Lung conditions

Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is the general name for a collection of diseases which affect the lungs, including chronic bronchitis, emphysema and chronic obstructive airways disease.

Often people with COPD have both emphysema and chronic bronchitis. People with COPD have trouble breathing in and out (airflow obstruction) and their lungs become inflamed due to irritation (usually by cigarette smoke).

It is not fully understood why or how COPD develops, but smoking is by far the most common cause of the condition because cigarette smoke inflames and damages the delicate lining of the airways.

In Cornwall and the Isles of Scilly there are over 8,000 people that are living with COPD. This extends to nearly 900,000 people across the UK, but most people are not diagnosed and around 3 million people in the UK may have the condition. The older you are the more likely you are to develop COPD. The average age at which COPD is diagnosed in the UK is 67, usually after many years of less severe symptoms.

Over many years the inflammation leads to permanent changes in the lung. These changes cause airflow obstruction, where the flow of air into and out of the body is impaired. The airflow is reduced because the walls of the airways get thicker in response to the inflammation and more mucus is produced. Damage to the delicate walls of the air sacs in the lungs means the lungs lose their normal elasticity, and it becomes much harder work to breathe, especially on exertion.

Symptoms of COPD

It is the changes in the lungs that lead to the symptoms of COPD:

  • breathlessness
  • cough
  • phlegm

Although any damage that has already occurred to your lungs cannot be reversed, you can prevent COPD from developing or getting worse by making changes to the way you live.

The British Lung Foundation website has information about support groups. Find your nearest Breathe Easy local support group.

Understanding asthma

Asthma is a long-term condition in which over-sensitive airways become narrow and inflamed, making it difficult to breathe in and out normally. Its cause is not completely understood, but asthma is one of a group of allergic conditions, including eczema and hay fever, which often occur together.

You are more likely to develop asthma if you:

  • smoke
  • have another allergic disease, such as eczema or hay fever
  • have a close relative who has asthma, eczema, hay fever or allergic conjunctivitis
  • were born prematurely or with a low birth weight
  • had bronchiolitis as a child
  • were exposed to tobacco smoke as a child

Asthma is usually experienced as an episode. There are periods of time when you have asthma symptoms, but in between you are generally well, even for many years. The severity and duration of symptoms vary and are difficult to predict.

Talk to your doctor or nurse about how severe your asthma is and the long-term outlook.

If your asthma is mild to moderate, your asthma may improve over time, and many adults even become symptom-free.

Even in severe cases, some adults with asthma may experience improvement, depending on the degree of obstruction in the lungs and the timeliness and effectiveness of treatment.

In about 1 in 10 people with severe, persistent asthma, the structure of the walls of the airways changes, which leads to a progressive decline in lung function. Asthma is a serious condition, but one that can be well-controlled in most people.

Support groups
It can often help to talk about your condition with others, especially when first diagnosed. There are a number of local groups that provide support and meet on a regular basis.

Breathers groups

Falmouth
Breathe Falmouth Club is an exercise club for people with breathing problems and the effects of COPD. The group meets every Thursday morning at Penryn Rugby Football Club, Kernick Road, 10am to 12pm. The club’s exercises follow the pulmonary rehabilitation programme from your local hospital and a private chartered physiotherapist visits the club regularly to ensure the quality of the exercise sessions. If you are interested in joining the club email bobh.kenvers@talktalk.net or call 01326 315165.

Helston
Meet every Thursday 1.30pm to 3.30pm at Helston Athletic Football Club, Kellaway Park Clodgey Lane TR13 8PJ.

Liskeard and south east Cornwall
The group is a non-profit making group that was set up in 2006 by a group of patients with COPD after completing an NHS rehabilitation course. Find out more about the Liskeard and south east Cornwall group.

Newquay Breather’s Group
Contact Paddy on 01637 874228 or email daspaddy@rocketmail.com for more information.

North Devon
Held at Marlborough Court (common room), Park Lane, Bideford EX39 2QN. Call 0300 003 0555 for more information.

Mabe (Kernow Huffa Puffas)
Meet on Thursdays, 10am to 12pm, at Mabe Community Hall, Cunningham Park, Mabe TR10 9HB. Call Trish on 01326 375238 or email trisheashe@yahoo.co.uk for more information.

Saltash Breather’s Group
Held on Tuesday, 1:30pm to 3pm at SHADO Centre PL12 6DJ. Call Christine Phillips on 01752 844402 for more information.

St Ives Wheezer’s Group
Contact Jean Lea on 01736 794097 or email jeanlea@talktalk.net for more information.

Torpoint Breather’s Group
Contact Pat Tivnan on 01752 813613 for more information.

Exercise classes

Oakhampton
Held on Wednesdays, 11.45am to 12.45pm, at OCRA Pavilion Okehampton, College Mill Road, Okehampton, Devon EX20 1PW. Call Lynne Rogers on 07827 787867 or email lynne-inmotion@email.com for more information.

Penryn
View the list of exercise classes. For more information call Steve Winnan on 07908 334832 or email steve@intelligentfitnesscornwall.co.uk.

Pulmonary fibrosis groups

Exeter
Held every 4 months at Royal Devon and Exeter Hospital, EX2 5DW. Call Sarah Lines on 01392 406253 or email sarah.lines@nhs.net for more information.

Singing classes

Hayle
Held on Fridays, 2pm to 4pm, during term time at Townshend Village Hall TR27 6AG. Call Pip Wright on 01736 763766 or Chris Moore on 01736 740833 for more information.

Liskeard
Held on Fridays, 10.30am to 12pm, at Liskerrett Centre, Liskeard PL14 4AP. Call Emily Foulkes on 07702 675397 or email emily@cymazmusic.org.uk for more information.

Walking groups

Contact Karen Dawking on 01726 818881 for more information or visit the Eden Project website.
Looking after yourself
COPD cannot be cured with treatment, but medical treatments, breathing exercises, physical activity and stopping smoking can help control symptoms and limit disability. There is no cure for asthma, but with the right support and treatment you can control your symptoms and lead a healthy, active life.

Breathing techniques

There are various breathing techniques that some people find helpful for breathlessness. These include breathing control, breathing gently, using the least effort, with the shoulders supported. This can help when people with COPD feel short of breath.

Breathing techniques for people who are more active include:

  • relaxed, slow deep breathing
  • breathing through pursed lips, as if whistling
  • breathing out hard when doing an activity that needs a big effort
  • paced breathing, using a rhythm in time with the activity, such as climbing stairs

Exercise

People with COPD who exercise or keep active regularly have improved breathing, less severe symptoms and a better quality of life.

For most people with COPD who are disabled by their breathlessness, a structured programme of pulmonary rehabilitation provided by experienced healthcare professionals does the most good. Getting breathless is unpleasant but it is not harmful. Every patient should exercise as much as they can, however limited that may seem, twice a day. Even chair-bound people can do some arm and upper body movements.

Research shows that pulmonary rehabilitation improves exercise tolerance, breathlessness and health-related quality of life. It results in people seeing doctors less often and spending less time in hospital.

Healthy weight

Carrying extra weight can make breathlessness worse, so it is good to lose some pounds if you are overweight. This can be difficult because the breathlessness caused by COPD can make it hard to exercise.

However, some people with COPD find that they lose weight because they use up so much energy breathing. Eating food that is high in protein, and taking in enough calories, is important to maintain a healthy weight.

Research has shown that people with COPD who are underweight will have fewer COPD symptoms if they manage to increase their weight.

Find out if you are overweight or underweight with the healthy weight calculator.

Get immunised

The vaccines below are recommended for people with COPD, which are designed to reduce the risk of flare-ups:

  • a yearly flu jab, given each autumn, protects against flu (influenza) and so reduces the risk of associated chest infections
  • anti-pneumoccocal vaccination, a one-off injection that provides protection against a specific serious chest infection called pneumococcal pneumonia

Self care

Self care is an integral part of daily life and is all about you taking responsibility for your own health and well-being with support from the people involved in your care. Self care includes the actions you take for yourself every day in order to stay fit and maintain good physical and mental health, prevent illness or accidents and care more effectively for minor ailments and long term conditions.

People living with long term conditions can benefit enormously from being supported to self care – they can live longer, have less pain, anxiety, depression and fatigue, have a better quality of life and be more active and independent.

With the right treatment and management, asthma should not restrict your daily life.

Diet
Most people with asthma can eat a normal diet. Occasionally, people with asthma may have allergic triggers, and will need to avoid foods such as cow’s milk, eggs, fish, shellfish, yeast products, nuts and some food colourings and preservatives. But this is rare.

Exercise
Some people with asthma find that exercise triggers asthma symptoms. This does not mean you should avoid it, as physical activity will improve lung function and general health. Talk to your doctor about what to do before exercising, for example, using your inhaler before or after exercise to prevent symptoms.

Sleeping
Asthma symptoms are often worse at night. This means you might wake up some nights coughing or with a tight chest. This will obviously disrupt your sleep. Achieving good control of asthma by using the treatment your GP recommends will reduce your symptoms, so you should sleep better.

Social life
You should be able to enjoy a full social life, unaffected by your asthma. However, it is a good idea to avoid cigarette smoke, which is now much easier since the introduction of the smoking ban.

Many people with a long-term health condition experience feelings of stress, anxiety and depression.

You may find it helpful to talk about your experience of asthma with others in a similar position. Patient organisations have local groups where you can meet others who have been diagnosed with asthma and undergone treatment.

If you are experiencing feelings of depression, talk to your GP. They will be able to provide advice and support.

Check the weather

Check the forecast to see if the weather is going to have an effect on COPD symptoms. Keep a look out especially for cold spells lasting for at least a week and periods of hot weather and humidity, both of which can cause breathing problems.

The Met Office provides a service called Healthy Outlook COPD Forecast Alert. It warns people when the weather is likely to make their symptoms worse, and suggests simple measures they can take to stay well. The scheme provides weekly weather forecasts, warning people whether the risk of the weather causing an exacerbation of COPD is normal or elevated.

There is also a system for contacting all patients who have registered with the scheme when the forecast risk rises to elevated. Patients are warned by an automated telephone call about expected weather conditions, and referred to information packs for further advice. The system then asks whether their symptoms have become worse than normal, and if they have enough medication for the next two weeks. It alerts the patient’s GP surgery about the call, and their responses are stored in a database, which the GP staff can use for follow-up.

You may be able to use a web based health app to help you to manage your COPD. Ask your GP about the MyCOPD health app.