Medical

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

• You have severe trouble breathing.

Call your doctor now or seek immediate medical care if:

• Your symptoms do not get better after you have followed your asthma action plan.
• You have new or worse trouble breathing.
• Your coughing and wheezing get worse.
• You cough up dark brown or bloody mucus (sputum).
• You have a new or higher fever.

Watch closely for changes in your health, and be sure to contact your doctor if:

• You need to use quick-relief medicine on more than 2 days a week (unless it is just for exercise).
• You cough more deeply or more often, especially if you notice more mucus or a change in the color of your mucus.
• You are not getting better as expected.

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Chronic Obstructive Pulmonary Disease (COPD): Care Instructions

Your Care Instructions

Chronic obstructive pulmonary disease (COPD) is a general term for a group of lung diseases, including emphysema and chronic bronchitis. People with COPD have decreased airflow in and out of the lungs, which makes it hard to breathe. The airways also can get clogged with thick mucus. Cigarette smoking is a major cause of COPD.

Although there is no cure for COPD, you can slow its progress. Following your treatment plan and taking care of yourself can help you feel better and live longer.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

Staying healthy

• Do not smoke. This is the most important step you can take to prevent more damage to your lungs. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• Avoid colds and flu. Get a pneumococcal vaccine shot. If you have had one before, ask your doctor whether you need a second dose. Get the flu vaccine every fall. If you must be around people with colds or the flu, wash your hands often.
• Avoid secondhand smoke, air pollution, and high altitudes. Also avoid cold, dry air and hot, humid air. Stay at home with your windows closed when air pollution is bad.

Medicines and oxygen therapy

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• You may be taking medicines such as:
  • Bronchodilators. These help open your airways and make breathing easier. Bronchodilators are either short-acting (work for 6 to 9 hours) or long-acting (work for 24 hours). You inhale most bronchodilators, so they start to act quickly. Always carry your quick-relief inhaler with you in case you need it while you are away from home.
  • Corticosteroids (prednisone, budesonide). These reduce airway inflammation. They come in pill or inhaled form. You must take these medicines every day for them to work well.
• A spacer may help you get more inhaled medicine to your lungs. Ask your doctor or pharmacist if a spacer is right for you. If it is, ask how to use it properly.
• Do not take any vitamins, over-the-counter medicine, or herbal products without talking to your doctor first.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• Oxygen therapy boosts the amount of oxygen in your blood and helps you breathe easier. Use the flow rate your doctor has recommended, and do not change it without talking to your doctor first.

Activity

• Get regular exercise. Walking is an easy way to get exercise. Start out slowly, and walk a little more each day.
• Pay attention to your breathing. You are exercising too hard if you cannot talk while you are exercising.
• Take short rest breaks when doing household chores and other activities.
• Learn breathing methods—such as breathing through pursed lips—to help you become less short of breath.
• If your doctor has not set you up with a pulmonary rehabilitation program, talk to him or her about whether rehab is right for you. Rehab includes exercise programs, education about your disease and how to manage it, help with diet and other changes, and emotional support.

Diet

• Eat regular, healthy meals. Use bronchodilators about 1 hour before you eat to make it easier to eat. Eat several small meals instead of three large ones. Drink beverages at the end of the meal. Avoid foods that are hard to chew.
• Eat foods that contain fat and protein so that you do not lose weight and muscle mass. These foods include ice cream, pudding, cheese, eggs, and peanut butter.

Mental health

• Talk to your family, friends, or a therapist about your feelings. It is normal to feel frightened, angry, hopeless, helpless, and even guilty. Talking openly about bad feelings can help you cope. If these feelings last, talk to your doctor.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

• You have severe trouble breathing.

Call your doctor now or seek immediate medical care if:

• You have new or worse trouble breathing.
• You cough up blood.
• You have a fever.

Watch closely for changes in your health, and be sure to contact your doctor if:

• You cough more deeply or more often, especially if you notice more mucus or a change in the color of your mucus.
• You have new or worse swelling in your legs or belly.
• You are not getting better as expected.

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Oxygen Therapy: Care Instructions

Your Care Instructions

Oxygen therapy helps you get more oxygen into your lungs and bloodstream. You may use it if you have a disease that makes it hard to breathe, such as COPD, pulmonary fibrosis (scarring of the lungs), or heart failure. Oxygen therapy can make it easier for you to breathe and can reduce your heart’s workload.

Some people need extra oxygen all the time. Others need it from time to time throughout the day or overnight. A doctor will prescribe how much oxygen you need and how often to use it.

To breathe the oxygen, most people use a nasal cannula (say “KAN-yuh-luh”). This is a thin tube with two prongs that fit just inside your nose. People who need a lot of oxygen may need to use a mask that fits over the nose and mouth.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

To help yourself

• Using oxygen may dry out your nose or lips. Use water-based lubricants on your lips or nostrils. Do not use an oil-based product like petroleum jelly.
• If you use a nasal cannula, the tubing may rub under your nostrils and around your ears. To keep your skin from getting sore, tuck some gauze under the tubing. Use a water-based lotion on rubbed areas.
• Do not use alcohol or take drugs that relax you, because they will slow your breathing rate.
• Keep track of how much oxygen is in the tank, and reorder before it runs out. If a holiday is coming up or you expect bad weather, order in advance or make your regular order larger.
• You may need extra oxygen when you travel to high altitudes or travel by plane. Ask your doctor about this.
• If you are getting oxygen directly to your windpipe through an opening in your neck, your doctor will teach you how to care for the equipment.

To make sure oxygen is flowing

• Check the flow by holding your mask or cannula up to your ear and listening for the “hiss” of airflow.
• If you have a nasal cannula, dip the prongs in a glass of water. If you see bubbles, oxygen is coming through.
• Check your pressure gauge or contents indicator.
• If you use an oxygen concentrator, make sure it is turned on and plugged in. If you use a cylinder, make sure the valve is open.
• Look for kinks, blockages, or water in the tubing. Be sure the tubing is connected to the oxygen source.
• Do not change your oxygen flow rate. Your doctor sets this at the correct level. Higher flow rates usually do not help and can increase the risk of harmful carbon dioxide buildup in the blood.

To be safe

• Do not leave cords or tubing running across an area where you or someone else may trip on it.
• Do not let oxygen containers get hot. Store them in a cool place where there is airflow. Do not leave them in a car trunk or a hot vehicle.
• Keep oxygen containers upright. Make sure they do not fall over and get damaged. Try securing the tanks in a sturdy container or securing them with a rope or a chain.
• Watch for signs of oxygen leaks. If you hear a loud hissing from your container or if it empties too fast, stay away from the container. Open windows right away and call the company that brought the oxygen system to your home.
• Do not use oxygen around anything that could spark or easily cause a fire.
  • Do not smoke or let others smoke while you are using oxygen. Put up “no smoking” signs in your home.
  • Do not use oxygen near open flames, such as candles, fireplaces, gas stoves, or hot water heaters. Do not use it near electric razors, hair dryers, heating pads, or anything that may spark.
  • Keep a working fire extinguisher in your home where it is easy to get to.
  • If a fire starts, turn off the oxygen right away and leave the house.
  • If you have an oxygen concentrator, do not use it if the cord looks damaged. Do not use an extension cord to plug it in. Do not plug it into an outlet that has other appliances plugged into it.

To care for the equipment

• Follow the directions that come with the equipment for using and caring for it.
• Wash your cannula or mask with a liquid soap and warm water 1 or 2 times a week. Replace them every 2 to 4 weeks.
• If you have a cold, change the nasal prongs when your cold symptoms are done.
• If you have an oxygen concentrator, unplug the unit and wipe down the cabinet with a damp cloth daily. Clean the air filter at least 2 times a week.

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Sleep Apnea: Care Instructions

Your Care Instructions

Sleep apnea means that you frequently stop breathing for 10 seconds or longer during sleep. It can be mild to severe, based on the number of times an hour that you stop breathing or have slowed breathing.

Blocked or narrowed airways in your nose, mouth, or throat can cause sleep apnea. Your airway can become blocked when your throat muscles and tongue relax during sleep.

You can treat sleep apnea at home by making lifestyle changes. You also can use a CPAP breathing machine that keeps tissues in the throat from blocking your airway. Or your doctor may suggest that you use a breathing device while you sleep. It helps keep your airway open. This could be a device that you put in your mouth. Other examples include strips or disks that you use on your nose. In some cases, surgery may be needed to remove enlarged tissues in the throat.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

• Lose weight, if needed. It may reduce the number of times you stop breathing or have slowed breathing.
• Sleep on your side. It may stop mild apnea. If you tend to roll onto your back, sew a pocket in the back of your pajama top. Put a tennis ball into the pocket, and stitch the pocket shut. This will help keep you from sleeping on your back.
• Avoid alcohol and medicines such as sleeping pills and sedatives before bed.
• Do not smoke. Smoking can make sleep apnea worse. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• Prop up the head of your bed 4 to 6 inches by putting bricks under the legs of the bed.
• Treat breathing problems, such as a stuffy nose, caused by a cold or allergies.
• Try a continuous positive airway pressure (CPAP) breathing machine if your doctor recommends it. The machine keeps your airway open when you sleep.
• If CPAP does not work for you, ask your doctor if you can try other breathing machines. A bilevel positive airway pressure machine uses one type of air pressure for breathing in and another type for breathing out. Another device raises or lowers air pressure as needed while you breathe.
• Talk to your doctor if:
  • Your nose feels dry or bleeds when you use one of these machines. You may need to increase moisture in the air. A humidifier may help.
  • Your nose is runny or stuffy from using a breathing machine. Decongestants or a corticosteroid nasal spray may help.
  • You are sleepy during the day and it gets in the way of the normal things you do. Do not drive when you are drowsy.

When should you call for help?

Watch closely for changes in your health, and be sure to contact your doctor if:

• You still have sleep apnea even though you have made lifestyle changes.
• You are thinking of trying a device such as CPAP.
• You are having problems using a CPAP or similar machine.

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Learning About CPAP for Sleep Apnea

What is CPAP?

CPAP is a small machine that you use at home every night while you sleep. It increases air pressure in your throat to keep your airway open. When you have sleep apnea, this can help you sleep better so you feel much better. CPAP stands for “continuous positive airway pressure.”

The CPAP machine will have one of the following:

• A mask that covers your nose and mouth
• Prongs that fit into your nose
• A mask that covers your nose only, the most common type. This type is called NCPAP. The N stands for “nasal.”

Why is it done?

CPAP is usually the best treatment for obstructive sleep apnea. It is the first treatment choice and the most widely used. Your doctor may suggest CPAP if you have:

• Moderate to severe sleep apnea.
• Sleep apnea and coronary artery disease (CAD) or heart failure.

How does it help?

• CPAP can help you have more normal sleep, so you feel less sleepy and more alert during the daytime.
• CPAP may help keep heart failure or other heart problems from getting worse.
• CPAP may help lower your blood pressure.
• If you use CPAP, your bed partner may also sleep better because you are not snoring or restless.

What are the side effects?

Some people who use CPAP have:

• A dry or stuffy nose and a sore throat.A dry or stuffy nose and a sore throat.A dry or stuffy nose and a sore throat.
• Irritated skin on the face.
• Sore eyes.
• Bloating.

If you have any of these problems, work with your doctor to fix them. Here are some things you can try:

• Be sure the mask or nasal prongs fit well.
• See if your doctor can adjust the pressure of your CPAP.
• If your nose is dry, try a humidifier.
• If your nose is runny or stuffy, try decongestant medicine or a steroid nasal spray. Be safe with medicines. Read and follow all instructions on the label. Do not use the medicine longer than the label says.

If these things do not help, you might try a different type of machine. Some machines have air pressure that adjusts on its own. Others have air pressures that are different when you breathe in than when you breathe out. This may reduce discomfort caused by too much pressure in your nose.

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Pneumonia: Care Instructions

Your Care Instructions

Pneumonia is an infection of the lungs. Most cases are caused by infections from bacteria or viruses.

Pneumonia may be mild or very severe. If it is caused by bacteria, you will be treated with antibiotics. It may take a few weeks to a few months to recover fully from pneumonia, depending on how sick you were and whether your overall health is good.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

• Take your antibiotics exactly as directed. Do not stop taking the medicine just because you are feeling better. You need to take the full course of antibiotics.
• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Get plenty of rest and sleep. You may feel weak and tired for a while, but your energy level will improve with time.
• To prevent dehydration, drink plenty of fluids, enough so that your urine is light yellow or clear like water. Choose water and other caffeine-free clear liquids until you feel better. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
• Take care of your cough so you can rest. A cough that brings up mucus from your lungs is common with pneumonia. It is one way your body gets rid of the infection. But if coughing keeps you from resting or causes severe fatigue and chest-wall pain, talk to your doctor. He or she may suggest that you take a medicine to reduce the cough.
• Use a vaporizer or humidifier to add moisture to your bedroom. Follow the directions for cleaning the machine.
• Do not smoke or allow others to smoke around you. Smoke will make your cough last longer. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• Take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Read and follow all instructions on the label.
• Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
• If you were given a spirometer to measure how well your lungs are working, use it as instructed. This can help your doctor tell how your recovery is going.
• To prevent pneumonia in the future, talk to your doctor about getting a flu vaccine (once a year) and a pneumococcal vaccine (one time only for most people).

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

• You have severe trouble breathing.

Call your doctor now or seek immediate medical care if:

• You cough up dark brown or bloody mucus (sputum).
• You have new or worse trouble breathing.
• You are dizzy or lightheaded, or you feel like you may faint.

Watch closely for changes in your health, and be sure to contact your doctor if:

• You have a new or higher fever.
• You are coughing more deeply or more often.
• You are not getting better after 2 days (48 hours).
• You do not get better as expected.