Coping with setbacks, warning signs

If the person has never had an acute exacerbation the normal  pattern of their illness is of a slow reduction in exercise tolerance and increasing levels of breathlessness and tiredness with everyday activity.

For those who have had an exacerbation it is especially important to get them to recognise problems before they become severe. The earlier an episode is treated and the quicker the medication is given, the better the outcome.

Everyone has a bad day every now and again but not 2 or 3 in row. Here is an example:

  • Everyone has experienced a bad Monday.
  • If Tuesday also feels like a bad day, most people will know why. They are getting a cold or a sore throat or they have slept poorly but with respiratory illness people may just feel a bit lethargic or off their food.
  • If on Wednesday they still feel unwell, even with no overt symptoms, they should start their rescue medication (if they have this at home) or contact their GP.
  • Often tiredness is the presenting symptom. There maybe no change in the chest signs on examination and breathlessness may only happen later in the process.
  • People who have repeated exacerbations should discuss having rescue medication at home. This means that with guidance, the person has quick access to medication before an infection or exacerbation gets worse.

Setbacks: Monday: temperature, Tuesday: blowing nose, Wednesday: large number of used tissues

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