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Rock Street, San Francisco

My boss was on my back today about a deadline that I haven’t submitted yet. I have been on so much stress lately that I always sneak out back for a quick smoke. I’ve been sick on and off with this cold that I can’t seem to shake off for months now. I have been coughing for weeks and it makes me very tired and sometimes I have trouble breathing. I sometimes wheeze when I breath as if I have asthma and my chest sometimes feels a little discomfort as if a bear is sitting on my chest. There are times where I continue to try to clear my throat as I feel as if I have something stuck down there. I was out for about 4 days last week due to a slight fever. My wife recommended I go to the doctor today after work and even though I’m not the biggest fan of the doctors I decided to go with her. The doctor decided to make me go thru a series of tests. First, I got a CT scan and after I got my blood drawn to test for acidity and the amount of oxygen and carbon dioxide in the blood. They also gave me a spirometer to see how well my lungs are working. I had to blow really hard into this tube thing with a peak flow monitor that measured how fast air is coming out of my lungs. These tests really took the wind out of me, I was huffing and puffing for awhile after and my throat felt a bit sore. My wife joked that I was the wolf blowing the pig’s house down in that children’s story. Hours later the doctor brought us into his office. He told me that I had what was called chronic bronchitis. He carefully explained that this disease is caused mostly with the act of smoking that changes the lining of my airways, the epithelium and the structure of small air tubes called bronchioles. As a set of defense mechanisms, the lungs have physical barriers, coughing and other reflexive responses, alveolar macrophages, the mucociliary apparatus, and immune responses which are important due to the high amount of air that is inhaled daily. Some exposures however can overwhelm these defenses such as cigarette smoke that impairs mucociliary clearance, inhibits the role of alveolar macrophages and can cause hypertrophy and hyperplasia of mucus glands. The inflammatory response to the smoke involves the mucosal surface, submucosal glands and gland ducts. The immune cells associated with the inflammatory response, such as PMNs, T lymphocytes, macrophages and B cells, penetrate the epithelium, subepithelium and glandular tissue. The enlargement or inflammation of the mucous glands persistently occurs when damaged by smoke inhalation and the airway epithelial cells send inflammatory mediators in response to it. There is a buildup of excess mucus in the airway’s lumen that causes a chronic cough and a thick mucus layer in the bronchial lining thickens over time which narrows the airways so it is difficult to breath. This all made sense in my case since I normally smoke a couple packs a day. “How can I get this treated??” I asked him after listening to all of that nonsense words he had just thrown at me. He told me the best way to start was to quit smoking and start taking meds and using inhalers. Stopping smoking has been shown to increase chance of survival and improve symptoms. He said it was useful to go to pulmonary rehabilitation which’ll help the wellbeing of people who have breathing problems. With chronic bronchitis I am more susceptible to lung infections in the future. This disease is long-term serious condition and many viruses will be able to easily infect my bronchial tubes that are constantly irritated. The chance of a full recovery from chronic bronchitis is very low, especially if it is a severe case, but it is possible with an early diagnosis and if I follow instructions. Since people with this disease usually have trouble breathing and breathe fairly fast, the physical activity part of my life will be altered. Going to rehabilitations will aid in controlling breathing during activities and I will have to learn methods of breathing to help air get to my lungs smoothly. I laid in bed that night wide awake.This was going to be really tough. I’ve had buddies from college who have tried breaking the habit of smoking but they always ended up falling back into their old habits the second something in their life went astray. But I have to do this for my wife and for my kids. I slowly got up and went to my stash of cigarette cases in my closet. I carried them all downstairs into the kitchen and plopped them in the trash.Tomorrow I’ll sign up for pulmonary rehabilitation.I’ll get there. Just one step at a time.

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