Key Signs of Infection in COPD
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. It is a progressive respiratory condition (1).
Typical symptoms including cough, breathing difficulty, mucus (sputum) production and wheezing. This can limit your ability to walk quickly, up stairs or for long distances without becoming short of breath. It can also increase your risk of lung cancer, developing heart disease, or contracting viruses. Acute exacerbations can occur, as the disease progresses these occur with increasing duration and frequency. With subsequent episodes and disease progression, hospital admission is required to manage the exacerbation (2).
Symptoms of an ACUTE EXACERBATION include:
1) Worsening shortness of breathe- more difficulty breathing than usual, when doing activities such as walking upstairs. More trouble breathing when at rest than your usual/ or a new onset of trouble breathing at rest- which you may not have felt before. May present as feeling "hungry for air", "gasping" or "heaviness".
2) Worsening cough- when your 'normal' cough has increased in severity or duration. You may have difficulty controlling or stopping yourself when a 'coughing fit' occurs.
3) Increased mucus (sputum) and a change in colour- If you have an increased amount of sputum being cleared out of your lungs with cough than usual, or if the sputum has changed color to yellow/ green this indicates infection.
4) FEVER! - an increase in your temperature indicates an infection as your body fights the bacteria.
5) Feeling fatigued/ or unwell- this occurs as your body is using more energy to fight the infection. As well as your body is not receiving as much oxygen to your vital organs, via your lungs and airways, as they are blocked by sputum and airway narrowing.
6) Wheeze or chest tightness- a wheeze present on your breathe in and out, this reflects airway narrowing, and may feel like your chest is 'tightening'.
7) Symptoms (listed above) persisting- symptoms that persist past a few days, and do not seem to be improving, or are worsening.
If you notice any of these symptoms and they are persisting, it is important to see your Doctor, or begin your COPD Action Plan, if this is something you and your Doctor have set up as part of your treatment plan. Medications such as antibiotics to fight the infection and respiratory medications such as bronchodilators to support your breathing and airway will be prescribed. If you allow an exacerbation to worsen significantly, you may put your health at risk! This could result in an extended hospital admission or even require ICU admission, as your lungs require extra oxygen support.
Physiotherapy can help in preventing an exacerbation, and improve symptoms if an exacerbation does occur. Physiotherapy treatment aims to manage respiratory symptoms (airway clearance, breathing strategies), and improve/ maintain your exercise capacity to keep you living life to the fullest!
Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD. These two conditions usually occur together and can vary in severity among individuals with COPD.
Chronic bronchitis is inflammation of the lining of the bronchial tubes, which carry air to and from the air sacs (alveoli) of the lungs. It's characterized by daily cough and mucus (sputum) production.
Emphysema is a condition in which the alveoli at the end of the smallest air passages (bronchioles) of the lungs are destroyed as a result of damaging exposure to cigarette smoke and other irritating gases and particulate matter.
It is often caused by long term exposure to irritating gases or particulate matter- most often from cigarette smoke. Your lungs have an amazing capacity to heal however- so even if you have smoked for many years, stopping smoking now can still improve your lung health! (It is never a lost cause!) (1).
Natasha Prokop, Registered Physiotherapist
Natasha is a CardioRespiratory telephysiotherapist with extensive post-graduate training. Her goal is to treat people for cardio respiratory conditions using online physio (telephysio, telerehab) from the comfort of their home.
1. Pryor J and Prasad SA (eds) Physiotherapy for Respiratory and Cardiac Problems (4th edition) 2008 Churchill Livingstone
2. GOLD – Global Initiative for Chronic Obstructive Lung Disease – www.goldcopd.com