If you have chronic obstructive pulmonary disease (COPD), you may have some of the problems described below.

Certain things are special about the cough you get when you have COPD. Here are some of them:

• A COPD cough is a deep, rough cough that brings up mucus (also called phlegm or sputum)

• The mucus may be thin or thick, clear or yellow-green

• Your cough is often worse first thing in the morning

• You may cough a little or a lot during the day

• You may cough more when you exercise or smoke a cigarette

• But you probably cough every day, even though you don't have any of the other symptoms of a cold or flu.

COPD can make you feel breathless, but so can several other lung and heart conditions. If you get out of breath more than you used to, you should find out why. Most people get out of breath if they run up a hill. But if you feel breathless when you go up a few stairs, walk a little way uphill, or run a short distance, you may need tests to find out why.

If you have COPD, you can feel out of breath because:

• Your lungs don't pump air in and out very well

• Your airways may be blocked with mucus, and air may be getting trapped

• There may be less room for new air to get in because your lungs aren't emptying the way they should.

You might notice that you're losing weight if you've had COPD for a long time. ^[5] If it's hard for you to breathe, you have to use lots of energy just to get air in and out of your lungs. If you use up more energy than you get from the food you're eating, you may lose weight.

Another sign that you've had COPD for a long time is feeling tired a lot. Everything seems like a big effort and you may not feel as if you have the energy for everyday activities, like walking, shopping, or going to work. You feel tired because your body isn't getting enough oxygen from your lungs to work the way it should, or your lungs need to work very hard to get that oxygen in.

There are a lot of reasons why people's ankles can swell up, but the basic problem is that blood isn't moving around in the body very well. If you've had COPD for a long time, your heart may be working so hard that it becomes strained. A tired heart doesn't work very well. If your heartbeat isn't very strong, your blood moves along slowly, causing fluid to back up. That can make your ankles swell.

You may have been told you have heart failure.

Your bones may get brittle so that they break easily. One cause of thin bones is taking drugs called steroids over and over again or for a long time. ^[10] These drugs help treat COPD, but they can also make bones weaker. Not getting enough exercise can make your bones weaker as well. Other reasons why people with COPD get thin bones include smoking and losing weight.