Recognizing Signs and Symptoms of COPD

The early signs of chronic obstructive pulmonary disease (COPD) for which many people seek medical attention before being formally diagnosed include marked shortness of breath with exertion, a cough that won’t go away, or frequent respiratory infections. This is often at a point when the disease is already advanced. Many people might be identified earlier if their doctors routinely screen all patients who are smokers or previous smokers.

Why should I be aware of changes in my symptoms?
What are the early warning signs?
When should I call the doctor?
What will make my symptoms worse?

Why should I be aware of changes in my symptoms?

Once COPD has been diagnosed, recognizing worsening signs and symptoms of chronic obstructive pulmonary disease (COPD) is an important part of managing your illness. Knowing when symptoms are changing is helpful so that treatment and other interventions can begin quickly. Early treatment is most effective and likely preserves lung function long term. If severe symptoms are present, it is vital to begin the appropriate treatment right away. Accurate and timely assessment of your symptoms can help you and your healthcare provider decide if treatment should begin in the home, at your healthcare provider’s office or in the emergency room.

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What are the early warning signs?

Early symptoms or warning signs are unique to each person. These warning signs may be the same, similar or different with each episode. Usually, you will be the best person to know if you are having trouble breathing. However, some changes are more likely to be noticed by other persons. It is important to share this information sheet with your family and those close to you.

A change or increase in the symptoms you often have may be the only early warning sign. You may notice one or more of the following:

• An increase or decrease in the amount of sputum produced
• An increase in the thickness or stickiness of sputum
• A change in sputum color to yellow or green or the presence of blood in the sputum
• An increase in the severity of shortness of breath, cough and/or wheezing
• A general feeling of ill health
• Ankle swelling
• Forgetfulness, confusion, slurring of speech and sleepiness
• Trouble sleeping
• Using more pillows or sleeping in a chair instead of a bed to avoid shortness of breath
• An unexplained increase or decrease in weight
• Increased feeling of fatigue and lack of energy that is persistent
• A lack of sexual drive
• Increasing morning headaches, dizzy spells, restlessness

Symptoms do not go away when they are ignored. Therefore, knowing when to call your healthcare provider is very important in managing your chronic lung disease. It is very important for you to work with your healthcare provider to determine the best treatment for signs and symptoms of COPD.

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When should I call the doctor?

Call immediately if forgetfulness, confusion, slurring of speech or sleepiness occurs during an acute respiratory infection.

Call within 6-8 hours if shortness of breath or wheezing does not stop or decrease with inhaled bronchodilator treatments one hour apart.

Call within 24 hours if you notice one or more of the following severe respiratory symptoms:

• Change in color, thickness, odor or amount of sputum persists
• Ankle swelling lasts even after a night of sleeping with your feet up
• You awaken short of breath more than once a night
• Fatigue lasts more than one day

Severe respiratory symptoms are a life-threatening emergency. Have an action plan for getting emergency care quickly in the event of severe symptoms. Inform family members and those who are close to you of this emergency action plan.

It is very important to work with your healthcare provider to determine the best treatment steps for signs and symptoms of respiratory trouble. Remember, these are only guidelines. Your specific treatment plan should be determined by you and your healthcare provider.

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What will make my symptoms worse?

While there are many effective measures you can do at home to treat signs and symptoms, there are also actions that should be avoided:

• Do not take any extra doses of theophylline
• Do not take codeine or any other cough suppressant
• Do not use over-the-counter nasal sprays for more than 3 days
• Do not increase the liter flow of prescribed oxygen
• Do not smoke
• Do not wait any longer than 24 hours to contact your doctor if symptoms continue

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This information has been approved by Ron Balkissoon, MD and Susan Jorgenson MSN, RN, AE-C (April 2006).