Jake's Flea Market

As a male in my early sixties, I’m one of the twelve percent of thirty- five- to seventy- nine- year- old Canadians who’ve been diagnosed with Chronic Obstructive Pulmonary Disease (COPD). Alberta, the Canadian province that is my home, in the summer is exposed either to heat and smoke or to humidity with impending rain. In winter, the air becomes visible in below freezing temperatures; and strong winds shift snow, dust, and soil in all seasons. Alberta’s breathing isn’t affected by these triggers. Mine is.

I’m not the first in my family who’s had COPD develop in the lungs. My Grandfather’s breathing was wheezy, and I remember he whistled when he exhaled. Both my father and one of his brothers had hoses from oxygen tanks connected to their nostrils, and to some extent COPD contributed to their deaths. Though it hasn’t progressed to that severity with us yet, both my older brother and I are now afflicted with the disease. All this gives me the thought that there’s a family disposition toward the development of COPD. Be that as it may, a stronger case can be developed for the contribution of local air quality as a cause for the disease. The air we breathe— the wind brings pollutants that everyone is exposed to: Smoke from distant forest fires; exhaust from distant cars; toxins from distant industries such as farming, mining, and manufacturing. But where air quality affects one lung a little, it affects another lung more. The same can be said for a person’s lifestyle— one’s behaviors while at play or at work. While one person without a mask can work with toxic materials or in toxic environments a thousand times without injury to the lungs, the next person is damaging the lungs while spraying from an aerosol can, using chemicals to clean things, or while stripping and painting a fence. However much these other factors contribute to the development of COPD in a person’s lungs, the most prominent cause of the disease remains cigarette smoking.

In my reading I’ve discovered that anywhere from seventy to ninety percent of COPD patients are or were smokers. When I started smoking in the mid- seventies, a substantially higher percentage of the population smoked; and a greater percentage of people were exposed to second hand smoke. With the reduction of the number of people smoking now, there is a hope to be taken that COPD will be closer to eradication for future generations. I’d never regarded myself a heavy smoker: For most of the years that I smoked I had a three- quarter pack a day addiction. I don’t recall ever having smoked a full package in a day. Yet I know people who were heavy smokers— who smoked two packs a day, and yet never developed any lung issues. COPD isn’t determined by how much one smokes: I believe it has more to do with how the lungs are affected by smoking. Some lungs are affected less. My lungs happen to be more sensitive than the lungs of others. Now I’m dying of trying to fit in as a teenager.

I expect Chronic Obstructive Pulmonary Disease to be a part of the cause of my death when that time comes. On my last visit to his new office at on May 3^rd of this year, Dr. Henkelman told me in a more serious tone that the damage to my lungs was severe. I’d never considered myself to have a severe case of the disease: I’d said for years that mine was only a mild case. Before that most recent visit with the doctor, I hadn’t given much attention to how I was feeling and breathing: The feelings of tightness in the chest and the challenges with breathing were just inconveniences to be adapted to. I thought I’d feel and breath better later in the day, or in the next day or week. But after that diagnosis I began to be more attentive to how I was feeling and breathing. I realized that I’d been feeling, to a lesser or greater extent, a constant congestion in my lungs that hadn’t been there last year or prior to that: It might diminish, but it’s never completely gone. I also had to admit to myself that the uphill walks I was able to take last summer without stopping for anything— this summer I’m having to stop at every light standard to settle my breathing. The current severity of the damage to my lungs was emphasized by Dr. Henkelman’s bringing up the subject of a lung transplant and suggesting that I consider it. The COPD in my lungs has substantially progressed in the last year— it’s become that much more severe. It’s an irreversible and progressive disease. I don’t expect it to be cured, nor do I expect the challenges with breathing to get easier in the future. Nor should I have expected it to remain as mild as it was when it was first diagnosed.

Dr. Henkelman first diagnosed me with COPD when I was in my mid- fifties. I was referred to him by my family doctor, Dr. Jonker. After chest x-rays and spirometer testing, I went to the clinic Dr. Henkelman operated out of as a Pulmonary Medicine Specialist and Respirologist who practiced General Internal Medicine. That was the first time I was told I had COPD. The X- rays, the spirometer tests, and the consultation with the doctor have become an annual event; but this is the first time I hear that the damage to my lungs is severe.

The severity of my condition doesn’t stop me from browsing online job boards though. I want to work. I see security guard positions offered and I want to submit a cover letter and a resume. But I’ve already submitted cover letters and resumes to all those companies. I’ve had interviews with many of those employers and informed them, that because I have COPD, I’m looking for a job indoors that doesn’t require a lot of exertion. Those aren’t the kind of positions being offered. Many are looking for casual, on call staff: And all are looking for staff that can work in all conditions and walk for hours at a time. So, I don’t expect to find steady employment in that field. A couple of months ago, I started examining the job descriptions for other kinds of positions; I determined I could serve as a front desk agent at a motel, or in customer service somehow. I drafted up cover letters and resumes for those kinds of positions and delivered them to employers who were looking for help. I’ve had interviews for those positions too. I’ve been told that I should expect physical exertion to be required for those kinds of jobs too. Earlier this year, I had opportunities to work both as a security guard and as a front desk agent: I couldn’t meet the physical demands for either position. I’m having to accept that I’m very limited in what I can do with the experience, training, and qualifications I have. This year I’m far from the person I was— even the person I was last year.  

Fourteen months ago, I left a job at an independent living facility. In my five years there I’d been promoted from dish washer to server, and then from server to concierge. At the time I was working as a concierge eight hours a day, four days a week. But at the end of twenty- twenty- one the concierge position was eliminated: The facility was moving toward assisted living, and the concierges were replaced with RNs. I was offered a job as a server, but the last time I’d worked as a server I wasn’t able to keep up with the pace and the physical demands of the position. I declined the offer and resigned. In the fourteen months since I’ve been far less active. While I took a year to determine what I wanted to do next, and to take an ABST Security Course and First Aid to prepare myself for a return to the work force, I didn’t work. And during the winter months when I didn’t go out as much, I was more inactive than was healthy. Since the end of winter, unless the weather was extremely smokey, humid, windy, or hot, I’ve managed to walk for an hour most days. But I’ve gained some weight and a couple of inches around the waist, while I lost some of the conditioning I had. I believe inactivity does little to keep the progression of COPD at bay: And I believe a flu does less. Last fall, in October when I was telling myself I should get in and get my shots, I caught a flu. During the two weeks that I was ill, there were some days where I was severely ill. It seems to me that my breathing was better before the flu: And at the same time, it seems the COPD symptoms have intensified, and my limitations have increased since. I believe the disease progressed while I was sick: From the reading I’ve done on the matter, it’s in times of sickness that it gets worse. And with it being a progressive condition, sometimes it takes the mind a few months to catch up to that fact that it has progressed.

It seems to me that there are degrees of denial with progressive diseases. I’m still in denial of how limited I’ve become. Denial is the absence of acceptance, and without acceptance, there is no integration; there is no making this condition part of me. Part of me is sure that I can still live as I’ve always lived. I need a job to do that, and I want a job. Having a job is simpler and easier than going through all the hassles of applying for disability benefits. It would allow me to sustain myself and at the same time contribute to the community and the economy. As a person who’s alone in the world, having work gives me people to see, places to go, and things to do: It gives me a way of establishing and maintaining human connections.  But I’ve tried to do the kind of work I use to be able do and failed at it. I’ve become like the lady at Alberta Supports, who tells me there’s still things I can do: I tell myself that, and I ask myself, “What? What are you going to do Jake?” I don’t know. I don’t have an answer.