Chronic Obstructive Lung Disease - Lifestyle Changes

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Breath Holding and Coughing. A simple technique is to inhale deeply and slowly, holding the breath for five to 10 seconds. Then the patient coughs on exhalation.

Controlling Secretions

Fluids and Humidity. Patients who experience congestion and heavy sputum can benefit from maintaining good fluid intake and keeping their homes humidified.

Expectorants. Although unproven, many patients report benefits from using over-the-counter expectorant drugs that thin mucus. These drugs should not be used during an acute exacerbation of COLD, however.

Chest Therapy. Chest therapy involves rhythmic inhalation for three or four deep breaths followed by coughing to produce sputum. Tapping the chest may also help in loosening and raising sputum. This should be avoided during an acute exacerbation of COLD.

Postural Drainage. The patients should also practice postural drainage. This involves leaning over the side of the bed, head down with elbows on a pillow placed on the floor. A family member or caregiver thumps gently on the back while the patient coughs.

Mucus-Producing Coughs. When coughing to produce mucus, one effective method is to lean forward and "huff" repeatedly, take relaxed breaths, and huff again. If possible, forceful coughing should be avoided.

Devices for Improving Lung Function

Flutter Valve. The flutter valve is a small hand-held device that looks like a pipe. It contains a steel ball that sits in a small plastic cone. The patient inhales deeply, holding the breath for two to three seconds. As the patient exhales (keeping the cheeks in), the ball is pushed up toward the top of the device and then falls back down. About 10 to 50 vibrations per second are generated and transmitted to the lungs to help loosen secretions. This is repeated for up to 15 breath cycles. The patient coughs at the end.

Chest Compression Devices. Devices are available that allow the patient to be passive and still expel air. One called the Vest (formerly the ThAIRapy Vest) consists of an inflatable vest attached by hoses to a generator that triggers pulses of air into the vest. The rapid pressure and release of the air around the chest acts like tiny hugs to create small coughs. It is very expensive (about $16,000), but may be covered by insurance for specific patients.