Coping with Chronic Lung Disease

Good health is one of the things many of us take for granted, as 62-year-old Eugenio F. can attest. His two-pack a day smoking habit for the past 30 years has resulted in a disease that makes it difficult for him to do many things – even carry his grandchildren or walk up the stairs in his own home.

Chronic Obstructive Pulmonary Disease or COPD afflicts Eugenio and thousands more people around the globe. It is the fourth leading cause of death and a significant health risk especially to smokers.

About 80 to 90 percent of COPD cases are caused by smoking. A smoker is 10 times more likely than a non-smoker to die of COPD. Other known causes are exposure to industrial fumes and chemicals and air pollution.

What is COPD?

COPD includes emphysema and chronic bronchitis – diseases that are characterized by obstruction to air flow in the lungs. It can be controlled, but not cured.

Chronic bronchitis is the inflammation and eventual scarring of the lining of the lung’s bronchial tubes. Symptoms include increased mucus, frequent clearing of the throat and shortness of breath. It is defined by the presence of a mucus-producing cough most days of the month, three months of a year for two successive years without other underlying disease to explain the cough.

Emphysema is a condition in which there is over-inflation of structures in the lungs known as alveoli or air sacs. This over-inflation results from a breakdown of the wall of the alveoli, which causes a decrease in respiratory function (the way the lungs work) and often, breathlessness.

Emphysema begins with the destruction of air sacs (alveoli) in the lungs where oxygen from the air is exchanged for carbon dioxide in the blood. The wall of the air sacs are thin and fragile, and damage to them is irreversible and results in permanent "holes" in the lungs.

A person may initially visit the doctor because he or she has begun to feel short of breath during an activity or exercise. As the disease progresses, a brief walk can be enough to bring on difficulty in breathing. Diagnosis is made by pulmonary function tests, along with the patient’s history, examination and other tests.

Life after diagnosis

The quality of life for a person suffering from COPD diminishes as the disease progresses. At the onset, there is minimal shortness of breath, but people with COPD may eventually require supplement oxygen and may have to rely on mechanical respiratory assistance.

Depending on the severity of the disease, treatments may include the prescription of bronchodilators or inhalers, which open up air passages in the lungs, antibiotics, and exercise to strengthen muscles. Quitting smoking is the best and most important course of action to stop lung damage and improve breathing.

Another recommendation for COPD sufferers is pulmonary rehabilitation, a preventive health-care program provided by a team of health professionals to help patients cope physically, psychologically and socially with COPD. The disease has many stages, and it affects each individual differently.

Daily realities

It is difficult to illustrate in words the fear, depression, anger, resentment and frustration most COPD sufferers struggle with at one time or another, but success in coping with these emotions may well be one of the most important elements in the management of the disease. "In the beginning, it’s hard to deal with being so short of breath you can barely make it to the bathroom and back. Or how difficult it may be to towel off after a bath," relates Carlos M., a 52-year-old patient who was diagnosed with COPD three years ago. "There’s the fear when you gasp for breath and fumble for an inhaler that may end up in the emergency room again."

Another COPD patient, Teddy B., has to cope with anxiety attacks. His episodes of breathlessness sometimes lead to panic, although he is learning to manage through pulmonary rehab. His twice-weekly sessions give him "something to look forward to, " he says.

Making friends with other respiratory patients offers valuable support for patients, comparing notes about the disease and celebrating successes in the course of management and rehabilitation do wonders for self-esteem.

Accentuating the positive

"There are good days, and there are bad days. But you learn how to downplay the negative and be grateful for the positive," says Carlos.

Improving one’s quality of life with COPD has a lot to do with adapting to and accepting one’s new lifestyle. "With the help of new medications, some routine changes and time, life started taking on a new meaning. Being able stay home and spend all the time I wanted with my children and grandchildren was wonderful," says Maria, a 67-year-old COPD patient.

"Soon, I became interested in activities that were possible to achieve. I found that I could still take care of my garden at a comfortable pace. I learned how to use the Internet and did more research about COPD. I found excellent information and tips on the World Wide Web, and I subscribed to COPD mailing lists and support groups online and learned from others like me around the world," she says.

Caregivers and comfort

There are many problems COPD patients must overcome daily, making it important to have the support of a caring family member of friend to help them keep up the routine of medication, diet and exercise.

Maria has found an unexpected ally in her seven-year-old grandson. "When he notices my breathing becomes wheezy and labored, he gets my inhaler and says, ‘Grandma, sit down and take your medicine.’ He carries grocery bags that I am not able to handle at all. He constantly asks, ‘Are you okay, Grandma?’ "

Dely, 50, has been the caregiver of her husband Eugenio since he was diagnosed with COPD. She quit her full-time job as a registered nurse to make him her sole "patient. "It’s a challenge taking care of someone with an illness, " she relates. "Each individual situation is different in many ways for each caregiver. But caregivers have many things in common. First and foremost being that we are taking care of someone that we love, and second is that we all have the same feeling of being overwhelmed with responsibilities. But we get through each day as best as we can, doing as much as we can to comfort the one we love along with the regular part of our lives that must continue."

Eugenio adds, "COPD patients often don’t give our caretakers enough credit for the job they do tending to our needs. Whether it be because we are unable to physically do the things we need to do, because we need the organization to keep our medications straight, the nagging to exercise, or the encouragement to make it all well – our loved ones’ support and presence make all the difference." – PLG News & Views