and out
of the lung. Conditions of COPD include chronic bronchitis and emphysema. All
these conditions cause chronic obstruction of airflow through the airways.
Symptoms of COPD include:
• Shortness of breath during activities
• Coughing
• Increased mucous production (coughing up phlegm).
COPD usually occurs in people who have smoked or continue to smoke
cigarettes. Exposure to irritants like dust and fumes can also increase the risk
of developing COPD.
A very small proportion of COPD cases are caused by an inherited problem.
The most accurate way to diagnose COPD is by performing a lung function test
called spirometry. This can be done by your GP or respiratory specialist.
COPD is a chronic condition. Although there is no cure, there are many steps
you can take now to reduce the impact of symptoms and increase your quality
of life. Learning as much as you can about what you can do to manage COPD
will help you feel more in control of your health and your life.
A Patient Information Booklet 3
How the lungs work
What is COPD?
Understanding COPD medications and devices
Understanding COPD medications and devices
Managing your medications is very important. It is essential that you
take your medications as instructed by your doctor, even when you feel
well. When you take medication as prescribed, you may be able to better
manage your COPD. Although medications cannot cure COPD, when used
as instructed they can go a long way towards reducing your symptoms
and preventing flare-ups. Learn how your medications work. This will
help you understand why you need to take them. If you are worried or
confused about your medications and how to take them, talk to your doctor,
pharmacist, and nurse. Do not be afraid to ask questions.
Here is a checklist of what you should know
about each of your medications:
What is the medication for?
How does the medication work?
When is the best time to take the medication?
How long is the dose effective for?
What are the possible side effects of the medication and how can
you avoid or reduce them?
Will the medication cause any problems with other medications
you are taking?
4 Chronic Obstructive Pulmonary Disease
Relievers
Relievers should be used when you experience a sudden increase in your
breathlessness. These work by relaxing muscles that may have tightened
around the airways, making the tubes wider. This allows the air to move in
and out more easily. They work within minutes and their effects last for a few
hours. Always make sure you carry a reliever inhaler with you, just in case.
Examples include Ventolin, Bricanyl, Airomir and Asmol.
Maintenance medication
Like relievers, these medications also open up the airway tubes. Maintenance
medications usually take a longer time than relievers to start working, but
their effects last longer. Examples include Spiriva and Onbrez (effects last 24
hours) and also Atrovent (effects last 4 hours).
Preventer medication
Preventer inhalers can contain steroids. They help to reduce the number
of flare-ups you may experience. Preventers work by reducing the inflammation
on the inside of the airway which causes swelling and mucous production in your
airways. Just like maintenance medications, preventers must be taken every day
to be effective. Examples include Pulmicort, Flixotide, Alvesco and QVAR.
Combination medications
Some inhalers contain both a maintenance bronchodilator and a preventer
(steroid) so that you receive both medications together when you use the
inhaler. Examples of this include Seretide and Symbicort.
“It is very important that you rinse your mouth out with water after
using inhaled steroids, to prevent the common side effects of hoarse
voice, irritated throat and oral thrush.”
Antibiotics
They help the body fight bacterial infections. People with chronic lung disease
are more likely to develop bacterial infections in their chest. In the majority
of cases, antibiotics are needed to fight the infection. It is important that
you take the full course as prescribed, and if you do not feel better by the
completion of the course you need to contact your GP.
A Patient Information Booklet 5
Understanding COPD medications and devices
Types of medication:
Understanding COPD medications and devices
Using your inhaler
There are different types of inhalers and
it is important that you learn how to use
them correctly. If you do not use the
inhaler properly than you will not get the
full benefit from your medication. Make
sure you read the instructions that come
with your inhaler before you use it. Ask
someone to watch you while you use
your inhaler to check your technique.
People who can check your technique include:
•
•
•
•
Your GP/ Specialist
A nurse
Your pharmacist
someone from your pulmonary rehabilitation team such as your
physiotherapist.
Spacers should be used with all puffers. Spacers deliver more medication
effectively to your lungs rather than into your mouth. Spacers should be
cleaned monthly, washed with warm soapy water and left to air dry- do not
rinse the soap out or dry with a cloth.
(Picture courtesy of http://www.rch.org.au/emplibrary/kidsinfo/largespacer.jpg)
6 Chronic Obstructive Pulmonary Disease
Stop smoking is the single most important thing
you can do to help your chronic lung disease. It
will improve your lung health and help slow down
worsening of COPD. Do everything you can to give
up smoking for good. Your health depends on it.
Most people need help to quit smoking. Ask
for help from your doctor, pharmacist or nurse.
Nicotine replacement therapy and prescription
anti-smoking medications may help you quit.
The National Smoking Quit line can provide assistance, contact them by:
Ph: 137848 | Website: www.quitnow.info.au
The Cancer Council ACT offer smoking cessation information and courses.
They can be contacted by:
Ph: 02 6257 9999 | Email: [email protected]
The Chronic Care Program at Canberra Hospital runs a Quit Now smoking
cessation program, phone 02 6244 2273 to see if you are eligible.
A Patient Information Booklet 7
Smoking and COPD
Smoking and COPD
Working together with your healthcare team
Working together with your healthcare team
Your healthcare team may consist of your doctor, nurse, pharmacist,
physiotherapist, family members, friends and anyone else involved in looking
after your health. Good communication with everyone in your team will help
you to look after your health.
Seeing your doctor and other healthcare providers regularly is essential to help
you meet your treatment goals. You should go to your appointments even if you
are feeling well, so together you can keep track of your health and progress.
It is important that you understand what the doctor tells you. Don’t be
embarrassed to ask them to explain the information again or ask questions.
Doctors know that you have a lot to take in. You may want to take paper and
pen with you to write things down in your appointment. It may be useful to
write down any questions or concerns that you have before your visit.
8 Chronic Obstructive Pulmonary Disease
To lower your chances of contracting a chest infection you should have a flu
vaccination every year before winter; and a pneumonia vaccination once every
5 years. These are given free of charge if you have a chronic condition.
It is also very important that you learn to monitor your lungs and be familiar
with what is normal for you. You can then recognise the signs and symptoms
of a chest infection and seek help straight away to treat the infection and
avoid going to hospital. The following is a list of symptoms that may indicate
that you are having a flare up and need to see your GP:
•
•
•
•
•
•
•
•
more breathless than normal
coughing more often
less energy for usual activities
loss of appetite
change in amount of phlegm
change in colour of phlegm: yellow, green, brown
signs of fever
need inhaler/nebuliser more than usual
Develop an ‘Action Plan’ with your doctor which includes steps of what to
do if you become unwell. Actions plans should be reviewed regularly by your
doctor. Your doctor or nurse will be able to provide you with information and
forms regarding Action Plans.
A Patient Information Booklet 9
Protecting against chest infections
Protecting against chest infections
Exercise/Pulmonary Rehab
Exercise/Pulmonary Rehab
Exercise is among one of the simplest and most effective ways to improve
your ability to live a full life with a chronic lung disease. Physical activity
strengthens muscles, improves mood, increases energy levels, and improves
the way the heart and lungs work.
Pulmonary rehabilitation is one of the most effective and important
treatments you can do for COPD. Pulmonary rehabilitation consists of low
impact aerobic exercise e.g. walking, and strength training. Education sessions
are also provided once a week covering a range of relevant topics including
medications, nutrition, relaxation and breathing.
The Canberra Hospital runs an 8 week pulmonary rehabilitation program.
Ph: 02 6244 2154.
Queanbeyan Hospital holds an 8 week pulmonary rehabilitation program.
Ph: 02 6298 9306.
The follow-on maintenance program from pulmonary rehab is “Lungs in
Action”. This is held at the University of Canberra, Belconnen.
Ph: 02 6201 2936.
The YMCA of Canberra runs community fitness programs on both the
Northside and Southside of Canberra.
Ph: 02 6281 0124.
Southern Cross health club run rehabilitation classes which are targeted for
people who have completed pulmonary rehabilitation.
Ph: 02 6283 7340.
10 Chronic Obstructive Pulmonary Disease
It is important to stay well nourished to keep your breathing muscles strong
and energy levels up. Healthy eating is another step you can take to help you
take control of your health. Follow these basic rules:
Eat a variety of foods so that the body gets all the essential nutrients it needs
to function well.
Eat regularly and eat breakfast. It is far
better to have 5 smaller meals throughout
the day rather than 3 huge meals—eating
too much in one go can cause problems
such as indigestion and
difficulty breathing when
the stomach becomes
distended and the
diaphragm is crowded.
There are many people
you can talk to if you need
assistance with diet and
nutrition—these include
your doctor, nurse, and dietician. You can self refer to a
dietician through Community Health Intake on 02 6207 9977.
A Patient Information Booklet 11
Nutrition
Nutrition
Home Oxygen
Home Oxygen
Oxygen is prescribed for people with chronic lung disease who have a low
blood oxygen level. It is up to your specialist to decide if you need oxygen.
You will not be prescribed oxygen if you are still smoking. The ACT Domiciliary
Scheme covers the cost of oxygen for people living in the ACT who meet the
eligibility criteria.
Image below: home oxygen tubing.
12 Chronic Obstructive Pulmonary Disease
You are not alone! There are many people who have COPD, and it is great to
get out and meet other people experiencing the same things. ‘Lung Life’ is
the ACT regions support group; they meet once a month for an educational
and fun filled meeting. Their aim is to provide a supportive and informative
environment for people with a variety of lung conditions and their carers.
They can be contacted on 02 6281 2988.
Do a Self Management Course
You can participate in a six week self management course titled ‘Living a
Healthy Life with Long-Term Conditions’ which can assist you in managing
your condition.
The course is also open to carers and is taught by a health professional and a
person who has a chronic illness. The course leaders teach strategies to assist
with symptom management, action planning and problem solving.
To register for a free course contact Community Health Intake on 02 6207 9977.
A Patient Information Booklet 13
You are not alone!
Join a support group
Useful contacts
ACT Equipment Loan Service
Ph: 02 6207 0658
ACT Domiciliary Oxygen and Respiratory
Support Scheme
Ph: 02 6205 2622
Australian Lung Foundation
Ph: 1800 654 301
Web: www.lungfoundation.com.au
Canberra Hospital switchboard
Ph: 02 6244 2222
Cancer Council ACT
Ph: 02 6257 9999
Smoking Cessation Information
Email: [email protected]
Calvary Hospital switchboard
Ph: 02 6201 6111
Carers ACT
Ph: 02 6296 9900
Community Health Intake
Ph: 02 6207 9977
Email: [email protected]
COPD Clinical Nurse Consultant
Chronic Care Program
Ph: 02 6244 2273
Department of Respiratory and Sleep
Medicine Canberra Hospital
Ph: 026244 2066
Lung Life Support Group
Ph: 02 6281 2988
Email: [email protected]
National Quit line
Ph: 13 78 48
Web www.quitnow.gov.au
Pulmonary Rehabilitation
Canberra Hospital
Ph: 02 6244 2154
Pulmonary Rehabilitation
Queanbeyan Hospital
Ph: 02 6298 9306
Quit smoking service ACT
Ph: 13 18 48
Web: www.actcancer.org
Respiratory ward 6a Canberra Hospital
Ph: 02 6244 2732
Self Help Organisations United
Ph: 02 6290 1984
Together (SHOUT) ACT
Web: www.shout.org.au
Southern Cross Health Club
Ph: 02 6283 7340
YMCA Canberra
Ph: 02 6281 0124
Community fitness programs
Email: [email protected]
Web: www.canberra.ymca.org.au