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. And 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.

Early Warning Signs

Early symptoms or warning signs of COPD are unique to each person, and may be the same, similar or different with each episode in the same person. 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, since 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:

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

When to Call Your Doctor

It is very important to work with your healthcare provider to determine the best treatment steps for signs and symptoms of respiratory trouble. Here are some general guidelines for when to contact your doctor, but your specific treatment plan should be determined by you and your healthcare provider.

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Call immediately
If forgetfulness, confusion, slurring of speech or sleepiness occurs during an acute respiratory infection.
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Call within 6-8 hours
If shortness of breath or wheezing does not stop or decrease with inhaled bronchodilator treatments one hour apart.
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Call within 24 hours
If you notice one or more of the following severe respiratory symptoms:
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Change in color, thickness, odor or amount of sputum persists
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Ankle swelling lasts even after a night of sleeping with your feet up
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You awaken short of breath more than once a night
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Fatigue lasts more than one day.

Things That Make 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:

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Smoking
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Taking any extra doses of theophylline
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Taking codeine or any other cough suppressant
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Use of over-the-counter nasal sprays for more than 3 days
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Increasing the liter flow of prescribed oxygen
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Waiting any longer than 24 hours to contact your doctor if symptoms continue.

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