COPD Education Never Ends
Researchers are working overtime to learn more about our disease. This is done in an attempt to help all people living with COPD live better and longer than ever before. Because of this, the learning must never stop. As a respiratory therapist, a huge part of my job is COPD education. Of course, I’m constantly learning new things about it, and it’s my job to share what I learn with my patients.
Engaging with my patients
Sometimes patients refuse to be educated. I have come to accept that some people simply don’t want ongoing education. I could delve into some theories explaining this in a future post, although for the sake of this post, we’ll just come to terms with it as a reality.
For example, yesterday I asked a patient if he was ready for some COPD education. He looked at me, rolled his eyes, and said, “Look, I have had COPD longer than you have been alive.” Of course, he says this after using his inhaler incorrectly.
Okay! I’m fine with it. I can respect that.
Sometimes though, if appropriate, I take this a step further in an attempt to start the conversation. I say something like, “Okay, so, can you tell me what you do know about COPD.” Usually, the conversation takes off from there.
Most patients, I find, enjoy learning. So, they accept my attempts to educate them. So, what does COPD education entail? It usually begins with the basics.
Do you know COPD basics?
Oftentimes it begins with the basics and most of my patients (most of you reading this) know the basics. But we can always benefit from a good review.
We talk about emphysema, and how lung tissue breaks apart. We talk about chronic bronchitis and how airways are affected. We talk about how taking medicines daily may help keep airways open and calm to prevent flare-ups.
We talk about making lifestyle changes. We talk about quitting smoking if they smoke. I often show them the Fletcher-Peto Curve. This curve helps them see for themselves how quitting smoking can prolong their life. This motivates some people to try and try again to quit.
But there is more to COPD education than just the basics. There is so much more to it than that, and your inhaler technique is a big one.
Do you use an inhaler?
The GOLD COPD Guidelines were updated in 2018. These are guidelines used by hospitals and doctors and they offer strategies for helping us best help you. These newest guidelines recommend technique before increasing medicine doses and switching to or adding new medicines. I'm referring to the inhaler technique.1
This is on the heels of studies showing that 90% of people do not use proper inhaler technique.2 If you're not using it properly, you're not getting the most benefit from the medicine you are inhaling. Proper inhaler technique helps get more medicine to your airways which may help you obtain improved COPD control.
Given this importance, I may ask you to demonstrate your inhaler technique. I don’t do this just to criticize you. Think of it like a baseball player learning to hit a baseball. Mike Trout is the best player in the game, but even he goes into slumps. Sometimes even the best ballplayers can't spot their own errors so they have coaches watch their swing every day and make recommendations for how they can improve.
Do you use a metered-dose inhaler (MDI)?
If you use an MDI (like albuterol or Symbicort), you may benefit from using a spacer. These devices can help you improve your inhaler technique. They may also help reduce inhaler side effects and improve the distribution of respiratory medicine to your airways.3 At the present time, nearly all asthma and COPD guidelines recommend spacers with MDIs.3
Do you have a nebulizer?
If so, do you know how to clean it? Nebulizers should be washed regularly. This is to prevent germs from collecting in them. This is to prevent you from inhaling germs that may cause respiratory infections.
Do you have a COPD action plan?
I think every COPD patient ought to have a COPD action plan. This is a plan you put together with your doctor and they help you decide what to do when you are experiencing symptoms. Do you make a simple change on your own? Do you call your doctor? Do you call 911?
Knowing what to do can be a HUGE boon for you and part of my job is helping you create one. At the very least, I may encourage you to discuss creating one with your physician.
Do you have a flutter valve device?
Many people with COPD have a cough and many have secretions that they have a hard time bringing up. So, flutter valve devices (like an Acapella) help you mobilize and clear secretions. They are devices you inhale into, causing your airways to vibrate. The goal is to knock stubborn secretions from your airway walls, making them easier to cough up. I usually give one of these to my COPD patients and I educate you on how best to use them. Most of my patients say they find these very helpful.
COPD education is an ongoing thing. If you end up in the hospital setting, you may be approached by a COPD teacher like myself. We’ll do our best to help you stay on top of your COPD game, although the goal is for you to stay well enough at home to avoid having to see people like me. There are many ways to stay up on your COPD education. One is by having discussions with your COPD doctor and another is hanging out in COPD communities like ours.
Which of the following best describes your COPD diagnosis?