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The dangers of smoking are many, and developing Chronic Obstructive Pulmonary Disease (COPD) is one of them. This debilitating disease literally leaves sufferers gasping for air.
Stop smoking to breathe easy
If even short walks leave you wheezing and short of breath, you could have some form of Chronic Obstructive Pulmonary Disease (COPD), a condition heavy smokers are most at risk of. COPD, characterised by airflow obstruction in and out of the lungs, is comprised of two main diseases – emphysema and bronchitis. The World Health Organisation projects COPD could kill 10 million around the world by 2020, 27,397 a day or 1,114 every hour.
“Last year, the Singapore General Hospital (SGH) received 700 admissions with COPD as the primary cause, and another 1,000 cases with COPD as the secondary cause,” says Dr Ong Thun How, Consultant, Department of Respiratory and Critical Care Medicine, Singapore General Hospital. “It is an upward trend due to the rapidly ageing population.”
An archive image of emphysema, where air sacs and small airways (bronchioles) lose their elasticity.
Breathing problems
In emphysema, the air sacs and small airways (bronchioles) lose their elasticity. This makes it harder for fresh air (oxygen) to enter, and waste (carbon dioxide) to exit from the body. In bronchitis, there are two main types – acute and chronic. Despite its ominous name, acute bronchitis is usually a viral infection that develops suddenly but goes away within a few days. Its symptoms include a wheezing cough, a cough that produces yellow or green phlegmand shortness of breath.
Chronic bronchitis, however, develops slowly and is defined as a daily phlegmy cough that continues for a long time. Smoking is the main cause of chronic bronchitis. COPD patients have to contend with breathlessness brought on by the slightest physical movement, with serious bouts of the disease causing pain and possible hospital admissions as Accident & Emergency (A&E) cases.
Smoking is the main cause of COPD
“While some may be genetically predisposed or live and work in adverse environments involving bio-fuel burning or smoke, for most people, smoking is the main cause of COPD,” says Dr Ong. “In fact, anyone smoking one pack of 20 sticks of cigarettes a day is at risk of COPD. The bad news is that COPD is irreversible and most smokers remain unaware until the condition is advanced. The good news is that treatments are available at SGH to arrest the decline and improve the quality of life.”
“The first thing the patient must do is to stop smoking,” Dr Ong says. Besides the debilitating effect of acute breathlessness even with the slightest physical movement such as walking to the toilet and copious coughing, COPD patients and their families have to contend with frequent re-admissions as A&E cases, and hospitalisation. During a serious bout of COPD, a patient will be painfully breathless.
Early diagnosis critical
Anyone who suspects that he or she is suffering from COPD should go for a screening at the nearest polyclinic. Tests include a recording of the clinical symptoms, X-rays, and a lung-function test called a spirometry. A patient will breathe into a spirometer attached to a monitoring unit to record the volume inhaled, and the rate at which air is expelled from the lungs.
Treatments for COPD patients at SGH include long-term use of oxygen tanks at home, medication for relief of symptoms, various types of inhalers and rehab programmes. Results have shown that a carefully structured rehab programme can improve the patient’s quality of life, effort tolerance, and stop the disease from advancing. “In extreme cases, surgery may be a last resort. One option is for a lung transplant of which so far, two have been done at SGH,” says Dr Ong.
“The less invasive option is a bronchoscopy in which a fibre-optic endoscope is inserted into the lungs through either the mouth or nose to inspect and collect samples of mucus and take a biopsy specimen (tissues). With the use of an endoscopy, diathermy or cryosurgery can be carried out,” she says. COPD is irreversible, and lung function will continue to deteriorate even after the patient stops smoking. “But at least with proper treatment, the rate of deterioration can be slowed down and patients can better manage their daily activities,” says Dr Ong. |