When you’re in stage IV of chronic obstructive pulmonary disease(COPD), years of living with the disease may have led to a lot of lungdamage. While you can’t reverse it, you can still do a lot to manage the symptoms.

Just like in the earlier stages, the more you keep up with your care and appointments, the better.

What Are the Symptoms?

Many of the symptoms you had in earlier stages, like coughing, mucus, shortness of breath, and tiredness, are likely to get worse.

Just breathing takes a lot of effort. You might feel out of breath without doing much of anything. Flare-ups may happen more often, and they tend to be more severe.

You may also get a condition called chronic respiratory failure. This is when not enough oxygen moves from your lungs into your blood, or when your lungs don’t take enough carbon dioxide out of your blood. Sometimes, both happen.

Some other problems you may notice are:

  • Crackling sound as you start to breathe in
  • Barrel chest
  • Constant wheezing
  • Out breaths that last very long

As with stage III, it gets harder to keep up with eating and exercise. That’s going to affect the strength of your muscles and your energy level. It also makes you more likely to get infections and affects your overall health. You’re more likely to have problems like arthritis, asthma, diabetes, and stroke.

How Will My Doctor Check for Stage IV?

You may get a few tests. The first is the same spirometry test used in earlier stages. Your doctor may take a measurement called “forced expiratory volume for one second” (FEV1). In Stage IV COPD, the FEVis less than 30%. You might still be in Stage IV if your FEV1 is higher.

That’s why your doctor may also check for chronic respiratory failure with these:

Arterial blood gas test. This checks the oxygen and carbon dioxide levels in your blood.

Pulse oximetry test. A small sensor on your finger or ear tells you how much oxygen you have in your blood.

If your FEV1 is less than 50%, but you also have chronic respiratory failure, then you may have stage IV.

How Is It Treated?

You use the same treatments from earlier stages, though you may need different doses or need some of them more often:

  • Short-term and long-term bronchodilators
  • Steroids and antibiotics
  • Pulmonary rehab plan
  • Oxygen therapy

Surgery may also be an option. You’d only get it if drugs don’t work for you. And even then, it only helps a small number of people.

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