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Monday, February 22, 2016

Living Longer with End Stage COPD

The following was written by me and published at on October 6, 2015.

9 Ways to Live Longer with End Stage COPD

End Stage COPD, also known as Severe COPD or Stage IV COPD, severely limits your airflow, making it hard to perform any basic activities. At this stage you may have also developed Cor Pulmonale or Congestive Heart Failure. While your quality of life may be limited, this is not a death sentence—there are still ways to live in the "end stage." You may, however, have to alter your life to adjust, starting with...

Quit Smoking. Studies show that quitting smoking, even in the late stages of the disease, is the most effective way of prolonging life. This is why your doctor will encourage smoking cessation even in the later stages of disease -- if you haven’t quit already.  

COPD Action Plans. These are agreements you create with your doctor to help you decide what actions to take when you feel symptoms.  Read my post “What Is A COPD Action Plan?”  The key to these plans is that it is essential that you take action sooner rather than later.  The earlier you seek help for flare-ups, the easier it will be to fix you and to get you back home.

Drug Therapy. As the disease progresses, most people with COPD benefit from a combination of medicines.  Bronchodilators and anticholinergics open airways and keep them open long term. Corticosteroids reduce inflammation to keep airways open to prevent and treat flare ups. Anxiolytics are useful for treating and preventing anxiety, and to assure adequate sleep at night. Opiates are useful for relieving the feeling of air hunger (dyspnea). While poor lung function in COPD cannot be reversed, studies suggest a combination of these medicines can help you take a deeper breath and reduce the feeling of dyspnea.

Oxygen Therapy. If resting oxygen levels are low, supplemental oxygen should be worn to maintain safe oxygen levels.  

Oxygen is the only drug proven to prolong life.

Noninvasive Positive Pressure Ventilation (such as CPAP and BiPAP). This is a pressure supplied to your airway by a mask.  It’s usually only worn while you are sleeping, because that’s when your breathing is most relaxed. CPAP supplies a pressure on inspiration and expiration to keep your airways patent and to assure adequate oxygenation.  BiPAP supplies CPAP plus a pressure on inspiration to assure you take deep enough breaths to blow off carbon dioxide.

Pulmonary Rehabilitation. Other than quitting smoking and wearing your oxygen as prescribed, this might be the most important part of any treatment program.  Such programs keep you in touch with experts who specialize in training you how to obtain proper exercise, conditioning, nutrition, and coping skills. It also keeps you in touch with others like you who will motivate you to stay fit and active so you can keep up your strength.

Nutrition. You may need to see a dietician to learn how to eat properly with COPD.  Most experts recommend that you eat smaller meals with increased frequency, as opposed to three larger meals. There may also be other tips a dietician can give you to help you keep up your strength and live better with it.

Education.  Educators, which may include your doctor, nurse, respiratory therapist, physical therapist, or rehabilitation specialist, will teach you about your disease and the importance of sticking with your agreed to treatment regime.  They will assure you that the best way to live long and well is to be the gallant COPD patient who stays positive and does everything right.

Follow-up.  The end stages of this disease are when most hospital admissions occur.  Recent efforts by hospitals have focused on following-up with COPD patients after they are discharged to assure they are being compliant with their treatment programs, as compliance is the key to staying well.  Early studies suggest these programs are effective in preventing recurring flare-ups and readmissions.

Bottom Line.  The fact that people are living longer with End Stage COPD is just the beginning—the quest to find better options to help the nearly 13 million people living with it breathe better is ongoing.

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