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C.o.p.d. Final Stage

Disability Insurance News & Discussion

C.o.p.d. Final Stage

Postby Raedmund » Sat Sep 13, 2014 11:25 pm

My husband has had COPD for a number of years.  He was hospitalized in May with pneumonia(3rd time in the last 5 years).  He is currently on home health care, has been on oxygen 24/7(3.5 liters)for the past 3 years.  X-rays and tests show that he only has 19% lung usage.  He has lost an additional 5 pounds since being released from hospital(weighs 111 and is 5'10") He has started sleeping most of the day now, gets confused at times, but rallies if someone calls or visits.  His oxygen levels fluctuate between 91-96; heart rate elevates with the least bit of activity(143). He is in denial, does not want to sign a "DNR" but we do have living wills.  In your professional opinion, do you think he is in the final stage?  Thank you, Barb
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C.o.p.d. Final Stage

Postby Zebulun » Sun Sep 14, 2014 2:44 am

Hi Barb and thanks for writing,

It certainly sounds like your husband is in a very advanced stage of COPD and may be nearing the final stage, although everyone’s experience is different and some folks remain in the ‘final stage’ for many years while others succumb much faster. This is very general and may not be the course your husband follows, but I can tell you how an average COPD patient may proceed towards the end of the disease.

Basically the COPD deprives the body of oxygen and the patient becomes short of breath, tires easily and will rest more and more as they grow weaker. You are already witnessing this as he tires quickly when he exerts himself even a little and his heat rate increases rapidly. Occasionally Blood Transfusions will provide temporary relief if the Haemoglobin falls too low; low Hg can also cause Angina(chest pains).

Eventually he may be so weak he won't want to move around too much and may stay in bed or sit in an easy chair most of the day; just washing and dressing will be exhausting. People with COPD often lose their appetite due to decreased energy so it's a vicious circle: low oxygen causes low energy & weakness which decreases appetite, and decreased appetite leads to weakness(hence the weight loss you have already observed).

Treatment is generally "Comfort Measures" like Oxygen to ease shortness of breath, maybe some medications to ease the heart's workload, and some puffers to open the airways, but it's not typically aggressive treatment as COPD is progressive and irreversible.

In the end the patient is often weak and bedridden and simply slips away quietly after a slow peaceful decline. The patient will feel weak and will be short of breath after exerting themselves, but do not "gasp for breath". Low oxygen levels can cause confusion though and occasionally the confused patient can become agitated. The most common symptom of COPD is Anxiety related to feeling of not being able to catch your breath – doctors often prescribe anti-anxiety medications such as Ativan for their COPD patients, but use these only as required as these medications are sedating and can increase weakness and increase the risk for falls in the elderly.

I hope this has helped to answer your questions and I wish you both all my best; please write again if I can be of any more assistance.

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