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Chronic Obstructive Pulmonary Disease (COPD)

Everything you need to know about living well with COPD

  • Introduction
  • Types
  • Symptoms
  • Daily Living
  • Support
  • Glossary

Introduction

If you, or someone you know, have recently been given a diagnosis of COPD, this guide is designed to help you understand more about the condition.

You may be wondering, what is chronic obstructive pulmonary disease? Below, we explore what causes chronic obstructive pulmonary disease what the symptoms of chronic obstructive pulmonary disease are, and what treatments for chronic obstructive pulmonary disease are available. Remember, you are not alone, and there are many sources of support available to you and your family.

Any medical information provided here is for informational purposes and does not replace medical advice given to you by a medical professional. If you are concerned that you may have any of the COPD symptoms discussed below, please see your GP.

Introduction

What is chronic obstructive pulmonary disease?

Chronic obstructive pulmonary disease (COPD) is an umbrella term for a couple of conditions caused by irreversible damage to the lungs and resulting in breathing problems. Many people live with the condition for years before it is diagnosed, because they dismiss early symptoms until they become worse. The main cause of COPD is smoking or second hand smoking.

COPD affects around 1.2 million people in the UK, so it is fairly common. COPD usually affects older adults, but symptoms may start to appear around the mid-30s. There are COPD treatments available to help reduce symptoms of COPD, but there are no cures available. COPD may affect life expectancy, but people live for many years with the condition. It does affect a person’s daily life to some degree, but everyone experiences it to different levels. COPD often progresses in stages, and during later stages, the condition can be quite challenging. There are ways to live well with the condition though and enjoy a high quality of life and wellbeing. For more information on COPD, visit the NHS website.

What causes chronic obstructive pulmonary disease?

Chronic obstructive pulmonary disease is caused by narrowing of the lung’s airways, which reduces the function of the lungs.

Lungs have a crucial job in the body – to take in breaths containing oxygen. Every cell in the body needs oxygen to function. Oxygen is then carried by the blood to the heart. The heart pumps oxygen-rich blood round the body through arteries. When the body works, the cells release carbon dioxide which our bodies do not need, so this is carried back through the veins to the lungs to be breathed back out.

The British Lung Foundation provides an explanation of how your lungs work.

Smoking any type of tobacco is confirmed as one of the biggest causes of COPD. This is because tobacco contains toxic chemicals, poisons and tar which not only damage the tiny cilia in the lungs but which are also distributed around the body, causing damage.

Inhaling chemicals or certain types of dust may also cause chronic obstructive pulmonary disease e.g. working in coal mines during the 20th century has left many ex-miners in the UK with COPD.

There is evidence that COPD runs in families, suggesting that genes may cause the disease, but this affects very few people out of the millions who have the condition. It is likely that smoking habits run through generations of families, resulting in multiple family members developing a smoking related illness such as COPD, which may make it appear as though COPD is hereditary.

The NHS explores what causes COPD.

Did you know... "COPD is a long-term condition that affects breathing and causes damage within the lungs."

Main Types of Chronic Obstructive Pulmonary Disease

There are two main conditions that fall under the umbrella of COPD.

These two conditions are caused by damage within the lungs that makes airways more narrow, and breathing more difficult. They do differ though in how the lung damage occurs. These types of COPD both have the same symptoms which may include breathlessness, coughing and chest infections. If you are given a diagnosis of chronic obstructive pulmonary disease, you are likely to be told which condition you have, but it can be difficult to tell these apart in some people. You may also have a combination of the two types of COPD.

Introduction

The two main types of chronic obstructive pulmonary disease are:

Chronic bronchitis: there are two types of bronchitis, one which is described as acute, and one which is more serious, referred to as ‘chronic’ which means it does not go away. The latter condition causes inflammation in the bronchi (tube-like airways) that take oxygen to your lungs via your trachea. Inflammation is caused by an irritant, such as tobacco smoke. This makes it harder to breathe because there is less room in the airways for air to pass through, and more phlegm is produced as a result of the inflammation. My Lungs, My Life provides an excellent visual explanation of chronic bronchitis.

Emphysema: this is slightly different in that it is caused by damage to the alveoli. If an irritant such as tobacco smoke enters these tiny sacs, they become inflamed which affects the essential exchange of gases that occurs here and traps carbon dioxide. This leads to the diaphragm working extra hard to move air in and out of the lungs, causing breathlessness and fatigue. My Lungs, My Life provides an excellent animation of COPD and emphysema.

Did you know... "COPD is mostly caused by smoking, and stopping smoking is the best way to avoid developing COPD, or to help stop COPD from getting worse."

Symptoms of Chronic Obstructive Pulmonary Disease

Read on to find out the symptoms of COPD.

Everyone will experience chronic obstructive pulmonary disease differently. Many people experience early symptoms for years before they seek healthcare advice or a diagnosis. COPD symptoms may begin very mildly. It is important that if you notice any of the symptoms listed here, you see your GP. These symptoms are often symptoms of other healthcare conditions which may be minor, but it is advisable to have these checked early. Earlier diagnosis of COPD can help make the condition more manageable in the long term. COPD may begin in the mid-thirties, but people may not have or notice any symptoms until much later in life.

Introduction

Everybody experiences COPD differently and not everybody will have all of these symptoms, but the most common ones are:

• Breathlessness – this is the feeling of being ‘out of breath’ or finding it hard, or uncomfortable, to breathe regularly through the day or for long periods of time, more so than just normal breathlessness due to exercise or physical activity

• Constant or excessive phlegm or mucus

• Wheezing when breathing or having a cough for long periods of time

• Regular chest infections

• Feelings of tiredness, fatigue or exhaustion

• Oedema

Some people find that their symptoms get worse over time but treatments are available to help reduce the impact of symptoms on a person’s life and wellbeing.

The NHS provides information on symptoms and the British Lung Foundation covers the COPD symptom of breathlessness in great detail.

Diagnosis of chronic obstructive pulmonary disease

If you are concerned about any of the COPD symptoms listed in this guide, you should visit your GP. Many symptoms such as breathlessness, may be a result of other conditions and are not necessarily COPD. Anxiety for example, may cause breathlessness. Keeping a diary of symptoms can help your GP to understand any triggers and may help reach a diagnosis more quickly.

If you present with any of these symptoms, your GP is likely to listen to your breathing and ask if you are a smoker or have ever smoked. If they suspect you may have a lung condition, they may refer you for further tests which are likely to be carried out at a hospital, including for example a spirometry test and chest x-ray. These tests will try to find out if your lungs are working as they should, if you have any infections present, and your oxygen levels are adequate. You are likely to be seen by a chest specialist.

The British Lung Foundation provides a guide to getting the best from your doctor, with a range of questions you may wish to ask when you visit your GP or any other medical professionals.

Read on to find out more about treatments for COPD that can help relieve symptoms, as well as things you may need to consider if you are living with chronic obstructive pulmonary disease.

Did you know... "People diagnosed with COPD may experience breathlessness, excess phlegm, fatigue and chest infections."

Living with Chronic Obstructive Pulmonary Disease

Read on to find out more about COPD treatments, products for COPD and other aspects of daily living with COPD.

Learning that you have a chronic, long-term health condition such as COPD can be a shock and may take some time to come to terms with. There may be some important lifestyle changes for you to make, such as quitting smoking or getting more exercise, which may help your condition. There are treatments for COPD available, which we cover below. Symptoms affect everyone differently and each person will have a different experience learning to live with the condition.

Introduction

Impact on daily living

COPD affects everybody differently – some people are affected more severely, or earlier on in life than others. Some people find that by taking care of themselves, quitting smoking, eating well and getting exercise, their symptoms are reduced and they have an excellent quality of life and sense of wellbeing. COPD does not have to stop you doing what you love to do, and many people find ways to socialise, enjoy family life, participate in hobbies, travel, etc.

Some people may find that COPD creates challenges in their day to day life and activities; for example, some people with a severe case of COPD may find their legs swell and, combined with their breathlessness, their mobility is affected by this. There are products for chronic obstructive pulmonary disease, called daily living aids, which may help you undertake daily chores and tasks independently. If you are finding daily tasks have become more difficult due to your condition, speak to your local social services team who may be able to refer you for an assessment by an Occupational Therapist (OT). An OT may be able to recommend adaptions to the way you do activities, or ways to change your home environment to make life a little easier. They may also be able to recommend daily living aids that may make daily tasks easier.

It may help to read stories from other people experiencing COPD themselves or who have family with the condition. These stories highlight the many different experiences of people with the condition, from those who are able to manage their condition well with a healthy lifestyle, to others who have supported loved ones through the disease to the end of life.

The NHS provides information on living with COPD, including breathing techniques to control breathlessness, ways to look after yourself, as well as practical matters such as financial support and travel.

My Lungs, My Life also provides tips for daily living and how to adapt the way you do things to help make life easier.

Treatments for chronic obstructive pulmonary disease

There is no cure for COPD, but there are drug and surgical treatment options available. These can help manage symptoms and reduce the impact of the condition on a person’s life.

Medication treatments include:

• Inhalers – these contain drugs such as steroids and beta-2 agonists that are inhaled into the lungs to act directly on widening the airways to make it easier to breathe

Theophylline – comes in tablet form and makes the airways more relaxed

Mucolytic tablets – these help if you have excess phlegm or regular coughs

Steroids – come in tablet form and help reduce inflamed airways

• Antibiotics – usually in tablet form, these are given if you have an infection

Some people who have severe COPD, either during temporary flare-ups or permanently, may require medication to be delivered through a mask or mouthpiece, using a nebuliser.

Some people may also require oxygen to be delivered into their lungs, which is usually at a serious stage of COPD where the person is not getting enough oxygen through breathing. In this case, a person requires an oxygen tank for a large portion of the day, which they breathe in through a face mask or mouthpiece.

Surgical treatments are available for severe COPD and will be used as a last resort. These include:

Lung transplant

Lung volume reduction

Bullectomy

The NHS provides a lot of information about all COPD treatments including specific information about lung transplants.

Smoking and COPD

If you have COPD and are a smoker, you will be advised to quit smoking. This is really important and will help stop further damage to your lungs and help slow down how quickly COPD progresses. Some people wrongly believe that there is no point stopping smoking if they have already got a lung condition, but this is absolutely not true. Most people report a reduction of symptoms when they stop smoking, and quitting can increase your life expectancy. There is a lot of support for people looking to quit smoking, including medications and access to ‘stop smoking advisers’ who can provide guidance to groups of people or individuals. For more advice on how to quit smoking, visit the NHS Stop Smoking webpage.

The British Lung Foundation website features a story from an ex-smoker who regrets not giving up much sooner, read ‘I quit smoking – here are 6 reasons you should too’.

Products for chronic obstructive pulmonary disease

If COPD is affecting what you are able to do during your daily life, for example, if breathlessness is making it difficult for you to get around or you’re fatigued and find standing for long periods difficult, there are products known as “daily living aids” which can help make everyday tasks easier.

At NRS Healthcare, we supply daily living aids that are designed to help people with healthcare conditions or disabilities to continue to live independently and help with tasks they are finding difficult. Many people do not realise that such equipment exists, or they believe using it is ‘giving in’ to their condition. We believe that, just as you would take medication to help relieve symptoms, you can also use daily living equipment to achieve the same thing, meaning your condition will not determine what you can and cannot do.

Below, we list a selection of products that provide support with a variety of daily living activities that some people with COPD may find difficult. Not everybody will need to use daily living aids, but for some people, they can help them remain independent by making life easier.

Mobility aids – if you are experiencing breathlessness or fatigue, you may need equipment that will help you get around at your own pace, which may make moving around less strenuous

o 4 wheeled rollator with a seat – ideal for walking and resting indoors or outdoors

o Transit wheelchair – ideal for short distances and occasional use

o Attendant controlled wheelchair – ideal for more frequent or longer periods of use, this is pushed by a companion when you need to rest

o Ramp – ideal for wheelchair or rollator users who need to avoid steps

Toileting aids – if the toilet is too far away for you to get to, it may help to have a commode or portable toilet, which you can position in the bedroom or lounge, wherever is convenient

o Traditional commode – looks like a lounge chair for discrete toileting

o Folding commode – ideal for taking on trips or storing away easily

o Porta Potti – a portable flushing toilet

Bathing aids – getting in and out of the bath can be difficult and strenuous for some people but these aids may provide assistance

o Bath lift – lowers you down into a bath and lifts you back up again when you have finished

Shower aids – some people may find they are unable to stand for long enough to enjoy their shower

o Shower chair – a comfortable seat in the shower

Bed and chair aids – some people find that getting in and out of a bed or chair is difficult if they are breathless or fatigued

o Bed rail – helps you pull yourself up from lying to sitting

o Furniture raisers – makes beds and chairs higher, so less bending is required to sit or lie down

o Rise and recline chair – manoeuvres down to a relaxed sitting or lying position, then lifts you back up again for easier standing

o Electrically operated bed – allows you to adjust your position in bed with a remote control

Aids for household chores – you may find that your symptoms affect your ability to do things around the home

o Household trolley – useful if you need to transport items around the home but find it difficult to carry them

o Perching stool – can be used in the shower or kitchen to help wash or do chores whilst resting rather than standing up

Exercise aids – exercise can help your lungs work more effectively

o Pedal exerciser – enables you to do seated, aerobic exercise

o Resistance band – helps strengthen and tone muscle and build strength

o Dumbbells – builds and tones muscles to help you get stronger

If you are unsure what products may help you or someone you know, NRS Healthcare has a team of occupational therapist product advisors who can advise you. Contact them on 0345 121 8111 or email [email protected]

Diet for chronic obstructive pulmonary disease

Eating a healthy, varied and balanced diet is really important, especially if you have a chronic, long-term health condition such as COPD. A healthy COPD diet will help you fight off infections and keep the lungs, heart and the rest of the body working well. Maintaining a healthy weight is also important to ensure that your body, in particular your heart and lungs, is not put under too much strain, which may make symptoms worse.

Drinking at least 8 cups of fluid each day is important too and water is the best source of fluid, but all non-alcoholic drinks count towards this amount. Some people report that their breathlessness affects their ability to eat, and enjoyment of eating. Some people may feel uncomfortable after eating because their breathing difficulties mean they swallow air when they eat. There are lots of tips on how to solve these issues on the British Lung Foundation website, where they discuss lots of aspects of eating well with a lung condition and the Eatwell Guide provides a graphical explanation of what constitutes a healthy diet.

Exercise for chronic obstructive pulmonary disease

If you have received a diagnosis of COPD, you are likely to be advised to exercise and you may be referred to a pulmonary rehabilitation course. This is an exercise and education programme for people with COPD or similar conditions, through which you undertake fitness classes and learn how to look after your health. It is usually run by a multi-disciplinary team of healthcare professionals such as physiotherapists. Many people report that pulmonary rehabilitation has helped them manage their condition better and encouraged them to undertake regular exercise.

You should aim to do 30 minutes of exercise each day with the aim of getting your heart pumping and making your muscles stronger. A physiotherapist may be able to devise a programme of exercise that is suitable for you, if you are concerned about exercise making your symptoms worse.

In the long run, exercise may help you manage your symptoms better, as well as making your lungs work better and making you feel emotionally and mentally well. The NHS provides more advice about how to get fit for free, and the British Lung Foundation gives a wealth of information about pulmonary rehabilitation and keeping active with a lung condition.

Chronic obstructive pulmonary disease and employment

Many people with COPD are able to work, but some people do find that their symptoms mean they have to reduce their working hours, change jobs, or leave work altogether. This can be a difficult decision to make. The British Lung Foundation provides lots of advice if you find yourself unable to work or if you are interested in understanding what financial support is available to you if you have COPD.

Did you know... "There are treatments for COPD which may help manage symptoms, but there is no cure."

Support for chronic obstructive pulmonary disease

Remember – you are not alone!

We hope this guide to COPD has been helpful to you. Lots of people are living with a diagnosis of COPD, and so you are not alone in your situation. However, your experience of the condition will certainly differ from other people’s. Many people live well and have a good quality of life, whereas some people may find their condition is more serious and requires more support.

Because COPD is a fairly common condition in the UK, there is lots of COPD help available to you. Some people find it helpful to access COPD support groups, and we have listed some of these below. We’ve also included a list of other online resources that you may find useful. If you are concerned about anything you read in this guide, please discuss with your GP.

Introduction

Communities

British Lung Foundation Forum – provided by the UK’s leading charity for people affected by lung disease, this forum connects people affected by COPD and other lung conditions to discuss their experiences

COPD Friends for Friends – a Facebook group for people living with COPD or lung problems to connect and share their experiences

Resources

British Lung Foundation – the UK’s leading charity supporting people with lung conditions, and fundraising for research, with a website that features lots of information about COPD and other conditions, as well as a helpline and local Breathe Easy support groups

My Lungs My Life – practical advice and information about living with COPD or asthma, including symptoms, treatments, and daily living tips

NARA The Breathing Charity – a UK charity campaigning for people with lung and respiratory conditions, funding equipment such as nebulisers for people that need them

NHS Choices – source of official medical information about causes, symptoms and treatments for COPD

Glossary

Unsure what something means? Checkout our Glossary section below.

Although we always try to explain things as simply and as clearly as possible, sometimes it’s necessary to use the correct medical terminology. Medical terms are often known for being tricky to pronounce and if you’re not an expert in the subject, they can also be a little difficult to understand. Below, we’ve put together a list of terms used on this page along with a brief explanation of what they mean to help make your understanding of chronic obstructive pulmonary disease as straightforward as possible.


Introduction

Acute

– when referring to a healthcare condition, the illness is of a short duration, and sometimes sudden in its occurrence

Alveoli

– tiny sacs in the lungs which exchange oxygen molecules for carbon dioxide ones

Arteries

– tubes in the body through which blood is pumped from the heart all around the body

Beta-2 agonists

– a group of medications usually taken through an inhaler, which can help reduce symptoms for around 12 hours

Bullectomy

– a surgical procedure that removes bullae from the lungs, which are damaged alveoli (air sacs) that take up space in the lungs but do not have any function

Bronchi

– airways in the lungs that come from the windpipe

Carbon dioxide

– gas that is present in the air and which is a by-product of cell activity and exhaled as a waste gas

Chest x-ray

– images of the internal parts of the body e.g. the lungs, which are taken with an x-ray machine and analysed by a specialist

Cilia

– the delicate hair like structures in lungs

Diaphragm

– the muscle that controls breathing by inflating the lungs to take in air

Exchange of gases

– the process which occurs in healthy lungs, in the tiny air sacs called alveoli, where oxygen moves into the blood and carbon dioxide diffuses out of the blood, to be removed by exhalation

Heart

– the organ in the body responsible for pumping blood around the body

Lungs

– a pair of organs in the chest of a human body, protected by the ribcage, that transfer oxygen to the blood and remove carbon dioxide

Lung transplant

– a serious operation which replaces severely damaged, poorly functioning lung or lungs, with lungs from a deceased organ donor

Lung volume reduction

– removal of damaged parts in the lungs to reduce trapped air and make breathing more comfortable

Mucolytic tablets

– a medication that dissolves phlegm or mucus in the body by making it thinner and easier to remove naturally

Nebuliser

– electric device which turns liquid medication into a mist that is administered by breathing it in through a mask or mouthpiece

Oxygen

– a gas in the atmosphere that we breathe in through the nose and mouth, and which every cell in the human body requires in order to survive

Pulmonary

– related to the lungs

Phlegm

– a substance made in the body which, in the lungs, helps make the airways more lubricated but which can be excessive if it is protecting against irritants such as infection, smoke or chemicals

Spirometry test

– a test to find out how well the lungs function by measuring the amount of inhaled air, exhaled air and how fast it is exhaled

Steroids

– medication that treats a variety of conditions such as asthma and COPD, which reduces inflammation because it is a man-made version of a naturally occurring hormone in the body

Theophylline

– a medication used for conditions such as asthma or COPD which relaxes airway muscles, letting air in more easily and reducing breathlessness

Trachea

– otherwise known as the windpipe in the body, which connects the voice box to the lungs and through which air flows

Veins

– tubes that carry blood back to the heart after it has circulated the body, oxygenated cells and organs, and which therefore carries blood without oxygen


Last updated on 05/02/2019

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