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Thursday, May 23, 2013
COPD (Chronic Obstructive Pulmonary Disease)
My dad has COPD...How do I deal with it??
Hi. I have some questions about COPD. My dad has had it for a while. He just hasd`t told me until the doctors told us he was in the FINAL stages of it. I didn`t know there were stages. He has ATTACKS all the time. We went back home in July (I live out of state) and the doctors wanted to admit him to the hospital, but he wouldn`t go because we were there. He has been in the hospital for 3 weeks now. He got moved to ICU last night after they were going to discharge him. How can he go down hill so fast?? He wears a BI-PAP. I don`t really know what that is either. His nurses told us last night that it would be a miracle if he would make it through the night! So I talked to him, meaning they put the phone to his ear but he couldn`t talk back. He is fighting so hard and is so tired. How does all of this happen? I feel lost. We have until 5:00 today to see if he will pull out of it, or they want to give him morphine to make him comfortable and let him go. Is he really suffering? I don`t know. I`m not there. He wanted to talk to me this morning to hear my voice again, to tell me he loves me and he is very very proud of me. Is this the way he is trying to say his goodbyes to me? Thanks so much I just feel so lost and don`t know where else to turn when I am so far away.
You are in a very difficult situation, and this information is very late in getting to you.
We use the GOLD criteria for staging COPD. It has four levels:
- very severe
These are based on Pulmonary Function Testing (PFTs) which show obstruction (FEV1/FVC ratio of < 70%) and how much a person can exhale in one second. Patients with severe disease frequently develop cough, phlegm production and shortness of breath. As the disease progresses those symptoms get worse and patients often develop fatigue and weakness. An acute exacerbation (worsening of above symptoms) can occur with minimal warning. This can be triggered by viral or bacterial lung infections, pollution or unknown causes.
BIPAP is a type of non-invasive ventilation which gives both inspiratory and expiratory (bilevel) positive airway pressure and can be used to help patients who have CO2 retention.
It sounds like your father is in very capable clinical hands, and while he is "fighting hard and tired", I am sure his caretakers are/will do everything they can to make him comfortable.
Gretchen Whitby, APRN
Nurse Practitioner of Chronic Obstructive Pulmonary Disease
College of Medicine
The Ohio State University