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. 2014 Sep 18;24:14062. doi: 10.1038/npjpcrm.2014.62

Table 3. Patient identification of exacerbation: visible and invisible symptoms.

Measurable ‘visible’ symptoms
Physical symptoms Cough ‘I started coughing and I know by morning I’d been coughing like every three quarters of an hour and … it’s bad’ (HA002) Sputum production: colour, viscosity, taste and amount. ‘Well I do, I start coughing up a bit of phlegm and that and it tastes vile and then I know I’m getting an infection.’ (HA009) ‘I knew that the … sputum was green and getting thicker’ (HA003) Cold symptoms ‘normally the first time I’m getting something going to the chest is I normally start to get a sore throat’ (HA015)
Physical limitations Functional limitations ‘I can’t even walk from the bathroom to the bedroom without having to stop’ (HA003)
   
Subjective ‘invisible’ symptoms
Chest sensations Soreness of chest ‘I would say it’s my chest telling me, the soreness in my chest developing into, not pain as such but it starts feeling, see just across there, it starts feeling a bit sore there [points at chest with hand].’ (HA009) Tight chest ‘Get really tight down here [points at chest with hand] I mean say in all my life you have cold, the first thing it do is they get it to your chest and it gets tight.’ (HA008) Heavy chest ‘I start to feel, feel unwell and I can feel the weight on my chest. You can feel the stuff building up’ (HA015) Breathlessness ‘I couldn’t breathe, my chest went and I just couldn’t breathe’ (HA009)
Body knows Lack of energy ‘generally feeling sort of rough… Lethargic. Yes. Lose the energy factor’ (HA012) Knowing ‘you know in your own body what’s right or wrong’ (PR032)