Question #10450
1 day ago
26
How can I get rid of breathing trouble? - #10450
Subenoy Bhattacharjee
I am a COPD Patient since 2018. By walking a few yards and ascending a few steps in staircase I feel short of breath. Even by doing some work leaning down, I feel the breathing trouble. I need to sit then and there immediately. Otherwise I have no other disease. I am under treatment of an Alopathy Dictor who prescribed Inhaler. But for last two years the inhaler alsodoes not work as before. My pulmonary rate is 45. My age is now 70.
Age: 70
Chronic illnesses: COPD
300 INR (~3.53 USD)
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Doctors’ responses
(You may no longer be responding to monotherapy or short-acting agents)
1. Switch to Dual Bronchodilator Inhaler (LAMA + LABA):
Tiotropium 18 mcg (Spiriva) capsule with Handihaler – 1 capsule inhaled once daily
OR
Tiotropium + Olodaterol (e.g., Stiolto Respimat)
2 puffs once daily
2. Add Inhaled Corticosteroid if Frequent Exacerbations:
ICS + LABA combo: Budesonide + Formoterol (Foracort 200/400)
2 puffs twice daily via spacer
Use spacer for better delivery in elderly patients.
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Supportive Medications:
Tablet Deriphyllin Retard 150/300 mg
1 tab twice daily after food
Tablet Montelukast + Levocetirizine
1 tab at night if post-nasal drip or allergic symptoms present
Mucolytics: Tablet Ambroxol + Guaifenesin
1 tab twice daily to loosen phlegm
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Pulmonary Rehab & Monitoring:
Enroll in Pulmonary Rehabilitation Program: Supervised breathing exercises, chest physiotherapy, and resistance training
Perform home spirometry or 6-minute walk test regularly if feasible
Pulse oximeter at home: maintain SpO₂ ≥ 92% at rest and mild exertion
Vaccinations:
Influenza vaccine yearly
Pneumococcal vaccine (PPSV23 + PCV13)
COVID-19 booster if not yet taken
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Given what you've described—increasing breathlessness even with mild activity, diminished inhaler effectiveness, and a pulmonary function rate of 45%—you’re likely in moderate to severe stage COPD (GOLD Stage 3 or 4).
LABA + ICS (combination) Formoterol + Budesonide (e.g., Symbicort, Foracort
Nebulizer duolin at night
Pulmonary Rehabilitation
This is extremely helpful in improving your breathing capacity, strength, and endurance.
Breathing exercises (pursed-lip breathing)
Chest physiotherapy like spirometry
Mild walking with rest intervals
Nutritional support and oxygen training if needed
You may have associated diseases so kindly get these test done
repeat Chest X-ray / CT Chest
blood tests CBC,
ECG
oxygen saturation (SpO2)
Pulmonary function test
Avoid over using duolin as it can generate tolerance
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Hello sir
Please be aware
See you may be on medications
In addition please do some respiratory exercise for increasing respiratory capacity
There may be chances of addition of nasal decongestant or respiratory stimulation
Better consult pulmonary surgeon for better clarification
Regards
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At age 70 with COPD and a pulmonary rate of 45%, worsening breathlessness despite inhalers suggests disease progression or inhaler resistance. Pulmonary rehabilitation, breathing exercises, and possibly adding nebulizers or long-acting bronchodilators may help improve your daily function. Consult a pulmonologist to reassess your treatment plan and explore advanced options like oxygen therapy or non-invasive ventilation support.
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