4 Stages of COPD Explained: Stage 4 - Severe COPD (Living Healthy with COPD)

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4 Stages of COPD Explained: Stage 4 - Severe COPD
In stage 4 of COPD, lung function is very low. Stage 3 symptoms worsen and become more persistent. Shortness of breath and chest tightness occur with everyday activities, and it becomes a big effort just to breathe. Hospitalizations for breathing complications, lung infections, or respiratory failure are common during stage 4 COPD, and sudden flare-ups can be life-threatening.
Other symptoms of stage 4 COPD include:
A crackling sound when you breathe in
Barrel chest
Delirium
An irregular or fast heartbeat
Weight loss
Pulmonary hypertension, a form of high blood pressure that affects the arteries in your lungs and the right side of your heart
There are various treatment options for severe COPD symptoms, including supplemental oxygen, pulmonary rehabilitation, and steroids taken orally, intravenously, or via inhaler. Potential side effects from steroids include swelling in the airways and mouth, muscle weakness, weight loss, fatigue, and increased risk for pneumonia. Read our previous blog to learn more about managing medication side effects, and speak with your doctor if you have questions or concerns.
Supplemental oxygen, or oxygen therapy, helps get more oxygen into your lungs and increases your tolerance for physical activities. There are several devices for oxygen therapy. The most common is a nasal cannula, a device with two small tubes that fit into your nostrils and a connected oxygen tank. Adjusting to supplemental oxygen is a process, but you’ll come to feel more and more comfortable with time. The American Lung Association has helpful resources for anyone starting oxygen therapy.
Lung surgery or lung transplants are also options for some people with severe COPD. Eligibility is based on many factors, including participation in a pulmonary rehabilitation program, lung function tests, and additional considerations such as whether you are strong enough for the procedure and if you smoke. (You cannot be a current smoker for lung surgery eligibility.) Your doctor can help you determine if lung surgery is right for you.

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Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, and refractory (non-reversible) asthma. This disease is characterized by increasing breathlessness.

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