There are a number of things that help determine the prognosis (the likely course of a disease or ailment) of patients with COPD. One of the more important factors is how often they may have a transient worsening of their disease. We refer to this as an exacerbation, and it is specifically defined as “an acute worsening of respiratory symptoms that results in additional therapy”.
When I see patients in the office for their routine follow-up visit, I ask if they have had a hospitalization, or gone to the emergency room or an outpatient care center, for any lung issues. What all patients should know is that any flare-up is important to mention. Often patients will simply say that they had a “cold”, but handled it themselves. These are exacerbations that need to be reported. Data suggest that 75% of exacerbations are not reported to the physician. Why is reporting important?
The severity and frequency of exacerbations impacts the progression of disease. Those with more frequent exacerbations can have more rapidly advancing disease. The frequency and intensity of exacerbations may indicate the need for a change in the medications taken and the overall treatment strategy.
My best advice is not to hold back, tell you pulmonary physician, or even your family physician, about flare-ups of your lung problems, even though they did not require emergency room or hospital care, and always remember to take your medications daily to help avoid and mediate problems.
