For people who suffer from COPD, a management plan will be a combination of things that they can do to manage the progression of their condition and keep it well managed. The exact detail of this plan often depends on how severe the person’s condition is. However, like most things in life, a management plan is never one-size-fits-all, and nor is it static. There will be times when the program is no longer as effective as it used to be and that will mean changing it. However, in order to recognize that you need to change it, you need to be able to see that it is not working - and be willing to admit it. So, how do you do that?
The answer: Monitoring
If you are recently diagnosed with COPD, you are probably worried about the progression of your condition. Well, this series is built to give you the information you need to build a lasting and effective program to curb its progression (as best as you can).
How Can You Slow the Progression of COPD?
There are a number of things that you can do to slow the progression. Taking your medication, avoiding lifestyle choices that make it worse, and doing simple things like eating well and getting enough sleep are all practical ways to help. However, most of these rely on you tracking the aspect to ensure you don’t take too much medication, identify the lifestyle choices that affect you the most, find out what a perfect amount of sleep is, and for those able - to get those steps in. In this guide, we get laser-focused on how to start tracking the most important aspects of your condition so that you can sleep well knowing you have the most suitable management plan. In this we will look at:
- Symptoms: by tracking your symptoms daily, you can what days were ‘good’ days and what days were ‘bad’ days.
- Lung Function: tracking your lung function acts as another day to see how your condition is daily, and if it is getting better or worse over a time period.
- Quality of Life: tracking how your condition affects your life can be a powerful way, to be honest about whether your condition is getting better or worse.
The progression of COPD is assessed by looking at a number of different factors. However, when it comes to those factors that you can assess, the most important are a worsening of symptoms, lung function, and quality of life. So, it’s very important you monitor these three aspects.
Monitoring your Symptoms
Monitoring your symptoms is one of the primary ways to understand how well managed you have your condition. The two characteristics of symptoms that you want to be aware of are frequency and intensity. Or in order words, how often are the symptoms happening (frequency)? how bad is it relative to the previous times you have experienced it (severity)?
In the case of COPD, understanding the signs of a poorly controlled state is really important. These include wheezing, breathlessness, coughing, chest tightness, sputum volume, etc...
💡 If you notice that any of these symptoms become persistent, you should consult your doctor to review your management plan so that you can get your condition under control.
One of the common reasons for having symptoms is that you have come into contact with one of your triggers. Triggers can take many forms such as stress, poor air quality, temperature… there are many of them out there. If you are recently diagnosed, it can be hard to know what it might be. One way to try and identify them is for you to track when you experience them (day + time) and note anything that might have happened that day (maybe you went to a new place or visited your friend's house that just got a dog). You can keep it simple, use a pen and paper to keep track and you might be surprised what you find.
💡 There are also various digital tools (tracking apps, journal apps, chat apps) that you can use to help you track and find patterns around your symptoms.
Monitoring your Lung Function
Lung function is a term that defines a number of different measurements that help give an indication as to how healthy your lungs are. These measurements are normally taken by a device called a spirometer. Two of the most common measurements that come from this device are Peak Flow and FEV1. Your lung function can be a good indicator of how your condition’s progressing. But, be careful about comparing your lung function to others - it is highly related to your age, weight, height, condition, and ethnicity so understanding what your baseline is, and comparing your result to that, is very important.
One of the most influential factors that affect someone's condition (COPD or not) is age. As a person gets older, it naturally starts to decline. However, it can also decline when your condition is ‘flared up’ and especially when this flare-up has been persistent for a prolonged period of time.
“but I know when my condition is flared up - why would I need to track it”
people tend to push out addressing problems. Tracking keeps you honest about how long you have been feeling a certain way, and as we have noted, the length of time you experience a flare-up can have a long-term effect on it. So, tracking your lung function will help you recognize if something needs to be changed in your management plan. As mentioned above, there is a device called a spirometer that can help you measure your lung function. You can get access to one of these spirometers through:
- You can visit/ask your doctor who will use a spirometry machine. It's a device reserved for checking the functioning of your lungs.
- You can purchase a peak flow meter that you can assess your lung function peak flow at home.
- You can purchase a digital spirometer to assess your full lung function at home.
💡 You can check out this calculator that will give you a baseline for the values around your spirometer. As always, consulting your doctor on how this fits into your management plan is always advised.
Monitoring your Quality of Life
The last aspect we are going to talk about is Quality Of Life (QOL). Your quality of life is a broad sense of the standard of health, comfort, and happiness experienced - or as the WHO defines - “a broad multidimensional concept that usually includes subjective evaluations of both positive and negative aspects of life”. Because the quality of our life can be affected by many things like health, finances, and relationships it can be hard to pin down why we are feeling the way we are. So it is important to see how we can look at it from the lens of your health.
🏆 Having an active lifestyle is scientifically linked to so many benefits - managing your condition and mental health to name just a few. But, getting started is often very difficult. To help you get started, we have put together a 30-day guide full of practical tips.
A practical way to assess your HRQOL (Health-Related Quality of Life) is to ask yourself a set of questions that give you an indicator of too much your health is impacting your life. At the end of every 12 months, you can review the answers that you have logged and compare them with previous years. An example question set that you can use:
- “How has my health affected my work in the last _ months”
- “How has my health affected my social life in the last _ months”
- “How has my health affected my mood in the last _ months”
- “How has my health affected my ability to exercise in the last _ months”
💡 Another option is to take an ACT score test. This test has been clinically validated and gives you an indicator as to how well controlled you have your COPD.
Like lung function, one thing to be aware of is that your health will naturally decline as you grow older (we can’t be young forever… yet). So, instead of looking at your HRQOL over 10-20 years, try to focus on the last 2-5 years. If there has been a decrease, has this been caused by my condition? Is this naturally given by the condition's severity? As always, keep a log of your answers and talk through them with your doctor to help you determine if there is something that can be done to improve your management plan and your HRQOL.
Monitoring everything, all the time, is really really hard - it requires a lot of work. So the most important thing is to build a monitoring program that you can follow, and build it up from there. So start small and you will soon be more educated about how well you are managing your condition. You will also be able to have more proactive discussions with your doctor about how you are feeling and talk through your options as a team. All of which will mean a better management program, and a better quality of life.