Tuesday, October 21, 2014
Pulmonary Fibrosis & Congestive Heart Failure
My 87 yr old grandmother was had fibrosis for 7 yrs. Last Nov she went on full time oxygen. Level 2 is where she started now at level 3. It doesn`t matter if you set on level 5 if she tries to walk. As her oxygen level drops to the upper 60`s. As long as she sits she can maintain 90% or better. She has the coughing,shortness of breath, and sleep disturbances already. She is down to 90 lbs. Her blood pressure jumps excessively high from time to time 200/100. They have told her there is nothing more to do. Memory if felling fast as she repeats and forget quickly. Are we looking at a few months? As we know her heart is working overtime trying to help keep up. Thanks,Caregiver
As patients get into a more advanced stage of pulmonary fibrosis, their oxygen level falls lower with less and less exertion. Low oxygen can result in memory problems as can a rising carbon dioxide level (which can also occur in advanced stages of pulmonary fibrosis). Frequently, hospice can be valuable in advanced stages of pulmonary fibrosis to assist with controlling the shortness of breath and insuring that there is sufficient oxygen to help relieve shortness of breath.
It is not possible to predict with certainty how many weeks or months an individual patient has left to live. The average life expectancy is 3-5 years from the time of diagnosis and generally, when the blood oxygen level falls with minimal activity despite supplemental oxygen, patients are approaching a time when initiation of hospice is appropriate. In general, we start hospice when we think a patient has less than 6 months to live.
James N Allen, Jr, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University