Chronic Obstructive Pulmonary Disease, aka COPD

Chronic Obstructive Pulmonary Disease, aka COPD.  I have it.  And, I was diagnosed with it about nine years ago.  I have three reasons for coming down with this, beside just being an older person starting to live with the consequences of my younger decisions.  One thing to understand though, is rehab helps.  Here is my story.

My First Warning

The first time I actually felt like I had a problem happened when I got an adverse reaction of a newer drug used for Fibromyalgia.  I had started getting nerve pain in my right hand when I bowled.  So, of course, I was up for this new drug that would work against the nerve pain associated with that illness.

Unfortunately, taking a new drug means you might get reactions that the clinical study people didn’t get, or considered “not a significant” reaction.  Now, they do put “breathlessness” as a possible side effect.  A little late for me.  But, others now know that they aren’t crazy when they complain about not being able to breath suddenly.

Genetic Predisposition

My poor daughter.  Her father had childhood asthma but grew out of it in his teens.  So, I assured her that she would grow out of her very serious asthma challenge.  I had hay fever, but I didn’t have asthma.  Until I turned 42 and came down with “adult onset asthma”.  I was already in college, when my mother developed it and she didn’t mention it, so I didn’t know.

Unfortunately, my youngest got both sets of DNA and still has asthma.  However, she was smart enough to stay away from the killer and final reason one gets this disease.

My asthma was out of control for many years.  I just got used to wheezing and thought it was normal.  After coming down with pneumonia when I was 45, I started trying to get it under control. That helped.  And I really thought it didn’t have any physical ramification for me anymore.

Foolish Choices

I actually didn’t start smoking until I was seventeen, which was pretty late, at that time.  I was on my own, trying to find work to support myself and I lived in a boarding house with some older women.  They all smoked.  I tried it, just to fit in.  And, I discovered that it tasted terrible and made me totally dizzy, so that I crushed it out half-smoked and went straight to bed.  And, I basically passed out.  Wow, did I think this was telling me something?

Remember, I was seventeen, lonely and a little depressed.  I decided to use cigarettes as a easy, cheap, sleeping pill.  Yup, I thought I had an easy way to get to sleep easily, without tossing and turning and worrying half the night.

Needless to say, I was addicted very soon afterward and they didn’t work that way anymore, but I was now part of the group and kept smoking for the next 20 years.  I told myself, I was a very light smoker.  Which was true, for that day and age.  I only smoked a pack a day, and that was about half what everyone else smoked.

And, I quit when I was 42.  That is supposed to make a huge difference, right.  Well, it does and it doesn’t.  I still have COPD, but I’m not on oxygen yet.  A friend of mine, who still smoked until she was diagnosed, is on oxygen 24/7 and has real walking,  and stamina problems. She an I were diagnosed at the same time.  I never see her anymore.

Now the Medical Information

Now, I’m going to go a little medical on you, so you completely understand what this disease is and what it means to you.  I got most of this information when I actually went into Pulmonary Rehab as an outpatient.  I learned a lot.  That is what this information is coming from, The Krames Patient Education Brochure.

Chronic Lung Disease

Chronic Obstructive Pulmonary Disease

Obstructions (blockages) in the airways make breathing harder and can affect gas exchange.  Chronic obstructive pulmonary disease (COPD) is a category of diseases usually caused by smoking:

  • Chronic bronchitis.  More mucus is produced than normal.  Mucus builds up, blocking the airways.  The airways may also become inflamed (swollen), so there’s less space for air to pass.
  • Emphysema.  Damaged airways lose their stretchiness (elasticity) and get baggy.  They may collapse when you exhale, trapping air in the sacs.  This trapped air makes breathing harder.  Over time, the air sacs lose their clustered shape.  This may mean less oxygen enters the blood vessels.
  • Chronic Asthma.  That is my challenge.  The airways become inflamed and narrowed.  The muscles surrounding the airways go into spasms and tighten.  This makes it hard for air to pass through the airways.
  • Interstitial Lung Disease.  This is a disease that has scarring or inflammation damage in the small airways in the lungs.  This makes breathing harder and may interfere with oxygen entering the blood vessels.  WebMD say “Some of the types of interstitial lung disease include: Interstitial pneumonia, Bacteria, viruses, or fungi may infect the interstitium of the lung.  A bacterium called Mycoplasma pneumonia is the most common cause.  Idiopathic pulmonary fibrosis: a chronic progressive form of fibrosis (scarring) of the interstitium.  (There is a new drug called “Nintedanib” being tested in the UK that is supposed to really make a difference.  The post was on the 19th of May 2014.)

Chronic Obstructive Pulmonary Disease

Other things that fall under the COPD Banner

Other Conditions.  People who have cystic fibrosis, bronchiectasis, lung cancer, and other chronic lung diseases can also benefit from pulmonary rehab.  In addition, pulmonary rehab can help people who have had or who are preparing for lung surgery.

How do you get diagnosed?

There are a bunch of tests that doctors will give you that determine if this is actually Chronic Obstructive Pulmonary Disease.

  • Pulmonary function tests measure the flow of air into and out of your lungs, and the volume of air your lungs can hold. The first time I had one of these, I just barely fit in under the criteria.  That was because of the bad side effect of the drug.
  • Pulse oximetry. That is that little thing they put on your fore finger.  It shows how much oxygen is in your blood (oxygen saturation).
  • Arterial blood gas tests measure levels of oxygen and carbon dioxide in your blood. (When you are feeling really short of breath, that is when your carbon dioxide is out of balance with your oxygen.  I didn’t know that until they showed me how to bring my oxygen and carbon dioxide into balance.  It is really easy.)
  • Chest X-rays show the size and shape of your lungs.  They can also show certain problems in the lungs.
  • CT (computed tomography) scans product images of the lungs that are more detailed than x-rays.
  • And, there are other tests, but these are the most used.

OK, so now what do you do?

I have to tell you.  I am really lucky.  When I was 48, I started falling easily, so I found a way, that I enjoyed, to get my balance back on track.  I didn’t want to sprain my ankle, bruise my knees and pull a groin muscle again!  I actually did that in a space of six weeks.  And, when I tried to use crutches (which require a modicum of balance), that was just embarrassing.

So, I started taking Salsa lessons.  I had read that dancing was good for your “core” which is a huge part of your ability to balance.  I discovered I liked dancing.  In fact, I loved it.  I went on to take every dance I could get lessons in. And, eventually, became a dance instructor for the Seniors at a Senior Center. This, of course, was after I retired from teaching students as a Special Ed Teacher.

So, I did really well in the rehab because, a lot of the treatment consists of getting your stamina back and preventing falling.

Treatment Plan

  1. Breathing retraining- (Called Pursed-Lip and Diaphragmatic Breathing.  There are exercises with pictures on google.)
  2. Exercise – They had this wonderful recumbent bike type machine there that didn’t hurt my back, and I slowly worked up to a five on their scale of ten.  I used it to warm up and cool down.  Somehow, it also worked on the Kegel muscles.
  3. Energy conservation and pacing techniques – I learned when and how to manage my breathing, what situations I was not comfortable with and what I could still do.  (For one thing, I discovered that heat and humidity are something I can no longer handle.  I just can’t breath under those conditions. There went my idea of moving to Florida.)
  4. Medications – I take four medications.  Three are inhaled.  Two I take twice a day, one I take in the morning, and the last is to be used if I’m having a problem.
  5. Treatment for anxiety or depression – As I mentioned in the first of this article, I have had depression for many years.  I finally realized that I needed to go to counseling and discover ways to handle it that didn’t involve medication.  I did so and that made a big difference.
  6. Stress management and relaxation techniques- For me, putting on a beautiful song, dancing a little, taking a nap and reading a good book are all great stress management techniques.
  7. Techniques for coping with chronic illness – Counseling.
  8. Special diet – Depends on other factors, weight being one of them.
  9. Symptom management and prevention – Paying attention all the time.  Stay away from sick people!!!
  10. Help for Sleep disorders – I have sleep Apnea with a CPAP machine.
  11. Airway clearance techniques – beat your chest much?  Sort of like that.
  12. Oxygen therapy – They will tell you when that is needed.
  13. Quitting smoking – Well duh!
  14. Other needed behavior and lifestyle changes based on COPD situation.

You have to be part of the solution

Now, I cannot stress this enough!!!  You have to be part of the solution.  During my 35 patient sessions, both education and exercise, which I did for three times a week for about three months, I watched an awful lot of people not take this seriously.

And, you know, you have to keep it up, even after you have graduated.  I got lazy and started seeing my stamina go away again.  So, I set myself a regime that now includes 15 minutes of walking and stretching three times a day.

My rehab program took away my afternoons for about three hours because it was in another city that was about an hour away.  I was doing 25 minutes on a recumbent bike (which I had to work up to), 15 minutes on a treadmill (started at three minutes) and 10 minutes on stretching and weight bearing machines.

The stretching consisted of several balance and muscle lengthening exercises.  I’m so glad I learned them.  Not only because they are good for me, but they also get rid of a lot of body stress that I develop from sitting in front of the computer.

 

There is so much more involved being diagnosed with this Chronic Illness, but you can fight and keep your life style pretty normal.  I was diagnosed nine years ago and I only needed the rehab because I stopped my exercising when I decided to write a book.  Not a good idea.  I now still write, but I stop ever couple hours and work on stamina.  That is what is needed.  That and a good pulmonary specialist to follow your progress.

Hope you enjoyed and got good information from this

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