Sci207: Vocational Issues with Copd

Social Implications for Patient’s with COPD SCI207: Social Implications of Medical Issues August 1, 2011 Social Implications for Patient’s with COPD CASE 1 Mr. L. , a 55-year-old bartender in a large metropolitan area, has been a heavy smoker for 40 years. He was diagnosed as having COPD 7 years ago. Mr. L. lives in the city and takes the city bus to work, although he still has to walk about three blocks to the bar where he works. He has found it increasingly difficult to walk the three blocks without stopping to rest at frequent intervals. At work, his manager has also expressed concern about the effect Mr.
L. ’s continuous coughing has on customers. (p. 440). According to the National Center for Biotechnology Information (NCBI), smoking is the leading cause of Chronic Obstructive Pulmonary Disease (COPD), and it is considered one of the most common lung diseases known. “COPD is a diagnostic term used to describe a group of conditions that are characterized by respiratory symptoms such as dyspnea (shortness of breath), cough, sputum production, limitation of air flow, and chronic inflammation of the lungs. ” (Falvo, 2008, p. 420). Often, people have both.
On the flip side, there are also the rare cases of nonsmokers who lack a protein called alpha-1 antitrypsin that can develop into emphysema. The longer a person smokes, the likelihood of developing COPD is high but there are some who are exceptionally fortunate who do not contract this disease as a result of routine, long term smoking. This paper will examine the causes, the symptoms and complications and what the social implications of having COPD that can affect an individual in an adverse way using the above case study as the example. It is known that Mr. L. began smoking at fifteen years of age.

At age 48, he was diagnosed with COPD yet still continues to smoke. Let us assume that Mr. L. has had a nice physique given to him from good genetics rather than regular visits to the gym. Let us also assume that he is a New Yorker and has lived there all of his life. Because the city is so large, there is also automobile traffic that never ceases at any hour – day or night which produces high amounts of carcinogens into the air. There are still manufacturing buildings that also produce pollutants such as exposure to gases or fumes as well as tens of thousands of smokers who release second hand smoke into the environment.
Add barbeques and smoke pits or poor ventilation in a smoky bar into the mix and one is exposed to heavy amounts of carcinogenic pollutants every single day. This kind of long term exposure can attribute to some of the causes that may be factored in as to why he was diagnosed with COPD. Mr. L. has been told by his physician that he needs to quit smoking and start a regular exercise routine along with the prescribed medicine to make his conditions manageable and bearable. Because Mr. L. as smoked for 40 years and lived in an urban environment with long term exposure to pollutants along with his own habit, he began to notice a “smoker’s cough” or excessive mucus that is lingering much longer than a common cold. He notices that he begins to wheeze and gets fatigued when simply walking a few blocks from his bus stop to work or home. Once at work or home, he may realize that he has a hard time catching his breath (dyspnea) with any mild activity such as changing out a keg, moving a case of beer or carrying out the garbage.
He’s given up going to the gym as it wears him out to easily and is embarrassing to him because he wheezes and coughs too often and doesn’t want to be the subject of ridicule from younger, healthy people. He has noticed more lines on his face from not only age, but the smoking has aged him even faster. His teeth are yellowed from nicotine as well as his index and middle fingers from where he holds his cigarettes. New York has passed a non-smoking law for all public places as of the year 2000 and where there were once many smokers, it seems that more have quit than smoke.
His patrons have been verbal about his coughing near their beverages or how they have to wait on him as he runs out back to catch a quick smoke, and he does this quite often because he is a 2 pack a day smoker. They complain that his breath and clothing smell of stale cigarettes even though he tries to cover it with breath fresheners and cologne. The patron’s regularly harass him on his choice to smoke and taunt him to quit which annoys him and makes him irritable. Smoking which at one time made him look cool, has now made him a pariah in most social circles as well as the stigma attached to his habit and symptoms.
They tease him and say that he will become one of “those” people who will have to carry an oxygen tank around with him. Johnson, Campbell, Bowers and Nichol assert that “Stigma is a social construction that defines people in terms of a distinguishing characteristic or mark, and devalues them as a consequence”. Their article further reports that, “a study involving 27 women and men living with COPD reported that respondents repeatedly described a sense of stigmatization that was a direct result of using supplemental oxygen around other people and which led to feelings of embarrassment and social isolation. (2007). Since there is no cure for COPD, clearly the fastest way to retard lung damage for Mr. L. before he absolutely needs the oxygen tank is to stop smoking. Taking his prescribed medications can treat many of the symptoms such as the wheezing, coughing and shortness of breath. He can increase the amount of time walking to build up strength. The stigma of smoking will then change to encouragement from his patrons to see success in his effort to quit. His breath will not be so offensive nor will his clothes smell of cigarettes.
His nails will begin to lose the yellow discoloration and he can whiten his teeth so that he can feel better about his physical looks along with his self pride can be restored by committing to quit. No longer will he feel dismay, embarrassment or be annoyed because of the stigma attached to a smoker that displays the outward symptoms of his disease. Mr. L. ’s whole outlook and attitude will change by simply giving up a horrible habit that can destroy not only his health, but other’s as well. References Falvo, D. R. (2008). Medical and Psychosocial Aspects of Chronic Illness and Disability. 4th ed. ). Sudbury: Jones and Bartlett Publishers. Johnson, J. L. , Campbell, A. C. , Bowers, M. & Nichol, A. (2007). Understanding the Social Consequences of Chronic Obstructive Pulminary Disease: The Effects of Stigma and Gender. The Proceedings of the American Thoracic Society. Retrieved August 1, 2011 from: http://pats. atsjournals. org/cgi/content/full/4/8/680#otherarticles The National Center for Biotechnology Information Web site provides information on COPD http://www. ncbi. nlm. nih. gov/pubmedhealth/PMH0001153/