There is no home-based test available for COPD. See your doctor if you think you might have COPD. Based on your symptoms and risk factors, your doctor may refer you to a pulmonary specialist or hospital pulmonary function lab to get tested for COPD. If you don't have access to a doctor, contact NHServiceLink for assistance.
The breathing test used to diagnose COPD is spirometry. You will probably also be tested for Alpha-1 Antitrypsin Deficiency (Alpha-1) with a simple blood draw or finger stick test. Alpha-1 is a genetic condition that can cause COPD. Consult with your health insurance provider to determine if your plan covers the cost of these tests. Breathe New Hampshire sometimes hosts free spirometry testing events.
Spirometry is a simple, non-invasive, outpatient test. A device called a spirometer is used to measure the amount of air you can blow out of your lungs and how fast you can blow it out. Spirometry can detect COPD, even in its early stages. The test is also used to differentiate between diseases like asthma and COPD. Stage of COPD is based on severity of airflow limitation: mild, moderate, severe, or very severe. After initial diagnosis, spirometry may be used again later when you are undergoing treatment to check how well medicines are working.
You have taken the first step by being aware of your symptoms and seeing your doctor for testing and diagnosis. Know that while COPD cannot be cured, you can take steps to make breathing easier and live a longer and more active life.
Are you a caregiver for someone newly diagnosed with COPD? Visit our caregiver information page for tips. Caregiver Info
Alpha-1 Antitrypsin Deficiency (Alpha-1) is a condition that is passed from parents to their children through their genes. This condition may result in serious lung and/or liver disease at various ages in life. People with Alpha-1 have received two defective alpha-1 antitrypsin genes. One defective gene came from their mother and one from their father. The most common abnormal genes are called S and Z. Normal genes are called M. A person who does not have Alpha-1 will have two M genes (MM). People identified with Alpha-1 most commonly have two Z genes (ZZ). Another deficient gene combination is SZ, although people with this gene combination are less likely to get lung or liver problems than those with two Z genes.
Alpha-1 occurs when there is a lack of a protein in the blood called alpha-1 antitrypsin or AAT that is produced by the liver. The main function of AAT is to protect the lungs from inflammation caused by infection and inhaled irritants such as tobacco smoke. The low level of AAT in the blood occurs because the AAT is abnormal and cannot be released from the liver at the normal rate. This leads to a build up of abnormal AAT in the liver that can cause liver disease and a decrease of AAT in the blood that can lead to lung disease.
The most common signs and symptoms of disease caused by Alpha-1 are:
Early diagnosis and adherence to the proper health management plan are important elements to attaining an optimal quality of life.
The World Health Organization (WHO), the American Thoracic Society (ATS), the European Respiratory Society (ERS), and the Alpha-1 Foundation’s Medical and Scientific Advisory Committee (MASAC) recommend that individuals diagnosed with the following diseases should be tested for Alpha-1:
Alpha-1 can not be diagnosed by symptoms or by a medical examination. It can only be diagnosed through a blood test. Contact your doctor and discuss if testing for Alpha-1 is appropriate for you. If you agree to be tested, your doctor will write a prescription for the test.
Testing for Alpha-1 is simple, quick and highly accurate. Testing can be conducted on a blood sample (blood draw or finger stick test). Consult with your health insurance provider to determine if your plan covers the cost of this test. The Alpha-1 Foundation offers some free alpha-1 testing options.
COPD has no cure yet, but lifestyle changes and treatments can help you feel better, stay active, and slow the progress of the disease.
Many types of medicines are available for COPD. You may be on several medicines. You may take daily medicines and use others only when needed. It’s important to know the names of your medicines and how they work so that you can manage your COPD.
Medicines for COPD can:
Talk with your doctor or health care provider about which medicines are best for you. Ask them to show you the correct way to take your medicine so your body gets the medicine it needs. Remember to ask your doctor or your local pharmacist about possible side effects and tips for dealing with them.
Use Your COPD Action Plan to track medications and chart dosages, time of day, symptoms and side effects. This record can help your doctor to fine-tune your medication regimen for best results. Take medicines as directed by your doctor.
An inhaler is a portable drug delivery device. Many COPD medications (in powder or liquid form) are breathed in using an inhaler. Ask your healthcare provider or pharmacist to show you proper inhaler use for your specific inhaler type. If you're not using your inhaler correctly, your medications may not be able to work properly. There are many different types of inhalers and they all work a bit differently. You may have more than one type of COPD inhaler. Some inhalers (controllers or long-acting medicines) are used to prevent COPD symptoms, so you may need to take them every day, even when you’re feeling okay. Others (fast or short-acting medicines) give you quick relief from your COPD symptoms.
A nebulizer is a drug delivery device that turns liquid medication into a mist for inhalation. Nebulizers are not portable and are commonly used for taking medicine when you are at home. You may use a nebulizer instead of an inhaler, or with an inhaler.
How to use Inhalers
For more information on how to properly use inhalers, visit use-inhalers.com
If your COPD has progressed, and your blood oxygen levels are low, getting more oxygen can help you breathe better, improve your quality of life and live longer.
If your doctor prescribes oxygen therapy, you will purchase oxygen and supplies from a durable medical equipment (DME) company. The company will deliver supplies to your home. You will use a tube, called a cannula, to breathe in oxygen through your nose. The tube will connect to a tank, a concentrator or a container depending on the type of oxygen you use (gas or liquid.)
You do not have to stay at home or be in a hospital to use oxygen. Oxygen systems are portable and you can use them throughout your day inside or outside the home. Oxygen therapy contains little risk as long as you follow your provider's instructions. However, oxygen is a fire hazard, so it should not be used around lit cigarettes, open flames (furnaces, candles) or flammable materials.
It is important to have a safety plan if you use oxygen therapy:
What to do during an a Power Outage (additional information)
Insurance coverage for COPD medical services and prescriptions may vary depending upon the company and your specific health plan. Consult with your health insurance provider to determine if your plan covers the cost of your COPD medicines and related medical services. Your health plan may also offer a COPD management program, so be sure to ask. If you are not able to afford your medications, contact your doctor right away. Pharmaceutical companies may offer coupons or financial assistance for their branded medications. If you do not have health insurance, you may benefit from using the NH Rx Card - Prescription Assistance Program (PAP).
Aerobic exercise and breathing exercises are good for your lungs and the rest of your body. Overall fitness and strengthening of the diaphragm can help make breathing easier. Did you know that regular exercise can improve your sleep, too? Set goals and keep track of what you eat and your activity level. If you are web savvy, you might want to try calorie and activity tracking at myfitnesspal.com.
Always consult with your doctor before beginning an exercise routine.
PR is a program of exercise and education for people living with COPD and other lung diseases. Usually conducted in a group format at a hospital or health care facility, a pulmonary rehabilitation program gives you a chance to interact with others living with lung disease. The initial program runs about 6-8 weeks. Usually, a maintenance program is available there after. Many participants say that PR is the best thing they could have done to live better with COPD! PR also offers you training and support on the following:
Ask your doctor or health care provider if you could benefit from a pulmonary rehabilitation program. Check with your health insurance plan representative to find out what to expect for covered versus out-of-pocket expenses before registering for a PR class. Pulmonary Rehabilitation is not a cure for COPD or other lung diseases, but it can help you breathe easier and live a longer and more active life. If your doctor refers you, Medicare covers many PR programs.
Team Orange is a program of Breathe NH to help motivate participants to meet their pulmonary rehabilitation goals. Team Orange members track their exercise and log their minutes or miles for a Team Orange Challenge kicking off in March during Pulmonary Rehabilitation Week and ending in May.
You can retrain yourself in breathing to help your airways stay open longer as you breathe out. If you empty more of the old "stale" air out of your lungs, you will have more room for "fresh" air when you breathe in. This also takes less energy to get air in and out.
Pursed lip breathing creates back pressure on your airways and helps keep them open. This will allow more of the stale air in your lungs to get out and create room for fresh air to get in. You will be able to catch your breath faster and easier and will feel less short of breath. Practice pursed-lip breathing when you are short of breath.
Steps to Follow
Adjust your breathing rhythm and the amount your purse your lips to increase your comfort. Use this technique during exercise or activities that cause you to be short of breath. However, this technique can be practiced anytime.
The diaphragm is the main muscle for breathing and is located between the chest and the abdomen. The diaphragm moves down as you breathe in, making the chest size larger so that air can flow into the lungs. When you breathe out the diaphragm moves upward and reduces the chest size so that the air is pushed out of the lungs.
Most people breathe using their diaphragm. Other people, because of certain lung diseases, such as asthma and COPD don't use their diaphragm to the fullest extent. Exercising the diaphragm can improve its function. Learning how is a part of re-teaching yourself to breathe.
Steps to Follow
While breathing in and out, keep the muscles in your chest and neck as relaxed as possible because using these muscles will increase tension and waste energy.
The only way to retrain yourself to breathe is by practicing. Begin by going through the steps a few times an hour when you are relaxed. When you feel comfortable doing the exercises lying down, then begin practicing them while standing, walking, and sitting. You will find eventually these breathing exercises will decrease your episodes of shortness of breath. You will actually be able to do more activity.
Don't become discouraged if breathing exercises don't seem to be helping. Remember you are retraining your muscles and that takes time. The more you practice, the more natural and automatic it will become. When you become tense or short of breath then slow down, concentrate, relax, and do your breathing retraining exercises. This will help you catch your breath.
Coordinate diaphragmatic and pursed lip breathing with your activity.
You can help manage your COPD by avoiding triggers or things that can make your COPD worse. It’s important to be aware of these common triggers so you can take steps to protect yourself and prevent a flare-up of COPD symptoms:
Quit Smoking. Tobacco smoke (from cigarettes, pipes, cigars) makes symptoms worse. Do not smoke and avoid secondhand smoke. If you have COPD and currently smoke, you are not alone. Many people with COPD find it hard to quit. But, quitting is the most important step you can take to prevent more damage to your lungs.
Quitting smoking will:
Any type of infection, like the common cold or seasonal flu, can make your COPD symptoms worse.
Tips for reducing your risk from an infection from a virus, bacteria or other organism:
Strong smells can make you cough and irritate your airways, increasing your chance of having a COPD flare-up.
Common sources of strong odors:
Tips to help avoid strong smells:
Temperature, humidity, wind conditions and air quality can affect your breathing and make your COPD symptoms worse.
During fall and winter months, dry air and sudden changes in temperature, like going in and out of your home, can bring on COPD symptoms. Use a mask or cover your mouth and nose when outside. Use a humidifier inside.
During summer months, heat and humidity can make breathing very difficult. Stay inside and/or use air conditioners or fans.
Indoor air quality can affect your COPD:
Learn more about clean indoor air here.
Be aware of your air. Check the NH Air Quality Forecast before going outside. Stay inside when air quality is poor. If you have to go out on a bad air day, wear a mask and avoid going out when air pollution levels are highest.
Learn more about outdoor air quality here.
Do you have trouble getting a good night sleep due to COPD symptoms like coughing or from medication side effects? You are not alone.
Sleeping well is important to your health. During sleep, your body is working to support healthy brain function and maintain your physical health. Duration and quality of sleep also impact daytime sleepiness. It is not uncommon for individuals living with COPD to have trouble with sleep or to have an underlying sleep disorder.
If you have trouble falling asleep, staying asleep, or feeling refreshed after waking up, talk to your doctor. They may refer you for evaluation at an accredited sleep center to determine the cause of your sleep problem and identify appropriate treatment. Check with your insurance plan representative before making an appointment so you know what to expect for covered versus out-of-pocket expenses.
Tips for sleeping better with COPD
Practice Good Sleep Hygiene
Food provides essential nutrients and energy we need to stay healthy. Eating well can help you feel more energetic and will help your body to fight off infection. Nutrition is especially important in managing a chronic disease, like COPD. Living with COPD, you may find that you have trouble losing or gaining weight. It’s also easy to get dehydrated due to medication side effects or complications from other health conditions. It can be tricky to know what to eat and what to avoid eating when you need to manage your COPD in addition to other medical conditions and medication side effects. A registered dietician (RD) can help you create a personal meal plan. Contact your local hospital for a referral or to find nutrition classes. Check with your insurance plan representative before making an appointment so you know what to expect for covered versus out-of-pocket expenses.
Shopping, preparing and cooking meals can also be challenging if you have COPD. Here are some ideas:
Talk with your doctor about your nutritional needs before making any changes to your eating plan. Here are some general guidelines from the Food & Drug Administration (FDA):
COPD Support Groups - Join a monthly COPD Support Group. In addition to finding support from others, groups provide the opportunity to share new information and strategies, encourage each other to live each day to its full potential and feel empowered to cope with the challenges of living with COPD. Contact: 603.669.2411 or COPD@breathenh.org
COPD Foundation Patient Information Line: 1-866-316-COPD (2673)
National COPD Foundation COPD360Social Online Community
COPD International International Support Network Online Community
Call 911 if you or a loved one are in immediate danger. Notify the operator that this is a psychiatric emergency and ask for an officer trained to help people with a mental health condition.
National Suicide Prevention Lifeline: 1-800-273-TALK (8255) (open 24-hours)
National Alliance on Mental Illness (NAMI) Helpline
1-800-950-NAMI (6264) (open Monday through Friday, 10AM - 6PM, ET)
NH Health Cost - Compare health costs and quality of care in New Hampshire.