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Expert Answers: When COPD Symptoms Get Worse

Sometimes, COPD can cause a person to experience a sudden worsening of symptoms of the condition. These can be called COPD “exacerbations”, “attacks”, or “flare-ups.” These COPD attacks can be very scary, especially when they happen all of a sudden, without warning. We’ve noticed several community members asking what to do if or when this happens, so we asked our experts John, Leon, and Lyn to share some advice for the following question:

What do I do if my symptoms suddenly get worse? 

Response from John
It is now recommended that every COPD patient have a COPD Action Plan. This is a plan you work on with your doctor to help you decide what actions to take when you feel symptoms. Should you use your rescue inhaler? Should you call your doctor? Should you go to an emergency room? The plan will guide your actions. Still, that said, if your symptoms get worse, and you are not sure what to do, seek medical attention immediately — at least call your doctor. Keep in mind that the earlier you seek help the easier it will be to get you feeling better.

Response from Leon
A flare-up is when some or all of your symptoms suddenly get worse. Symptoms can be your cough and/or shortness of breath, and may include an increase in the amount of mucus.
If you have a sudden worsening of your symptoms you can:

However, if the symptoms are severe, you may need to call 9-1-1, or go to the emergency department.

Response from Lyn
We recommend that all our patients have a COPD Action Plan for monitoring their symptoms.

You can ask your Pulmonologist for one or you can access one online. Here are a few I like:

Essentially they provide an algorithm to follow whether you’re feeling well, slightly worse, or much worse. Depending on the severity of your symptoms, you may feel you can manage them at home with a preplanned strategy or you may need to seek medical help.

How about you? Do you have go-to strategies for flare-ups that other people in the community might find useful? Please feel free to share in the comments below!


  • Smedley
    3 years ago

    My doctor prescribed a nebulizer, which uses vials of albuterol sulfate solution. I think of it as my ambulance, since that’s what the paramedics gave me when I called them after the first flareup a couple years ago. I take a treatment when I wake up to clear up the overnight congestion. I also purchased a portable nebulizer which runs on rechargeable batteries or house power. I take it with me along with my oxygen when I go out. Never can know when you might overexert yourself and find yourself in trouble. I’ve had to use as many as three vials in succession if I’ve done something really dumb like running after the garbage man.

  • Leon Lebowitz, BA, RRT moderator
    3 years ago

    Hi Smedley – thanks so much for sharing your very own ‘go to’ strategies when dealing with flare-ups and exacerbations. I’m so glad these strategies work so well for you. Keep up the good work!
    All the best,
    Leon (site moderator)

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