Winter wellness: How to stay one step ahead of COPD flare-ups

The winter season is officially here bringing in woolly jumpers and warm beverages. But for those with Chronic Obstructive Pulmonary Disease (COPD), winter isn’t always a season of cozy comfort, for some, it’s a time that threatens to wreak havoc on their health.

In Australia 1 in 13 older adults are living with a progressive and debilitating lung condition known as COPD, yet almost half of them don’t know it.

For people with COPD, winter can turn into a dangerous game of respiratory Rusian Roulette and can turn their peaceful winter wonderland into a frantic dash to the hospital.

However, there’s good news: with some simple measures and an action plan in place, you can stay as well as possible this winter season.

With that in mind, Starts at 60 speaks to Lung Foundation Australia Respiratory Care Nurse Amanda Curran to help better understand the signs and symptoms of a COPD flare-up and what actions to take in the event of a flare-up.

What is COPD?

COPD is an umbrella term that includes a number of lung conditions such as emphysema, chronic bronchitis and chronic asthma. The condition causes narrowing of the airways in the lungs, making it hard to breathe. COPD is a progressive condition, which means that it tends to get worse over time. Age, exposure to toxic fumes or cigarette smoke, and genetics are key risk factors for COPD.

Symptoms of COPD tend to creep up slowly and people often put the symptoms down to ageing or lack of fitness rather than seeking medical advice.

If you’re experiencing respiratory symptoms such as breathlessness or a persistent cough, don’t ignore them. Curran says early diagnosis and treatment are important to slowing the progression of COPD and helping you better manage your condition and live well.

What does a COPD flare-up look like?

A COPD flare-up or exacerbation is when your symptoms worsen quickly, usually over a few days. It may be caused by an infection or triggered by air pollutants or irritants.

These flare-ups are common in winter and can make it harder to do even simple day-to-day activities and can cause further long-term damage to your lungs.

Curran says a delay of 24 hours or more in seeking treatment for a flare-up doubles the chance of hospitalisation. The earlier you recognise the warning signs and the fewer symptoms you experience, the greater your chances of initiating treatment promptly for optimal results.

Awareness is key when it comes to COPD flare-ups. Curran says it’s important to know how you feel on a typical day (your baseline), so you’re able to recognise when symptoms change.

While everyone experiences different COPD symptoms, the common symptoms of a flare-up include:

• Coughing more than usual
• Finding it harder to breathe than usual
• Any change in sputum (phlegm)
• Being more tired and less active than usual.

Curran says it’s more important than ever to talk to your doctor about a flu shot and, if indicated, pneumococcal pneumonia vaccination as catching these viruses can be dangerous for people with COPD.

Curran adds that staying active, eating well, and most importantly, having a written COPD action plan on hand are simple ways you can tackle the cold months ahead.

Types of COPD testing

When it comes to getting a COPD diagnosis, there are a series of specialised tests, known as pulmonary function tests, which examine your respiratory system to measure things such as your lung’s air capacity and oxygen delivery.

Some of the tests available include:

Spirometry

This is one of the most common, and painless, methods doctors use for the diagnosis of COPD.

To perform this test, you will be asked to exhale as forcefully as you can into a tube connected to a small machine called a spirometer, which will measure the amount of air you have expelled, also known as the forced vital capacity (FVC).

These results tell doctors what type of lung disease you may have and its severity. This test can effectively determine COPD before any significant symptoms appear.

Bronchodilator reversibility test

This test uses both spirometry and bronchodilator, which is a type of medication designed to help open your airways.

You start this test by first undergoing a spirometry examination to examine the baseline measurement of your lung functions. After about 15 minutes, you will be given a dosage of bronchodilator and retake the spirometry.

A bronchodilator reversibility test is particularly helpful for individuals already diagnosed with COPD, asthma, or both, as it aids in monitoring their condition.

Electrocardiogram (ECG or EKG)

Another test doctors may recommend is an electrocardiogram (ECG or EKG). This test helps determine whether your shortness of breath is due to lung issues or a heart condition.

In some cases, prolonged breathing issues from COPD may rise to heart complications like irregular heart rhythms, heart failure, and heart attacks.

By measuring the electrical activity in your heart, an EKG can help in the diagnosis of any disturbances in your heart rhythm.

What is a COPD action plan?

If you have COPD, you should develop an action plan with your doctor so you can recognise when your baseline symptoms change and what action you should take to avoid ending up in hospital.

This includes ensuring your medications and scripts for daily and emergency medicines are up to date and on hand. Having a plan means that both you and your loved ones know what to do if a flare-up occurs.

Jo Lockyer has been living with COPD for a decade and says having an action plan in place helps her to know that even on the hard days, she has the tools to help herself.

“It might seem a bit silly, but having a plan written down that very clearly tells me what to do when I’m struggling is really important. It’s very hard not to panic when you’re getting desperate and you just can’t get that air into your lungs,” she says.

“I keep my action plan on the fridge to remind me that it’s going to be okay if I follow these steps.”

She notes that an action plan isn’t only important for the person living with COPD, but it can also provide great comfort for their loved ones.

“For people around you, when they see you struggling like that, they can panic too. They’ll want to help so if it’s clearly written down for everybody, we can help each other get through it.”

Curran says that “while having a written plan seems like a really simple concept, when you’re experiencing a flare-up your ability to be calm and make rational decisions about your health can be affected by feeling so unwell.”

“Coupled with the anxiety caused by not being able to breathe, it can be a really scary time,” she adds.

Remember, understanding the signs and symptom of COPD this winter is vital and make a substantial difference for those who suffer from the disease.

By staying proactive, getting the necessary vaccinations, staying active, and having a written COPD action plan, you can better prepare yourself for the chilly months ahead.

Awareness, prevention, and preparedness are key to safeguarding your health during this winter season.

This article was originally published on July 8, 2020, and has been updated on May 16, 2023. 

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.