COPD: A common condition, an uncommon level of care

John Mitchell has had lung problems since he was a child.

“I had pneumonia three different times between the age of two and second grade,” he recalls. “I also had asthma, and I’d get stopped up with pollens and dust, so I got used to having breathing trouble.”

But the 83-year-old has never let it hold him back. A pediatrician with a special interest in pediatric oncology, Mitchell practiced medicine for 35 years in Long Beach, where he established a busy practice until a massive heart attack convinced him to retire.

“I was the kind of doctor who saw kids in the office during the day, and went to the emergency room if they got sick at night,” he says. “If that wasn’t possible for me to do anymore — and my personal doctors said I needed to scale back — then I didn’t want to practice anymore.”

Over the span of his medical career, Mitchell saw almost 30,000 patients. He also devoted countless hours to raising money for kids with cancer.and for the March of Dimes. One of his proudest achievements was organizing a rubella immunization event during which, “We immunized 50,000 people in one day,” he relates.

Not surprisingly, Mitchell got bored doing “nothing” in retirement.

“I’d had a real estate license for years, so when I moved to Palm Springs, it seemed natural to make it my next career,” he says.

Mitchell had purchased a pied-a-terre in Palm Springs when he had his medical practice.

The desert’s dry heat isn’t best for lung problems

“It had been a way to get away from it all when I was practicing medicine,” he says, “so I decided to move here permanently in 2000. I thought the dry warm weather would be good for my lungs.”

But once Mitchell got to the desert, he started having more difficulty breathing. It turns out, he had chronic obstructive pulmonary disease (COPD).

COPD is a chronic condition in which there is a slow, progressive obstruction of airflow into or out of the lungs. The most common forms of COPD are chronic bronchitis and emphysema. Unlike other types of lung disease, COPD is most common in older adults. It’s the third most common cause of death in the United States.

Cigarette smoking and exposure to second-hand smoke are the primary causes of COPD — and Mitchell had been a smoker from the age of 15 until 2013. Other causes include air pollution, infectious diseases and genetic conditions. What’s more, people with asthma are 40 times more likely to develop COPD than those without the condition.

“But the heat made my coughing worse,” Mitchell says. “So I bought a small place in San Diego to escape the desert when it’s really bad.”

“Patients with COPD typically tolerate a drier climate better,” explains Justin Thomas, MD, Board Certified in Pulmonary Medicine, Interventional Pulmonology, Critical Care Medicine and Internal Medicine. “But the air quality isn’t very good here in the desert; it’s very dusty, with all the sand, and we also get airborne particulate matter from Los Angeles.”

Treating the doctor

Dr. Thomas began caring for Mitchell in 2014, after Mitchell’s previous pulmonologist had left the desert.

“Around that time, Dr. Mitchell had pneumonia and a severe COPD exacerbation,” Dr. Thomas relates (an exacerbation is an acute worsening, or flare-up, of COPD symptoms). “We treated him with steroids and antibiotics, an inhaler and nebulizer medications. He eventually recovered. We also got him involved in a pulmonary rehabilitation program.”

“I’m probably the worst patient he’s seen still walking around and breathing,” Mitchell says, chuckling. “But my symptoms and exacerbations stay pretty much under control if I do what Dr. Thomas says.”

Managing COPD

“Quitting smoking is the number-one most important thing people with COPD can do,” Dr. Thomas stresses. “The medications we offer can help improve quality of life, decrease symptoms and rates of exacerbations. But, their effectiveness is dramatically reduced if patients continue to smoke. They don’t improve survival but quitting smoking does.”

Other strategies to help manage COPD include staying up-to-date on flu and pneumonia immunizations, and treating other conditions such as sleep apnea and gastroesophageal reflux disease (GERD) that can increase the risk of exacerbations.

“It’s also important that patients with COPD are evaluated for cardiac risk factors since a lot of the symptoms for COPD are the same as for heart disease,” adds Dr. Thomas.

Despite the severity of his COPD, Mitchell refuses to allow it to limit him.

“I’m still working every day, and for three years in a row I’ve been in the top two percent of the 88,000 realtors nationwide in the company I work with,” he says. “I’m not happy about my COPD — it’s very aggravating and at times incapacitating — but not so much that I haven’t seen two houses and sold one this morning.

“I walk slowly and not for long distances, I sleep with supplemental oxygen, and I take my inhalers and nebulizer treatments,” he continues. “The regimen is working, and I’m grateful to Dr. Thomas for that.

“I love him, and I’d go see him even if I wasn’t sick,” he adds. “He’s kind, warm and friendly, and he talks to you as a friend, not just a patient. He practices the art of medicine, and he listens. Every doctor needs to be that way.”