Patients with COPD diagnosis don’t start with the diagnosis. In fact, they start early in their disease without realizing of it (with their “smokers cough”). Although the main trigger for development of the disease is the exposure to the irritant, the first reaction is the self protection of the lungs: “Do not smoke” (like in the restaurant) here and then you start to close the door (Your lungs close the door reducing the size of the opening). In terms of lung function this is bronchospasm, airflow limitation, airway obstruction, or bronchoconstriction. All these terms imply the main natural response of our body: safety of the organ (protecting the organ). Smokers also develop a cellular and biochemical reaction to keep warning us of the damage in which we incur.
Many ways to describe a progressive disease
Many authors have described the string of events in different ways. Some of them point out to a downward spiral of decline, others indicate the clinical course of COPD, or the progression of the disease, natural evolution, natural history, vicious circle, etc. I feel challenged to entitle it as the “progressive decline of untreated COPD”.
Untreated and undertreated patients start with a congenital signal. Apparently, not easy to recognize until the effects are manifest, the susceptibility to environmental pollutants and mainly cigarette smoke comes with us since we are born.
A short scheme
When the subject smokes regularly the imbalance in the normal tone of the muscles surrounding the airways is lost. The net effect is the increased tone and subsequent contraction with reduced airflow, especially during the expiration. This is intensified during moderate activities when our organism requires more breathing. The respiratory impairment will be visible due to the air trapping and hyperinflation and the patient will complaint of dyspnea, followed by less activities, sedentary lifestyle, more dyspnea with minor activities, until the untreated patient feels isolated with a very reduced quality of life.
A curse for all?
However, this is the course of untreated or undertreated patients not the “curse” of a well treated and attended COPD patient. A well treated and attended patient should also be self-engaging in the management of their disease. A COPD patient shoudl get interest in their disease, playing an active role, looking for opportunities in their participation, assessing themselves in terms of benefits obtained, of deleterious effects, positive changes in their lifestyle.
Physicians love those patients, because they consider those patients an expression of their intervention. Physicians get more involved and positive in the management of patients who respond to recommendations, teachings, as well as patients who provide with results or ask key questions.
Patients who talk to the Respiratory Therapist, to the nurse practitioner, or tho the Physician Assistant, will get the right information. The level of information about the disease for each patient should be self controlled if they don’t want to get confused. With so many sources of information, the patient need to be sensitive and particular and should be oriented by the medical team.
Don’t worry, get well
If you’re a COPD patient get out of the “downward spiral” and participate consciously in the management of the disease. If you are a member of a team supporting a COPD patient, lend a hand and get them in the right track soon. Everybody could be happier sooner reverting any “curse” from around.