Wednesday, November 15, 2006

Did you know what day it was?

My old friends at Radio Four have let me down. I can no longer look to them as my principal source of information on upcoming medical issues. The thing is they have completely missed the fact that today is World COPD Day.

To be fair to them, they are not alone. It hasn't been fanfared much anywhere else either. Which is a shame.

For those not in the know COPD stands for Chronic Obstructive Pulmonary Disease. It is a mixed bag of rspiratory ailments that used to be called things like Chronic Bronchitis or Emphysema. Mostly, in the developed world, it has a strong association with smoking. It also represents the end point of a number of industrial chest dieseases and some rarer inherited disorders. Whatever the cause it leaves patients increasingly short of breath, and , if untreated, likely to progress to an early death from respiratory failure.

The real problem with it is that it's not a very sexy ailment. Many physicians view it as self inflicted because of its association with smoking. Further, hospital doctors look on COPD patients as frustrating becuase the ones they see are always pretty ill, hard to treat, and by deffinition impossible to get properly better. Those admitted to hospital tend to be pretty dependent even when "well" and during exacerbations caused by infections or severe weather, their coping mechanisms fall apart completely. This tends to mean they end up needing urgent hospital admission and then require several days (or sometimes weeks) of rehab before they can be got home. And for all the time they occupy a hospital bed they are a living reminder to the physician in charge of their care that he is not the omnipotent god-like healer he otherwise believes himself to be. And worse, they are keeping other "more deserving" patients out of that bed....

Well, here are some headline figures you all should have heard this morning.

COPD is ranked the fourth highest killer disease worldwide. Well above some of the scarier cancers and even HIV.

Current estimates put UK incidence at around 900,000.

Stopping Smoking would go a long way to reducing this incidence. (Sadly not so for the Third World where the main cause implicated is smoke from biomass fuels -- though they are the latest target market for Big Tobacco too as it happens).

Any patient with this beastly disease can be helped to feel better with simple interventions in the form of inhalers, exercise and occasionally home oxygen. Many can be improved dramatically.

I suspect the real problem with World COPD Day is that it doesn't have a ribbon, or a trendy wrist band. Perhaps it's time it did.

Anyway, enough polemic for one day. I'm off to Homebase now.

(Where our Community COPD Nurse has been freezing in the name of the cause, before you ask.)


Z said...

I remember, when I was in my teens, going to stay with a schoolfriend whose (comparatively elderly) father suffered from emphysema. I listened to his wheezy breathing each evening and was afraid he'd die in the night.

Ironically, he outlived my much younger and healthier father, but that's how it goes......

Shinga said...

Earlier this year, The Daily Record published a thoughtful piece on Four Letters That Spell Death: COPD is the killer disease that no one has heard of. The title was dramatic but it was good to see that the serious/Cinderella issue of chronic obstructive pulmonary disease (COPD) is getting some coverage.

I'm not pleased by the lack of coverage of World COPD day. But then, I was very annoyed with the BBC for bombarding us with heat alerts during the summer and even how to adminster first aid to a Llama with heat-stroke but never gave any advice for people with COPD, asthma etc.

There has been a lot of research fuss this year about COPD being under-diagnosed and under-treated. There are some indications that women may be given a diagnosis of asthma rather than COPD and that there are gender differences in the presentations of COPD and the disability associated with it. Plus the meta-analysis (the name escapes me) that claims that anticholinergics should be the brochodilator of choice for COPD although only they are currently only 5% of all prescriptions for COPD with beta-agonists being what most doctors prescribe (doubtless for reasons for which I am having a brain fade).

COPD does have a wretched impact of quality of life and there does seem to be such a stigma of shame about it. A number of my neighbours are suffering quite badly at present because they were affected by the bonfires and fireworks during recent celebrations. The particulates just keep on coming because there is a local building site that (somehow) has permission to burn the lumber that they clear and other rubbish.

COPD is so common, it almost beggars belief that so many people resign themselves to it despite the improvement in the management guidelines.

I must scramble off my soap-box. Who is interested in shuffling, wheezing older people when there are more photogenic illnesses out there.

Regards - Shinga

Doctor Jest said...

z-- there is indeed something profoundly unsettling about the sound of someone struggling for breath. But as you say that state can continue for may years and very often does.

shinga-- erudite as always. I'm sure many folk just learn to live within their diminishing exercise tolerance rather than present for help. Especially when they know the first thing they are likely to get is a wigging for being a smoker...

Wendz in France said...

Oooh - I shouldn't have read this post..seeing as I am a heavy smoker..

*exits wheezing*

Damian said...

Bah! I've already read this one.

It's terrible when my two favourite doctors haven't updated their blogs.

My eyes are still watering from Doctor Ben's account. I came here hoping for something to take the edge off.