Smoking increase chances of contracting COPD
Tantri Yuliandini, The Jakarta Post, Jakarta
A man is shown breathing heavily, a long tube protruding out of his chest into a contraption at the base of his hospital bed is filled with blackish matter.
"This man is in the advanced stages of COPD. The machine helps reinflate his lungs because they can no longer reinflate themselves," Pradjnaparamita of the COPD Center at the Department of Respiratory Medicine at the University of Indonesia said.
A couple of scenes later, the video showed a sleeping woman with various tubes and monitoring devices coming from her nose and body.
"This woman could no longer breathe without help from a respiratory machine," Pradjnaparamita explained.
COPD, or Chronic Obstructive Pulmonary Disease, is an umbrella term used to describe the airflow obstruction associated mainly with emphysema and chronic bronchitis.
Emphysema causes irreversible lung damage by weakening and breaking the air sacs within the lungs, while chronic bronchitis is an inflammatory disease in the airways that causes an increase in mucus and bacterial infections that block the bronchial tubes.
Both conditions decrease the lungs' ability to take in oxygen and remove carbon dioxide. The combination of too little oxygen and too much carbon dioxide in the blood may have an impact on the brain, causing a variety of other health problems, including headaches, sleeplessness, impaired mental ability and irritability.
Approximately 80 percent to 90 percent of COPD cases are caused by smoking, Hadiarto Mangunnegoro, a pulmonologist at the University of Indonesia, said, adding that a smoker is 10 times more likely to die of COPD than a nonsmoker.
"The first, second, third and fourth causes of COPD are smoking, then the other causes come fifth," he said, explaining that other causes included heredity, second-hand smoke, air pollution and a history of frequent childhood respiratory infections.
The World Health Organization (WHO) has estimated some 2.74 million deaths are caused by COPD every year, with more than 600 million people in the world suffering from the disease.
Pulmonologist Faisal Yunus estimated that in Indonesia some 4.8 million people suffer from COPD.
"However, the figures are only a rough estimate because the disease isn't yet well known in Indonesia," he said, adding that COPD is often overlooked by both the public and doctors who often confuse it with asthma or other diseases caused by old age.
Because COPD symptoms are only apparent when the lungs have lost 60 percent of their functions, for most of their lifetime sufferers do not realize they have the disease, Hadiarto, who is also the chairman of the Indonesian COPD Expert Committee (ICEC), said.
The lungs function at their peak when a person is between the ages of 20 and 30, after which they slowly begin to decline, he said, explaining that the lung capacity of an average Indonesian was approximately three liters.
"Among smokers, the lungs' capacity can shrink by as much as 50 milliliters a year," he said.
According to the American Lung Association, a typical course of COPD might begin after a person has been smoking for 10 years, after which the patient begins developing a productive chronic cough and, after the age of 40, they may begin developing shortness of breath during exertion.
The quality of life for a person suffering from COPD diminishes as the disease progresses. At the onset, there is minimal shortness of breath, but people with COPD may eventually require supplemental oxygen and rely on respiratory assistance.
In a survey, Confronting COPD in America, of 573 people with COPD-related diseases interviewed between August and November 2000, some 58 percent of respondents said they had shortness of breath every day during their worst three months of the previous year, and 23 percent said symptoms woke them up every night.
In general, 51 percent said their condition limited their ability to work and many said it also limited them in normal physical exertion (70 percent), household chores (56 percent), social activities (53 percent), sleeping (50 percent) and family activities (46 percent).
None of the existing medications for COPD have been shown to modify the long-term decline in lung function, Hadiarto said, therefore, pharmacotherapy for COPD is used mainly to decrease symptoms and complications.
The best weapon against COPD is to avoid or cease smoking all together, he said, explaining that ceasing smoking slows the disease process significantly.
Because the diagnosis of COPD is frequently made when patients are in their late 50s or 60s, the goal of treating patients with COPD is to help relieve symptoms, help better manage the effects of their disease, and to help them live as full and active lives as possible.
People with COPD can better manage their disease by:
* Avoiding cigarettes, dust, air pollution, cigarette smoke and work-related fumes.
* Avoiding contact with people who have respiratory infections, such as colds and flu.
* Avoiding excessive heat, cold or high altitudes.
* Maintaining a healthy diet and an exercise program supervised by a health care provider.
* Having regular contact and visits with a health care provider so that he or she can carefully monitor the disease.