Vesagas: COPD: A silent respiratory condition-A A +A
Tuesday, November 5, 2013
THIS week is also known as the COPD awareness week. But what in the word is COPD?
Chronic Obstructive Pulmonary Disease (COPD) is defined by Dr. Karen Hill, a doctorate in nursing and an expert in respiratory health as a group of pulmonary diseases involving obstruction of airflow that is chronic [long-term] and recurrent.
The Center for Disease Control and Prevention (CDCP) maintains that COPD includes emphysema, chronic bronchitis, and in some cases, asthma.
Similarly, the National Heart, Lung and Blood Institute (NHLBI) explains that in COPD, less air flows in and out of lungs because of one or more of the following reasons: the airways lose their elastic quality; the walls between the air sacs are destroyed; the walls of airways become inflamed and thick; and the airways make more mucus [secretions] than usual that can cause clogging.
“In emphysema the walls between the many of the air sacs are damaged,” it points out.
“This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones, thus, the amount of gas exchange in the lungs is reduced.”
On the other hand, in chronic emphysema, it states that the lining of the airways is constantly irritated and inflamed.
“This causes the lining to thicken and as such, lots of thick mucus forms in the airways, making it hard to breathe,” it explains.
In another vein, Dr. Roland Harrison and his associates write in the ‘Clinical Application of Respiratory Care’ that in addition to the genetic predisposition, there are three general precipitating factors of acquiring COPD: cigarette smoking, air pollution and the increasing geriatric population.
According to Carol Porth, a nurse physiologist, clinical findings or symptoms for COPD are almost always absent during its early stages.
Thus, “by the time symptoms appear, the disease [COPD] is in far advanced [stage],” she explains.
At the sociological level, the CDCP adds the following demographic factors: people aged 65 to 74 years; Hispanics and non-whites; women; individuals who are unemployed, retired or unable to work; people with lower incomes; current or former smokers; individuals who are divorced, separated; and those with history of asthma.
In terms of statistics, the World Health Organization (WHO) estimates 65 million people globally have severe to moderate COPD.
Furthermore, it states that more than 3 million died of COPD in 2005.
By 2030, WHO projects that COPD will become the third leading cause of deaths worldwide.
In the Philippines, data from the Department of Health shared that COPD is among the top 10 leading causes of mortality and morbidity in the country.
In 2011, a team of experts from the Department of Pulmonary Medicine of the Lung Center of the Philippines conducted a study with the goal of determining the risk factors and prevalence associated with COPD in rural settings in the Philippines.
It was then found that in addition to smoking history, the use of firewood for cooking, working on a farm and a history of tuberculosis were significantly associated with airflow obstruction that is associated with COPD.
Meanwhile, CDCP recommends the following in the effective treatment of COPD:
(1) Thorough evaluation of the physician;
(2) Smoking cessation;
(3) Avoiding tobacco smoke and air pollutants; and
(4) Medications to treat symptoms like coughing or sneezing.
Digressing a little, my four years of clinical experience as a nurse educator in the intensive care unit (ICU) have proven the reality and insidiousness of COPD.
Most patients with COPD that are confined in the ICU where I was for a time stationed had ages between 65 to 80 years.
However, we had cases of as early as mid-30s with mostly males.
Secondly, these patients had come from middle to lower social standings as evidenced by the nature of their work: jeepney drivers and hard laborers for several decades.
Thirdly, a common denominator for them all was that they were all smokers and had been exposed to air pollution for at least a decade prior their confinement.
While COPD remains lifelong and progressive a disease, preventive measures such as smoking cessation and avoiding second hand smoke may actually help in preventing complications brought about by this silent respiratory condition.
Published in the Sun.Star Cagayan de Oro newspaper on November 05, 2013.