Staying Healthy During the Coldest Months With COPD

January, February, and March tend to be the coldest months of the winter in most areas. I don't about you, but I'm not a huge fan of winter. I do enjoy the snow as long as it's not on the roads, but definitely not the frigid temperatures. Breathing in cold air can trigger my asthma, but I can usually deal with it by breathing through a scarf.

Understand risks

If you have COPD, the coldest months of the year can also be the most dangerous for you, health-wise. As we move into the new year, temperatures will be dropping over most of the U.S. It's important to understand risks and how to avoid them. Preventing COPD exacerbations, or flare-ups, is essential.

Cold weather factors that impact COPD

There are a number of factors associated with cold weather and the winter months that may trigger a COPD flare-up:¹

• Breathing in extreme cold air. When you inhale outside in cold weather, particularly through your nose, the air doesn't get warm enough to avoid a shock to your airways. Cold air tends to be drier, and dry air can irritate your airways, especially when you have COPD. If it's windy, the effects can be even worse.
• More circulating germs and respiratory illnesses. The cold months of the year are also when the most cold, flu, and pneumonia germs are in the air.
• Increased exposure to tobacco and wood smoke. Because cold weather naturally drives most of us to spend more time indoors, you're more likely to come into contact with smokers. Wood-burning stoves or fireplaces may emit smoke into your indoor environment that is extremely irritating.
• Higher levels of outdoor air pollution. Air pollution levels tend to be higher in winter, especially in areas that have a lot of wood-burning. When I lived in Idaho, we could go weeks with low lying clouds of smoke and fog called inversions. That was bad news for everyone!

Signs of an exacerbation

Exacerbations are a way of life when you have COPD. That is to say, they're not necessarily unusual, although each person is different. Some people may have exacerbations only rarely, while others have them more regularly. Also, living with COPD usually means living with at least some symptoms most of the time.

So, how do you know if you're having an exacerbation and if you should be concerned about your symptoms? Here are a few signs that things are slipping out of control and that you may need medical attention:²

• You're coughing more often and more severely.
• You may be coughing up more mucus as well, or the mucus may be yellowish, greenish or bloody.
• Your shortness of breath is worse, comes on suddenly and may also include wheezing.
• You are running a temperature, or a fever.
• You're feeling more tired than usual, and/or more depressed or anxious.

Exacerbations in winter

So why worry any more about exacerbations in the cold months than in the rest of the year? Exacerbations are never anything to take lightly, right? This is true, but a recent study presented at the CHEST Annual Meeting 2019 in New Orleans highlighted the following: Exacerbations during winter resulted in higher hospitalization and death rates.

In fact, most hospitalizations in COPD patients occurred during the first quarter of the year.³ Even more disturbing, COPD sufferers hospitalized during this time of year were also more likely to be readmitted to the hospital again. Plus, they also tended to have worse health outcomes, stayed longer in the hospital, and had the highest death rates.³ Researchers found, however, that intensifying preventive treatment during this time of year could definitely have a positive impact on those rates and lower health care costs, as well.³

Controlling COPD exacerbations

The good news is there are some steps you can take to ward off those nasty COPD exacerbations!

1. When going outdoors, warm the air you breathe.

You should always cover your mouth and nose when you go outdoors during the cold months. I've found that a fleece scarf or neck gaiter works really well to both warm and moisturize the air I'm inhaling. There are even masks made especially for people with COPD. At the very least, cup your hands around your mouth and nose. If you use portable oxygen on the go, be sure to tuck the tubing inside your coat to keep it warm.

2. Take preventive measures against respiratory infections.

First off, get your annual flu shot each year. Also, check with your doctor about when you might need a pneumonia shot (pneumonia vaccines last for a number of years). Wash your hands before touching your nose, eyes or mouth, especially when out in public places. Avoid sick people.

3. Avoid smoke, fumes, and air pollution as much as possible.

Monitor the outdoor air quality by checking local forecasts or by visiting a site such as AirNow.gov. Stay indoors on days when the air quality is poor. In indoor spaces, avoid wood smoke, tobacco smoke, and fumes from candles or other perfumed decorations.

4. Practice healthy lifestyle behaviors.

Strengthen your health and immune system during this time of year by living as healthy as you possibly can. This means:

• Taking your COPD medications as prescribed, if you have any. If you have a quick-relief inhaler, be sure to keep it with you at all times.
• Getting plenty of sleep and rest.
• Drinking plenty of water.
• Making healthy food choices.
• Staying active, even if it means taking up indoor exercise.
• Managing your stress to the best of your ability.

Stay as healthy as possible

While you are at greater risk of COPD exacerbations over the next few months, having them or needing to go to the hospital is not inevitable. You can take the steps listed above to help stay as healthy as possible during this time. And also, be alert to any signs that your COPD symptoms are worsening. If you believe they are, then take action to get in touch with your health care team right away, so that you can hopefully head problems off at the pass.