From time to time, people with chronic obstructive pulmonary disease (COPD) have what’s known as an exacerbation. Think of it as a flare.

You may suddenly have trouble breathing, or make more noise when you do. You may cough a lot and feel bad all over.

Exacerbations are often linked to a lung infection that results from a virus or bacteria, like a cold or some other illness. Spending time in smoggy or dirty air can also make your symptoms get worse quickly.

Don’t ignore the warning signs. If you don’t get to a doctor ASAP, you could wind up in the hospital or lose some of your lung function.

Call your doctor if you have one or more of the following symptoms. If you have medications (like antibiotics or oral steroids) at home, he’ll tell you when and how to use them. He can also let you know whether you need to go to the hospital for quicker treatment.

1. Shortness of breath. You feel like you can’t get enough air. You might notice it when you’re at rest or during light physical activity.

2. Noisy breathing. Your breath makes strange noises. Wheezing suggests mucus or pus is blocking your airways. Gurgling or rattling means fluid in your lungs.

3. Worry. When you’re not getting enough air, it’s easy to feel anxious or panicked. You tense your muscles, which makes it even harder to breathe.

4. Irregular breathing. You feel like you have to use your chest muscles to breathe instead of your diaphragm. Your breathing gets uneven. Sometimes your chest moves a lot faster; sometimes it’s much slower.

5. Cough. It’s more severe or frequent than usual. It could be dry or bring up yellow, green, or bloody phlegm. It gets worse when you lie down — so much that you have to sit in a chair to sleep.

6. Changes in skin or nail color. You see a bluish tint around your lips or notice that your nails seem blue or purple. Your skin looks yellow or gray.

7. Trouble sleeping and eating. You can’t get to sleep, and you don’t feel like having food.

8. Can’t talk. You’re unable to get any words out. You have to use hand gestures to let someone know something is wrong with you.

9. Early morning headaches. You start the day with a throbbing head, because low oxygen levels cause a buildup of carbon dioxide in your blood.

10. Swollen ankles or legs or belly pain. These symptoms are linked to problems with your heart or lungs

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