Chronic obstructive pulmonary disease, or COPD, is an umbrella term for a group of disorders that damage the lungs and reduce the flow of air through the airways. There is no cure for COPD, but new treatments and programs that include exercise, education and support significantly improve quality of life. “The diseases involved include emphysema, chronic bronchitis and certain forms of asthma,” says Neil Schachter, M.D., a pulmonologist at Mt. Sinai Hospital in New York City. Exposure to lung irritants, referred to as ‘triggers,’ cause symptoms that worsen suddenly. These attacks are called COPD exacerbations, or flare-ups. Here are seven common triggers.
Viral and bacterial lung infections are the most common cause of flare-ups. Viruses that cause the ordinary cold, flu and acute bronchitis, and bacteria responsible for pneumonia and flu can all bring on lung infections that last longer and make symptoms worse. How to manage: Adults with COPD have a higher risk of complications from diseases that could be prevented with vaccines. An annual flu shot clearly reduces the number of flare-ups. Also plan on have a pneumonia shot or two. The timing of pneumonia vaccines is tricky, so talk to your doctor.
Both winter’s cold and summer’s heat can trigger flare-ups. Temperatures below freezing and above 90 degrees F are particularly dangerous extremes when flare-ups become more common. During a cold spell, shortness of breath and coughing typically get worse. During a hot spell, high levels of ozone cause coughing and wheezing. How to manage: In cold weather, cover your nose and mouth with a scarf when you go outdoors to warm up the air you inhale. In hot weather, stay indoors and keep your house cool. Closing curtains or blinds can help. No matter the weather, make sure to drink water regularly to avoid becoming dehydrated.
According to the Cleveland Clinic, stress makes it harder to breathe, and shortness of breath leads to even faster, more shallow breathing that gives rise to anxiety and feelings of panic. How to manage: Dealing with stress effectively can break the anxiety-breathlessness cycle. Some people find that carving out as little as 10 minutes each day to listen to music, read a book or do something else they enjoy damps down anxiety. Others rely on meditation, yoga or tai chi. 
Until tomorrow: As you get older it is harder to have heroes, but it is sort of necessary.

Dorothy Prats

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