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Monday, March 10, 2014
AND (a natural death)???
My mother was recently hospitalized for shortness of breath and possible pnuemonia. After 2wks in ICU she was diagnosed with end stage pulmonary fibrosis. With her wishes we have not kept her on any machines to stimulate her breathing only an oxygen mask which allows her to breath. My mother breaths on her own inhaling and exhaling, she is maintaining a 96% sat. We agreed to comfort measures and she has been on morphine...so then my question is if the lungs cannot breathe and circulate needed oxygen why does she still breathe even though she is becoming unresponsive??? Her heart rhythems are relitively normal, so are her respirations and sat rate in high 90s...her blood pressure has been high and she is on meds for this and diabetes. It seems that her lungs are working and I dont understand if all invasive treatment has stopped why drs say there is not any hope??? Her start to finish of diagnosis was less than 4mos and her deteoration period lasted 1wk??? I am being asked to consider removing her oxygen mask and feel that this is part of at least "comfort measures" so that she may not have to suffer??? Have I misunderstood something ????
This is a complex problem and I may not be able to give you good advice without knowing all of the details. A good starting point would be to request that a specialist in palliative medicine or palliative care assist you. These are typically physicians or nurse specialists who have experience in these kind of problems. Speaking with a pulmonologist involved in your mother's care can also be very helpful in understanding all of the issues. In patients with advanced lung disease, it is often helpful to know both the oxygen level and the carbon dioxide level as the carbon dioxide level can be quite high even when the oxygen level is normal.
James N Allen, Jr, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University