Like a Fish Out of Water
The Reality of COPD by B.J. Hoilman 

Like a fish out of water.......how many times had I heard that one, before I really understood what it meant? A fish out of water cannot "breathe" and cannot long survive. A fish out of water..............that is me. No kidding, it really is. Because of my own diseased lungs, the very atmosphere I am breathing feels alien to me, just as our oxygen rich air feels to the gasping flounder, who is trying desperately to "breath" in an alien world, out of it's own environment. 

I have COPD and daily face the realities of the disease. I am also a fisherman (actually, fisherwoman, in this case) By the way, contrary to popular belief, there is no difference in the sexes of fisherpeople. They all are characterized by the same uncontrollable urges and longings. They all sport the corniest little hats that either heap high praise on ocean denizens or exaggerate their own fishing prowess. And their eyes all have that same perpetual glaze between the months of April and October. 

Anyway, fishing has been one of the loves of my life. That and my family and nursing. As a young nurse, I worked long hard hours at a major medical center hospital in Winston-Salem, NC. It was tough work......dealing with life and death issues every minute of every day. It took a big toll. Had I not had fishing as my "stress relief", those years would have been much harder. I had every other weekend off, and every time I could, away I would go.........to the coast.....just a rod and reel, a tackle box, and a change of clothes. I would have two glorious days fishing and then drive the 225 miles home, and back to work by Monday morning, relaxed, smiling and ready to face the world again. 

I often go back in my mind to that young woman, working her first night as a new Registered Nurse. I will always remember one of my 10 patients that night. He was a man who had COPD and he was dying. I remember how I struggled to keep him as comfortable as possible, and how hard that was to do. I remember how, that very young woman, just realizing we all eventually get something, made a silent plea, "God, when it comes time to pass out my disease, please whatever you do, please don't let it be LUNG disease." But that was, in fact, what I got..........and it started when I was only 40 years old. At first, I didn't pay too much attention to the mild shortness of breath. It was very mild and I put it down to getting older, to all my allergies and to smoking. So I quit smoking. Simple, right? No, the reality was, the shortness of breath still got worse. And the other realities of COPD began to make themselves known to me. The reality is that you eventually lose almost every part of yourself, one piece at a time. I know that sounds pretty dramatic. But I don't want you to take me wrong. I don't have time to sit and whine about this, or I will not survive long. As the shortness of breath increases, you incur more losses. I have had to learn ways to deal with these losses, and have tried to make sure they are not complete losses. For each thing I lose, I MUST learn a way to cope, a new way to be. And I must accept the new person I am. I have no options. 

The reality of COPD is that you eventually lose: 
  Your Independence: You are no longer able to independently manage    your life. 

  • Your Self Confidence: You must realize you have lost the ability to do many things you once could do easily. 
  • Your Body Image: You don't even recognize the person in the mirror, after years of medication that weakens muscles and overhaul your body into something quite different than what you recognize as YOU. 
  • Your Occupation: In most cases, you have to quit work, simply unable to keep up with the physical demands. 
  • Your Mobility: Big one. Your mobility decreases, usually gradually, but surely. The shortness of breath and weakness see to that. 
  • Your Hobbies: You often lose the ability to participate in hobbies which had been a big part of your life. 
  • Relationships: You don't lose all your relationships, but you may lose some. There are always some who either cannot or choose not to deal with the realities of COPD with you. 

And perhaps the biggest and most important you lose your innocence. You suddenly know the ways of the world..........the realities. 

The above list looks like dry words. Wonder what it really means, on a personal level, to a woman who is 50 years old? It means I now struggle to walk a few steps with a cane. It means that one year ago, I had to quit my work that I loved, so severely limited by increasing shortness of breath, that I could no longer keep up with everyone else. My condition has steadily declined over the past year. I know what this means........I am a nurse. And I am a realist. But I am not a quitter. Many days I suffer with each breath. If you think gasping for breath is not a form of pain, lets just look again at the definition of pain. I am often in pain. But I don't dwell on it more than necessary. I don't talk about it too much. I want to maintain some sort of dignity, and this is my way of managing that. It is one loss I can try to prevent. 

I joined a COPD group on-line. It provides a lively forum for discussion and sharing of information. And it provides emotional support through friendships formed there. I spend a lot of time exercising my mind, since my body will not cooperate. 

Winter has gone and spring has come once again, and I am still here, thanking God that I am here. My goals are different now. I no longer make plans for age 60. I now pray to live long enough that my grandchildren will remember me. I hope to waken tomorrow. And I am truly thankful for each day. 

My grandson, Corey, spends a lot of time with me. I am so grateful that this little boy can love me so much, even though I am weak and unable to run and play. So, I try to give him other parts of myself that I hope he will carry through life.

I teach him about the beauties of the world, and how to enjoy the outdoors, and how to plant and tend a garden. I find him too, too aware of the limitations that my disease inflicts on me...........I find him aware of things a 5 year old should not have to know. Noticing my breathing become wheezy and labored, he gets my inhaler and says, "Grandma, sit down and take your medicine. You need to take your medicine." He carries grocery bags that I am not able to handle at all. He worries when he senses my breathing becoming more labored....."Are you OK, Grandma?" He routinely says things like, "If you are here when I am 7 years old," ............etc. He knows the reality of COPD, more than many adults. He knows more about the reality of COPD than I would like, but since he is so close to me, he lives with it, as I do. 
 

Last night, I dreamed I was standing on warm, wet sand, casting my line to the surf, and for awhile, I was strong again. For awhile, I was limber and mobile and happy and free hearted as I had not been for years. I reveled in the feelings.........until I woke............to find myself still a fish out of water. But that dream remains a part of my existence. I won't let it be a source of sadness to me. I can't give up dreams just because they hurt a little. In spite of all the realities of this disease, I will hold to the dreams. For they stem from a part of my reality that still exists apart from this disease. They are a part of my wonderful memories. And so, they are a part of me. B. J. Hoilman April 1998 bjflounder@aol.com