How to Prevent COPD Exacerbation in Every Season?

Seasonal changes can magnify COPD symptoms, but there’s a lot you can do to protect your health. Find out how to breathe more easily when the snow is falling, temperatures are soaring or pollen is filling the air.

From summer heat to winter’s bitter chill, extreme weather can cause discomfort for anyone. But if you’re living with chronic obstructive pulmonary disease (COPD), these seasonal conditions can make dangerous symptoms worse.

COPD is an umbrella term for incurable lung conditions, such as emphysema and chronic bronchitis, that affect breathing. Other COPD symptoms include coughing, wheezing and tightness in the chest.

“Major weather changes make COPD patients work harder to breathe,” says pulmonologist Harish Murthy, MD, director of Neurosciences Intensive Care at Good Samaritan Hospital in San Jose, CA.

Temperatures below freezing or above 90 degrees often cause flare-ups in COPD symptoms, leading to more shortness of breath and an increase in saliva and mucus production, according to the COPD Foundation. And increased pollen counts in spring or fall can worsen allergies, another trigger for breathing problems.

But what causes one COPD patient to gasp for air may not affect another.

“I’ve had patients who are symptom-free in summer but have a lot of trouble breathing in winter, and vice versa,” Dr. Murthy says. “Some patients find it easier to breathe in coastal areas, and others the desert.”

Wherever you call home, here are expert-recommended steps to help keep COPD symptoms in check during every season.

Summertime troubles: Heat and pollution 

In extreme heat, your body uses more energy to maintain a normal temperature – and that can reduce the amount of energy you have to breathe.

As a result, the hotter the air, the greater your risk of COPD flare-ups. Each 10-degree rise in daily temperature was associated with a 4.7% increase in emergency hospitalizations for respiratory diseases,  according to a 2015 study published in COPD: Journal of Chronic Obstructive Pulmonary Disease.

What’s more, air pollution often becomes worse as temperatures rise, exacerbating breathing problems, according to the American Lung Association (ALA).

Solution: Avoid outdoor heat. 
Minimize your time outside when the temperature is over 90 degrees, the COPD Foundation says.  Use an air conditioner to stay cool indoors

On days when air pollution levels are high, stay home with doors and windows closed. And make sure your home air conditioner has a high-quality filter that removes the smallest particles. (To find out about local air quality, check news websites or the government’s AirNow site.)

Also, watch out for local “Ozone Action Day” alerts declared by county or state governments. Ozone, a gas produced by vehicle exhaust and industrial plants, can be especially irritating to the lungs, according to the COPD Foundation.

If you must spend time outdoors, do so in the early morning or late evening, when temperatures are usually milder and pollution levels lower.

Wear light, cooling clothes and drink plenty of liquids, even if you’re not thirsty, advices Raj Dasgupta, MD, assistant professor of clinical medicine at the University of Southern California’s Keck School of Medicine in Los Angeles.

Solution: Handle humidity.
Some COPD patients may notice their symptoms flaring up when heat is accompanied by high humidity levels, the ALA says.

Excessive moisture in the air promotes the growth of fungi and mold, and raises the amount of dust mites and other allergens, which can increase mucus and affect breathing. Air density also increases, creating more resistance to air flow in the lungs, according to the COPD Foundation.

Outdoor humidity levels are often included in local weather reports. To measure indoor levels, try using a device called a hygrometer, found in hardware stores.

In general, minimal humidity levels (about 40% and lower) are best for people with COPD, the foundation says.

If your air conditioner doesn’t do a good enough job reducing indoor moisture, use a dehumidifier set to 30% to 50%.

Solution: Mind your medications.
COPD medicines can be sensitive to heat and may lose effectiveness if left in a hot car or humid bathroom, Dr. Dasgupta says.

Most drugs should be kept in a cool, dry place, such as a cabinet that isn’t in the bathroom or close to heat sources. But ask your pharmacist if there are any special handling instructions.

Wintertime troubles: Frigid temperatures, colds and flu
Cold air and wind, combined with an increased chance of catching a respiratory illness, make winter an especially risky time for people with COPD. In fact, flare-ups occur twice as often in winter as in summer, according to a 2017 study in the European Respiratory Journal.

Solution: Keep warm.
Breathing frigid air can trigger bronchial spasms (a sudden narrowing of the airways) and shortness of breath. So avoid spending time outdoors when the mercury is below freezing (32 degrees F), the COPD Foundation recommends.

If you must be outdoors, wear a scarf or mask around your face and neck to warm the air before you breathe it.
When you first go outside, take it easy – let your airways acclimate to the cold, suggests Shawn J. Skerrett, MD, a professor in the Division of Pulmonary and Critical Care Medicine at University of Washington in Seattle. Sudden heavy breathing due to exertion could make respiratory problems more likely, he says.

Solution: Find ways to stay active.
Avoiding cold weather is no excuse to hibernate all winter. Regular exercise is vital for COPD patients, because it improves heart and muscle function and reduces breathing problems, advises Clark Fuller, MD, director of thoracic surgery at Providence Saint John’s Health Center in Santa Monica, CA.

In the wintertime, “you can quickly become a prisoner of that La-Z-Boy without even knowing it,” he says. “[But] getting exercise, frequently and consistently, is important.”

If the weather doesn’t permit outdoor activities, try walking around a mall, going to a gym for a light workout, or using a treadmill or stationary bike at home, Dr. Skerrett suggests.

Solution: Protect your health.
Frigid winter temperatures “force patients indoors in close proximity with other people who may be ill,” Dr. Fuller says.

And that can be risky if you have COPD.
“People with weak lungs aren’t as good at fighting off infections and viruses and often get sick – even requiring hospitalization – during winter,” says Richard Casaburi, MD, PhD, professor of medicine and associate chief for research at the David Geffen School of Medicine at UCLA.

Luckily, the best defense is simple: Get your flu shot and the pneumococcal (pneumonia) vaccine.

“Influenza vaccinations reduce the number of acute flare-ups in people with COPD and may reduce hospitalizations and [death],” Dr. Dasgupta says. “And having both vaccines may be more effective than either vaccine alone.”

To further reduce your risk, avoid people who are sick whenever possible, the COPD Foundation advises. Wash your hands frequently and refrain from touching your eyes and nose, where infections can easily spread.

If you do get sick, seek treatment.

“I tell my COPD patients that they should have a low threshold for seeing their physicians,” Dr. Murthy says. “Check in if you have any respiratory symptoms that last longer than a day.”

Springtime and autumn troubles: Allergens in the air
COPD patients with allergies are at the greatest risk for a flare-up and are more likely to suffer symptoms such as wheezing, chronic coughing and increased phlegm, according to a 2013 study by Johns Hopkins University in Baltimore.

That’s because exposure to airborne tree, grass and weed pollen, along with mold spores, can narrow airways and increase mucus production, making breathing difficulties worse, the ALA says.

If you’re not sure whether allergies are the reason for your coughing and sneezing, your physician may give you a blood test, Dr. Dasgupta says. It measures white blood cells called eosinophils, a component of the immune system that plays a role in allergic reactions.

Solution: Keep allergens out.
If allergens worsen symptoms, you need to avoid them as much as possible, according to the National Institutes of Health (NIH).

Check out the National Allergy Bureau’s website to find pollen and mold counts for your area.

On days when allergen counts are high, stay indoors as much as you can, the NIH says. Use a household air cleaner with a HEPA (high-efficiency particulate air) filter, which rids air of tiny particles. Install high-quality filters in your air-conditioning and heating systems, and use a cabin air filter in your car.

Also, clean and vacuum frequently to get rid of pollen, mold and spores, Dr. Dasgupta suggests. Pollen can stick to you, so bathe and wash your hair in the evening.

Solution: Get the right treatment.
COPD patients shouldn’t self-medicate for allergies with over-the-counter drugs, Dr. Dasgupta cautions.

“Although antihistamines are effective at relieving common symptoms of allergies such as stuffy nose, watery eyes and sneezing, they can dry air passages,” he says. “That makes breathing harder and can cause difficulty when coughing up excess mucus.”

Also, some antihistamines, such as diphenhydramine, “can be sedating and cause respiratory depression, and should be avoided in COPD patients,” Dr. Dasgupta adds.

Ask your physician what allergy treatments are right for you, and how they fit in with your COPD medication regimen, he says.

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