Dealing with a Bad COPD Exacerbation & Maybe Dodging an E.R. Visit (2nd Edition)

By J.D. (“Joffre”) Meyer
Those of us with COPD (Chronic Obstructive Pulmonary Disorder) live with the strong risk of an exacerbation that is severe enough to go to the Emergency Room by way of ambulance. I developed asthma 18 years before COPD too. We face a mix of lung spasms, excess chest phlegm, and a low FEV (Forced Exhale Volume). Asthma-COPD Overlap Syndrome (ACOS) is known for increased breathlessness and sputum–but a better response to inhaled corticosteroids.

It’s typical for me to have some coughing and wheezing when I awake, and sometimes after a walk. Choice #1 is using an asthma rescue inhaler, such as Pro-Air. It’s like a “Bud Light” version of the nebulizer, as both use albuterol. But the likelihood of its effectiveness goes downhill if our attack is more than simply mild. Rule #2 is not to take the long-term inhalers during an acute attack, such as Advair or Symbicort, and Singulair.

So we go for our dear friend, the nebulizer, and pour a vial of albuterol or albuterol-ipratropium in the receptacle. We get “Albut-Iprat” when our condition becomes worse. I just started getting Combivent, the stronger “Albut-Iprat” inhaler. Our next choice is mask or “pipe.” Most say the pipe-like hose is better because we get more of the medicine. So here’s my first original suggestion. If you wear the mask, put your oxygen canula up your nose (assuming you own one). Really tired COPD sufferers may have difficulties with the pipe.

Speaking of phlegm, keep a plastic can with a lid handy, such as my old Folger’s coffee can, the regular 10.3 oz. size. Don’t even consider swallowing that phlegm. I’m not trying to be funny because it’s not. Don’t expect to be able to run to spit in the nearest toilet or sink either. Make sure you drink enough water too–a likely weak area for most people. 1.5 liters daily should be enough since other fluids are okay; vegetables and fruits are full of water too. I use an attractive purple jug for my water, so I’ll notice it better! I can keep the squirt cap on when I take my many morning pills. Then I remove the cap for water guzzling!

Now let’s look at the OTC (over-the-counter) medicines. For your chest congestion, take some guaifenesin; that is, Mucinex or a generic version. COPD is a mix of emphysema and bronchitis. Bronchitis is like having a perpetual chest cold while emphysema is a destruction of the lung sacs and a lack of elasticity in the lungs.

What if you have nasal congestion? A saline nasal spray will open a constricted nose. Later I submitted this article to COPD Breathing Buddies of Facebook, and I was warned about Sudafed. This drug may reduce nasal congestion, but Sudafed can raise your blood pressure, which may happen anyway during a COPD attack. Lately, I’ve been adding ginger root slices, eucalyptus leaves, and even garlic cloves to my morning coffee drip bin. My goal is to reduce inflammation.

If you have severe or moderate COPD, take your Daliresp pill. By the way, since you’re taking all these pills have a water bottle next to your bed. The more water you drink, the more the mucus will be thinned.
Here’s my second original tip. If you have a C-PAP machine for sleep apnea, you can use it when you’re wide awake to force air into your inelastic, sagging emphysema-ridden lungs! Don’t overuse your nebulizer; try a wide range of strategies to stop the COPD attack.

Please check out my methods for battling severe COPD exacerbations! Maybe I have a higher tolerance for pain than many, or a fear of walking home from the E.R. before sunrise? My latest severe attack lasted for 1 hour & 40 minutes!!
And when you quit choking, take your Symbicort and Singulair or whatever.

Consider calling your G.P. M.D. later for an office visit. Last week I got a shot of Salumedrol, a steroid, at her office. Then I got prescriptions for prednisone pills and a Z-Pac antibiotic.

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