It’s your children. They are supposed to be your support when you grow old. No matter how many helpers you keep, blood is always thicker than water.
This happened last week, on a routine call to the Pulmonology ward (Lung Disease ward). The man was probably taking his last few breaths. Even the high flow oxygen was not sufficient to cure his breathlessness.
Chronic Obstructive Pulmonary Disease (COPD) will be the third leading cause of death among smokers by 2020 especially people who smoke about more than 10 packs per year. {{(Pack per year=number of cigarettes smoked per day X duration of smoking) ÷ 20}}. But not all smoker develop this disease, certain genetic factors seems to play a part.
In the respiratory system, COPD targets:
• The pulmonary arterial vasculature: resulting in remodeling which impairs the right side of the heart performance.
• The Bronchus: It causes irritation of the airway pathway (Bronchus) which results in inflammation and increased mucus secreting glands and goblet cells. As a result the patient complains of increased cough with sputum, resulting in chronic bronchitis.
• In the lung Parenchyma: Loss of elastic tissue in the lungs decreases the functional capabilities of the lungs and hence the compliance of the lung decreases.
• At the level of terminal bronchioles: It will result in abnormal dilation of bronchioles resulting in emphysema
COPD is preventable and it can be well managed if the person discontinues smoking and oxygen is supplied via masks at regular intervals also known as long term domiciliary oxygen therapy.
COPD affects different parts of the body, like :
• Starting with your fat metabolism, it makes the person lose all the subcutaneous fat and visceral fat, hence making the person thin ( cachexia ).
• It will affect the bones resulting in more pathological fractures.
• It impairs salt and water excretion in the kidney, making the person have leg swelling.
• The person will eventually develop muscle weakness and
• To a certain extent it will affect your heart, especially the right side and henceforth Right heart failure occurs. The heart is unable to pump blood and the consequence is reduced arterial perfusion of tissues all around the body.
Going back to the old man, he either suffered from acute exacerbation of COPD or he developed heart failure. Judging by the way he was sitting ( propped up), it goes in favor of heart failure. So he developed severe breathlessness and high flow oxygen was no longer doing any good. His son supported him by waving some more air for him and took him by his arm. They exchanged looks and it was a very emotional moment for both of them.
The father was sharing his last few moments with his son and later he was shifted to the ICU. I don’t know what happened to that man later that night.
At the end of it all, people decide their own fate when it comes to death. No matter how many times, I mention the disadvantages of smoking people still smoke. No matter how much medical improvements have been established, there is nothing greater t
han the supportive care of children to their parents.
Be wise people, stop smoking!
