Chronic Obstructive Pulmonary Disease (COPD): Heavy Smoking Has Damaged His Lungs
Symptoms of Chronic Obstructive Pulmonary Disease (COPD) include breathlessness, a longterm cough and tiredness. Learn about its causes and treatments from the Department of Respiratory and Critical Care Medicine at Singapore General Hospital (SGH).
A heavy smoking habit has damaged one man’s lungs so badly that he now depends on machines to stay alive
Mr H, 66, has been a virtual prisoner in his own home for the past four years.
It has been ages since he last visited a shopping mall, supermarket or coffee shop, because stepping out of his flat for even a few minutes leaves him breathless and exhausted.
“I was aware that I wasn’t well as far back as 1998,” said Mr H. “I always felt tired and had no appetite. I consulted several doctors, but they couldn’t find anything wrong with me.”
It was only in 2004 that he was diagnosed with chronic obstructive pulmonary disease, or COPD, a condition where the lung function (or how well the lungs work) has been damaged. There are two forms of the disease – chronic bronchitis, where the bronchial tubes are inflamed and there is a persistent cough that produces mucus; and emphysema, a degeneration of the lungs.
People who suffer from the disease find their breathing becoming increasingly difficult. Smoking is one of the main causes: Mr H started smoking when he was 12, and used to go through two to three packets of cigarettes a day, stopping only after he found out about his condition about eight years ago.
Today, Mr H is usually hooked up to one of four devices, which cost $20,000 in total and include oxygen concentrators and bi-level positive airway pressure (BPAP) machines, to maintain his respiratory function.
The airway pressure machine pushes oxygen through a tube to a mask that Mr H wears over his nose, mouth or both. The machine constantly increases and decreases air pressure in response to inhalation and exhalation.
Once an active man whose family runs a quail business in Lim Chu Kang, Mr H now spends his day watching television, taking naps and chatting with friends and relatives who drop in occasionally to cheer him up. The only trips that he makes are to the
Singapore General Hospital (SGH) for his three-monthly appointments. He has to take a portable ventilator with him during these visits.
Since his diagnosis, his condition has become worse. “When I watch a TV programme that gets too exciting, I will become breathless,” he said. “I get tired easily and I am very sensitive to the environment, such as changes in the weather.”
Mr H is married with two sons, both in their 40s. His wife is 62. “I am not a normal person; I am abnormal,” he said of his condition. “But I consider myself very lucky to still have 18 per cent lung function (lung function that is 18 per cent that of an average person of a similar age). It’s not easy going through life like this.”
Smoking a leading cause of COPD
“Our lung function slowly deteriorates once we are 25 and above,” said
Dr Ong Thun How, Senior Consultant,
Department of Respiratory and Critical Care Medicine,
Singapore General Hospital (SGH), a member of the
“Most people lose a small amount of lung function every year. However, for most of us, by the time we die – say of heart attack or cancer at 95 – our lung function would still be good enough for most activities.
“But, for some people, the deterioration is much faster, due to a smoking habit or genetic susceptibility. For them, their lung function when they are 60 may be on a par with those who are about 80 to 90 years old.”
Cigarette smoke contains toxins which contribute to this trend, said Dr Ong. While not all smokers will suffer an accelerated decline in lung function, about 30 per cent of them are likely to experience a rapid deterioration. More importantly, a smoker who quits his habit will gradually experience rates of decline similar to those of non-smokers.
A higher percentage of men are diagnosed with the chronic lung illness, mainly because most smokers are men. Patients are usually in their 70s and 80s because the damage accumulates and is evident only much later.
What are the symptoms of COPD?
The symptoms of chronic respiratory disease include breathlessness, a longterm cough and tiredness. The disease was the seventh most common principal cause of death in Singapore in 2010, when it claimed about 440 lives. It was also the seventh most common condition in patients who were hospitalised, with more than 10,000 admissions in 2010, The Straits Times reported in June this year.
Underlining the seriousness of the disease, the World Health Organization has predicted that chronic obstructive pulmonary disease would become the third leading cause of death worldwide by 2030.
Treatments for COPD
Available treatment includes the use of a nebuliser – a device that delivers medication in the form of a mist that’s inhaled into the lungs – or an airway pressure breathing machine, said Dr Ong. Smokers should also stop smoking, she added. In Mr H’s case, the breathing machine helps minimise the number of visits he has to make to SGH, which is a boon given his condition. These devices help improve a patient’s quality of life, allowing him to stay reasonably active, said Dr Ong.