Ongoing Concerns

COPD gradually gets worse over time.

Shortness of breath gets worse as COPD gets worse.

• If you are diagnosed early, before you have a lot of lung damage, you may have very mild symptoms, even when you are active.
• If you are diagnosed later, you may have already lost much of your lung function.
  • If you are active, you may be short of breath during more strenuous activities.
  • If you are not very active, you may not notice how much shortness of breath you have until your COPD gets worse.
• If you have had COPD for many years, you may be short of breath even when resting. Even simple activities may cause very bad shortness of breath.

It's very important to stop smoking. If you keep smoking after being diagnosed with COPD, the disease will get worse faster, your symptoms will be worse, and you will have a greater risk of having other serious health problems.

The lung damage that causes symptoms of COPD does not heal and cannot be repaired. But if you have mild to moderate COPD and you stop smoking, you can slow the rate at which breathing becomes more difficult. You will never be able to breathe as well as you would have if you had never smoked, but you may be able to postpone or avoid more serious problems with breathing.

Complications

Other health problems from COPD may include:

• COPD flare-ups, also called exacerbations, which are sudden increases in coughing, shortness of breath, and/or the amount or color of mucus you cough up.
• More frequent lung infections, such as pneumonia.
• An increased risk of thinning bones (osteoporosis), especially if you use oral corticosteroids.
• Depression or anxiety. COPD may limit your ability to work and may reduce your independence, sexual activity, social activities, and self-esteem. This often causes depression. Having trouble breathing can make you feel very anxious.
• Problems with weight. If chronic bronchitis is the main part of your COPD, you may need to lose weight. If emphysema is your main problem, you may need to gain weight and muscle mass.
• Heart failure affecting the right side of the heart (cor pulmonale).
• A collapsed lung (pneumothorax). COPD can damage the lung's structure and allow air to leak into the chest cavity.
• Sleep problems because you are not getting enough oxygen into your lungs.

Care at the end of life

Treatment for COPD is getting better and better at helping people live longer. But COPD is a disease that keeps getting worse, and it can be fatal.

It's important to talk with your doctor about these issues:

• What is your idea of the "ideal death"? Do you want to be kept alive at all costs? Do you want a calm, peaceful death?
• If you have sudden, life-threatening breathing problems, do you want mechanical ventilation, which means being connected to a machine that breathes for you?
• What other kinds of medical treatment do you want, or not want, when you are near the end of life?
• Do you want an advance directive, which is a legal document that tells your doctor what treatment you want or don't want if you become unable to communicate?

• Care at the End of Life
• Writing an Advance Directive