Exacerbations: They Are Different for All of Us

This article was originally published on April 30, 2020

Some people with COPD have never had the experience of an exacerbation, but others know all too well what it is and when it is time to ask for help.

What is a COPD exacerbation?

A COPD exacerbation or flare-up is a worsening of symptoms. Those of us with COPD usually know what that means. For me, it's usually a chest infection, like a cold, that brings greater shortness of breath and additional phlegm production. This can lead to pneumonia and could result in being put on the dreaded ventilator or life support.

Long-term effects of a flare-up

For most of us, having an exacerbation is our greatest fear. Encountering someone who has a cold can mean a life-changing situation. Some of us will bounce back, but others will not, and we are often left with a permanent setback in exercise tolerance and breathing ability.

To know whether you are experiencing a true exacerbation, we must first establish a baseline. Exacerbations can be sudden or gradual. It is also a good idea to journal your symptoms daily to better understand what's normal vs. what's not. Only then can we begin to understand our COPD.

Staying safe when going out

We are ever so careful of using carts in the store or touching handles and doorknobs. I used to think I was a germaphobe but now I realize that it is just good personal hygiene. Washing my hands more than the average person would and always avoiding large crowds and intimate contact is what works for me.

I tend to stay in most days and must set goals to work at leaving my house 2 or 3 times per week. I am very careful to plan trips so there is always a positive outcome. I can only stay out for as long as my oxygen tank will allow me to, so my trips tend to be shorter than 5 hours.

Your COPD action plan

For most of us, our doctors have given us a standing prescription of antibiotics and steroids, which are an important part of an exacerbation action plan. We should have been schooled on when and how to begin our action plan. If you are still not sure, contact your doctor and follow their advice on starting the action plan set out for you. In the absence of being able to talk to your doctor, you should go to the emergency room, especially if you do not have home oxygen or a BiPap machine.

For me, an exacerbation is a little more serious and leads to a sudden cardiac arrest. It is a fatal condition where the heart loses its connection and stops beating. Without CPR or an AED, I would have died 4 years ago. Each time I have an exacerbation, it leaves me a little weaker. After each exacerbation, I start my exercise regimen again and hope to build up in a few weeks to the level where I left off.

What do exacerbations feel like for you? Share more here!

Editor’s Note: We are extremely saddened to say that on January 7th, 2024, Barbara Moore passed away. Barbara’s advocacy efforts and writing continue to reach many. She will be deeply missed.