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Signs to call your doctor about

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Know your breathing signs.

Use this as a guide, not a rule. When in doubt, call your doctor. If it feels like an emergency, call 911. You and your care team decide together.

Signs of a steady day

These often mean things are on track. Keep to your daily plan.

  • Breathing like your usual self.
  • Mucus that is its usual color and amount.
  • Sleeping through the night without coughing.

Changes worth a call to your doctor

A change from your usual is worth telling your doctor's office about.912

  • Breathing that is harder than usual, even after rest.
  • More coughing, or mucus that is thicker, darker, or a new color.
  • Needing your rescue inhaler more often than usual.
  • New swelling in your ankles or legs.
  • Waking at night short of breath.

Symptoms treated as emergencies

Symptoms like these are the kind that care teams treat right away.912

  • Much harder to breathe, even at rest.
  • Coughing up blood.
  • Chest pain, especially with breathing.
  • Blue or gray lips or fingernails.
  • New confusion, or trouble staying awake.
  1. 1Pursed-lip breathing: breathe in through the nose, then breathe out slowly and gently through pursed lips (the technique and how it helps). StatPearls, NCBI Bookshelf
  2. 2Pursed-lip and belly (diaphragmatic) breathing exercises, including the counts: in through the nose about 2 counts, out through pursed lips about 4 counts. American Lung Association
  3. 3About 87% of U.S. patients make at least one error using a metered-dose inhaler. PubMed Central
  4. 4Asthma quick-relief drugs: using them twice a week or more can mean your asthma is not under control. MedlinePlus
  5. 5How to use a metered-dose inhaler, including waiting 1 minute between puffs. National Heart, Lung, and Blood Institute
  6. 6Pulmonary rehab: most programs meet 2 to 3 times a week and last 4 to 12 weeks or more. American Thoracic Society
  7. 7COPD quick-relief drugs: needing them more than 3 times a week can mean your COPD is not under control. MedlinePlus
  8. 8How to use a dry powder inhaler, including rinsing your mouth with water and spitting it out after a steroid medicine, and wiping the mouthpiece weekly with a dry cloth, never water. National Heart, Lung, and Blood Institute
  9. 9COPD flare-up signs (harder breathing, wheezing, more mucus or a change in mucus color) and signs treated urgently, like blue lips or fingertips, chest pain, trouble speaking full sentences, or feeling sleepy or confused. MedlinePlus
  10. 10Home oxygen equipment care, including replacing your cannula every 2 to 4 weeks. MedlinePlus
  11. 11Oxygen safety: never smoke near oxygen and stay at least 5 feet from open flames. American Lung Association
  12. 12COPD warning signs after a hospital stay that are worth a call to your provider: breathing that is harder or faster than usual, trouble speaking, fever, coughing up dark mucus, blue fingertips, or feeling sleepy or confused. MedlinePlus
  13. 13In people hospitalized for COPD, starting pulmonary rehab early after discharge is linked to living longer (lower 1-year death rate). Lindenauer et al., JAMA 2020
  14. 14Saving energy during daily activities: sit for tasks like folding laundry, breathe out on effort, use a wheeled cart to move things, trade off harder and easier activities with rest, and keep daily items on the counter within reach. American Lung Association
  15. 15How to use a metered-dose inhaler without a spacer, including shaking the inhaler hard 10 to 15 times before each use. MedlinePlus
  16. 16How to use a metered-dose inhaler with a spacer, including that a spacer helps get more medicine into your airways. MedlinePlus