The doctor looked at his patient, and said, “Joe, you have COPD.”
Normally a friendly guy, a talker, Joe was speechless. He was stunned, then began to feel anxious, making him short of breath – even more so than usual. His doctor went on, explaining what COPD is and what could – and couldn’t – be done about it. Maybe Joe heard that. Maybe he didn’t.
“You’re going to have this for the rest of your life. It’s not going to go away.”
“I’m always going to be short of breath like this? No way! I can’t do anything around the house anymore without gasping.”
“Joe, right now you’re recovering from a bad bout of pneumonia. We’ll do some tests and see how things go in the next few weeks.”
“Now hold on here, doc. The pneumonia came out of the blue. I was fine before that.”
“Joe, chances are the COPD has been coming on for a long time. It can be there for years before we notice it.”
A little calmer now, Joe said, “OK, doc. So I have this… this… COPD… or whatever you want to call it. There must be something that will help – a pill or something.”
“There are medicines you can take, but COPD is, for all intents and purposes, irreversible.” The doctor repeated, “You’ll have this for the rest of your life.”
“The rest of my life? Now, wait a minute. That sounds so… final. This can’t be. I’ve worked hard all my life. I just retired, and I’ve got things to do. Plans to travel. Grandchildren to spoil.”
“I know, Joe. I’m sorry. The nurse will be back in a few minutes to tell you about your new medicines. I’ll see you in a few weeks.”
There’s no doubt that you, a health care professional, are all too familiar with this scenario. How should we talk to a patient who has just been told he has COPD? Here are some thoughts on starting that conversation.
First, let’s note that Joe’s doctor was actually pretty gentle and forthcoming. Patients are sometimes told how they did this to themselves by smoking, they are told to go home and make final arrangements and that’s about it. They may be given little or no information on COPD. Sometimes they’re not given any positive information at all.
It’s common that patients do not take in everything the doctor said. A good way to start is to say, “Let’s go over what the doctor said. Why don’t you begin by telling me what you heard.”
Don’t Give In or Give Up
Your patient may have just been told how long he may expect to live, given his diagnosis of COPD. Assure him that many people live a long time with COPD. If he has a sense of humor, you might say something like, “Take your shoes and socks off and look at the bottom of your feet. Do you see an expiration date? You don’t? Well, that means that you nobody knows for sure how long you’re going to live.”
“I know this is very scary. But you’re not alone. There are an estimated 24 million people or more in the US with COPD. And there is a lot that can be done to help you breathe easier.”
Tell your patient about pulmonary rehabilitation, a program of exercise and education especially designed for people with COPD. Hopefully your hospital or clinic has a pulmonary rehab program on site, but if you don’t know where the nearest pulmonary rehab program is located, contact the AACVPR (American Association of Cardiovascular and Pulmonary Rehabilitation) by visiting the AACVPR website.
Before mentioning exercise, explain that the health care professionals at pulmonary rehab are experts in working with people who are short of breath. In pulmonary rehab he’ll gain strength, stamina, and flexibility and learn a lot about his lungs and how to stay as healthy as possible. He’ll learn about breathing techniques, relaxation, medications, and more. He’ll also find friends who have many of the same concerns.
Breathing Support Group
If your organization has a breathing support group, give your patient information about that group and their meetings. Encourage him to go, to learn about COPD and how he can breathe easier and get on with his life. Remind him that he will meet people there who are dealing with the same issues.
If your patient has online access, tell him about the COPD360Social online community. There he will see a wealth of conversations along with good questions form people like him and solid answers, often from lung health professionals. He can spend time in the community, remain anonymous and learn (lurk and learn), or he can participate as an active member. Assure him that no matter what, he will be in good company with wise and courageous people.
Coping and a Positive Attitude
Learning to cope with a diagnosis of any chronic, incurable, progressive disease is a process that takes time. Help him understand that it may be a while before he’s able to take all of this in. He may experience a range of emotions. If he smoked cigarettes, he shouldn’t judge himself too harshly. What’s past is past. All he can do now is go forward and do the best he can. Reassure him that facing his challenges, learning about COPD and having a positive attitude can help him have better control over his breathing, and his life.
Please share your thoughts in the comments on supporting those newly diagnosed with COPD.