Question

How will exacerbation of Jim’s COPD affect his quality of life? What about other quality issues like showering himself, walking around , doing work etc?

Answer 1

Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease, commonly mentioned as COPD, may be a group of progressive lung diseases. The foremost common diseases are emphysema and bronchitis. Many of us with COPD have both of those conditions.

COPD may be a slowly progressing disease with an extended asymptomatic phase, during which lung function continues to turn down. Persistent cough, particularly with mucus production, may be a common symptom. Dyspnea, especially with exercise, wheezing, and chest tightness can also be present. Patients often present with the primary acute exacerbation of COPD at a complicated stage. Symptoms do not usually occur until forced expiratory volume in 1 second (FEV1) is approximately 50% of the anticipated normal value. Because the disease progresses, exacerbations may become more frequent and life-threatening complications may develop. End-stage COPD is characterized by severe airflow limitation, severely limited performance, and systemic complications. Patients often give way to respiratory failure or pulmonary infection.

Patients with COPD perceive that symptoms can impose a considerable limitation on their ability to perform normal activities throughout the day (including physical activity and exercise) and may impair sleep quality. Morning symptoms of COPD are considered by patients to be a key barrier to performing their daily activities. Furthermore, morning symptoms are related to a better likelihood of workplace absenteeism. A variety of daily activities (e.g. going up and down stairs, doing heavy household chores, going shopping, and participating in sports and hobbies) and morning-specific daily activities (washing, dressing, drying, and getting out of bed) are cited by patients because the aspects of their normal functioning most compromised by COPD symptoms.

It has been noted that patients with COPD experience worse psychological functioning and greater psychological distress. Anxiety and depression are important comorbidities in patients with COPD.

Sleep disturbances are common among patients with COPD, affecting in more than 70% of patients. Sleep disturbances include difficulties in initiating and maintaining sleep and increased number of arousals during the night, and arise from a mixture of disturbances in ventilation and gas exchange caused by the underlying condition and disruption caused by night respiratory symptoms (particularly coughing, breathlessness, and sputum production) and other generalized symptoms like pain,heartburn/palpitations,and night fear and anxiety . Sleep-related breathing disturbances in patients with COPD end in hypoxemia and hypercapnia, which are related to cardiac arrhythmias, pulmonary hypertension, and nocturnal death, especially during acute exacerbations. Disturbed sleep results in difficulties in getting up within the morning and is related to depressive and anxiety symptoms.

Showering Himself

Steam from a shower increases the humidity level within the bathroom.This will also exacerbate COPD, triggering coughing and shortness of breath.To avoid worsening symptoms, only shower in well-ventilated bathrooms. If possible, shower with the door open, crack a toilet window or use a fan.

Walking Around

COPD patients are less active than the typical population. It is reported that one third of severe COPD patients walk but 15 min/day. Patients with the foremost severe levels of COPD spend less time walking and once they do, they walk at slower speeds. The decreased physical activity seen in COPD patients is not directly related to disease severity.

Doing work

Many more people may have the disease and not even realize it. Symptoms often worsen over time and may limit your routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself. People with COPD often need to hand over work because their breathlessness stops them doing what they have to try for his or her job.

References

Understanding the impact of symptoms on the burden of COPD. Marc Miravitlles & Anna Ribera. Respiratory Research volume 18, Article number: 67 (2017)

Everything You Need to Know About Chronic Obstructive Pulmonary Disease (COPD) Symptoms. https://www.healthline.com/health/copd.

Caring for the Older Person with Chronic Obstructive Pulmonary Disease: “I was worried that he didn’t have much room to decline”.Terri R. Fried, M.D.,1,2 Carlos A. Vaz Fragoso, M.D.,1,2 and Michael W. Rabow, M.D.

Chronic Obstructive Pulmonary Disease: An Overview John F. Devine, DO, FACP*. Am Health Drug Benefits. 2008 Sep; 1(7): 34–42.