COPD: Clearing your lungs

Normally, mucus in the body is thin and fluid. Mucus protects and moistens the lining of body organs, such as the lungs, stomach, and intestines. It also helps remove bacteria.

But if you have COPD, your airways may make more mucus than normal. The mucus may be so thick that it gets stuck in your lungs and airways. This makes it hard to breathe and easy to get infections.

Infections in the airways and lungs cause coughing, wheezing, and breathing problems. An infection may lead to more mucus in your lungs that becomes thicker and harder to move. The mucus may also change color.

Continue to Why?

You can't undo the damage to your lungs. But doing controlled coughing, postural drainage, and chest percussion can help drain mucus from your lungs. This can:

• Open your airways and make it easier to breathe.
• Help prevent infections. If you have fewer infections, you will likely have fewer lung problems.
• Help you manage your symptoms and feel better.

Continue to How?

Controlled coughing

Coughing is how your body tries to get rid of mucus. But the kind of coughing you cannot control makes things worse. It causes your airways to close. It also traps the mucus in your lungs.

Controlled coughing comes from deep in your lungs. It loosens mucus and moves it though your airways. It is best to do it after you use your inhaler or other medicine. Follow these steps for controlled coughing:

• Sit on the edge of a chair, and keep both feet on the floor.
• Lean forward a little, and relax.
• Breathe in slowly through your nose, and fold your arms over your belly.
• As you exhale, lean forward. Push your arms against your belly.
• Cough 2 or 3 times as you exhale with your mouth slightly open. Make the coughs short and sharp. Push on your belly with your arms as you cough. The first cough brings the mucus through the lung airways. The next coughs bring it up and out.
• Inhale again, but do it slowly and gently through your nose. Do not take quick or deep breaths through your mouth. It can block the mucus coming out of the lungs. It also can cause uncontrolled coughing.
• Rest, and repeat if you need to.

Postural drainage

Postural drainage means lying down in different positions to help drain mucus from your lungs.

Hold each position for 5 minutes. Do it about 30 minutes after you use your inhaler. Make sure you have an empty stomach. If you need to cough, sit up and do controlled coughing.

Follow these steps for postural drainage:

• Lie down on a bed or the floor.Use pillows to help you with different positions.
• To drain the front of your lungs
  • Lie on your back. Make sure that your chest is lower than your hips. Put two pillows under your hips. Use a small pillow under your head. Keep your arms at your sides.
  • Then follow these instructions for breathing: With one hand on your belly and the other on your chest, breathe in. Push your belly out as far as possible. You should be able to feel the hand on your belly move out, while the hand on your chest should not move. When you breathe out, you should be able to feel the hand on your belly move in. This is called belly breathing or diaphragmatic (say "die-uh-fruhg-MAT-ik") breathing. You will use it in the other drainage positions too.
• To drain the sides of your lungs
  • Do this step as you lie on one side. Then turn over, and do it on the other side.
  • Place two or three pillows under your hips. Use a small pillow under your head. Make sure your chest is lower than your hips. Use belly breathing. After 5 or 10 minutes, switch sides.
• To drain the back of your lungs
  • Lie on your stomach.
  • Place two or three pillows under your hips. Use a small pillow under your head.
  • Place your arms by your head.
  • Use belly breathing.

Chest percussion

Chest percussion means that you lightly tap your chest and back. The tapping loosens the mucus in your lungs.

Follow these steps to do chest percussion:

• Cup your hand, and lightly tap your chest and back.
• Ask your doctor where the best spots are to tap. Avoid your spine and breastbone.
• It may be easier to have someone do the tapping for you.

Continue to Where?

Controlled coughing, postural drainage, and chest percussion may not work for everyone. Talk with your doctor about these methods to clear your lungs.

It is important to remain active and to exercise when you have COPD. Activity and exercise can:

• Build muscle strength and endurance. This will help you be more active—you will be able to do more activities for longer amounts of time.
• Reduce shortness of breath.

Always talk with your doctor before starting any exercise program.

For more information, see:

Using exercise to feel better

If you have questions about this information, print it out and take it with you when you visit your doctor. You may want to use a highlighter to mark areas or make notes in the margins of pages where you have questions.

If you would like more information on COPD, the following resources are available:

Online Resource

Smokefree.gov
Smokefree.gov
Web Address:	www.smokefree.gov
This Web site was created by the Tobacco Control Research Branch of the National Cancer Institute with important contributions from other national agencies such as the Centers for Disease Control and the American Cancer Society. It offers an online guide to quitting smoking, including online messaging and telephone support from the National Cancer Institute.

Organizations

American Lung Association
1301 Pennsylvania Avenue NW
Suite 800
Washington, DC  20004
Phone:	1-800-LUNG-USA (1-800-586-4872) 1-800-548-8252 (to speak with a lung professional) (212) 315-8700
Web Address:	www.lungusa.org
The American Lung Association provides programs of education, community service, and advocacy. Some of the topics available include asthma, tobacco control, emphysema, asbestos, carbon monoxide, radon, and ozone.
American Thoracic Society
61 Broadway
New York, NY  10006-2755
Phone:	(212) 315-8600
Fax:	(212) 315-6498
E-mail:	atsinfo@thoracic.org
Web Address:	www.thoracic.org
The American Thoracic Society provides information for professionals and consumers about the prevention and treatment of lung diseases. It provides educational material for the consumer through its Web site.
National Jewish Medical and Research Center
1400 Jackson Street
Denver, CO  80206
Phone:	1-800-222-LUNG (1-800-222-5864) (303) 388-4461 (outside the United States)
E-mail:	lungline@njc.org
Web Address:	http://www.njc.org or http://www.NationalJewish.org
The National Jewish Medical and Research Center is devoted to treatment, research, and education in chronic respiratory diseases. It also publishes a newsletter and pamphlets; maintains the LUNG LINE, a free call-in information service for consumers; and has a patient referral center (inpatient and outpatient services).