Author Archives: Jackie Aim

Annual medical review and lifestyle changes

They may also discuss:

  • Weighing scales and measuring tape

    Your diet

    If you are under or overweight. If you are having difficulty eating.

  • Outline of head and brain

    Your mood

    Whether you are feeling a bit low or depressed.

  • House picture

    Help at home

    Whether you need some help at home.

  • Cigarettes

    Smoking

    If you are a smoker, they will discuss smoking and the impact on your COPD (please see Help to stop smoking on this website).

Annual medical review at your health centre

preview Description: A mature woman patient consulting a GP in the surgery consulting room.

© Crown Copyright 2009

You should receive a review from your doctor or more commonly, your practice nurse at least once per year.
This will involve:

  • A discussion about any changes in your symptoms
  • A check of your breathing and lung function. If your symptoms have changed significantly you may be retested using the spirometry test.
  • A discussion about smoking if you are a smoker (see Help to stop smoking section).
  • Measuring your blood oxygen level. They may use an oximeter to check whether oxygen therapy may help you.
  • A review of the medications and inhalers you are on.
  • A discussion about your inhaler technique to make sure you are still getting the most from your inhaled medicine.
  • A discussion about activity and if needed a referral to Pulmonary Rehabilitation.

Your annual review should be a two way process and it is also a good time to ask about anything which you are concerned about or not sure about. You can tell your doctor or nurse specialist about how your COPD is affecting you physically, emotionally or in daily life.

Preparing to leave Hospital

  • You may find that you have lost some strength and fitness while in hospital.
  • Your recovery at home may take some time.
  • You may be offered help to stop smoking. A variety of help is available.
  • Perhaps you were finding it difficult coping with all your daily chores before you came into hospital?

An assessment of certain daily tasks and how you will manage these at home will help to ensure your return home is successful and worry free.

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An assessment of certain daily tasks and how you will manage these at home will help to ensure your return home is successful and worry free. This may involve;

  • Physiotherapist. They may look at your strength and fitness. This can involve tasks such as walking distances similar to those that you cover at home and climbing stairs. They will monitor your oxygen levels, breathing and energy levels.
  • Occupational Therapist. They may help to arrange equipment to help with daily activities you might find more tiring such as bathing, dressing or kitchen tasks. They can advise on pacing your activities to preserve energy or refer for help in your home with heavier tasks.
  • Nurse. They will discuss your medication. They will explain any changes to your inhalers or medicines especially if they are different to ones you have had before. They may talk over your action plan with you or refer you to your practice nurse for further discussion.


Staff may discuss making a referral to pulmonary rehabilitation with you. Although you may not feel like exercising while you are in hospital, going to pulmonary rehabilitation following your discharge can really improve your recovery. You are also less likely to need to come back into hospital.

For more information please see:

Important messages

Important

  • Don’t ignore early warning signs! AMBER Early recognition and treatment of a chest infection can prevent further damage to your lungs and hopefully keep you out of hospital.
  • Always finish your course of antibiotics and/or steroids.
  • If you have a chest infection take things easy, rest more and drink plenty of fluids.
  • If your symptoms do not improve then go back to your GP or call NHS 24 (111) for advice.
  • If you do not feel better or if you feel worse a few days after starting antibiotics or steroids let your GP know. You may need a different antibiotic or further treatment.

Red

Select this image to see an enlarged version of the COPD asthma plan

Select this image to see an enlarged version of the COPD plan

If you have been in the Amber Zone for 24 – 48 hours and are not feeling any better – its time to alert your GP/Respiratory Nurse. You may need to start your Rescue Medication (antibiotics and steroids) which your GP/Nurse can provide.

If you have Rescue Medication at home use it when:

  • Your sputum has increased or changed colour, start home supply of antibiotics.
  • You are significantly more breathless, start home supply of steroids.

Click on the red traffic light for more information.

Important

You are in the red zone and need to be looking out for the following more serious symptoms when:

  • You are extremely breathless or have difficulty breathing.
  • You feel drowsy or confused.
  • You have chest pain.
  • You have a high temperature.

If you have any of these or you are not feeling better after 48 hours of taking Rescue Medication you must contact your GP/ NHS 24 urgently or call 999 for an ambulance.

You may be treated at home or need a hospital admission for specialist treatment.

Amber – looking for changes

Traffic lights showing amber

Look for changes in symptoms

  • Sputum/Phlegm/Glut. This can change in colour, thickness and amount. It can be darker than your normal colour if infection is present, i.e.-yellow to green. There can be more or less of it. An infection can increase the amount or it can become thick and sticky so it’s harder to clear from your chest.
  • Coughing up blood.  When you have an infection you may cough up small amounts of blood, this is not unusual and it should clear up when you feel better. If you continue to have blood in your sputum after you have recovered from an exacerbation or flare up you must speak to your own GP.
  • Cough. You may notice more coughing than usual.
  • Wheeze. You may feel wheezy, or that your chest is tight.
  • Temperature. You may feel hot or shivery.
  • Breathlessness. It may be harder to do your every day activities and they take more effort.
  • Appetite and energy levels reduce.
  • Many people with COPD will find there is one particular thing that tells them when they are becoming unwell – vague pains in the chest or elsewhere, feeling very down. It’s useful if you can identify this for yourself.

Green – normal

Select this image to see an enlarged version of the COPD asthma plan

Select this image to see an enlarged version of the COPD  plan

Sputum chart

Sputum chart

Recognising your normal chest symptoms is important. You should be aware of your normal:

  • Sputum colour and thickness.
  • Cough/wheeze (if any).
  • Breathlessness.
  • Appetite and energy levels.

Select the green traffic light on the right to see an enlarged version of the COPD asthma plan.

The traffic light system

GREEN AMBER! RED!!

Traffic lights

If you have COPD  you are more likely to suffer from chest infections. Recognising the warning signs of infection is an important step in getting help quickly to reduce the impact before an infection can take hold. With every infection there is a risk that further damage will be done to the lungs.

It is important to know when an infection is beginning and get treatment from your GP as soon as possible.

A written plan to help you manage a chest infection can be presented as a set of ‘traffic lights’. Using the ‘traffic lights’ information will allow you to have a better understanding of your COPD and more control over your own health. ‘Traffic lights’ will alert you to when you should be contacting your GP or NHS 24 on 111 for advice and treatment.

Before using your local traffic lights system discuss with your doctor, respiratory nurse or healthcare professional. They will give you local contact details and information specific for you.

Advice following Immunisation

A jug of drinking water

© Crown Copyright 2009

  • Most people will have no side effects.
  • The benefits of having these vaccinations far outweigh any minor side effects.
  • If you have a sore or red area on your arm try applying a clean cold cloth.
  • If you have a headache or slight fever drink plenty of fluids and take regular doses of paracetamol (but do not exceed the recommended dose).
  • If you have increased breathlessness, swelling or a rash in the few days after vaccination contact your doctor or nurse.

Pneumococcal vaccine – how is it given

A doctor giving a young man a vaccination injection in the upper arm.

© Crown copyright 2014

Most people only need one dose of pneumococcal vaccine. However if you have certain medical conditions (kidney disease and problems with your immune system) you may need a booster every 5 years.

It is given by injection to the upper outer area of your arm. It takes only seconds. It can be given at the same time as your flu vaccine.

Side effects are usually mild and only last a day or two. They may include swelling, redness and pain at the injection site. Occasionally some people experience fever and muscle pain.