By Edie Humiston
For The Independent

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Independent/Barrett Stinson Don Schmitt of Dannebrog, who has been dealing with chronic obstructive pulmonary disease (COPD) since 2005, must use an external oxygen source 24 hours a day, seven days a week to continue to breathe normally. Schmitt must also stay cool by running his air conditioner year-round. In the winter it runs to offset the heat created by his oxygen generator. Independent/Barrett Stinson Don Schmitt coughs while sitting in his Dannebrog apartment. A nebulizer sits to his right, and an oxygen generator sits behind his chair to his left. When he travels out of his apartment, Schmitt uses air tanks for the oxygen that sustains his life. While he spends a great deal of time watching television in the chair he is sitting in, Schmitt sleeps in the chair at left so he can stay upright. Independent/Barrett Stinson Don Schmitt¹s ³wheels to the world² is a three-wheeled scooter that breaks down to easily fit in the trunk of his car. A longtime auto mechanic, Schmitt fabricated a holder for his oxygen tanks on the rear of the scooter. Click Thumbnails to View

One of those 12 million is Don Schmitt of Dannebrog who was diagnosed in 2005 when he had a bad breathing attack.

"I couldn't breathe," he said. It was "10:30 at night (when) my son took me to the hospital. It was obvious I was in trouble. I've been on oxygen ever since."

Although COPD isn't contagious, it's also not curable. COPD is a serious lung disease characterized by airflow limitation that progressively worsens.

Symptoms of COPD are chronic cough, excess sputum production, shortness of breath, wheezing, feeling like you can't take a deep breath and feeling like you can't breathe.

"You feel very compressed, like someone's standing on your chest," Schmitt said. "Just hold your hand over your mouth and nose, and that's the feeling you get. When an attack hits, you feel very desperate, you sit down and you just gasp. It's a devastating feeling."

According to Dr. T. Hageman, of Internal Medical Center, every COPD patient has a combination of three processes: bronchitis, emphysema and asthma. Each patient has different amounts of each component but all of the components are present to some degree.

"Bronchitis, or airway inflammation, is swelling of the airways," he said. "Emphysema is the result when the support structures of the airways are destroyed leaving the airways 'floppy' and prone to collapse. Asthma, or airway constriction, is caused by the contraction of the muscles surrounding the airways."

COPD, occurs most often in people age 40 and over that currently smoke, or were former smokers. "

"However," Hageman added, "some people never get COPD despite having multiple risk factors, whereas other people simply live in a house with a smoker and develop it."

As many as 1 out of 6 people with COPD have never smoked.

Other risk factors that increases the odds for COPD include secondhand smoke, air pollution, history of childhood respiratory infections, allergies, asthma, occupational exposure to certain industrial dusts and pollutants, deficiencies of antioxidant vitamins such as C and E, and genetic mutations such as alpha-1-antitrypsin deficiency.

"COPD and coronary artery disease share a common risk factor in smoking and commonly coexist," Hageman said. "On top of coronary artery disease, COPD also can predispose patients to arrhythmias, pulmonary hypertension and congestive heart failure. Other problems include osteoporosis, depression and aneurysms of the aorta."

According to Hageman, a Pulmonary Function Test (PFT) is used to determine if a patient has COPD.

"During this test, patients are required to blow into a machine to determine how much they can exhale in a given length of time. The severity of the illness can be determined by this means as well."

Treatment for COPD varies according to each patient's symptoms and severity of the disease. Treatments are not to cure the patient, they only relieve symptoms and help the patient breathe more easily. They include bronchodilators, steroids, mucolytics, oxygen, antibiotics and surgery.

"The mainstay of treatment is avoidance of risk factors," Hageman said. "All patients with COPD should be advised to quit smoking, be educated about COPD and given a yearly influenza vaccination. In addition, the pneumonia vaccine should be given to patients who are 65 years old, or who are younger than 65 years with moderate to severe COPD."

Managing symptoms of COPD, not smoking, avoiding risk situations, eating healthy and exercising all help to slow the damage to the lungs. However, as the disease progresses, exercise and daily routines become increasingly difficult. It becomes necessary to make life as easy as possible.

"Your lifestyle changes a bunch," Schmitt said. "I went from traveling and being very active to 18 hours of rocking chair time. COPD curtails your activity a bunch."

Downsizing from his home in Grand Island to a small single bedroom apartment in Dannebrog became a necessity as his condition worsened.

"I can take care of it," Schmitt said of his apartment. "I'll clean about half a floor at a time. Then sit down and catch my breath, then go at it again. I keep everything to a minimum. You can do everything you used to, it just takes three times longer."

The air conditioner and fan run constantly in his apartment to keep the temperature cool and for air movement.

"I have to have air on 24/7," Schmitt said. "People think it's funny to come into my apartment in the middle of winter and find the air conditioner and fan on, but with this emphysema, you have to stay cool. If you get warm, you feel very, very uncomfortable. My oxygen generator will bring the room up to 80 degrees. So, I have the air conditioner on all the time and a big ceiling fan that blows on me continuously."

He realizes the seriousness of his condition but takes a straightforward view towards his illness.

"I smoked for a number of years, I've been a mechanic all my life, I did carpenter work a few years, I guess my lifestyle was a contributor to it," he said. "I've had a good life, I'm 71 years old, and I've been blessed with a world of friends."

Once lung damage has occurred, the lungs will not regenerate. Treatments for COPD will only elieve symptoms and help the patient breath more easily there is no cure for COPD. However, if a patient is diagnosed early, it provides an opportunity to slow the progression of the disease, and possibly, stop the damage from getting worse.