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Routine, awareness, and self management.

Routine, Awareness, and Self-Management

You want to live? Of course you do. In this short article hopefully I will offer an insight that might one day save your life. We must appreciate that most if not all of us with COPD are often like a fragile flower. Make no mistake. A wrong move can be deadly. Sadly many have fallen to never recover because of inaction, bad management, or awareness. For that reason beating the reaper is our game.

Routine, awareness, and self management might one day save your life. Awareness has certainly saved mine. While self management has almost certainly kept me out of hospital, and healthier. Sadly many have died because of inaction. Don’t let that happen to you.

Routine is essential. Without routine I would be all over the place. I would forget to take my very important inhalers. Other medication too, or the dreaded steroids if needed. Routine will have us doing things automatically. For instance: I swing my legs out of bed in the morning. The inhalers are beside me on the bedside cabinet ready to inhale my medication. If I need the bathroom first that is ok. I return and inhale then. Evening I go to my bedroom and get ready to shower. And inhale. At breakfast, or evening meal, I have tablets to take. Routine will become habit. I am sure most of you have a system. But if you don’t, time to gain that all important routine.

One of the most important assets to have is awareness. How am I feeling today? Is my breathing normal or worse than usual? Am I more breathless than yesterday, or do I have more mucus? If so is there any sign of infection, different color in my mucus? How is my pulse rate? Do I have my normal get up and go? Awareness. We must be aware of what our bodies are telling us. I use an oximeter to keep an eye on my oxygen blood saturation levels. Always sensible in my opinion because 88% or lower and I have a problem to resolve.

Amazingly an oximeter will tell me if I am heading into an exacerbation at least 24 hours before I feel it, if my oxygen saturation level is lower than usual, and my pulse rate higher. I am aware to take emergency action as per my self management plan as soon as the physical feeling of an exacerbation takes hold. It has occurred to me to take the medication as soon as the oximeter indicates trouble ahead. But instead am ready at the starting gate.

More than once I was rushed to hospital within hours of feeling perfectly well. Both times pneumonia was to blame. The lesson is: pneumonia can, and often does kick in within hours. If you feel your breathing is becoming worse rapidly don’t wait to see. It really is time for the emergency room. Remember: be aware. Stay ahead of the game.

I do a lot of volunteer work within health management, and recently was invited to, and attended a self management seminar at the University of Wales in Cardiff. Self management in Wales, UK, is now recognised as one of the best ways to both improve the health of those with Chronic illness, and to save lives. Wales as in many other parts of the world is using self management with many illnesses, and is in the process of developing apps for the smart phone to help in this important task. But even now, you can play an active part, and help yourself to stay healthy.

If you are at the moderate stage of COPD or above please make sure you talk to your doctor about keeping an emergency pack of antibiotics, and steroids. These packs have helped me many times. It really is amazing how I will go down with an infection on a Friday evening when I cannot see my doctor until Monday or worse during a holiday when everywhere is closed longer. By then without that pack I could and probably would be in the emergency room. If you use oxygen always be aware to have plenty to spare, and a back up supply should you have a power outage, or bad weather such as snow cuts you off from the outside world.

If you have an emergency pack of medication as discussed with your physician, as soon as illness hits start taking the medication immediately. I have delayed, and ended up very ill through delay. Still others have delayed, and it has been too late. Speed when we are at the late stages of COPD is all important. For those of us that use oxygen, keep an eye on blood oxygen saturation levels. If saturation levels fall low increase the oxygen intake to keep saturation levels above 88% but below 94% if you can, and let your doctor know what is happening, and what you have done.

Self management is awareness, routine, and management all rolled into one. Each has a part with the other. Be sure to sleep as well as possible. To be nice to yourself. To exercise. Keep warm. Have medication at hand. Someone you can call if needed. Have all the aids you need in your daily life. Relax. Smile. Listen to music you like. Hear the sounds of nature. Enjoy life and don’t sweat the small things. All these help us to lead a good life despite our illness.

With that positive thought I leave you till I next write again. Whatever you are doing, Breathe Easy.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • lynn2u
    3 years ago

    Dear Derek,
    I love your articles. They reflect my own thoughts and feelings about this DX. I love life even with COPD and lead an active, happy life fostering cats, studying vet medicine and just being in the moment. I live in California and am grateful that I don’t have to face severe winters. I have a gym membership as well as having exercises I do at home and know how important it is to stay strong. I am 75 years old and good at self management so I won’t need medications and all the weakening side effects. Thanks for your articles!

  • Derek Cummings author
    3 years ago

    Hi Lynn. Many thanks for your comment. I always welcome input from readers of my short articles as it is always good to know what I write helps others.
    It is really good that you are active and have interests. Hobbies and interests are so important to enable us to stay active, and give us an interest in life. There is no doubt exercise makes a huge difference to our well being. Despite being 75 years of age you are doing great, and are an inspiration yourself to others. Breathe easy and keep up the good self management. 🙂

  • dmwjk99
    3 years ago

    Is it helpful to use the C pac machine with the oxygen tank?

  • Janet Plank moderator
    2 years ago

    dmwjk99 if you use both oxygen and the c-pap at night, certainly use them together. If you don’t have, there is an adapter that fits onto your cpap machine and there is a place on their that you can hook your oxygen tubing to. If you don’t have, I would call whoever you got your c-pap from and see if they have one for you.
    That was a very good question! Thank you
    Janet (site moderator)

  • Leon Lebowitz, BA, RRT moderator
    3 years ago

    Hi dmwjk99 and thanks for your question. We are unable to provide medical advice over the internet (for your own safety) but your inquiry warrants a response.
    Many patients use CPAP (continuous positive airway pressure) or BiPAP (Bilevel positive airway pressure machines) and some are also on oxygen. Without knowing your specific set up, I am unable to advise you. However, the physician who has prescribed the device/machine for you (and the supplemental oxygen, too) will be able to answer your question directly.
    Please check back with us and let us know how you’re doing.
    All the best,
    Leon (site moderator)

  • cassell
    3 years ago

    Do you mean checking your saturation levels while on oxygen? And then if below 88 you are heading for trouble? I’m not sure what your oxygen levels should be while on oxygen.

  • Leon Lebowitz, BA, RRT moderator
    3 years ago

    Cassell – although I cannot answer for Derek, the suggestion is to monitor your blood oxygen saturation (with the oximeter) while you’re on oxygen and also when you’re on room air. IN GENERAL, an oxygen saturation below 90% may telegraph discomfort for some people with COPD. Derek is saying that his lower limit is 88%. BUT REMEMBER, that number can vary from person to person. I would encourage you to speak directly with your private physician about your own specific condition. Please check back with us and let us know how you’re doing Warm regards, Leon (site moderator)

  • River Daniel
    3 years ago

    Derek, this piece should be required reading for everyone newly diagnosed with COPD. Your stuff really helps me think about how to live with this. Thanks, Lin

  • Derek Cummings author
    3 years ago

    Hi Lin. Many thanks for your kind comment. I am always pleased to read feedback from an article I have written that has helped others. All my articles are written from personal experience with copd in the hope it can make things easier for others with copd, and to help avoid the mistakes I have made along the way. Do things right and we can live a very long life with copd. Thank you for reading our posts Lin and as I always say – Breathe Easy. Derek Cummings

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