Dear COPD Coach,
I have a question on taking medications. I use a powdered inhaler twice a day and use a rescue inhaler throughout the day. My hardest time breathing is in the morning, but I am afraid that I am not able to breathe deeply enough to make the powdered inhaler effective when I first wake up. I also have to bring up a lot of mucus in the morning, and I am afraid that all the medications are doing is coating the mucus. Do you have any suggestions?
The one thing that is true about COPD is that it is not the same for all patients. Many COPD patients experience problems breathing in the morning, while others tend to have worsening symptoms later in the day. If you have a bronchitis component to your COPD, you might well be experiencing mucous plugs in the morning that restrict your breathing.
If this is the case, you should discuss this with your doctor. I also experience mucous plugs after awakening, and it seems at this time when I need the medications most, Mucus plugs are when the mucus you produce gathers in one area blocking your airway. You are also correct in assuming that the mucus you are experiencing might well be restricting the medicines. When you are out of breath to begin with, it is hard to generate enough strength to inhale the powdered inhaled deep enough to be effective.
What I generally do is try to time taking my dry inhalers to the time they would be most effective. Instead of taking my medications first thing when I get out of bed, I take them a little later in the morning when I have cleared some of the mucus. I am still taking as directed (once every 12 hours). The first order of business might well be to clear as much of the mucus as possible before taking your meds. Talk with your doctor about what methods and devices for mucus removal might be most effective. Drinking lots of water first thing in the morning often helps to thin the mucus making it easier to expel. There are also medications available that will help move the mucus more easily.
Once you have the mucus under control, you will have an easier time inhaling the powdered medication. You doctor might also suggest using your mist inhalers first to help open your airways to allow for more effective use of your other medication. Another trick to get rid of the mucus is to drink something very cold followed by something very hot. The theory is related to expansion and contraction, and in my case it seems to work!
If you want to learn more about mucus removal, check out Ask The Expert archives on this site that directly address this important topic.
The COPD Coach
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