Severe COPD: “I can't cry. If I cry, I can’t breathe"

1 in 4 individuals will develop COPD during their lifetime (Lancet, 2011).

The NYTimes CASES series describes the story of a lady with severe COPD:

"And she began to cry. But something was wrong. The woman was fumbling frantically in her large handbag. “I can’t cry!” she croaked, her voice faint.

I suddenly realized how quiet it was. Her shoulders and chest were heaving, but she wasn’t breathing. She was trembling, the tears streaming down her cheeks, and she couldn’t take a breath to use the inhaler. I sat still, trying to look calm, my mind racing. After an interminable moment she sucked in a couple of wheezy puffs. “If I cry,” she said, still panting, her face pale, “I can’t breathe. I can’t allow myself to cry.”

Then it struck me. Regular breathing was hard enough with her emphysema; crying — with its deep irregular inhalations — crippled her ability to draw in air."


Mind map of Chronic Obstructive Pulmonary Disease (COPD)

25% of American adults smoke (50 million people), 15-20% of smokers have airflow obstruction (COPD).

70% of smoker have made at least one attempt to quit, 46% make an annual attempt.

Telling smokers their spirometry "lung age" improves quit rates at 12 months from 6.4% to 13.6% according to a study of 561 UK smokers. The "lung age" concept (the age of the average person who has an FEV1 equal to the patient) was developed in 1985 to help patients understand complex PFTs and to show how they are prematurely aged by smoking.

Unaware of the UK study, the 2007 U.S. Preventive Services Task Force guidelines recommended against screening for COPD using spirometry.

Read more in Chronic Obstructive Pulmonary Disease (COPD) from AllergyCases.org.

References:
Desperate to Cry, Desperate Not To. NYTimes.
Chronic Obstructive Pulmonary Disease (COPD). AllergyCases.org.

Action plan is a key component of self-management programs in patients with COPD. Thorax, 20111.
Image source: Lungs, Wikipedia, public domain.