Professor Tim McDonnell, consultant respiratory physician and HSE national clinical lead for COPD programme
Meetings or tutorials dominate mornings, for example, a multidisciplinary lung cancer conference or teaching junior doctors how to recognise the signs of chronic obstructive pulmonary disorder (COPD).
Awareness of COPD is poor — people think it’s asthma or chronic bronchitis or emphysema, but in fact COPD is a combination of the latter two. It’s a chronic lung disease caused by narrowing of the airways. Symptoms include shortness of breath, persistent cough with phlegm and recurrent chest infections. Smokers and ex-smokers account for 90% of COPD diagnoses.
As well as working on developing care and services to treat COPD, I do general respiratory work at St Vincent’s University Hospital and St Michael’s in Dun Laoghaire, where I carry out ward rounds and patient consultations. At St Michael’s, we have a COPD outreach service where nurses visit patients in the home, teaching them how to manage the disease. It’s effective in reducing hospital admissions.
I check in on our pulmonary rehabilitation programme at St Michael’s. It’s based primarily around exercise under supervision. People mistakenly belief they shouldn’t be exercising if they have shortness of breath. The eight-week programme gives them more confidence about managing the disease. I’m constantly looking at ways of expanding the programme into more primary care settings.
I run a TB clinic at St Vincent’s Thursday afternoons. TB is still a problem in Ireland, albeit a much lesser one. The rate of infection is a third of what it was when I qualified in 1979.
Some afternoons are spent working on service development with the HSE. I’m very keen to see more nurse-led COPD clinics. There’s a shortage of doctors, so it makes sense to train nurses. It also makes sense to train and equip more GPs to diagnose COPD, at the moment, less than 20% can access spirometry (a breathing test) needed to diagnose it. Patients with COPD can now avail of an app called the Volari COPD to help manage their condition more efficiently. It’s free to download from iTunes App Store and Google Play.
If I don’t have too many emails to answer I like to walk the dog. My guilty pleasure is watching soccer, particularly Glasgow Celtic.
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