Living with Chronic Obstructive Pulmonary Disease (COPD) in Saint Lucia

Tobacco smoke causes toxic effects on the lungs and could lead to COPD. With the rise in both indoor and outdoor air pollution, COPD is no longer limited to cigarette smoke. Environmental factors can contribute to the development of COPD because the quality of air that we breathe is a major component of COPD.

COPD is a debilitating and progressive disease that causes loss of the normal elasticity of the lungs. COPD affects quality of life, decreases functional status and increases risk for heart failure, lung cancer and death.

COPD is often underdiagnosed and undertreated. People with COPD may display little symptoms at first and symptoms common to other illnesses so it may go unrecognized. There is no cure for COPD but interventions can help reduce symptoms, improve well-being and prevent death. Caring for loved ones with COPD can be a burden to families both physically, emotionally and financially.

Let us educate, empower, engage and encourage people with COPD. Let us share our knowledge.

What is COPD?

Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs (Mayo Clinic, 2022). COPD includes conditions such as bronchitis (prolonged cough and sputum production), asthma (swelling in the airway) and emphysema (a lung condition that leads to shortness of breath).

Causes of COPD

Some of the main causes of COPD are smoking constantly for prolonged periods of time, being a past smoker and exposure to second-hand smoke. Air pollution, dust, chemicals and fumes are also causes of COPD.

Some people genetically lack the enzyme Alpha-1 antitrypsin (A1AD) and develop COPD at an earlier age than smokers. Sometimes the etiology of COPD is unknown.

Common signs and symptoms

Symptoms can range from being mild to very severe, vary from person to person and depends on the severity of the condition. In the early stages, symptoms can be mild but vary from moderate to severe overtime. COPD is characterized by difficulty breathing during exertion, chronic cough and increased mucus production.

Anxiety, depression, heart failure and lung cancer are common. Some people present with wheezing, fatigue, frequent lung infections, chest tightness and decreased appetite accompanied by weight loss.

In the long run, people with COPD go into cor pulmonale (right sided heart failure), end stage lung disease and die.

Early detection

Early diagnosis and treatment of COPD are the key to reducing disease progression and complications, living better, improving quality of life and living longer with the disease.

COPD in Saint Lucia

COPD is a major public health issue in Saint Lucia as people being diagnosed with COPD is on the rise. The combined use of tobacco and marijuana is a growing and contributing factor.

There have been an increase in people in their 30s with full-blown COPD that require continuous oxygen. Basic activities such as moving from bed to chair causes extreme shortness of breath. As a result, these individuals have to gasp for air, use more respiratory effort and quickly go into moderate to severe respiratory distress.

They become dependent on oxygen so require it to perform all activities of daily living even when at home. Some COPD patients cannot purchase home oxygen cylinders and have to seek assistance from the government. Owning an oxygen cylinder means having to refill it every time it is empty, this is another burden as most times help is also required for oxygen refills.  

Heightened hospitalization and social case

Globally, majority of the cases admitted for COPD are men who are chronic smokers and a few individuals mostly women develop COPD with no known etiology. Hospitals have been burdened by the amount of patients who have become social cases. These patients live in the hospital since they are unable to care for themselves at home, are financially deprived and have no one to care for them upon discharge.

Some patients who suffer from COPD have good family support so go home to good care. Whilst other families explain that they are unfit to care for their loved ones and the patients altogether do not want to go home for fear of neglect and death.

This has caused increased costs for hospital administrators since more staff are needed to care for these patients who typically require extensive care, constant monitoring and assistance.

There has been a reduction in the availability of beds to house patients who actually need medical attention since the COPD patients take up the limited bed space. Most of the smokers suffer from permanent lung disease as a direct result of the toxic effects of tobacco smoke so require lung transplant.

Lung transplant is an expensive intervention that is not performed in some countries so individuals are placed on continuous low flow oxygen to help sustain life. Some patients are able to fly to other countries to have the procedure done.

Long-time COPD patients are “recurring decimals” due to the constant emergency room visits, admissions and longer hospital stays. Some patients become afraid to stay away from the hospital so refuse discharge and some return the same day they are discharged.

Many people who suffer from COPD become incapable of working especially if they are dependent on oxygen, tire easily and have constant and prolonged hospital stays. They lose their jobs overtime and become unable to provide an income to care for themselves and their family.

Rippling effect

The effects of COPD have a rippling effect. The patient becomes depressed, feels helpless and hopeless and have deceased quality of life. The family spends lots of money in hospital bills and treatment and worry about their loved one. The employer loses a worker. The government and tax payers bear the overall cost of care.

Funds have to be allotted by the government to care for COPD patients. The finances given to care for these individuals could be invested in other areas. The government must also pay the nursing homes for the patients who have become a social case. Therefore, there is an opportunity cost for the government.

The patients are referred to the social worker so a nursing home can be obtained. These individuals then fill the nursing homes and deprive those we actually need the home of the chance of getting a spot.

Also, a sick and dying population means reduced workforce and decreased economic output and revenue for the country.

Patient education

It is important for people to be aware that their risk for developing COPD increases with the amount of tobacco smoked each day along with the number of years. Efforts should be made to limit consumption and exposure to COPD triggers.

This blog post is dedicated to all the COPD patients I have nursed.

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Stay tuned for the next blog post on the management of COPD.

Reems Sonson

Our Tropical Living

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This is not a paid or sponsored blog post. This blog post is not affiliated with any hospital. I am merely sharing my knowledge and expertise from working with COPD patients and my research from holding a master’s degree in Public Health with my thesis being on tobacco use. This blog post is not intended to be a substitute for professional medical advice, diagnosis nor treatment. Please seek advice from your medical provider for further information and clarity on COPD.

Reference: Mayo Clinic. (2022). COPD. Retrieved from https://www.mayoclinic.org/diseases-conditions/copd/symptoms-causes/syc-20353679