COPD exacerbations (flare-ups) are taxing on both you and the healthcare system. Not to mention, they are one of the terrifying aspects of dealing with chronic obstructive pulmonary disease (COPD), and for a good reason. COPD exacerbations result in more than 100,000 deaths and over 500,000 hospitalizations each year. Did you know that 21% of COPD patients will be readmitted to the hospital within 30 days of hospitalization?

Imagine if you could make simple changes to your daily life that would reduce your chances of having a COPD exacerbation. In this guest post, Duke Reeves will share with us his first six of 13 simple strategies that you can use to reduce your chances of experiencing and even prevent COPD exacerbations

1. Pulmonary rehabilitation

Visualize a COPD support group that offers education along with exercise sessions to help you adjust to life with COPD. That’s exactly what pulmonary rehab is. Pulmonary rehabilitation is one of the most important pieces to the puzzle when you have been diagnosed with COPD. In a controlled environment, pulmonary rehabilitation gives you the courage to live an active, fun, and healthy lifestyle while managing your COPD exacerbations.

For starters, you will be in a group setting with other people diagnosed with COPD along with medical professionals who will educate you about your lungs and COPD. More importantly, they will teach you little tricks to help ease some of those terrible COPD symptoms. There are several different components that make up a full pulmonary rehab course, these include but are not limited to:

• Educational sessions discussing: breathing techniques, exercise techniques, disease processes, respiratory medications, and oxygen therapy
• Exercise reconditioning sessions
• Nutrition education
• Energy conservation techniques
• Oxygen dosing (when applicable)
• Individualized counseling reviewing results of tests, program recommendations, exercise prescription, offered by a medical professional will answer any questions you may have

A standard pulmonary rehab program lasts six to 10 weeks to ensure you are ready to treat and manage your COPD on your own. Most patients say pulmonary rehab was a key element to living a better life with COPD. Everyone we have spoken with has highly recommended other patients to go!

The first step to getting started with pulmonary rehab is to find a program. Here are a few different links for you to use to locate a program close to home:

• COPD Foundation
• Emphysema.net
• American Lung Association
• Local.com (search for pulmonary rehabilitation)

Joining a pulmonary rehab program yields immediate benefits. While you may be meeting with the group weekly, you will be responsible for keeping up with the program while you are at home to stay in tip-top shape for the next session.

Upon completion of the pulmonary rehab program, you will be equipped with all the necessary tools to treat and manage the progression of your COPD, and it will enhance the following 12 tips in this post. Not to mention, by following the pulmonary rehab program you can essentially minimize the amount and severity of exacerbations you may experience.

2. Hydration is key

When treating and managing your COPD it is imperative that you drink plenty of fluids. Staying hydrated can make an enormous difference in your COPD, but there are some recommended guidelines to follow.

When we say drink plenty of fluids, we mean caffeine-free liquids with as little sugar as possible. While the sugary and caffeinated drinks are tasty, they can dehydrate you and cause problems like bloating which can make it harder for you to breathe.

Obviously, water is the top fluid for hydration, but why is it so important to stay hydrated with COPD?

Your immune system runs at its highest ability when you have proper nutrition and proper hydration. You will be giving your immune system a much-needed boost by staying hydrated. Hydration will help prevent you from getting sick or experiencing more or worse COPD exacerbations. Proper hydration is especially important given that supplemental oxygen may dry your mucus membranes and cause irritation.

Staying hydrated also thins your mucus, making it much easier for you to expel from your body.

It is recommended that you drink 64 to 86 ounces of caffeine-free liquids every day. That equals eight to 12 cups. Here are the best fluids for staying hydrated:

• Water
• Real fruit juice (with little to no added sugar)
• Decaf coffee
• Decaf tea
• Milk

It may be hard to cut out some of your favorite drinks like soda, but it’s important to do the best job you can to take care of yourself. Yes, you can treat yourself to a soda every now and then, but make sure to follow it up with a glass of water or two so your soda doesn’t dehydrate you. If you need some ideas or tricks on how to drink more water every day, click here.

3. Wash your hands regularly

Getting sick plays a major role in experiencing COPD exacerbations. Something as small as a minor head cold can wreak havoc on your ability to breathe and your immune system. Having a hard time breathing and a compromised immune system can easily cause a COPD exacerbation.

As you touch different surfaces and objects throughout the day, germs begin to build up on your hands. As the germs accumulate, you can infect yourself by touching your eyes, nose, and/or mouth.

While it is impossible for you to keep your hands germ-free, frequently and regularly washing your hands is easily one of the best ways to reduce your chances of experiencing an exacerbation from getting sick.

Washing your hands takes a little more work than just putting your hands under running water. Here is a step-by-step process on how to properly wash your hands from the Mayo Clinic:

• Wet your hands with running water – either with warm or cold water.
• Apply liquid, bar, or powdered soap.
• Lather well.
• Rub your hands vigorously for at least 20 seconds. Remember to scrub all surfaces, including the backs of your hands, wrists, between your fingers, and under your finger nails.
• Rinse well.
• Dry your hands with a clean or disposable towel or air dryer.
• If possible, use a towel or your elbow to turn off the faucet.

Now that you know how to properly wash your hands, it’s time to determine when you should wash your hands, aside from when they look dirty.

Always wash your hands before any of the following activities:

• Preparing food
• Eating
• Treating wounds
• Giving medicine
• Caring for a sick or injured person

Always wash your hands after any of the following activities:

• Preparing food, especially raw meat or poultry
• Using the toilet
• Changing a diaper
• Touching an animal, animal toys, leashes, or waste
• Blowing your nose
• Coughing/sneezing into your hands
• Treating wounds
• Caring for a sick person
• Handling garbage
• Using chemically based cleaners
• Utilizing garden chemicals
• Shaking hands with others

When washing your hands, keep in mind that regular soap will do the job just as well as antibacterial soap. In fact, using antibacterial soap may lead to the development of bacteria that are resistant to the soap’s antibacterial agents. It’s also important to remember that washing your hands with soap and water instead of using hand sanitizer is better for your immune system. Using hand sanitizer kills 99.9% of germs including the good ones, but it will work in a pinch if you can’t get to a sink.

4. Reduce indoor air pollution

Keeping your home free of indoor pollutants can vastly improve your quality of life while minimizing the number of exacerbations you may experience throughout the year. The number of indoor pollutants that could be in your house may surprise you. Fear not, most are quick and easy fixes. Here is a list of indoor pollutants:

• Dust
• Mold
• Mildew
• Chemicals from cleaners and air fresheners
• Fumes from perfumes, colognes, and hairspray
• Pet dander
• Humidity
• Smoke from cigarettes, fires, cooking, and wood-burning stoves

There are many different things you can do and the strategies you can use to reduce and even eliminate the number of indoor pollutants you are exposed to.

Dealing With Dust

Dust can cause a flare-up of symptoms in a heartbeat, especially if you suffer from allergies. By keeping your home as dust free as possible you will improve the quality of air that you breathe and reduce your chances of experiencing an exacerbation. Here are a few tips on how to make your house as dust free as possible and maintain that level of cleanliness:

• Dust surfaces regularly to prevent buildup.
• Get air ducts cleaned periodically.
• Clean or replace air filters at least twice per year.
• Cover mattress, box spring, and pillows in dust-mite resistant covers.
• Wash sheets, blankets, and pillowcases once a week in hot water (at least 131 degrees Fahrenheit).
• Eliminate dust collecting décors like stuffed animals and decorative items.
• Remove piles of magazines and books (they degrade over time and produce more dust).
• Use fewer textiles like throw blankets, pillows, and tablecloths as they can produce and trap dust.
• Pay attention to seasonal allergies and keep windows closed when allergen counts are high or high winds are anticipated.
• Have friends, family, and all the guests take off dirty shoes at the door.
• Vacuum carpets regularly (twice per week if possible).
• If practical/within your budget replace carpeting with wood floors.

If possible, it’s best to have someone clean for you or help you clean. For one, cleaning can take a lot of energy and leave you feeling short of breath. Also, when you vacuum and dust you are exposing yourself to a lot of dust that gets kicked up in the act of cleaning. By reducing your contact with the dust particles, you’re keeping your lungs as healthy as possible.

We recommend choosing cleaning products that are hypoallergenic. To dust, you might want to consider Clorox Triple Action Dust Wipes. These are excellent for dust, hair, and allergens. Or, try Hypo-Allergenic Dusting and Cleaning Spray by Endust which is formulated with less-irritating ingredients and free of perfumes and fragrances that could trigger COPD expirations. Continue reading for our recommendations of organic cleaning solutions.

As you know, being exposed to fumes, scents, and smoke throughout the day can really cause problems with your COPD. In fact, if you are sensitive to strong scents or fumes and happen to inhale them you may experience chest tightness and shortness of breath almost immediately. Eliminating fumes from your home is much less work than making your home dust free. Here are some tips on how to eliminate strong scents and fumes from your home:

• Replace chemically based cleaners, especially those with bleach or ammonia, with “green” cleaning supplies, soap and water, baking soda, or vinegar.
• If you can’t replace your cleaning products, have someone else do the cleaning for you to avoid the harmful fumes.
• If you don’t have someone that can help you clean, the COPD Foundation recommends wearing a respirator mask rated “N95” by the National Institute for Occupational Safety and Health.
• Use unscented shampoo, soap, deodorant, and hairspray.
• Avoid cigarettes at all costs.
• Avoid using wood burning fireplaces and stoves, the smoke produced can cause complications with your COPD.
• Keep your home properly ventilated.
• Use an air purifier with a HEPA filter.

Once you start making changes in your home and eliminate the fumes, scents, and smoke that irritates your lungs you will immediately notice a difference in how you feel. It will also be easier for you to control your symptoms.

Controlling Humidity

Living in areas with high humidity can make it harder for you to breathe and possibly trigger an exacerbation, especially when the humidity invades your home. Low humidity areas are ideal for COPD patients like yourself, with 40% humidity being the sweet spot. You can easily and accurately check the humidity levels in your house with an inexpensive humidity monitor from Amazon.

Unfortunately, you can’t do anything to reduce the humidity outdoors, aside from moving, but you can and absolutely should control the humidity levels in your house. The steps you take to do so will be dependent on the weather outside. In order to control the humidity levels in your house, follow these tips:

• Watch the weather index to get an idea of how humid it is going to be that day.
• Properly ventilate your home, especially areas that create moisture like the kitchen, laundry room, and bathroom.
• Use fans to increase ventilation.
• Take colder, shorter showers.
• Open or close your windows based on the humidity and temperature outside.
• Use a dehumidifier to reduce humidity.
• Use a humidifier to increase humidity.
• Adjusting the AC or heat also helps control humidity levels.

Moisture Breeds Bacteria

Moisture build-up may go unnoticed until it’s too late and your symptoms start to flare-up. Simply put, moisture breeds bacteria, mold, and mildew that reduces air quality and can be detrimental to managing your COPD. By following these simple steps, you can nip moisture build up in the bud and improve the air quality in your home right now:

• Repair all leaks that may be present.
• Immediately wipe up spills.
• Use fans to increase ventilation in kitchens and bathrooms.
• Replace sponges frequently.
• Clean or replace showerheads at least twice per year.
• Throw out water-damaged carpet or cushions.

5. Weather and air quality reports are your best friends

Staying up-to-date on weather, pollen, and pollution reports can save you from a terrible COPD exacerbation. There are a few important factors to be mindful of, especially if you also suffer from asthma. Extreme temperatures, high pollen counts, and high pollution counts have all been known to cause COPD symptoms to flare-up and possibly cause hospitalization.

With these tips, you will know what to look for, how to prevent yourself from getting exposed to the elements, and how to prepare yourself if you absolutely have to go outside when the tables are turned against you.

Extreme Temperatures and Weather Conditions

Dealing with extreme temperatures can be frustrating for anyone. Depending on where you live, extreme temperatures are present for almost half of the year. During the summer months extreme heat and humidity, with some areas regularly breaching triple-digit temperatures, are a concern. During the winter you might be subjected to frigid temperatures and strong winds.

With a few exceptions to the rule, hot and humid climates cause COPD symptoms to flare-up. There are a select few people with COPD who do better in humid weather. Hotter temperatures also usually lead to higher pollution counts and lower air quality scores. Here are a few tips to help you beat the heat and manage your COPD symptoms during the summer:

• Check weather reports daily.
• Stay inside an air-conditioned environment on the hottest and most humid days.
• Limit activities to stay cool.
• If you must go outside, go when the temperature is as mild as possible (preferably in the morning or the evening).
• Stay hydrated and drink a lot of water. Not only does it help thin mucus and boost your immune system, but it will also help regulate your body temperature.

When the weather gets cold and windy, COPD symptoms are tough to manage. In fact, cold weather and strong winds are known to be COPD exacerbation triggers. Cold temperatures can also cause you to be fatigued even if you haven’t had to exert yourself. Here are some tips that will help you reduce exacerbations in the winter:

• Avoid going outside in the extreme cold.
• Avoid going outside when it’s really windy.
• When you go outside wear a loosely worn scarf or face mask over your nose and mouth.
• Breathe in through your nose when outside, this warms the air up before it reaches your lungs.
• Keep your oxygen tubing inside your clothing to warm the air.
• Wear several layers of loose clothing to protect you from the cold without restricting your breathing.
• Keep your inhalers warm as their optimum operating temperatures range between 50 and 80 degrees Fahrenheit.

Air Quality Is Key

As we mentioned before, COPD and air quality go hand in hand. Environmental pollution is one of the leading risk factors for COPD for non-smokers. When you expose yourself to high levels of pollution you are putting yourself at risk of experiencing an exacerbation. Depending on where you live, it may be harder to completely avoid pollution, especially in a major city like Los Angeles or New York. However, if you take these tips and apply them to your everyday life you will be able to minimize your exposure:

• Regularly check the air quality index which can be found here.
• Watch the news or read the paper to get warnings on pollution levels in your area.
• Follow advice from public service announcements telling you what level of outdoor activity is okay.
• Avoid poor air and harmful fumes when traveling by car.
• Take alternate, less crowded routes to your destination during rush hour.
• Plan your travel when traffic is light.
• Travel with your air conditioning on and windows rolled up (keep one window cracked to prevent oxygen from accumulating while you are traveling).
• Stay indoors when air quality reports are poor.
• Keep windows closed and air conditioning on in your home on high pollution days.

Pollution isn’t the only thing that can affect the air quality for COPD patients. If you suffer from allergies it’s important to watch pollen counts for your area because allergies can cause your symptoms to a flare-up in no time. Although there are several over-the-counter allergy medicines available, there are several different things you can do to prevent your allergies from affecting your COPD.

• You should check the allergy forecast for your area every day. It can be viewed here.
• If the allergy forecast is medium-high you will want to stay inside and keep your windows and doors closed and your air-conditioning unit on.
• Check with your doctor to see what allergy meds are okay for you to take.
• Regularly clean or have someone clean your house to prevent dust and pet dander from building up.
• Have your pet, if they go outdoors, brushed regularly as they are known to bring dust, dirt, and pollen into your home.
• If you must go outside when the allergy forecast is not favorable, carry your inhaler with you.

6. Clean your home or have your home cleaned regularly

Having a clean household can make a big difference when it comes to managing your COPD and preventing exacerbations. Indoor air pollutants are a major risk factor for exacerbations and will make it extremely hard to effectively manage your disease.

Indoor air pollution comes from various sources including, but not limited to; wood burning stoves, wood burning fireplaces, dust build up, pet dander, chemically based cleaners, perfume, and cologne. Don’t be intimidated by the long list of pollutants, we will go over how to minimize your exposure and offer alternative methods and products that will be COPD friendly.

First and foremost, if it’s feasible for you to do so, hire a service or ask a family member to clean for you. Not only do you have to worry about dust, fumes, and your COPD but cleaning with COPD requires a lot of energy and planning. There are services like Molly Maid, Merry Maids, and Maid Brigade that will come out to your house and clean on a regular basis.

If hiring a maid service isn’t an option, consider asking your children or grandchildren to clean for you or help you clean. After the original deep cleaning, it will just need to be maintained. The list of cleaning duties would include:

• Dust all surfaces often, including lampshades and windowsills with a damp cloth.
• Vacuum weekly with allergen-proof vacuum bags (you may also wear a mask for extra protection).
• Wiping down and disinfecting countertops
• Keep bathrooms clean and dry.
• Laundry
• Washing dishes

If a cleaning service isn’t an option and you don’t have family nearby it’s important that you clean regularly within your means. Before we can get into a regular cleaning schedule, we need to go over some quick tips that will help reduce indoor air pollution before the cleaning even starts.

Get Your Air Ducts Cleaned Periodically

Hiring a professional duct cleaning service will drastically increase the air quality in your home depending on the last time you got them cleaned. According to the EPA, if there is substantial visible mold growth, the ducts have an infestation of insects or rodents, or if the ducts are excessively clogged and are releasing particles into the home then you should have this cleaning done right away.

Make sure your professional duct cleaning service cleans all of the duct systems. If they do not, your ducts will become re-contaminated almost immediately. If you have a furnace, stove or fireplace make sure to have it inspected once a year to make sure it is not releasing deadly carbon monoxide fumes. However, you don’t want to get your air ducts cleaned just to have them cleaned.

Look for the following signs to tell if your ducts need to be cleaned:

• Visible mold on the ducts or other heating and cooling components
• Vermin in the ductwork
• Dust, debris, and other particles clogging the ducts and being released through supply registers

If you decide your ducts need to be cleaned here are some tips to ensure you deal with a reputable company that cares about your situation and your well-being:

• Only deal with a reputable and professional company. Make sure you check for licensing, look up reviews online, and ask for references.
• Make sure you let the cleaning company know they can’t use biocides or chemical treatments because of your COPD.
• Ensure the company will protect you and whoever else lives in your house from being exposed to chemicals and contaminants that may come loose during the cleaning.
• Leave your house while they clean your ducts.

Get Rid of Chemically Based Cleaning Supplies

No matter how good of a job they do, chemically based cleaning supplies can be detrimental to your COPD symptoms and spark an exacerbation whether you’re doing the cleaning or not. However, there is more risk involved if you are the one cleaning.

The mix of chemicals in each cleaner gives off fumes that you are breathing in every second you clean and for minutes, or in some cases, hours after you finish. There may be a few items you can’t do without like plain bleach or ammonia, but it would benefit you to remove as many chemically based cleaners from your house as possible. Look for “green” cleaners that are all natural or you can use a water and vinegar solution and baking soda. There aren’t many things vinegar and baking soda can’t clean.

We recommend using vinegar and baking soda since neither of them is a lung irritant. Here are some “recipes” and instructions for cleaning solutions using vinegar, water, baking soda, dish detergent, and ammonia (when needed).

Remember, when using ammonia or bleach to clean you will want to keep the mixture away from your face so you don’t breathe in the fumes. If possible, we recommend using a mask or respirator when using ammonia or bleach.

Toilet Cleaner

1. Pour two cups of baking soda around the inside of your toilet bowl and scrub with a long-handled brush to prevent bending at your waist and then flush the toilet when you finish scrubbing.
2. Pour two cups of vinegar inside the toilet bowl and swish around the entire bowl and then flush the toilet.
3. Make sure your toilet is not clogged when using this method to clean. If it is clogged the baking soda and vinegar will react and that’s a mess no one wants to deal with.

Carpet Cleaner/Deodorizer

1. Sprinkle baking soda over the affected area.
2. Let the baking soda sit and do its work. (The longer it sits, the better job it does.) It’s okay if you walk on the area you are treating.
3. After letting it sit, vacuum the treated area thoroughly.

All-Purpose Cleaner

1. Get a large spray bottle and put a half cup of baking soda into the bottle
2. Fill with enough water to dissolve the baking soda
3. Very slowly add a cup of vinegar to the bottle (the solution will begin to fizz a lot which is why you add the vinegar slowly)
4. Top the mixture off with water and let it sit overnight
5. In the morning flip, it ends over end to mix the solution (there will be more fizzing)
6. When the fizzing stops your solution is ready to use

Grease Cutting Cleaner

1. Follow the same recipe above for the All-Purpose Cleaner, but add a teaspoon of dish detergent

Window Cleaner

1. Mix warm water with one cup of vinegar and two capfuls of ammonia.
2. Wear a mask or respirator and mix away from your face.
3. Wear mask or respirator as you clean with the solution.

Tips to Clean Effectively and Efficiently with COPD

Before you start cleaning there are some tips and techniques you can use to conserve energy, cut out uncomfortable movements, and protect yourself from inhaling dust, fumes, and other particles while cleaning in a more effective and efficient way. Always remember, take frequent breaks as often as you need them while cleaning.

Tips to Remember While Vacuuming

When it comes to vacuuming it’s all about synchronizing your breathing pattern with the physical act of pushing/pulling the vacuum. Ideally, you will want to use the pursed lip breathing technique.

• Take a deep breath before you start the vacuum.
• Synchronize your breathing pattern with your movements as you push and pull the vacuum.
• Exhale as you push the vacuum.
• Inhale as you pull the vacuum.
• Good posture is key and will keep your diaphragm open, making it easier for you to breathe.
• When emptying the vacuum, use a damp newspaper to trap dust particles and reduce the number of dust particles getting into the air.

Tips to Remember While Dusting

Dusting is very intimidating to some COPD patients, and that’s understandable. It may seem like you are playing with fire by stirring up a known lung irritant, however, these tips will reduce your exposure to dust particles and help you conserve energy along the way.

• Use a mask to prevent yourself from breathing in loose dust particles. We recommend a respirator just to be safe.
• If possible, dust while sitting down. This will eliminate the need for you to bend over and dust, and it will conserve energy for later in the day.
• When dusting areas that are hard to reach, use a long-handled duster to avoid reaching or climbing.
• Avoid excessive furniture so you don’t have to move items around just to clean.

Tips to Remember While Cleaning Your Floors

Cleaning your hard-surfaced floors is very similar to vacuuming. You will want to focus on your pursed-lip breathing technique and synchronize your breathing pattern with the physical act of pushing/pulling your broom or mop. If possible, avoid kneeling and scrubbing because it requires a lot of energy and bending over which can make it harder for you to breathe.

Sweeping/Mopping Your Floors

• Stand tall with good posture to avoid bending at your waist.
• Synchronize your breathing pattern with your movements as you push and pull the mop/broom.
• Inhale as you push the mop/broom.
• Exhale as you pull the mop/broom.
• Use a long-handled dustpan when sweeping.
• When possible use floor coverings that are low maintenance.

Wiping Spills and Picking Up

• Use a small mop to wipe up spills to prevent bending at your waist or kneeling and scrubbing.
• Use pick up tongs to pick articles up from the floor.
• Use paper towels to reduce your laundry load.

Kneeling and Scrubbing Your Floors

As stated above, if possible you should avoid kneeling and scrubbing your floors. However, if you absolutely have to, here are some tips on how to scrub your floors with COPD:

• Use the pursed lip breathing technique.
• Start in the kneeling position.
• Take a deep inhale before bending down to scrub.
• As you exhale bend down to start scrubbing.
• Take as many breaks as you need.

Tips to Remember While Making Your Bed

The first chore almost any of us had to do was make our bed. Now that you have COPD that chore takes a lot more time and a considerable amount of energy to complete. It’s easiest to make your bed if you do it bit by bit and don’t try to rush. Here are some helpful tips to use:

• Use the pursed lip breathing technique.
• When straightening sheets, do one side at a time.
• Unfold your linen.
• Line it up with the center of your bed.
• Complete the side you are working on.
• Move on to the other side.
• When putting new sheets on, do one side at a time.
• Put bottom sheet, top sheet, and your blanket on all at once.
• Tuck the bottom sheet on one side.
• Tuck the bottom sheet on the other side.
• Put pillows in your pillowcase.

Remember, don’t over exert yourself while cleaning. Take as many breaks as you need and enlist help from family and friends when possible. It might seem like a daunting task, but if you clean in bits and pieces rather than all at once, you will be able to accomplish more without overexerting yourself.

Written by Duke Reeves and posted here with permission.

A little about Duke:

I have been employed with 1st Class Medical for the past four years where I have taken on a number of different roles from customer service to customer education. I work with customers and healthcare professionals alike to deliver non-technical readable content that is actionable and focused on improving the quality of life of our customers with respiratory illness.

My focus is patient education and awareness to help deliver information that is readable and easy to understand from a patient’s perspective. When I’m not working I am spending time with my dog Molly and exploring beautiful Colorado.

See more by Duke: http://www.1stclassmed.com/blog