[kali]

My husband has numerous issues: COPD from smoking (currently a non smoker), radiation therapy damage to lung, bone marrow transplant recipeient, scoliosis and ankylosing spondylititis. He currently is receiving nebulizer treatment with xopenex and ipratropium for the COPD He is on numerous other prescriptions for possible graft vs host disease which can effect the lungs.

We are feeling quite hopeless at this point. No one doctor can agree where the lung disfunction is primarly coming from. It could be related to the radiation therapy damage, or the emphysema or the graft vs host disease related to the bone marrow transplant, or possibly the spine abnormality is causing lung problems, the ankylosing spondylitis also could cause breathing problems. No one knows.

So my question is this: the COPD is staged as mild at this point. He is unable to walk any distance without serious shortness of breath. I mean to walk from the back door to the car is a struggle (and it is not a long walk). If COPD is the main issue, how much should one expect the nebulizer treatment to help? He has numerous appointments this week with numerous specialist and we are hoping to be able to push for some "real" help. How much should any treatments help?

[Davy9]

Kali.... You're correct that your husband has many things that can contribute to his shortness of breath. Pulmonary functions tests are a series of breathing exercises on a machine that assesses how the lungs are working. They can measure a number of different things. They can conduct a PF test before using the nebulized medication and then conduct another once the medicine has taken affect. This will demonstrate any short term improvements the treatments can have.

They can also provide for him a peak flow meter to use at home. This is a simple PF test with but a single instruction and one value. It requires the patient to take in a deep breath and blow it into the meter as fast as they can. (There's no need to exhale the entire breath. All you're interested in is the maximum exhaled flow rate.) That one value will help him gauge how he is doing on a day to day basis.

Regarding his shortness of breath on exertion they can also conduct a study of him under work load. This will help to better understand why he is becoming short of breath and how to approach making that better.

Since he is on a number of medications be certain that they are all reviewed by a physician for any possible untoward interactions that might be causing some of his problems.

His situation sounds complex but medicine often treats complex things so it may not be as hopeless as you paint it. I hope this helps. Good luck to you both.