So it Begins

April of 2012 found me hospitalized with pulmonary embolisms to both lungs. Strike one! One of those blood clots was lodged in the bifurcation of the main pulmonary artery of the left lung with infarction, which is the obstruction of the blood supply to an organ or region of tissue, typically by a thrombus or embolus, causing local death of the tissue. This type of embolism is usually found during a necropsy. I cheated the grim reaper, but learned that in addition to the pulmonary embolisms, I also had chronic obstructive pulmonary disease (COPD).

I was not very surprised actually. I am a smoker. Strike two! Smoking is the primary risk factor for this disease. Quite honestly, upon being given the news, I really needed a smoke. That just a reality of my 35 year tobacco habit.

I left the hospital on the blood thinner Coumadin and, my albuterol rescue inhaler, Qvar, which is an inhaled corticosteroid that I use twice daily along with Combivent, which is a bronchodilater used by COPD patients who have bronchospasms and need a second bronchodilater. They sent me home with a pretty blue spacer too. The spacer helps me get more of the inhaled medication into my lungs, rather than on the back of my mouth.

At first the inhalers weren’t so easy. One has to master proper technique. You have to press down on the inhaler, breathing in deeply as soon as the inhaler is pressed, holding your breath for several seconds and, exhaling. It’s all about timing. I’m a pro now.

I went into denial after the diagnosis. I even continued to smoke, but promised to gradually cut back. I set ‘quit dates’ repeatedly, but somehow always found an excuse to postpone those dates. I discovered electronic cigarettes which have been extremely helpful, in my case. As a nurse, I would be lecturing patients of the importance of kicking the habit and giving them the necessary information about smoking cessation and their available options. Let’s just say that I’m a much better nurse than I am a patient.

I’m not going to tell you that I was the perfect patient. I’m going to give you the hard truth, even if it seems as if I love smoking more than my life. I am an imperfect person with good intentions. I really want to quit. I’ve tried chantix, nicotine patches, wellbutrin, cold turkey, teas that claim to help one quit, and nicotine lozenges and gum. I even managed to go 52 days without smoking, but went back out of defiance. I still smoke 5 cigarettes a day, but try hard to cut that number back by using the e-cig. It’s a tough battle, but eventually, I am going to find the right method for me and give them up for good. I will not let this habit rule my life. I know I will succeed and make my pulmonologist a very happy man.

Now, strike three hit in October 2012. That’s when my immunologist diagnosed me with Primary Immunodeficiency. This is not cool. My immune system doesn’t work very well, and I have to give myself weekly infusions of immune globulin to boost my immune system. So, now, pneumonia or other upper respiratory infections are even harder to fight combined with COPD. In January of 2013, my hematologist diagnosed 2 blood clotting disorders. My blood is too thick and without blood thinners, I’m at high risk for the development of fatal blood clots. During the same month, my pulmonologist ran a test that showed that my alpha 1 antitrypsin level was pretty low. Normal range is between 100-200. My result was 104. Still enough to protect my lungs, but low enough to make me more vulnerable to lung disease. It also led to having my siblings and my daughter to be tested considering my father’s history and my phenotyping results showing that I’m a carrier. That was scary because I sure didn’t want to find out any of my loved ones had to potential to develop any kind of lung disease. My daughter is a carrier. My younger sister is fine.

I think I will stop here and let you digest all of this before continuing with my story. If you have questions or comments, please share. I’ll be more than happy to answer any questions and, I’d appreciate any comments you may have.

By writing this blog and sharing my story, I’m not only trying to help others, but also helping myself learn to manage my own COPD. Thank you in advance. I look forward to this journey with you.