COPD Education is Key: 15 Questions you Need to ask your Doctor

Have you ever left a conversation with your doctor confused about their instructions or explanations? It may have been the complicated terminology they were using, or long instructions about a prescription  you need to be taking, or a lack of explanations for your treatment. Studies show that there is a gap between patient–doctor communication leading to decreased quality of care.

Education is a vital element of the patient care process and can contribute to successful and  effective management of COPD.

Educating yourself about COPD is your job as the patient. This comes down to understanding your COPD symptoms, the testing, and management and treatment options involved. Then, you will be able to effectively ask your doctor questions and confidently understand their answers. 

This is a clear and cohesive guide that you can study before your next visit with your doctor to ensure that you understand the information you doctor presents to you, and you can ultimately advocate for yourself!

Effective patient education will enhance your experience dealing with the uncertainties and confusions of having a chronic illness like COPD.

Patient education also lead to:

• Satisfaction with your overall health care
• Understanding COPD and your treatment
• Comfort and skill in managing and monitoring your COPD by yourself

Important aspects of COPD you need to know: Medication, supplements, oxygen therapy, and pulmonary rehabilitation 

If you or someone you know has recently been diagnosed with COPD the amount of information about the disease may feel daunting. But remember; information is power, and knowing what your options are will open doors to a personalized treatment plan that is crucial for living with COPD.

The 3 basics of COPD: 

1. COPD is a chronic illness. This means that you live with it every day.
2. COPD is referred to as chronic bronchitis or emphysema.
3. You can do a lot of different things to treat and help manage the disease. There are medications you can take, you might try supplements if you have a deficiency, you can start oxygen therapy, and pulmonary rehabilitation, and get involved with social support groups

Medications and Supplements:

Your medications should be geared towards keeping your airways open as much as possible by helping clear mucus from your respiratory tract, and decrease inflammation. No single strategy or medicine is "best" for everyone, so do not settle for a medication that gives you adverse side-effects.

Personalization is key to addressing your COPD and finding the best plan for symptom control. Always be search for the right medication and supplements to to ensure:

1. Better breathing
2. Participation in the activities you enjoy
3. Fewer flare-ups

Bronchodilators

Bronchodilators relax the muscles around your airways, opening your airways, and helping you breathe easier. Most of the time, you take bronchodilators through an inhaler or it can be converted into a fine spray as a nebulizer, so you breathe the medicine straight into your lungs.

Inhalers work in different ways, so make sure to ask your doctor shows you how your specific inhaler works. Be sure that you are getting a full dose of medicine with each breath.

Three main categories of COPD inhalers:

1. Rescue inhalers use short-acting bronchodilators, which work quickly so that you get relief from symptoms fast, and these wear off in a few hours
2. Maintenance inhalers use medications known as long-acting bronchodilators, they provide relief for many hours, but the effect may act slower.
3. Steroid inhalers contain corticosteroid medications, which target the body's immune system to suppress inflammation in the lungs. These are mainly prescribed to treat COPD exacerbations.

Anti-Inflammatory medications

Anti-inflammatory medications decrease swelling and mucus production within your airways making it easier to breathe. These medicines are known as corticosteroids or steroids. They are usually inhaled with an inhaler.

You could also take corticosteroids as a pill but these will usually only be prescribed for short periods of time in special circumstances when your symptoms are getting more severe.

Steroids have serious side effects, such as weight gain, diabetes, osteoporosis, cataracts and increased risk of infection, so you and your doctor should monitor your use carefully.

Antibiotics

If you have COPD, you are more susceptible than others to catching illnesses from bacteria that infects your respiratory system. If your illness is caused by bacterial or viral infections your doctor may prescribe you an antibiotic for you to keep on hand for if you get an infection.

Talk to your doctor about the prescription of your antibiotic. It is imperative that you finish the perception by taking all of the antibiotics for the duration of time it is prescribed, even if you start to feel better and are not experiencing symptoms. If you do not finish your perspiration, the infection and symptoms can come back in full-swing before it's ever really gone.

Vaccinations

If you have COPD, you are especially vulnerable to viral and bacterial pulmonary infections. Infections are major causes of exacerbations, hospitalization, disease progression, and mortality in COPD patients. Effective vaccines reduced the risk of contracting respiratory infections and reducing flare ups COPD patients.

Supplements

Using herbal and nutritional supplements for COPD can also help with managing your symptoms. Before taking any supplements, you should discuss their use with your doctor because it can interfere with some drugs and cause side effects.

All of these vitamins and nutrients can be found in the foods and drinks you consume, but if just eating more nutrient rich food still leaves you with a vitamin deficiency, taking supplements may be a great option for you to get the nutrients your body needs.

Here is a table of vitamins that have been shown to improve lung health:

Oxygen therapy facts for COPD patients

Oxygen therapy is a great option for you if you have moderate to severe COPD and it is something that your doctor will need to prescribe to you. Oxygen therapy can improve your quality of life in a number of ways and it is one of the few treatments that can extend lung health as COPD progresses.

Research shows that even though oxygen is the foundation of treatment for severe COPD patients, many people may not be using it as often as recommended because it can restrict your ability to do certain activities.

You should have a conversation with your doctor if you've been reluctant to use oxygen for any reason. And you should know that there are many streamlined portable oxygen designs available that allow you to get out of the house and be active with far less shortness of breath and risk.

You have a lot of different options when it comes to choosing an oxygen concentrator, and like your treatment for COPD your oxygen concentrator should be personalized to your needs, and meet your requirements.

Some oxygen concentrators are lightweight, others have longer battery life, others have stronger pulse/continuous flow rates, and there are a few concentrators that embody a variety of these aspects in one

So choosing an oxygen concentrator is something that you should discussed in great detail with your doctor. This way when you get in contact with one of our specialists, they are able to accommodate all of your medical demands and physical goals with the best unit for you.

You and your doctor should discuss what type of oxygen concentrator you will need to full-fill your oxygen demands:

• Pulse Flow Oxygen Concentrators deliver oxygen in puffs of air called “boluses.” A bolus of oxygen is only administered when the patient is inhaling. Pulse flow units tended to be much lighter, allowing you to carry them on your shoulder or in a bag
• Continuous Flow Concentrators produces a constant stream of oxygen despite the patient’s breathing rate. continuous flow units are heavier but offer more options and often much higher oxygen output.
  

After you determine what type of flow will full-fill you oxygen needs bests, you can then make a list of priorities base on what you should look for in an oxygen concentrators. You can access this guide by clicking here.

Pulmonary therapy and rehabilitation 

Pulmonary rehabilitation can be an essential tool throughout your lifetime management of COPD. It requires the coordinated action of a multiple healthcare professional in order to deliver you a rehabilitation program that best fits your needs.

The most important components of pulmonary rehabilitation are exercise and self-management education. Studies have been shown that these are the most beneficial aspects for improving health-related quality of life.

By joining a pulmonary rehabilitation program, you are signing up for more than just physical therapy. The classes will often take place in a group setting, giving you the opportunity to meet others with COPD, you will develop physical strength while both giving and receiving emotional and mental support from and to others.

Social support groups

While this may not be a topic that comes up with your doctor, it is something you should consider if you are living with COPD. In the midst of a global pandemic its is ill-advised to spend time regular socializing with others, or joining group pulmonary rehab classes, however you are still not alone.

By joining Facebook groups or online forums, you are immediately welcomed into a community of people who are going through similar challenges and confusions as you. There may be an option to take a pulmonary rehabilitation classes online, and maintain connections with others through live videos and streaming. 

Terminology associated with COPD symptoms

If you understand what your symptoms are you can confidently differentiate when you need to call your doctor about and when you are able to manage certain symptoms on your own.

• Dyspnea: Shortness of breath while doing everyday activities
• Cyanosis: Blueness of the lips or fingernail beds
• Phlegm or sputum: The thick substance produced by the mucous from the the respiratory passages, especially when produced in excessive or abnormal quantities
• Flare ups: Is often referred to as an exacerbation and it occurs when you feel more short of breath or wheeze and cough more than you usually do. Flare ups can be very serious and could require medical attention
• Hypoxia: Means there is too little oxygen in the body

Terminology associated with COPD testing

If you are about to be tested for COPD it is critical you understand the metrics in which you are tested, and what the measurements mean.

• Spirometry: For this test, you blow air into a mouthpiece and tubing attached to a small machine. The machine measures the amount of air you blow out and how fast you can blow it. This test will provide your doctor with two measurements: forced vital capacity (FVC) and forced expiratory volume (FEV).
• FVC: is the total amount of air you can forcefully exhale
• FEV: is the amount of air you can exhale in a given period of time
• FEV1: calculates the amount of air that a person can force out of their lungs in 1 second. For COPD patients, lower FEV1 results suggest that the disease is in a more severe stage.
• Chest X-ray such as an arterial blood gas test: This test measures the oxygen level in your blood by showing how well your lungs are able to move oxygen into your blood and remove carbon dioxide from your blood.
• CT scan: This test is a CT scan of your lungs that can help detect emphysema and determine if you might benefit from surgery for COPD.

Terminology associated with COPD management

You should understand the terminology you doctor is using for your treatment so you feel confident leaving the doctors office and continue managing your COPD alone or at home.  

• BiPAP (bi-level positive airway pressure) machine that provides assistance in breathing through a tight fitting mask. This machine is often used in the emergency department or hospital if breathing is too difficult.
• Cannula is plastic tubing used to supply oxygen through the nose.
• CPAP (continuous positive airway pressure) is a technique for pumping a steady flow of air, at a constant pressure, into narrowed lung airways to keep them open.
• Intubation provides assistance with breathing by putting a tube, which is connected to a ventilator or respirator machine, through the nose or mouth and directly into the lungs. Allows the machine to do all or some of the breathing.
• Oxygen Concentrator is a machine used for oxygen therapy. It has a pump that takes oxygen from the air and moves it through a long narrow tube into the nose. It concentrates the amount of oxygen taken from the air. There are now portable oxygen concentrators available.
• Oxygen Therapy is a medically prescribed system of providing additional oxygen to the body. It is prescribed when diseased lungs are not able to meet the body’s oxygen needs.
• Pulmonary Rehabilitation is more than just physical therapy. It is a supervised program that includes exercise training, health education, and breathing techniques for people with lung diseases.
• Physiotherapy is a treatment performed by respiratory therapists that involves tapping on the chest and/or back to shake mucus loose.
• Pursed lip breathing is a technique that helps people who experience shortness of breath including COPD patients. This breathing technique helps control shortness of breath, and provides an easy way to slow your breathing, making each breath more effective. 

15 things you need to ask you doctor about your COPD

Now that you have the resources to learn and know more about your COPD symptoms, testing, and treatment options; you can ask your doctor some of these questions to better advocate for yourself.

1. What has caused my COPD?

Start at the beginning for your own clarity in the future. Be sure you understand what COPD is, and what to expect from the disease now and later on.

2. What stage of COPD am I in?

Knowing what stage of COPD you are in will determine how your treatment plan should be set up. It is important for you, and not just you doctor, to be able to discuss and research the severity of your COPD, and become aware of your options moving forward.

Stage 1: Mild

This early on, you may not know you have COPD yet. You might be experiencing more coughing or more mucus production than normal. The earlier COPD is diagnosed the sooner you can start to slow the progression. 

Stage 2: Moderate

At this stage, you would develop a cough, mucus, and shortness of breath. Do not pass these symptoms off as signs of aging or a cold. You should go see your doctor so they can give you a spirometry test, and from there your doctor is able to determine if you need treatment.

Stage 3: Severe

At this stage your lung function will have seriously declined. Symptoms are more severe and more common, and you may start to get flare-ups when your symptoms get worse. Your doctor will likely prescribe a long-acting bronchodilator and possibly steroids, or oxygen therapy.

Stage 4: Very Severe

At this stage, you have very minimal lung function. You get winded with small amounts of activity, and when your symptoms flare up it can be fatal. At this stage, your treatment would build on your current therapies. In severe cases if all treatment options have failed, a lung transplant may be necessary.

3. What is my FEV1 and FVC rate?

Your FEV1 and FVC rates can tell your doctor a lot about your COPD, but it can also tell you a lot about your options!

FEV1 is the volume of air that you can forcibly blow out 1 second, after a full inhale. Average values for FEV1 in healthy people depend mainly on sex and age, so values between 80% and 120% of the average value are considered normal.

FVC is a measurement of the greatest amount of air you can forcefully breathe out after breathing in as deeply as you can.

Comparing your FEV1 and FVC rates with other people’s will not show you a direct comparison of each other's COPD severity if you are different genders or ages.

COPD stage 1

The first stage is considered mild. Your FEV1 is equal to or greater than the predicted normal values with an FEV1/FVC less than 70 percent.

COPD stage 2

Your stage is considered moderate. And your FEV1 will fall between 50 percent and 79 percent of the predicted normal values with an FEV1/FVC of less than 70 percent.

COPD stage 3

This is a severe stage of COPD. Your FEV1 falls somewhere between 30 percent and 49 percent of the normal predicted values and your FEV1/FVC is less than 70 percent.

COPD stage 4

This is the most severe stage of COPD. Your FEV1 is less than 30 percent of normal predicted values or less than 50 percent with chronic respiratory failure.

4. What is my main problem in terms of my COPD at this time?

In order to grasp why your doctor is prescribing certain treatments or ordering certain tests you need to understand what’s going on with the status of your respiratory health at all times. If you don’t understand, there is a good chance that you won’t take action in a timely manner — or at least not the correct action.

5. Am I using my medication correctly?

You should always be taking your medications exactly how they are prescribed. Some inhalers and nebulizers can be tricky to use so you should show your doctor how you are using your medication to make sure you are doing it correctly. This also mean that you should ask your doctor how to use your antibiotics, and how to stay up to date on annual vaccines. 

6. What should I do if I miss a day or a dose?

It is important to ask this question upon receiving a perspiration, rather than waiting until you do miss a dose, so that you can be proactive. Mistakes happen, it is best to be prepared by writing down the steps you should take to ensure your medication works properly even if there are obstacles. 

7. What are the side effects of my medicines?

It is important to know when to call your doctor when you experience side effects that can put your life in danger, and alternatively when you are able to confidently manage certain side effects on you own.

8. What should I do if I feel my COPD worsening?

Talk to your doctor about what you should do if you feel your COPD worsening, and notify your doctor if you have a flare up/exacerbation. By knowing which symptoms to look out for you can better manage your COPD which helps prevent hospitalization.

9. Can you refer to me for a pulmonary rehabilitation program?

Pulmonary rehabilitation is a program for education and exercise, classes are laid out to teach you about your lungs and your COPD, and will be oriented to your capabilities in exercise, and strengthening your breathing muscles to be more active with less shortness of breath. The classes will often take place in a group setting, giving you the opportunity to meet others with COPD, or other similar conditions, while both giving and receiving support.

10. What vaccinations do I need?

With COPD, a cold or other respiratory infection can become very serious and induce a flare up. Talk to your doctor about vaccines against the flu and pneumonia, and encourage family and those around you to do the same.

11. What actions do I need to take next?

Ask your doctor to explain in detail the steps you should take after leaving the doctor's office, hospital, or getting off the phone. If you are confused at all, it is perfectly ok to ask your doctor to go over the information again in greater detail, or with a different explanation that makes more sense to you. Never leave communication with your doctor in a confused state, They should be happy to make sure you are comfortable with the steps you must take to accomplish your treatment correctly when they are not around.

12. Why is it important for me to do this?

Asking for more details about the reasons your doctor has prescribed something or given you a specific instruction, is very important because it will increase your drive to accomplish your treatment in a timely manner. Educating yourself will only help you be more aware of the reason you must exercise, or take certain medications, or add specific foods or supplements into your diet.

13. Do I need to be on supplemental oxygen?

People in the early stages of COPD do not always need to be on supplemental oxygen. Eventually, your lung condition may deteriorate, and your symptoms may become so severe that you are unable to get adequate oxygen throughout your body. At that point, pulse flow or continuous supplemental oxygen may help you to feel more comfortable, and improve your quality of life.

14. When do I need to call the doctor or seek emergency care?

When you experience COPD symptoms, it does not always mean you need to call the doctor or go to the local emergency room. That being said, you need to be able to determine when it is necessary to seek emergency care or go in for a check up.

15. What else can I do to improve my lung health and quality of life?

Talk with your doctor about all of the ways you can maintain a quality of life while living with COPD. You may find relief through medications, supplements, supplement oxygen and oxygen therapy, pulmonary rehabilitation programs, and support groups. Your doctor can guide you through all of these treatment plans to find the best options for you. 

Educate Yourself, Advocate for Yourself, and Do Not Hesitate to Ask Questions 

Use this guide to COPD as a means to educate yourself about symptoms, testing, and treatment options. It is our hope that by understanding your condition, inside and out, you will be able to effectively communicate with your doctor, and this will lead you to success in self-managing your COPD.

Remember, that communication is a two-way street and not every doctor will make the effort to meet you halfway. If this is the case, you may need to consider changing doctors. But before you go that route, take the initiative of educating yourself and ask them these 15 questions to improve communication with your doctor. 

Please leave a comment below if you have any questions regarding the formation laid out in this article.