“I was afraid I might not be able to breathe and die,” says a woman with COPD

A smoker of almost thirty years, rural producer Ana Regina Majzoub, 56, was diagnosed with COPD (chronic obstructive pulmonary disease) in 2009, at the age of 43. Currently at 32% respiratory capacity, she Ana says she saw her mental health compromised in the first few years following her diagnosis. She was afraid of not being able to breathe and of dying. After overcoming the difficulties, Ana encourages people to quit smoking and shares her story below:

“I started smoking at the age of 17. I knew about the harmful effects of cigarettes, I kept saying I would quit, but I never took an effective attitude towards it. In 2008, I made a New Year’s resolution and i was able to quit using tobacco and nicotine patches for a month but eventually came back.

A year later I got sick, felt tired and fatigued when showering. I found this strange and sought out a general practitioner for a checkup. The tests didn’t show much change, but the doctor recommended that I see a pulmonologist. What caught his attention was the fact that I had been smoking for 26 years. I went to the pulmonologist and he asked me for some complementary tests.

A few days later, I opened the results of one of the tests myself and read the word pulmonary emphysema. I didn’t know exactly what it was, but I figured it wasn’t good stuff.

I took the result to the doctor and went to the office without taking my pack of cigarettes with me: I took it with me everywhere I went, but I was so scared that I left it at home.

After seeing the scan, the pulmonologist diagnosed me with COPD, said it was caused by smoking, and explained that my type was associated with pulmonary emphysema.

COPD is a respiratory disease caused by inflammation of the airways leading to persistent obstruction of the bronchi, making breathing difficult, and has the following symptoms: tiredness, shortness of breath and irreversible loss of breathing capacity.

I was shocked by the diagnosis and that same day I started treatment with the use of firecrackers and gave up smoking: if I didn’t stop smoking, I could have serious complications.

It was difficult at first, but I’ve adopted a few strategies to help. I stopped drinking coffee for a few months and was not around other smokers including staying away from my husband when he smoked.

I think the biggest impact COPD has had is on my mental health. I had anxiety attacks, very afraid of feeling sick, not being able to breathe and dying. She didn’t go anywhere alone, she always had to be accompanied, she didn’t do any activity that required physical effort.

Ana is a rural producer and had to stop going to the fields

Image: personal archive

In my job —I’m a rural producer— I stopped going to the fields, I stayed in the office, I no longer participated in fairs and events. I didn’t even do the block near my house anymore, I preferred to do everything by car.

The doctor advised me to do some physical activity, he said it would be beneficial for the treatment. But I thought just walking a little faster would make me breathless, imagine if I did more strenuous exercise. I was scared and I didn’t. Also, I didn’t like to expose myself, I almost didn’t talk about my health problem with other people.

I have had two episodes where I was hospitalized with COPD, again caused by coughing and shortness of breath. The first hospitalization was a complication that started with a picture of sinusitis. The second was because I felt extreme tiredness that made it impossible for me to perform simple daily tasks: I only got tired walking from the bedroom to the kitchen and taking a shower.

One thing that helped me in the process was participating in COPD patients’ Facebook and WhatsApp groups, such as #CDD Informa Respiratory.

Hearing other people’s stories, hardships, and overcomings made me see the disease from another perspective.

Ana has COPD - Personal File - Personal File

Having contact with other people with COPD helped Ana cope with her disease

Image: personal archive

This contact encouraged me to lose the fear of exercise and to try new things. I did pilates for a while and started doing respiratory physiotherapy.

I learned to breathe and identify my limits. I currently have only 32% breathing capacity, but in general I lead a normal life and try to do things more slowly, at my own pace.

For many years I have heard from people that I should quit smoking. Had I followed their advice, I may not have developed COPD. I encourage smokers to give up addiction and seek healthier lifestyle habits.”

Learn more about COPD

COPD is an irreversible disease that leads to a persistent decrease in the velocity of airflow in the lungs, due to a chronic and progressive obstruction of the airways, and to the loss of respiratory capacity. It is slow in onset but can progress rapidly to a more severe stage, leading to respiratory failure and death.

It is between the third and fourth leading cause of death in developing countries. THE Brazil has one disease-related death every 15 minutes, characterized by persistent chronic bronchitis and/or pulmonary emphysema. In bronchitis, there is persistent mucus production and inflammation of the airways. In emphysema there is the destruction of the alveoli, structures responsible for the exchange of gases (oxygen and carbon dioxide) in the lungs.

  • One of the main causes of COPD is smoking, as the burning of cigarettes damages the airways.
  • Interestingly, in addition to traditional cigarettes, the use of electronic cigarettes (vape) and hookahs also leads to the disease.
  • Furthermore, it is also linked to the inhalation of other toxic substances, such as exposure to biomass smoke (firewood, coal) and air pollution.

Symptoms are:

  • Shortness of breath (dyspnea) progressive and limiting;
  • Tiredness;
  • Chronic fatigue;
  • Chronic cough which may be accompanied by phlegm which mainly comes out in the morning.

The main difficulties. Due to shortness of breath, the patient may not be able to perform daily activities, such as taking a shower, climbing stairs, walking, working. Excessive tiredness also affects physical and mental health.

The patient tends to be restricted, restricted, isolated and with an impaired quality of life, which can lead to depression. There is often a sense of guilt because the person got sick from smoking.

Treatment for COPD consists of:

  • The first point is smoking cessation and the use of inhalation devices – the famous firecrackers – which deliver bronchodilator drugs directly into the lungs.
  • The use of corticosteroids as anti-inflammatories may also be recommended.
  • There are cases where the gas exchange difficulty is so intense that the patient needs supplemental oxygen.
  • A pulmonary rehabilitation program with physiotherapy sessions is also indicated.
  • Treatments slow the progression of the disease by controlling symptoms and reducing complications.
  • It has no cure, but it can be controlled and reduce the risk of death.

It is worth mentioning that all treatments are available in the SUS and that there has been an important progress in Brazil with the incorporation in the new clinical protocol and therapeutic guidelines of 2021 of bronchodilators of different classes, with administration in a single device, expanding treatment options.

Source: Clisthenes odyr Soarespulmonologist and professor of Pneumology at Unifesp (Federal University of São Paulo).

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