Situated between the Appalachian and Blue Ridge ranges, West Virginia is known as the ‘mountain state’ and many of its counties are considered rural. Caroline lived in one such rural farming community in Ritchie County, West Virginia when she grew up. At that time, there were only two doctors, and the nearest hospital was an hour away. Although her family lived in a medical desert and had limited access to hospitals or specialized care, the doctors provided quality medical care and were well respected in her community.
It has been 40 years since she moved away from Ritchie County, but she keeps in touch with her childhood friends. “Even now, cell phone service and internet access are almost nonexistent in certain parts of the state. My friend needs to drive almost a mile just to make a call on her cell phone,” Caroline explained. Since moving to Beckley, a city in Southern West Virginia, she has more access to healthcare services and specialized care. This is important because, in 2013, Caroline was diagnosed with chronic obstructive pulmonary disease or COPD.
Because she had been a teacher, when Caroline was diagnosed with COPD her primary care provider gave her an “assignment.” He challenged her to learn about COPD from sources like the American Lung Association and the COPD Foundation, while staying away from “Dr. Google.” Through her research, Caroline found much more than information about COPD, “I found the hope I needed- that you can live with COPD, and it is not a death sentence,” she said.
Caroline’s Tips for Self-Advocacy
As Caroline navigated her COPD journey, she learned the importance of self-advocacy. Along with taking medication and using supplemental oxygen as prescribed, Caroline believes in taking an active role in her health, which involves asking questions and learning as much as she can about her condition. Below are Caroline’s tips to help others living with COPD advocate for their lung health:
- Exercise is medicine. Physical activity has many benefits. It can help you manage stress, strengthen your muscles and improve your breathing.
- Get enough rest. The right amount of sleep is important, and you need to talk to your healthcare provider if you are experiencing signs of a sleep disorder.
- Eat healthy. Nutrition plays a vital role in your lung health.
- Keep a positive mental outlook. Taking care of your emotional health is as important as taking care of your physical health.
- Stay up to date with your vaccinations. When you are living with COPD, you may be at a higher risk of serious illness from infectious respiratory diseases like the flu.
- Partner with your healthcare providers. Be an active part of your treatment plan. If you feel you are not getting the right care or your concerns are being dismissed, find another healthcare provider who will take the time to listen to you.
- Quit smoking and control your indoor air quality. Exposure to smoke, dust, fumes, vapors and chemicals can worsen your COPD. Free support is available to help you quit smoking. Call 1-800-LUNGUSA (1-800-586-4872 and press 2) to get started.
Talk to your healthcare provider, especially if you live in a rural area, about having prescriptions on hand for medication refills and medications, like prednisone and steroids. Caroline has medication on hand, if she has a COPD flare up. When she is having signs of a flare up, like more mucus or worsening cough, she calls her provider’s office and explains her symptoms. Her provider guides her through the treatment plan which may be to start the as needed medication or come in for an office visit.
Caroline and her healthcare providers work together to develop her treatment plan. Her COPD Action Plan helps her understand the steps to manage her COPD and offer solutions if something unusual comes up. For example, “I had trouble recognizing if I was more tired than usual because of poor sleep or my COPD was getting worse,” Caroline explained. After talking to her provider about these concerns, they updated the Action Plan, so she knows the signs and symptoms to look for and when to call her healthcare provider.
A COPD Action Plan is divided into three zones – green, yellow and red.
- The green zone highlights steps to take when your COPD is under control.
- The yellow zone includes steps to take when your symptoms get worse.
- The red zone is when your symptoms are serious, and immediate medical attention is needed.
It is important for people to know their everyday, normal symptoms (green zone) so that you can recognize them earlier if you are experiencing worsening, changing or new symptoms (yellow zone). This is vital because often when you live in a rural area, you may have to travel further to access medical care.
If transportation or in-person appointments are limited, ask your healthcare provider about telemedicine, virtual appointments or steps to take if you are having symptoms after appointment hours or weekends. Write down this information in a place you can easily find so you know where to find it in case of an emergency. Your health insurance provider, your county's Area Agencies on Aging or community programs may also offer resources for transportation assistance.
Advocating for the COPD Community
Caroline is active in the COPD community. She serves as a COPD Patient Advisory Group Member for the Lung Association, volunteers with the COPD Foundation and is a columnist for the COPD News Weekly. She says when she helps others- it helps her. “When I am speaking with a person who is newly diagnosed and very scared, I tell them that this is not a death sentence and that they can do things like get enough rest, eat well, exercise and stay up to date with their vaccinations, I am hearing this myself and it gives me renewed hope.” Caroline also works with respiratory therapy students at local colleges throughout West Virginia to help them understand COPD from a patient’s perspective. By sharing her story and volunteering, she hopes to offer others hope and let them know they are not alone.
Learn more about living with COPD at Lung.org/COPD.
This educational content was developed with support from AstraZeneca, GlaxoSmithKline, Genentech, Sanofi and Regeneron.
Blog last updated: October 29, 2025
