Breathing Trouble? 7 Signs Your Lungs Are in the Danger Zone

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We hear a lot about the risks of lung cancer -- but less about a lung condition that's just as common and debilitating, called COPD. This term, which stands for chronic obstructive pulmonary disease, refers to a combination of two conditions, emphysema and chronic obstructive bronchitis, both of which are caused by lung damage from smoking or exposure to other lung irritants, such as asbestos. Whether you're a smoker, a former smoker, or just unlucky, you can develop COPD as a result of damage to your lungs that gradually limits their ability to take in oxygen.

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When your lungs aren't functioning at full capacity, symptoms begin to appear that are sometimes so subtle that you may not recognize them as such. And because COPD is a progressive disease that can't be slowed without treatment -- and because it's the fourth leading cause of death in the U.S. -- it's critical to catch it as soon as possible. Here, seven signs that your lungs are trying to tell you they're in trouble.

1. Shortness of breath

"Many people start to experience shortness of breath, and they just think 'I'm old, I'm out of shape,' and they don't do anything about it other than cutting back their activity level," says Byron Thomashow, a physician and professor at Columbia University Medical Center and chairman of the board of the COPD Foundation. "Then when you have shortness of breath just getting to the bathroom, all of a sudden you take notice."

The problem with this, Thomashow says, is that the lung damage that constitutes COPD can't be reversed; all you can do is halt or slow the progression of the disease. And if you don't start treating it until you're already out of breath just walking around the house, you've got a lot less to work with. Not only that, but cutting back is the last thing you want to do to prevent COPD progression; maintaining and even increasing your activity level is key to keeping the lung function that you have.

One thing to look for: When you're climbing steps or exercising, do you have trouble inhaling a deep breath? An even more telltale sign: Do you take the elevator instead of the stairs to avoid this feeling? Experiment with different activities to see if you have shortness of breath when you increase your level of exertion, and note if there have been any changes over time. "I ask people, how's your breathing compared to last year -- can you do what you used to do a year ago?" says Thomashow. If you feel your ability to draw a deep breath is declining, ask your doctor to perform lung function tests to give you a clear picture of your lung health.

Cough symptoms

2. Frequent or worsening coughs

Everyone gets a cough once in awhile, but if you seem to be getting them more frequently, or they linger for a long time or become chronic, it's time to talk to your doctor. COPD inflames the bronchial tubes and the tiny sacs called alveoli that line the lungs, making them less flexible and elastic. When that happens, the walls of the airways thicken and produce more mucus than usual, which clogs them up.

What you'll notice is a phlegmy cough that feels like the type that usually accompanies the flu -- except you don't have other flu symptoms. If you cough up mucus that's any other color than clear, that can be a sign your condition is worsening, says Byron Thomashow of Columbia and the COPD Foundation. The mucus may be yellow, green, or even have blood in it.

One interesting fact to be aware of: If you're still smoking, your sputum production may not increase despite advancing COPD, whereas sputum production tends to increase after you quit.

Headaches and edema

3. Morning headaches

One of the more mysterious symptoms of COPD is waking up after a night's sleep with a dull, throbbing headache. "What's happening is that you're not breathing deeply enough at night, and the carbon dioxide builds up while you're sleeping," says physician Norman Edelman, chief medical officer for the American Lung Association. The buildup of carbon dioxide causes blood vessels in the brain to dilate, resulting in headaches.

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Many people don't connect the headaches to COPD, though; instead they treat them as a separate symptom. But unless you treat the underlying cause -- making sure you get enough oxygen into your lungs while you sleep -- the headaches won't go away. Talk to your doctor about setting up a treatment regimen for COPD designed to reduce inflammation and increase the absorbent capacity of the lungs.

4. Swollen ankles

As COPD advances, it becomes intertwined with heart failure, because your circulatory system isn't getting the oxygen it needs to be healthy. This can lead to fluid buildup, which is most easily recognizable as swollen feet and ankles. "As lungs get progressively worse, the ability of the body to compensate goes down and the heart can't pump strongly enough," says Norman Edelman of the American Lung Association.

When the heart can't pump enough blood to supply the liver and kidneys, they can't perform their necessary functions of flushing out toxins and removing fluid. The result: the same type of edema many people experience while flying or women experience when pregnant.

Sleep problems

5. Trouble sleeping or staying asleep

Ask yourself this: Do you pile up pillows to raise your chest and head and make it easier to breathe while you sleep? Do you sleep in a chair, such as a recliner, because breathing's easier in that position? It's also possible that you sleep flat but wake up feeling unwell or even dizzy.

Because lying flat forces your lungs to work harder, many people with COPD find they have trouble sleeping deeply -- but they may not realize it's the lung condition causing it. "Sleep is also hard for people with COPD because they may cough throughout the night, waking themselves up or interrupting deep sleep," says Byron Thomashow of the COPD Foundation.

The relationship between COPD and poor sleep gets complicated, because many people with COPD also develop sleep apnea and GERD (gastroesophageal reflux disease), neither of which is conducive to deep, refreshing sleep.

The bottom line: If you wake regularly throughout the night with breathing difficulties or coughing, or you wake up in the morning feeling weak, unrested, and possibly with a headache, talk to your doctor.

Barrel chest and blue blood

6. A barrel chest

One informal test that some doctors use to check for COPD progression is to have you breathe while raising your arms over your head. Why? They're looking for a change known as "barrel chest," which describes a particular posture and body shape that tends to develop as a secondary symptom of COPD.

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As a result of chronic inflammation, the lungs become enlarged and push the diaphragm downward, which makes it harder for the diaphragm to contract as efficiently. The chest wall becomes enlarged as well, weakening muscles in the chest, neck, and between the ribs; these are known as the "accessory respiratory muscles." When this happens, people with COPD unconsciously try to compensate by leaning forward when sitting, with their arms on their knees or in front of them. This posture stabilizes the upper chest and shoulders, making it easier to use the accessory breathing muscles.

7. A bluish tinge to lips or fingernails

Over time, if your blood doesn't circulate enough oxygen throughout your body, your lips and fingernails can take on a blue or gray tone. Sometimes the color, known as cyanosis, is most apparent in the nail beds; some people develop an overall grayish-blue tinge to the skin. The cause: Oxygen-rich blood is bright red, while blood with less oxygen turns dark and bluish-colored.

In dark-skinned people, the discoloration is most visible in the lips, gums, and around the eyes, and it can be easier to spot. Cyanosis usually occurs when oxygen levels in the blood drop below 90 percent. A doctor can check this for you; you can also monitor it yourself using a finger pulse oximeter, available in medical supply stores.


Melanie Haiken

Melanie Haiken discovered how important it is to provide accurate, targeted, usable health information to people facing difficult decisions when she was health editor of Parenting magazine. See full bio


3 months ago, said...

It seems pretty obvious to me that I am heading in this direction quite rapidly. Apart from back problems I am having problems when the hills are causing big breathless problems on my weekly walks, and I am only 76. An ex smoker, gave it away some 24 years ago but obviously having it effects now. Urging Smokers to cease as soon as possible. Smoking is an early death sentence.


7 months ago, said...

I do have some of the symptoms as described in this excellent article, but not to any serious effects at this stage, but obviously am now forewarned, and will keep a close check on progress.


11 months ago, said...

My Daddy is 87 years old and in a Nursing Home. His pulmonary doctor told him yesterday "your lungs are good as they're ever going to be." What does that mean? Is this the end stage?


over 2 years ago, said...

like to now more


over 2 years ago, said...

The information is very valuable to me personally. I intend to make an appointment with my doctor. Additionally, my father has been experiencing symptoms stated in the article. He has an appointment to see a specialist due to continual coughing, and shortness of breath. It will be interesting to find out what the specialist says.


over 2 years ago, said...

It,s not so much geeting less oxygen it,s more the fact your unable to get all the air out when exhaling


almost 3 years ago, said...

I have some of these symptoms. The ankle swelling in one leg is related to cellulitis in 2007 and a fracture in the same leg in 2010. I have to accept that it will never be the same again. But I will follow up with the other items, and will shortly have a lung function test. I cycle about 15 klms most days and also walk with a Heart Foundation Group once a week, whereby we alter the walks between easy and challenging. I am 73 and obviously feeling the effects of smoking, which I gave away 20 years ago. I was not a heavy smoker, but all I can say now is "never start".


almost 3 years ago, said...

Pictures of lungs with COPD in comparison with Interstitial Lung Disease.


about 3 years ago, said...

Amost 40 years I was smoking. Suddenly I gave up for one year. I had maintained very nice health and I was focussing well on my job without any urge for smoking. Slight running or climbing steps did not gave me any breathing problem. Thinking smoking is under control, I sarted to smoke in a limited manner but I noticed underneath my feet some wetness is felt and also unable to walk briskly after finishing smoking. I believe it Is due to smoking only. Can any one help me with the reason so that smoking once in while in a day can be stopped as I found myself having control over smoking.


over 3 years ago, said...

I have mod COPD. I now have wt loss headaches, less energy, and exhaustion. Quit Smoking 2 mths ago. W/D combined r brutal Dee


over 3 years ago, said...

I do have the feeling that I can not take a deep breath after even moderate exercise and must rest offen, however I check my O2 sat. and it stays around 99/98 never lower than 96. Is this normal. Maybe I am "JUST OUT OF SHAPE". I would like to know.


over 3 years ago, said...

Dr. told me at the VA just go home and stay in A/C. Can't get them to put me on oxygen. Doing my meds, getting sores in my mouth. Go out in the heat and humidity and can't hardly breath and cough and hack. but oxygen level don't get low enough to worry them so just deal with it is pretty much what I am told. I have just about had enough of it.


over 3 years ago, said...

This was very helpful to me since I have been thinking along these lines for a while. I have4 of the7 signs now. I plan to contact my doctor right away. Thank you.


over 3 years ago, said...

that's good but they didn't say that the person need to inhale some oils like coconut oil soaked up the lungs can get you get some therapy or buy something else for a home medication a CBD or a Kimotherapy drug cant kill you and doctors cant prescribe them either without getting the radiation with the drugs its a drug scam is what it is they sell you a big kimo therapy plan which if it doesn't kill you healthwise ill definably kill your money andm the feral reserve i don't think doctors are doing the justice on saving the patients any money at all noit a care in the world if our nation is fallible and can run out of money if doctors don't chan\ge their set paths someday I look forward to the day when all American will have been bedridden because of their bad am of over killed medical treatment they and thir doctors give their patients westeren medicine need s a big giant nail in the coofin because someday the country will have not more money left for kimotherapy or any other money left for that matter all because they didn't listen to this message right now so do something dacters you will kill America on the national debt ceiling issue without any therapy exept radatiuon and a lot of waste and no medicines drugs we don't want to get all that radiation and I don't like the national debt ceiling being breached by this kind of things your on so be cheaper on the therapys please were dieing so you better up antioxidant in high amount into the lung would be best and we need at least a mionor care of doctors without a big treatment plan for cancer that's crazy at the time were bankrupt already and going to spiral ionto a debt meltdown by this November so change is needed enevitably right leess radiuon and more of the good medices in smaller amount less kill and more money leftover for the country would be my prescription


over 3 years ago, said...

lol


over 3 years ago, said...

i had a pneumonectomy of my left lung 11 years ago (because of cancer) I have not been on oxygen since the surgery. Lately by oxygen levels has fluctuated a lot - as low as 77 to 94. Does it seem I need to be on oxygen to keep it at a constant level? I'm 77 years old. a female.


over 3 years ago, said...

Shortness of breath in cold breese for about 10 to 15 minutes when going from room tempature to a cold breese. extreme shorness of breathe.


over 3 years ago, said...

Even worse - you can be diagnosed with Idiopathic Pulmonary Fibrosis (one of the 180 pulmonary fibrosis diseases). Find more information about pulmonary fibrosis on the websites of IPF Today - www.ipftoday.com and the Pulmonary Fibrosis Foundation - www.pulmonaryfibrosis.org


over 3 years ago, said...

Good article. I cycle almost daily, people I used to overtake now pass me! I have a regular daily cough with phlegm out put, green. I am an ex smoker,20 years, it is now catching up with me. I do have right foot swelling ankle, cellulitis in this leg 2007, followed by a fracture of same leg in 2010. This year (Feb) I had a stent inserted in my right upper leg. The ankle swelling has increased.


over 3 years ago, said...

Good informative article for sure. I'm in my fourteenth year of being treated for COPD and you tell it like it is. I've been on oxygen the last ten of those years which has been a big help for a little better quality of life. I have no one to blame for my COPD as I chose to smoke when I was a teenage. I quit twenty-three years ago cold turkey but the damage to my lungs was already done. I have to believe the government could has put a stop or controls to smoking but did not want to give up the tax dollars tobacco generates. years ago.