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“COPD: Chronicles of Survival” – is a raw and honest diary of a man who has been fighting for every breath for over 20 years. The author journeys from an active life to being tethered to an oxygen concentrator, sharing unique insights: from the technical nuances of medical equipment to personal trials of cutting-edge peptide therapies. This is a book about maintaining spirit when oxygen levels hit 77%, and how the love and devotion of family become the ultimate medicine.

Preface

We abuse nature with our emissions, and nature retaliates with a disease – COPD.

Back in my student days, one could pass an exam in Strength of Materials and then, just a day or two later, pass Philosophy. But when you are writing books, it is difficult to switch from philosophy to “strength of materials.” In my previous books, I shared stories that happened to me throughout my long life and wrote about those who were by my side. Much that remains unwritten in the form of stories will die with me.

I truly do not want to be nothing more than a meaningless photograph on a gravestone for my grandchildren. People do not die when their hearts stop beating; they die when the memory of them fades – that is when they truly turn into just an old photograph. But just as manuscripts do not burn, memory preserved in books does not die.

In none of my previously published books did I mention that I have been living with COPD (Chronic Obstructive Pulmonary Disease) for twenty-five years. Average readers aren’t interested in that; they want a gripping plot, not the author’s struggles. Moreover, twenty-five years of fighting for your life is not the kind of anniversary that relatives and friends come to congratulate you on. What kind of “anniversary” can COPD even have? It carries only a life sentence.

I thought about this for a long time and finally concluded that I was wrong! There is a target audience that is not looking for a twisted plot, but specifically for a description of my challenges – especially considering that COPD is the third leading cause of death worldwide, trailing only heart attacks and ischemic diseases. Furthermore, in the wake of COVID—19, the number of people with lung issues has surged. Such books often become bestsellers.

These readers do not need the digitized perspective of a doctor looking at a CT scan; they need the perspective of a fellow patient, expressed in friendly language. That is why I decided to write. I only regret that I did not keep an observation diary; imagine how much useful information could have been gathered over 25 years!

COPD is not a term for a single specific illness, but an umbrella term used to describe chronic lung diseases that lead to airflow limitation. It is not just a simple “smoker’s cough,” but an underdiagnosed, life-threatening lung condition.

Dear readers, COPD – especially in its late stages – is very serious and, above all, agonizing. If a criminal is sentenced to hanging, they are hanged, and that is the end of it. A COPD patient, however, is sometimes “hanged” daily. Usually, the ambulance manages to take the patient out of the “noose,” but only so that they might end up in it again the very next day!

I am not a doctor treating COPD. I am something else – I am a COPD patient with, terrifyingly enough, 25 years of experience. I am alive thanks to a naturally strong constitution and – I am not afraid of this word – the heroism of my wife.

Risk Factors

The primary risk factors for COPD include:

– Smoking

– Occupational hazards (working in harmful industries)

– Atmospheric pollutants (contact with harmful particles in the air, burning landfills, and smoke from large factories).

I fell ill during a time when Georgia was without electricity, gas, or water for 10 years, from 1993 to 2003. It was a terrible time. We slept fully clothed… and in 1998, I got sick. Naturally, considering I smoked like a chimney back then – smoking everything that produced smoke – it was one of the primary reasons for my COPD.

We must also mention heredity. I have read very little about this, and what I did find was often buried in convoluted medical jargon. However, I have something to say on the matter: both of my grandmothers suffered from asthma (since, just like sex, “there was no COPD in the USSR”). My uncle from Rostov also had lung problems, and my beloved niece (a Tbilisi artist) also suffers from bronchial asthma. And, of course, your humble servant suffered from bronchitis and pneumonia since childhood, usually enduring them on my feet… because my grandmother’s favorite phrase was “it will heal before the wedding.”

But… it didn’t heal.

Let’s Talk About COPD

I want to warn you in advance – my texts will likely not be peppered with medical terms. Of course, I could go online and write… “lung parenchyma” – the sponge-like tissue of the respiratory organ – but I think that after two or three such terms, my readers would scatter.

COPD – Chronic Obstructive Pulmonary Disease – is a life-threatening condition where the airways steadily narrow due to chronic inflammation of the bronchi or emphysema. This disease is not always diagnosed in time, which significantly increases its danger.

COPD is one of the most common chronic lung diseases worldwide, affecting more than 300 million people. It ranks 3rd among the leading causes of death globally, following heart attacks and strokes.

COPD comes in two types:

As you can see from the illustration above, these two types are not the same. I never heard a word about this from doctors. Therefore, I strongly advise you to determine exactly which type of COPD you have – even just by external signs – because different types require different medications.

I cannot say anything specific about the first type, as I suffer from the second type. With this type, you won’t see your ribs; instead, you might gain 30—40 kg and develop a “beer belly”. Fight excess weight immediately – excess weight is the ENEMY!

– Emphysematous Type: Characterized by an expanded capillary network, low body weight, and shortness of breath. The intercostal spaces on the affected side are retracted and sharply narrowed. There is a pathological expansion of the internal lung cavities, where tissues are unnaturally stretched and inflated. A so-called “valve mechanism” occurs – air enters the tissues easily but exits with great difficulty.

– Bronchitic Type: Characterized by a wet, productive cough not caused by other diseases. Increased body weight and a bluish tint (cyanosis) of the skin indicate a lack of oxygen in the blood.

I gathered my experience bit by bit, mostly through trial and error. This stands in contrast to doctors, who are often focused on impressing the patient with their level of electronics, abundance of terminology, gestures, and smiles. They listen only cursorily to the symptoms the patient timidly tries to squeeze out, and are happy to insist how lucky you are to have come specifically to them – because as a “professional,” it is nothing for them to defeat the disease in a couple of weeks.

One of these “Aesculapians” once told me straight out: I won’t sew you moccasins, but as for curing you… it’s as easy as pie. But time went by, and the money earned through my back-breaking real estate work began to flow from the pockets of my red business jacket into the pockets of this doctor’s white coat. I think that with my money, he paved the road from his house to the hospital with two layers of asphalt. He would have been better off sewing moccasins.

And here is one more small piece of advice: if your city hospital receives a complex diagnostic machine along with, let’s say, a saxophone – do not think that learning to operate that machine is easier than blowing a melody on the saxophone. It’s just that when someone lies to you on a saxophone, you will realize it – but when a doctor lies to you about a diagnosis, you won’t.

Always keep that in mind!

Ten Years Without Light or Gas

Tbilisi survived for ten years without electricity, gas, or running water. Starting in 1993, gas supplies to Georgia were cut off, and restoration only began in the late 90s. The central heating system was completely destroyed. Consequently, boiler houses as such simply no longer exist in Georgia – today, everyone has their own individual heating system, depending on what they can afford.

In that situation, people found themselves at the center of a terrifying experiment: “Try to survive without gas, electricity, or heat”.

Electricity in Tbilisi was supplied on a rolling schedule. Power was turned on during peak hours in the morning from 8:00 to 10:00, and then again in the evening when people returned home – at best from 19:00 to 22:00. After that, a total blackout would begin again.

During the winter, local power grids constantly failed due to overload. As a result, entire districts would live without light – and consequently without water – for three or four days at a time. People stayed warm and cooked food using kerosene stoves. Those who could not afford kerosene warmed themselves with firewood.

It was a common sight to drive home and see a city in total darkness: no street lighting at all, with only car headlights visible. Public electric transport – trolleys, trams, and the metro – often stood idle. Over those ten years, trolleys and trams vanished from the city entirely: the rails were sold for scrap metal, and the contact wires for non-ferrous metal. Hospitals faced blackout schedules of 2—3 hours, while shops and offices adapted as best they could.

Georgia lived in this mode until 2003, when Mikhail Saakashvili’s team came to power.

A quarter of a century ago, Georgia was left without natural gas and electricity. People lit bonfires on city streets, lined up for firewood, and transportation did not run.

How many “smokers” with weakened lungs like mine fell ill with COPD during that reckless decade?