Emphysema

[Supermomtc721]

My mother has been diagnosed with COPD approximately two years now. Due to her other ailments, I am primarily her caretaker. She continously gets pneumonia or a cold at least twice a year. Just recently, she has contracted what is believed to be infection in the lungs for about 2 months now. The antibiotics prescribed by her primary care physician doesn't seem to be working. She has an appointment with her lung specialist this week. She also suffers from edema (lower extremeties), persistant cough, and difficulty breathing (currently on oxygen throughout the day now). Are there any questions I should ask her doctor since this lung disease seems to be worsening? Is this a sign that there is nothing that can be done -T. Hayes-Turner (Bryans Road, MD)

[Davy9]

You will want to be aware of her heart health and fluid load. In the latter stages of emphysema the right side of the heart is presented with a higher than usual workload because of damage to the lungs vascular system. This can result in right sided heart failure (AKA cor pulmonale) and the edema you describe. In time it can also result in left sided heart failure and pulmonary edema.

This is all part of the failing of the lungs. They are central to the body and their function interacts and impacts other systems.

I am sorry to learn of your moms situation. It maybe time to consider the services of a hospice provider. Ask your doctor how he/she feels about her prognosis and whether hospice is appropriate at this time or not.

[lefdal]

My husband has had copd/emphysea for thirty years. He still smokes.Three years ago they said he had thee monts to live.

He has really gone down hill in the last 2 weeks. I can't find anyone to tell me if swelling of the feet & stomach is normal or any other things that might mean any little thing.

I feel so helpless, I take care of him, but being stubborn (Norwegian ) I don't do anything right, then he tells me thanks and "I love you")I think he is still too aware to have Hospice come in, he can still urinate by himself.

I hope someone out there will talk to me.

[Davy9]

lefdal,

It sounds as though you are in a real tough spot. I doubt if your husband will shift at all in his behavior. In fact at this juncture I am certain that some of his behavior is due to his emphysema. He is in the late stages of the disease. The swelling you noted is likely associated with heart failure related to his emphysema. If you can get him to a doctor they can try and help get rid of some of this excess fluid and might help out his heart status.

But, his anger towards you is abetted by his situation. He will get angry doing anything he considers unnecessary because anything he does at all makes him short of breath. I suspect he is just angry all the time. It is not you personally. Try not to take it personally.

What can you do? You can only do what he lets happen. If he doesn't want to see a doctor then don't press him. He will only get angrier and honestly no doctor will cure him anyway. I suggest that you let him do whatever he decides and try to stay away from his hot-buttons.

Yes, he will get worse but probably not much worse. At some point he will likely start becoming delirious and perhaps start hallucinating. Then he may become comatose and slowly expire. He could also suffer from a cardiac event and quickly die. His body is at its maximum limits and could fail in a variety of ways. But it is usually respiratory failure as I described, or a cardiac event.

None of this is your doing. I am sure that over your lifetime together that you made every effort to try and get him to follow a healthier pathway. He chose this one and he is still deciding how it will all be managed. You, unfortunately, get to deal with the consequences of his choices. Steel yourself for what is to come and prepare yourself for how to manage its aftermath. I wish you only the best.

[shannontoledo]

hello my name is shannon i am a respiratory student and i am doing a paper on emphysema and i am writing a paper on the patient and their families view point and how they cope with the disease process I would really appreciate if you can provide me with some informaition thank you [moderator note: e-mail address has been removed]

[jbrown]

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