Can we talk about emergency plans?

@lesley56 I do not have COPD, but have Asthma and another lung disease, Bronchiectasis. I worked with my pulmonologist to create a plan that works for me - for now. At some point we may have to change it. I compare it to the emergency plan one makes if they are diabetic and tend to low blood sugar.

For now, my plan is - if I sense an exacerbation coming - more fatigue, more coughing, more mucus, fever, respiratory infection - I initiate higher levels of self-treatment.
Step one - Begin monitoring oxygen levels with pulse oximeter - if below 90 and doing the following treatments, go to the ER. Increase nebs from once/twice a day using levalbuterol and budesonide to as often as every 4 hours, sit up or recline to help breathing, cough up as much mucus as possible.
Step two - after 24 hours with no improvement, continue step one and start oral prednisone - we have already set the dose, and I always have a filled Rx on hand.
Step three - if steps one & two don't give improvement - start oral antibiotics, call pulmonologist and make arrangements for someone to take me to the ER if necessary.

We review our plan once a year, and so far I have managed to stay at steps one & two - even when I had Covid this fall.

If your condition, at COPD stage 4, is more prone to rapid decline, your plan may be different. For example, you may have a tendency to "trap" carbon dioxide in your lungs, which can quickly lead to confusion or non-responsiveness. So, if you get an exacerbation, you might need to have another person with you 24/7 during it, and they might need some written directions of when to wait, when to take you to the ER, and when to call 911.

Do you have someone who can be with you during an exacerbation? Can you make a plan with your pulmonologist?

I am a DNR . I don’t intend to be rushed to the ER. I have a prescriptions in my cupboard to try to make me either stop the mucus attack, expand my airways and clear an attack. Or when all fails , I will start on morphine. I do not intend to live in fear. I am stage 4 my pulmonologist says . I am on 4 liters . I have never used albuteral. I take Musinex 1200 every 12 hours . I do drink a lot of water . Seems to keep the mucus thin and coming up easily. I understand ones fear. Try to be positive and calm . It will help . Blessed Be, Crystal

What does the morphine do?

@lesley56 I do not have COPD, but have Asthma and another lung disease, Bronchiectasis. I worked with my pulmonologist to create a plan that works for me - for now. At some point we may have to change it. I compare it to the emergency plan one makes if they are diabetic and tend to low blood sugar.

For now, my plan is - if I sense an exacerbation coming - more fatigue, more coughing, more mucus, fever, respiratory infection - I initiate higher levels of self-treatment.
Step one - Begin monitoring oxygen levels with pulse oximeter - if below 90 and doing the following treatments, go to the ER. Increase nebs from once/twice a day using levalbuterol and budesonide to as often as every 4 hours, sit up or recline to help breathing, cough up as much mucus as possible.
Step two - after 24 hours with no improvement, continue step one and start oral prednisone - we have already set the dose, and I always have a filled Rx on hand.
Step three - if steps one & two don't give improvement - start oral antibiotics, call pulmonologist and make arrangements for someone to take me to the ER if necessary.

We review our plan once a year, and so far I have managed to stay at steps one & two - even when I had Covid this fall.

If your condition, at COPD stage 4, is more prone to rapid decline, your plan may be different. For example, you may have a tendency to "trap" carbon dioxide in your lungs, which can quickly lead to confusion or non-responsiveness. So, if you get an exacerbation, you might need to have another person with you 24/7 during it, and they might need some written directions of when to wait, when to take you to the ER, and when to call 911.

Do you have someone who can be with you during an exacerbation? Can you make a plan with your pulmonologist?