You could be having a reaction to something you were around outside. An exacerbation is usually considered to be a worsening of your symptoms that requires intervention by your doc; like an antibiotic or prednisone prescription, or hospitalization. So if it didn't require that sort of intervention, I would say it's not. I would talk with your doc about it and if you don't feel that she really knows much, ask for a referral to a pulmonologist. Do you use your O2 when you're out? What do you mean by a big day outside? Maybe you did too much and should try to do a little less whiled working through exercise to increase your stamina. The progression would be demonstrated by a reduction in your FEV1.

The flare ups can be a reaction like Jean said. See your specialist and tell him. He might send you for allergy testing. if you take a antihistimine they can test you with blood tests. I am now going through that and monday I am going for blood tests to see what is causing the scratchy throat. Good luck.

I also use my nebulizer when I have a flare up. I try not to use my rescuer unless I am out. The nebulizer is your rescuer but doesn't work as fast has the inhaler rescuer. I use ProAir it is also a hand inhaler and it is albuterol just like you use in the machine. Hope you all have a breathe-easy day, smiles and blessings

@A MyCOPDTeam Member I have a nebulizer at home as well. Don't ask me WHY I didn't use it during the "flare up" BUT I will definitely use it the next time!!!!

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A MyCOPDT...

I have a nebulizer for use at home - find this helps a lot when I'm having a flare. You might ask your pulmonologist about this.