Sunday, May 19, 2013
COPD (Chronic Obstructive Pulmonary Disease)
Oxygen and COPD
52 year old Diagnosed last year with stage 3-4 COPD ( pink puffer- diffuse involvement) and nocturnal hypoxemia. (Guess when I sleep I go into the low 80`s sat wise) I always have been thin, Drs comment on my "small" heart size, very low blood pressure ( syst. <90) and low resting hear rate (40`s). I also have micro coronary arteries ( post angio) with no blockage.
Currently the fast check sats my pulm. does show sats >94 after I walk up and down the hall for a couple of minutes. BUT I can`t even take a shower without having to rest and have noticed I`m almost becoming house bound due to SOB shopping, etc. Yet the Pulm. does not want me on O2 during the day yet. question: 1) Because this has become so significantly limiting in my ADL`s why do they not want me to use O2 during the day? Occ. I have done so and usually can get more out of my life but I don`t like going "against" their recommendations. I just can`t ever get a good answer from my Dr. on this 2) Have noticed my BP is going up over the last few months and now average a systolic > 120. Because I normally was so very low my whole life on syst ( <90) this increase concerns me but everyone still see`s it as ok because medically its still within general normal range. My mother had PHT and I am afraid to develop this component. Does the increase in syst. raise any red flags? Thanks for any information.
Thank you for visiting NetWellness and for your questions. Only a health professional performing a thorough clinical exam is able to evaluate your symptoms and discuss your case specifically. You raise some important points to discuss here though and seem to have a good understanding of your disease.
We currently do not have any information from studies to show benefit for people with oxygen saturations above 88% with exertion. The reason is because there have not been any studies done to evaluate the effectiveness of oxygen on survival since the early 1980s. This question is currenly being addressed in the long-term oxygen treatment trial, but it will be several years before this is complete. Some people feel better with oxygen (even with normal saturations) because it helps with hyperinflation when doing activities or exercise.
Optimizing medical treatment with bronchodilators may help with this also. If COPD is well controlled and oxygen levels are lower than expected, then an evaluation for pulmonary hypertension or sleep apnea may be useful.
An increase in systolic blood pressure could be a sign of stress, worsening heart disease, or deconditioning related to more inactivity and several other causes.
Finally, pulmonary rehabilitation can help improve symptoms of shortness of breath, improve exercise tolerance, and assess your true oxygen needs with exercise.
Michael E Ezzie, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University