Earlier this week doctors at the Victoria Hospital (VH) called on the public via a press statement to desist from a dangerous practice which is literally killing people but not before making them “Respiratory Cripples.” According to the Medical Director at Victoria Hospital, Dr. Lisa Charles, over the past ten years she has seen an epidemic emerging with an increased number of young patients suffering with Chronic Obstructive Pulmonary Disease or COPD.
“Patients who smoke marijuana mixed with tobacco are developing COPD at an extremely young age. We are talking about young men and women in their thirties with end-stage lung disease. And by end-stage lung disease I mean they are no longer able to carry out any normal activity such as cooking, walking from the bed to the bathroom because of severe shortness or breath,” Dr. Charles stated.
COPD is an extremely debilitating, progressive disease, which directly affects the lungs, and the effects of COPD cannot be reversed. Patients with the disease are literally confined to bed with oxygen tubes up their nostrils 24 hours a day, 7 days a week. “Because any degree of exertion, any degree of activity causes shortness of breath to the point where you have to stop, you have to sit. You cannot do any of those normal functions that you can do for yourself; you can no longer do them,” Dr. Charles added.
The Pan American Health Organization indicates that Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality in the Americas, representing an important public health challenge that is both preventable and treatable. COPD caused over 235,000 deaths in 2010, ranking as the sixth leading cause of death in the Americas. About 23% of these deaths occurred prematurely, in people aged 30-69 years. The World Health Organisation has designated November 16th as World Chronic Obstructive Pulmonary Disease Day.
The Medical Director indicated that available bed space at VH is severely compromised as a result of this increasing epidemic of COPD in patients. “So upwards of 12 patients per day require some degree of treatment for their breathing difficulty. In terms of patients who are end-stage, which is my primary concern, we probably have what we call a revolving door patient population of close to 15 – 20. These are patients who literally come to A&E either daily or weekly because their disease is so far progressed that they need that level and that frequency of attention in the emergency department and on the wards. We do also have patients who have lived at VH for the last several months because they can’t take care of themselves at home and they have no option but to stay with us because they need continuous oxygen and full care.”
Sherman Esnard was one of the patients whose case was highlighted via the media this week to drive home the point. Esnard was shown in a wheel-chair in the A&E department where he had been for five days, completely dependent on an oxygen tank. Now confined, Esnard, who earned a living as a carpenter, was also an avid football player – things for him which are now no more. The young COPD patient admitted that breathing was very difficult without a constant supply of oxygen. He spends most of his time between his home and the Victoria Hospital and can’t last a minute being disconnected from an oxygen tank.
When asked what he thinks contributed to his COPD Esnard lamented, “I know smoking has to do with it, smoking has a big part to do with it . . . I see people smoke more than me but they don’t have that problem. Maybe our bodies are just different but smoking has a part to play. “Financially I don’t think anybody wants to be like me at this point. Financially I’m ripping a hole in my people’s pocket right now. I cannot afford to buy an oxygen tank. The tank you see behind me I cannot afford that, it’s too expensive. . . I can go through three of these tanks, and $200 for one so do the maths. Three of that for a week, for a month, for a year,” Esnard added.
Dr. Charles revealed that the cost of treating COPD is tremendous with most of this cost being absorbed by the Victoria Hospital, the government and the taxpayers.“If you just look at oxygen alone, without looking at the nursing cost, the cost of physicians, the cost of other medications, the cost of nebulization, the cost of treating heart failure and the cost of inpatient hospital stays, I wouldn’t even know where to start to measure but it’s very significant.”
Esnard made a strong appeal to young persons to stop smoking and kick the habit: “Well, I know the feeling of smoking, you feeling nice for a while. But it’s only for a while. If you reach that stage where you have COPD, it’s all over. If you’re not strong mentally I think you will be gone even faster too. “So imagine you cannot do anything for yourself as a strong young feller just down in a flash. Smoking is not worth that. If you’re smoking today just take a look at me and just try to drop it, everything, just try and drop it. It’s not worth losing your life, your family or anything so. Just put down the cigarette and make a change.”
Esnard said that what he misses the most is not being able to take care of his daughter the way he wanted to as a father. The Victoria Hospital is optimistic that through public education and sensitization the COPD epidemic will be stemmed, more lives will be saved and less pressure brought to bear on the health institution. Since the VH revelation Dr. Marcus Day, the Director of the Saint Lucia-based Caribbean Drug and Alcohol Research Institute (CDARI) has challenged some of the assertions made by Charles stating that the medical professional was “a little off” in her conclusions.
“I think the first thing that we have to remember is that whenever you have such information from a Clinician what is seen is probably the worst case scenario at the hospital,” Day asserted. The CDARI Director explained that individuals have predispositions to lung issues, with the result that some people have more problems than others. “So that is an issue that I think Dr. Charles did not really take into consideration,” Day told the Times. He said he knew that the Food and Drug Administration in the United States has actually approved THC as a drug to address issues relating to COPD.
Day has been an open advocate for the legalization of marijuana and last year told the local press that the present administration needs to consider legalising the use of marijuana. Dr. Day believes that people, particularly young men, should not be punished for smoking small quantities of marijuana. He also called for an update from the recently established Caricom Commission to investigate the pros and cons of the decriminalisation of the drug in the region. In response to some of the feedback her comments have garnered Dr. Lisa Charles maintains that the issue is a cause for great concern and shouldn’t be overlooked.