Most Pulmonologists educate their patients self identification of Flare Ups (exacerbation), because early identification reduces Hospitalization & Complications (including death) along with positives like reduced treatment cost & duration.

During Asthma / COPD exacerbation, the airway and lung functions change quickly and dramatically. 

Exacerbations mostly occur due to infection, exposure to extreme weather / pollution conditions or inadequate medication.

Patients may suddenly experience more mucus clogging bronchial tubes or the muscles around airways may constrict significantly, cutting off the normal free air supply, causing suffocation, choking and congestion.

Symptoms of Asthma / COPD flare up are: 

1) Breathlessness or shortness of breath. Either feeling like you can’t breathe deeply or gasping for air, even while doing routine work.

2) Increase in coughing attacks. Coughing is continuous, disturbs work and sleep.

3) Wheezing (hearing a wheeze or whistling noise when you breathe means that air is being forced through a narrower passageway) due to congestion - it is a warning sign of increasing problem

4) Increase of mucus. You may begin to cough up more mucus, and it may be a different color (Yellow/ Black / Green / Dirty) than usual -  it is a warning sign of increasing problem

5) Fatigue or sleep problems. Sleep disturbances or exhaustion can indicate less oxygen is getting to your lungs and through your body, causing daytime fatigue - BE alert if patient starts to lose consciousness -  it is a warning sign of increasing problem

6) Cognitive impairment. Confusion, slowed down thought processing, depression, or memory lapses can happen as the brain isn’t receiving enough oxygen. 

7) Fever with chills -  it is a warning sign of increasing problem (Old age persons and Diabetics may not experience this symptom)

All these symptoms can appear in any order.

What to do:

1) Contact your treating doctor Immediately

2) Increase your Regular Inhaler / Rotahaler / Nebuliser intake, as per your need

3) Increase your Oxygen Intake (if you are prescribed ambulatory oxygen) 

4) Don't stop your other medicines (BP, Diabetes etc.)

Patient friendly information:

Asthma /COPD flare ups can be minimised by:

1) Influenza and Pneumococcal Vaccinations

2) Pranayama/ Yoga / Breathing Exercises - to be practised regularly, when patient is better / symptomless

3) Avoiding Air Pollution (Keep an eye on AQI & PM Levels, use masks / respirators / air purifiers as directed by Health Agencies / Doctors)

4) Stop Smoking (Active & Passive) 

Just remember, flare ups can occur due to many reasons and it is best to start treatment early to achieve quick relief