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Bronchiectasis, COPD and Cor Pulmonale


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#1 Worried Daughter

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Posted 22 June 2007 - 11:22 AM

If you know anything about Bronchiectasis, COPD and Cor Pulmonale, I sure could use your help!!!! I have just found out that my mother has the following: Bronchiectasis, COPD and Cor Pulmonale. Now... since I do not fully understand the details surrounding each of these diseases as of yet, it is very possible that she does not have all three of these at the same time; I am not sure if perhaps one of these diseases may have "lead" into another, or perhaps one disease may have "morphed" into another (I am sure you know what I mean). What I do know is that my father advised me that my mother does have all three. I am leaving later today to fly up to New York so that I can take my mother to her doctor on Monday (6/25) to try to find out what is exactly going on (I moved away last year so that is why I need to fly up). It is very difficult for me to hear matters of this nature via "third party", I need to know for myself the "exact" parameters of my mother's present condition and I want to hear it from her doctor. The reason why I am reaching out to you today is because my mother's present state of mind... it is not right. I know that my dad said that the right side of my mom's heart is swollen and that this is causing a terrible lack of oxygen to her brain, amongst other things. Now... if my memory serves me correct, I think my dad said that my mom's oxygen "percentage" is at about 40% or below, but I don't even know what that means as of yet. Is this bad? Is this good? We both just don't know. Now because of the lack of oxygen to my mother's brain, my mother is convinced that there is nothing wrong with her. As per her doctor, my mom is supposed to be taking oxygen 24/7 and she doesn't, she is supposed to be taking medications for these problems and she doesn't. I find the fact that she will not use the oxygen she was given and that fact that she will not take the medications that have been prescribed to her, because of her present mental state, unacceptable. I believe that there has got to be some way to make her take her oxygen and medications - make her in a nice loving way, obviously not by force. I have tried to explain to my mom that she needs to use her oxygen to help her, I have even given her examples reciting quotes of hers that did not make sense, but whenever I mention it, she gets very mad and very defensive, very quickly. To try to sum up what I am trying to say is that this has all come to my attention in an extremely short period of time. I have been terribly upset over this (even crying every day :P ) as I love my mother dearly and hate to see her health literally deteriorating day after day. If there is any advise, guidance or suggestions that you could perhaps offer at this time that may help me on the journey that I am about to embark on, I would greatly appreciate you taking the time to respond to this post. Thank you.

#2 Guest_Serra_*

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Posted 22 June 2007 - 11:33 AM

Hello Worried Daughter,

It could be the lack of oxygen to her brain is what is making her irrational about taking her oxygen and other medications. My humble suggestion would be to put her in the hospital and have the oxygen and medications given to her to see if some kind of logic and reasoning returns. Getting the meds and oxygen into her system seem to be the major undertaking right now. She could improve significantly.

Best wishes.

#3 Dee

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Posted 22 June 2007 - 12:07 PM

Hi Worried Daughter,

I can understand your fear and concern and we will help you all we can. Someone will be along soon with more knowledge who will try to answer your questions..

God bless,
Dee
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#4 Worried Daughter

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Posted 22 June 2007 - 12:08 PM

View PostSerra, on Jun 22 2007, 12:33 PM, said:

Hello Worried Daughter,

It could be the lack of oxygen to her brain is what is making her irrational about taking her oxygen and other medications. My humble suggestion would be to put her in the hospital and have the oxygen and medications given to her to see if some kind of logic and reasoning returns. Getting the meds and oxygen into her system seem to be the major undertaking right now. She could improve significantly.

Best wishes.


Hey Serra,

I thought about that, but the only problem I have is getting her to/in the hospital. She doesn't think she has anything wrong with her, so how do you get someone who thinks they are health and fine to admit themselves to the hospital? See, I thought that if I could get her in the hospital that I could reach out to a Social Worker or a Patient Advocate and then I realy think I could get the wheels moving, but again I am backed against the wall re: how to get her to admit herself? Any advise?

#5 Worried Daughter

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Posted 22 June 2007 - 12:10 PM

View PostDee, on Jun 22 2007, 01:07 PM, said:

Hi Worried Daughter,

I can understand your fear and concern and we will help you all we can. Someone will be along soon with more knowledge who will try to answer your questions..

God bless,
Dee


Hey Dee! Thank you for your kind words, I can use 'em right now. :P

#6 Dee

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Posted 22 June 2007 - 12:12 PM

Worried Daughter,

Try to convince her to go just for YOUR peace of mind. Sometimes a person will do things for someone else that they would not do for themselves.
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#7 Worried Daughter

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Posted 22 June 2007 - 12:18 PM

View PostDee, on Jun 22 2007, 01:12 PM, said:

Worried Daughter,

Try to convince her to go just for YOUR peace of mind. Sometimes a person will do things for someone else that they would not do for themselves.


I was thinking about that also - manipulation. My son is 8 and is the only grandchild, I could use him as a "tool" as well since he is coming with me to New York, but again, knowing the way she is, I don't think she is going to go, but I sure as heck are gonna try!

#8 Dee

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Posted 22 June 2007 - 12:21 PM

I would like to add :

Try not to panic, you are doing the right thing by educating yourself about your mother's health. Knowledge will help make you better able to help her and your father.

Dee
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#9 Dee

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Posted 22 June 2007 - 12:33 PM

Worried Daughter,

I think I would have died rather than seek the medical attention I needed, but somehow, when I needed it the most, I let caring people help me out. The love and support of my family allowed me to believe that it would be alright to trust these people to help me and not be afraid any more.
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#10 Tim

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Posted 22 June 2007 - 12:37 PM

Dear Worried Daughter,

I wish there was more I could do for you right now and I fully understand
your predicament.

If you would like to read some clinical definitions on the three diseases,
I would be more then happy to post some information for you.

Jane is at work right now but will answer you post as soon as she can.

I can tell you that all three of these ailments can intermingle and exist at the
same time. The dementia that you speak of could be from the lack of oxygen
or it could be from something else. Only the Doctors will be able to answer
that one. But, I can assure you that if she needs the O2 24/7 and hasn't been
using it, you will continue to see a decline in her health. Most of the meds that we
are on are maintence meds and when we don't take them as prescribed, We go
down hill very fast. Exercise and a healthy diet are also very important. If she
is smoking.....She must quit.

Although there is no cure for COPD, it is treatable. If your Mother refuses to seek
help or wont let you help her then I'm afraid it won't be long until she will find
herself in the ER and being admitted whether she wants to be or not.
I hope that you will find some way to convince her to help herself.

We are all here to support you in any way we can.....We will keep you all
in our Thoughts and Prayers.

#11 Guest_Serra_*

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Posted 22 June 2007 - 02:08 PM

Hello again WD,

Seems like the doctor would be willing to admit her since she is not taking her medications and oxygen and then there is the dementia which may or may not be a result of the lack of oxygen and meds. Could you call her doctor on the phone and speak to him about admitting her for a short stay?

Good luck to you WD.
Serra

#12 Jane M. Martin

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Posted 22 June 2007 - 04:16 PM

Dear Worried Daughter,

The input you see here, from Tim, Dee, and Serra, is right on. They have been there and they know, to some extent or another, what it is like to be in the bed and not looking down on it.

Your mother can, indeed, have all three of those disorders at the same time and Tim is right, they are connected. Bronchiectasis is a form of obstructive (trouble getting the air out) pulmonary disease in which there are a lot of secretions that tend to collect in little pockets in the lungs and breed infection. The Cor Pulmonale is right-sided heart failure that can come with a long-standing history of COPD.

The Oxygen level you refer to is probably the Oxygen Pressure measured in a blood gas. If it is in the 40's,yes, that is low for an Oxygen Pressure and could easily cause confusion. The Oxygen Saturation that we get with the pulse oximeter on our finger is a higher number. We should be in the 90's. A person who is very sick might be in the 80's or even in the 70's. Both the Oxygen pressure and the Oxygen saturation readings are available in a blood gas (blood drawn by a needle out of the artery).

In addition to the symptoms you mentioned, does your mom have a bluish or grey tinge to her nose, her lips, or her fingers? Can she only speak in partial sentences, a few words at a time before she needs to take a breath? Is she using her muscles up around her collarbones to breathe? These are things that are very serious and are good cause to get her to a hospital. If her feet and ankles look puffy and you gently poke your finger into her ankles and feet, does it leave a dent where your finger was? If so, this is a sign of water retention and heart failure. Again, something that requires immediate attention for sure, if not a hospital stay.

I agree that your mom's confusion might be caused by lack of oxygen. Or maybe a CO2 (carbon dioxide level) that is too high is also a problem and that can make her want to sleep a lot and be difficult to arouse.

Serra is right about seeing if the doctor will admit her. It sounds like she's headed for trouble if she stays on this course and he should be able to admit her with some diagnosis that is accurate and covered by insurance. And yes, if she does not improve, she will probably end up going to the ER. Unfortunately, sometimes the urgent ER trip in the ambulance is the very thing that leads to the reality check that leads to patients to make a positive change. But we hate to see anybody get so sick that they have to go through that.

I hope this helps. Give your doctor the facts and put the onus on him to do what he can as a professional. You don't have to be the bad guy here. If you mom is really that bad, she needs medical attention and she, unfortunately, is no longer in a position to argue about it. The doctor can take being the "bad guy" who admits her into the hospital. I hope that makes sense. You're doing the right thing by bringing professional attention to these medical problems in your mother. Be in touch and let us know how it goes.

Jane

#13 Guest_Serra_*

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Posted 22 June 2007 - 04:33 PM

What is this about poking your ankle to see if it stays dented? Do you mean that the indentation stays there without rebounding and for how long?

Isn't the stomach swelling and poking out a sign of water retention?

This is a good discussion.
Thank you.

#14 Jane M. Martin

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Posted 22 June 2007 - 06:59 PM

Well, sometimes fluid builds up in the stomach, but the stomach can be distended for many reasons and those causes are beyond my scope. Sorry, Serra! ;-)

Now, please remember, all, this is very, very general information and not intended as medical advice.

Very generally, if a person's heart is not pumping as strong as it should, fluids can't get around the body as well as they should and they tend to settle into the "dependent" parts of the body. Our feet and ankles are at the lower part of our bodies and gravity can cause the excess fluid to settle there.

If you gently poke your finger on your ankle or the top of your foot for just a second, after you lift your finger, you should not be able to see where your finger was. If there is a visible dent in your ankle or foot where you poked and the dent stays there for a few seconds, that may be edema. This is called by health professionals, "pitting edema" because there is like a little pit where you had your finger. I know it seems very unscientific, but this is something that nurses check all the time.

It is not healthy to have that much fluid collecting in your lower extremities. It can also cause shortness of breath if fluid is in the lungs and pushing around the heart. Now, that is very very simple, but a good thing to know and something to discuss with your doctor.

Thanks for asking, and I hope this helps.
Jane.

#15 Trudy

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Posted 22 June 2007 - 08:11 PM

Hi Worried Daughter,

I've been thinking of you a lot of the afternoon and thought I'd check in to see if someone answered more of your questions. It sounds like you received a lot of great advice. I'm glad you stopped in here as this is such a helpful place to learn more about chronic lung disease and to receive support and understanding. I'm so sorry you're going through all this with your mom. It must be so scary, especially when you don't understand what it all means. I sure hope your mom will get the help she needs. Hopefully it will help once you get there to be with her. You will remain in my thoughts and prayers. Do keep us in touch on your mom's condition.

Hang in there!
Trudy





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