Outdoor Working in Winter with COPD

[little_weed]

I am getting myself in a right state over whether or not I will be able to continue with my job in winter. I am a gardener with responsibility for approx 2 - 3 acres of historic garden. I work from 7.30 am until 4.30 pm, all year round. I have been diagnosed with COPD a few months ago, and referred to the hospital, where they have been doing further tests. I have just had all the PFT's done, resulting in a letter reporting "significant" damage, which they wish to furter assess with a CT scan. I could be waiting up to 2 months for the scan. I have emphysema, and according to my initial spirometry, it comes under "moderate", though I have yet to be given an official staging.
Whilst all this is going on , I am trying to stop smoking, and am worrying myself sick over working outdoors in the winter. I have read all the advice about wrap a scarf around your nose and mouth, to avoid the cold air, but outdoor workers have to do that ayway, because it is so cold. I am almost frightening myself into not ever going out over the front door step after October, until June!!!
Am I being alarmist??? I do NOT want this disease to progress. I am going to have to talk to my boss on Monday on what we are going to have to do.
How can I do a heavy, physical job in sub zero conditions and not worsen my condition??? I really cannot see that a scarf is going to be much help. I feel my life is falling around around me.
I am female, underweight, and aged 54. I have just started Champix as a last resort to help quit cigarettes.
Please help.
Thank you

[National Jewish Health]

The decision regarding your job is clearly of the utmost importance to you, especially if it is your only, likely source of income.  Fortunately, even with moderate to severe COPD/emphysema, you probably need not give up your job, out of concern regarding further, accelerated lung damage from the cold air exposure.  That doesn’t happen.  You only need be concerned about the acute effect of cold air on COPD.  There is no chronic effect. Unlike asthma, which can be very sensitive to cold air, COPD is usually much less so.

In addition, should you find that the cold air makes it more difficult to breathe, you can also pre-medicate with one or more long-acting bronchodilators and an inhaled steroid.  You should discuss this with your doctor.

Covering one’s mouth with a scarf can reduce that exposure but is cumbersome and unreliable.  More effective would be a simple “cold weather mask” of the type available at most pharmacies and medical supply stores.  These are light weight, small and can be effective.

If the small, simple mask doesn’t do the job, one can use a small portable respirator and that would definitely work.

It is terrific that you are trying to quit smoking.  This is one of the best decisions you will ever make.  With the combination of smoking cessation, a cold weather mask, proper COPD medication and the avoidance of work on extremely cold days, you should be able to continue your work for a very long time.

You should work with your doctor on this and also call your State’s Quit Line.  You can get their number and lots of other helpful information on quitting, at the following website.
http://www.naquitline.org

Good luck

[little_weed]

Anybody out there???????

[debbie58]

I applaud you in being able to do heavy physical work with moderate emphysema, at any rate.  I find it difficult to walk a block!  I've been diagnosed with moderate emphysema by PFTs and a cat scan.  I quit smoking 3 years ago.  I would say as long as you can do it do it.  I know I couldn't, Id simply collapse.

[little_weed]

Thank you so much for answering my question, and giving me such practical advice.
I am already use Spiriva in the mornings, and Salamol as and when required.

I would have found a winter temperature range useful both for myself and my boss, who is trying to work around my condition as best he can with the limited knowledge I have given him, and without getting his superiors involved, who could then say I am unable to do my job, and "remove" me!

[little_weed]

Don't be fooled, debbie58, I am REALLY struggling at the moment.

I have slowed right down, and am "pottering" more than working at the moment! I am avoiding the really heavy stuff, thinking that I will be OK maybe tomorrow, and that all this is a dreaful nightmare! I absolutely love my job, and the people I work with.

I have spent the last 6 years travelling up and down the country with first my mum, and then my dad, battling with cancer. I lost my mum last year, and was slowly getting my life back on track with my partner, and then  . . . this!

My grandfather died with emphysema (a heart attack) back in the 70's, and I can remember all too well, his faithful friend, the oxygen cylinder! It was a taboo subject then, and wasn't discussed, but I know what I'm in for.

I've got my CT scan on the 2nd September to further assess my "significant" damage as shown by my PFT's. The wait is not helping with the quitting smoking!

Thanks, sweetie, bet you're sorry you posted now, after my moaning on . . . sorry, I don't usually . . .

xxx

[debbie58]

Actually over the last 3 years i've been doing much better.  Quitting smoking is probably the best thing I did.  I also walk up to 2 miles a day at 2mph.  I have the added problem of severe osteoporosis, but am about to finish my second year on forteo.  I also have panic disorder which precedes (since childhood) either of the other two but feeds into them, especially the emphysema, big time.  It's also the one I've had the least amount of success in controlling.  Tried just about,in fact, everything.  I still like to walk around my woods and did extremely well at a funeral last night.  Funerals are a source of panic, but then with me, what isn't.  When you first described your job I was picturing you hauling around 50 lb. bags of mulch over your shoulder.  I hope your ct scan goes well.  I had one last April and it really scared me as my mother died of lung cancer at 60, the same age as me, but it all came out real well, except for the emphysema, but I already knew that.  Good luck and keep on as long as you can.  Inactivity is the WORST thing.  QUIT SMOKING,I'm still seeing my spirometry tests get better after 3 years, not to mention the cost and smell.  I used to think that people who complained about smoke in outdoor areas were kooks!  Guess what?  After a while it is annoying.  Good luck!

[little_weed]

Hauling 50lb bags of compost/mulch is what I'll be doing in a month's time! Gasp . . . Well, 80 litres x 5 pallets give or take a pallet! That's what is worrying me. Plus, on a hill on the South Downs. My lungs are cringing at the very thought . . . Just getting up the hill is a major operation!

You sound like you have a great positive attitude despite your difficuties. I know how painful osteoporosis can be; my mother was in a great deal of pain with it. You sound as if you have it all under control, even when it's not. It really is good to hear. Well done, you! If I could achieve a fraction of what you have, I'll be grateful.

And yes, I HAVE to quit smoking!
I saw the nurse tonight (in the UK we have NHS "Give Up Smoking" or "GUS" clinics) and she thinks that maybe the Champix will still kick in. If not, then it's Plan B . . . sew up my lips, and chop off my hands!

I think once I have had the CT Scan on the 2nd Sept, and seen the pulmonary specialist for the full story with all the test results, including the scan, I will be able to settle down, good or bad, and get on with it.

I am into family history etc and was shocked a couple of years ago to find that my Great Grandmother had died of lung cancer aged 54 (my age) Noone knew.
I suppose, like you, in the back of my mind, I am a bit worried that the CT Scan might show more than the emphysema damage. I know really that the scan is just for confirmation of the emphysema, but . . .

Thanks for your comments, deb, they've been a real boost.

[debbie58]

What really got me to quit smoking was back in 2006 I went into AARDS.  I was put on a ventilator.  The pulmonary Dr., who is still my Dr., watched over me in the ICU for a week.  They didn't think I would survive.  I did, but I definitely left hospital a non-smoker and so is everyone else who lives in my house.  If family and visitors need to smoke they can take out behind the barn.  Good Luck in quitting.  You will be so proud of yourself when you do, everything else will seem easy.  It's a difficult addiction to quit.  Deb

[little_weed]

Thanks deb58. You've put everything into it's proper perspective! I hope I do it before it gets too late . . .

Still. got the CT scan over with tonight, just wait now for the hospital appointment for the results, and I can get on with it with NO  more excuses, and hopefully nothing else going horribly wrong!!!

Thanks again x