You are likely between 35 and 40 years when it begins. It’s a subtle probably silent process initially. Perhaps you have bent over to tie a loose lace and experienced a momentary dizziness when righting yourself. You attribute the sensation to last evenings dinner excess and vow to cut back…but don’t. Or perhaps you garden and those two steps up to the porch leave you slightly winded. Again, you attribute the winded sensation to a life style deconditioning and promise to exercise…but never quite find the time. Now you have a raspy morning dry cough that progresses to interfering with telephone conversations. Nobody walks to the corner store anymore so it’s only those infrequent carpet contact sports with the grandchildren leave you short of breath.
Now your family is concerned and urge you to book a cardiology assessment. Lab work shows a modest increase in cholesterol and the cardiogram is normal. To be prudently cautious, a stress test is arranged but has to be cut short because you are too short of breath on the incline. Your heart is racing but no ECG changes are apparent; however your oxygen saturation is low and the subsequent spirometry shows decreased lung ventilation. You are told you have COPD… chronic obstructive pulmonary disease.
The reality is in front of you. Legislated regulation of industrial sources has virtually eliminated all but one cause of your emphysema and chronic bronchitis and lung scarring leading to loss of tissue elasticity. You smoke. Not the self admitted “few a day” but a harsh 30 pack years. Quit and your remarkably resilient lungs will rejuvenate themselves in as little as six months. But you don’t quit, rationalizing cutting back is as effective. Your medical team does what it can. Flu shots, pneumonia vaccine,chest X-rays to prescreen for the big C, more spirometry.
It’s been a decade and the shortness of breath is much more noticeable interfering with loving your life partner and pulling garden weeds. You complain about so much fatigue you can’t even ambulate the mall. Your doctor arranges a portable oxygen supplier to keep you mobile. Your harness and oxygen cylinder are your new best and dependable friend. Soon you graduate to a home night oxygen concentrator followed by continuous 24/7 need. You don’t leave the house anymore especially terrified of the potential consequences of exposure to our winter. Life is painful with the body unable to satisfy its oxygen needs. Your heart races continuously. You seemingly live in a clouded state with insufficient nutrient to your brain. Now your family are a haze and they watch helplessly as you deteriorate. Perhaps your family are incapable of your care so you are taken to the hospital and probably transferred to a hospice. The end is near now. Your mouth is so dry you cannot speak in spite of the attentive nursing care. That distressing rattling in the chest excursions indicate fluid building in the lungs, fluids your body no longer has the resources to displace. Your organs shut down one by one and finally your heart can do no more. This is the factual endpoint for the smoker.
Every day of every week in Canada another five hundred of our children and grandchildren and youth light up for the first time because cigarettes are available and it’s “cool”. I’ve painted the reality.
Dr. David Carll