Chronic Obstructive Pulmonary Disease - Report Example

Interview of a Patient with Chronic Obstructive Pulmonary Disorder Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease (COPD) is a respiratory tract disorder resulting from the impairment of the functions of bronchodilators within the lower respiratory tract. The air pathway gets constricted resulting in a limited supply and expulsion of air to the lungs. The cell surface receptors that initiate the cascade of reactions leading to dilation of the bronchial tree do not respond to stimulus thus leading to the occurrence of cyanopathies. As a result of this, there is a decrease in the oxygen supply to the lungs and acidosis from increased carbon dioxide retention within the lungs. The patients’ lungs lose their elasticity as a result of their minimal movement within the pleural cavity. COPD is ranked fourth in the leading causes of death within the United States, and, on a world wide scale, it is the 6th leading disease responsible for deaths. (Haplin, 2004) The disease has various ways of manifestation from its mild states to its chronic stages. It takes a long time to fully impact the patients’ life in an immense proportion limiting their mental, physical and emotional capabilities as well. Its symptoms are closely related with those of heart failure, not to mention they share causative factors such as smoking. The particulate matter that enters the respiratory tract harms the surface epithelium that has receptors as well as mucus-generating goblet cells. Surface epithelial metaplasia results from the exposure of the ciliated pseudo-stratified columnar epithelium of the respiratory tract. Metaplasia changes this epithelium to a squamous type reducing its efficiency in allowing the passage and cleaning of air as it travels along the tract tot the lungs. The surface cell receptors equally get destroyed leaving the control of the bronchial diameter to the unopposed parasympathetic system. The constrictions within the lower respiratory tract lead to a reduced efficiency of the whole system leading to shortness of breath and minimal gas exchange. The patients go through various treatment plans to reduce the symptoms of the disease and postpone its severe manifestation. Ms. Edna Bridges allowed an interview to get conducted on her after getting diagnosed with moderate COPD; she is under gluco-corticosteroid therapy and long-acting beta-agonist bronchodilators. She got diagnosed with COPD three years ago and is currently 44 years old. She is a bar owner in Thousand Oaks, California. At the age of 10, she had a measles attack. She got diagnosed with malaria after a camping trip in Kenya at 18; had a caesarian section during delivery of her two twins at in 1998; elucidated that she had previously suffered from a multiple rib fracture in an accident while she was 36 years old. At the same time, Bridges bean coughing out mucus, and it progressed continually until she got diagnosed with COPD. This left her with a flailing chest and gave her troubled breathing as chest movements cause her pain. She began having shortness of breath in 2007 while at work. She could not talk continuously for 15 seconds without stopping momentarily to catch a breath. “I could not raise my voice to customers over the loud music at the bar, I had to resort to whispering close to their ears to ensure that they would not find my frequent pauses within the conversation when I used a lot of energy in speaking” (Bridges, personal communication, November 22, 2012). Every 15 second she spoke forced her to take a five second break to catch her breath. For 5 years now she has been experiencing this difficulty in speaking. She has not been able to partake in strenuous activities ever since this began forcing her to stick to managerial tasks alone. The condition has been getting worse over the years. She can barely sleep without a propping herself up with pillows to ensure she can breathe with ease. The farthest she can walk is a mere 100 meters, the distance from her house to the nearby market. She has to board a taxi on her way back home due to the exhaustion she has from the walk. She had to buy supplements like ferrous sulphate to enhance her eating. These supplements decreased the activity of the satiety centres within her brain thus inducing an appetite enabling her to have the urge to eat. The reduction of leptin-based satiety by reacting with the leptin within the adipose tissue reduces its amount enabling her to have an appetite despite her satiety due to exhaustion. She had knowledge of this medication before she got diagnosed with COPD. She swallowed 3 100 gram iron sulphate tablets on a daily basis. These tablets had no side effects on her body (King & Brucker, 2009). She began coughing out mucus in 2002, and the condition worsened despite the use of expectorant over the years. She has long periods of colds during this period. The phlegm that accompanied her cough was green in color. The expectorant liquefied the mucus within her respiratory tract to clear it of solid mucus aggregations within her respiratory tract. The goblet cells respond by producing more mucus in a positive feedback design. The expulsion of mucus from the tract stimulates the ruined goblet cells to produce mucus further. The expectorant is in syrup form and gets taken orally. She takes 5 ml doses of the expectorant two times a day. This got prescribed to her with warning of allergic reactions to the components of the drug. It has a propensity to cause fatigue and dizziness to the patient. It requires her not to operate heavy machinery after taking it. It improves her breathing by clearing her already constricted bronchial pathway leading to the slowing of the COPD symptoms (Lippincott, 2006). She has been in close relation with tobacco smokers in her place of work. Her bar allows smoking inside, and this makes her a passive smoker on an almost daily basis. The area has a busy publishing office that releases a lot of soot and particles increasing the injury to her respiratory tract. The coughing must have been initiated by such environments that she often associated with at work. The particulate matter within the atmosphere of her work place is immense to the extent smog is prevalent within the town. The bar is filled with smokers within the town because other bar allows smoking within the premises. There is a cloud of smoke within the bar late in the night at the time we are closing. The cleaning after closing the bar is strenuous as the smoke makes it hard to breathe. (Bridges, personal communication, November) She did not have any history of childhood respiratory illnesses. Her family equally has no previous cases of emphysema or other COPD-related diseases (Rhoads, 2010). She does not have alpha-1 antitrypsin deficiency, and thus is not genetically prone to COPD. In case she had, it she would have been more predisposed to contacting the disease than if she did not have it. The rib fracture she had suffered and the caesarian section made her had her get a prescription of codeine for 6 months to numb the pain of her chest movements. It gets administered sub-dermal injections on a daily basis. This caused her utter dizziness, apathy, lack of mental focus and nausea. The painkillers raised the threshold for pain in her body reducing the discharging of pain nerve fibers within her chest during chest movements. The painkillers barred her from taking any alcoholic beverages or antihistamines. The drugs get extensively abused, but Edna did not abuse her prescription drugs. She got diagnosed with COPD after the integration of all the respiratory tract symptoms that affected her. She got prescribed to the long-acting beta-agonist bronchodilators, formoterol that served to inactivate beta-cholinergic receptors within the respiratory tract to reduce bronchial constriction. Gluco-corticoid doses are administered orally together with this inhaler twice a day. The steroid aided in reducing the inflammatory, allergic response of the respiratory tract epithelium to the inhaler. Edna Brides would recover better from the symptoms of COPD if she enrolled to a support group to help her cope with the condition she has. The support group might help her in terms of encouraging her to exercise and giving her hope of survival. She is well informed about her COPD and she also religiously takes her medicine without abusing it. The drugs she uses are best suited to help her reduce the effects of COPD on her life. References Haplin, D. M. (2004). COPD: Your Questions Answered. Amsterdam: Elsevier Health Sciences. King, T. L., & Brucker, M. C. (2009). Pharmacology for Womens Health. Barlington: Jones & Bartlett Learning. Rhoads, C. S. (2010). History and physical examination for COPD. Retrieved from www.webmd.com: http://www.webmd.com/lung/copd/history-and-physical-examination-for-copd Lippincott, W. (2006). Portable Pathophysiology. Alpen aan den Rijn: Wolters Kluwer Health. Read More