Advice needed copd and heart failure

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my Mum is 72 yrs old and has suffered with asthma for the past 20 yrs. Six mths ago she was diagnosed with COPD and congestive heart failure she was started on oxygen for 8hrs a day but was still able to have a reasonable quality of life. The speed of her deterioration is frightening she is now on oxygen 24hrs a day, is unable to walk or stand unaided, dress herself or go to the toilet as she seems to have become claustrophobic and is now having to use a commode. A district nurse visits 3times a week to change her leg dressings as fluid drips from her legs constantly.She wont talk about her prognosis and refuses to tell us what the doctors have said so we have no idea at what stage her illness is at. I wondered if anyone had any advice will she continue to detoriate and is there any improvements that can be made.

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  • Posted

    Paula, I'm afraid it does sound as if she'll continue to deteriorate.  Only the doctors will know what's can be done for her at this stage.

    Do yuou have a family doctor who could maybe persuade her to talk to her family about what's happening to her?  Or the district nurse who's already visiting her?

    That's a very painful situation you're in and I feel for you.

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  • Posted

    Thank you for your response my mum is now house bound and has for some reason lost her voice and is only able to whisper not sure if its connected to her illness or not. The nurse visits during the day whilst im at work and my dad is in complete denial so refuses to believe she will not get better. When recently hospitalised she was advised to speak to the family and to sign a DNR but she refuses.My Dad  has become a nervous wreck through exhaustion as he can no longer get her to the stair lift and they are both sleeping in armchairs as she refuses to let me lift her to it. Im not sure whether her doctors would speak to me without her permission.
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    • Posted

      Ethically the doctors probably couldn't talk to  you without her permission.  It seems to me that both your parents are in total denial of how ill she is and you're the only one trying to deal with reality.

      However, you can't do that if they obstruct you at every time:  are you able to focus on doing what you can for your mum in the time she has left.  Don't try and do stuff she doesn't want anyway, it won't hurt either of them to sleep in armchairs, I do it all the time and increasingly more often.

      Maybe she doesn't have enough energy left to speak any louder than a whisper?  Just a thought ........

      Take care of  yourself Paula, it sounds as if you're focussing away from yourself too much for your own wellbeing.  Concentrate on what you can do and let the rest go if she doesn't want it

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  • Posted

    Hi Paula, I am sorry to hear that your mom is having to go through this. From what I understand, congestive heart failure and copd, is when the lungs are not producing enough oxygen to meet the hearts needs. When the heart does not have the required oxygen, then the lungs begin to fill up with water. Then the heart failure begins. Usually they will use Lasix to rid her lungs of the water buildup, and possibly if her abdomen, legs, feet, etc. have water (edema) in them, it will help rid the water in them too. But, must be very careful using Lasix or any water reducing product, since dehydration is hard on the heart too. It is a good idea to keep her totally of salt due to water build up. Also, her claustrophobic, could it be she is suffering from panic anxiety attacks? It is probably good to keep her on a potty chair so her urine can be inspected, while pouring it out into the camode, just in case she develops a bladder infection too. It is difficult to walk, get out of bed, dress, stand alone, etc..this is due to having weakness to (stressed out) heart tissue making us weaker. and also copd's lack of oxygen making us weaker. 

    I had gone through this, but my heart failure was one that is 100% reversible. This was how they discovered I had copd. I had to go to the hospital three times during a Fall season, the first time was for 2 weeks due to heart failure, and, the second time was 2 weeks due to heart failure and copd, and, the third time was 3 weeks due to heart failure and copd. When I read about your mother, it reminded me so much of myself after I was home alone! I couldn't do anything, and my fears were sky high...afraid and suffered panic attacks all the time. 

    The best thing I did was try to walk about ten feet back and forth and for as long as I can, then sit. It can be very scary, since the heart will beat fast, and sometimes will not slow back down on its own...this is due to lack of oxygen, since when we walk the heart gets starved again, since oxygen goes down. It is very important that she wears oxygen when walking or being active.

    If you could, it is best to put her on a Recumbent stationary bike, or, join Re-hab, since this will build up muscles in her chest so her lungs and heart will become stronger. I went to re-hab and the respiratory techs were wonderful in giving me great education and exercise (sitting type machines with no resistance)..they taught me many things to do while at home in order to strengthen my lung muscles small and large.

    I didn't go to re hab for about one year, so had to manage everything myself with the help of my family. Look up 'Purse Lip breathing" online, and, "diaphragmic breathing"...try to get her to apply these two types of breathing in her daily schedule for a start. I use to do both of these through out the da. Also, I did an exercise, where I began walking in place, with a chair directly behind me. I pretended I was walking on a treadmill. I would walk for one minute, then sit down for another minute, and do it over again, and again...beginning with one minute intervals only. I added more minutes as I got stronger, but over a long period of weeks, I could only manage up to six minutes, but must be very careful with her, go very slowly, due to her heart condition plus the copd. The copd will cause lower oxygen when walking which can conflict with the heart, so best to go very slow. To check her heart beat and her oxygen saturation, purchase an 'oxymeter' at your local drug store. Also, eat lots of salad and fruits and take multi vitamins, and my favorite one is 'fish oil' in capsules (one a day). 

    I still can't walk too far, but physically, I can do a lot more, and feel much stronger. My family can't believe how far I've come, and claim that I have greatly improved, but the getting up out of the wheel chair, and doing things such as using a rollator instead of a wheel chair, and also doing various exercises, and eathing healthy, has greatly helped me. I use to panic a lot, but that has decreased, since I have become more confident that I can do things due to inner strength (over time), and also due to the heart healing and becoming stronger.I love how the exercises (breathing exercises plus physical exercises) have greatly helped me gain back my strength (and lungs feel much better too) that I purchased a used Schwinn's Recumbent stationary bike for myself and go on it five minute intervals (without resistance). 

    I hope this has helped! Please keep us updated about her!

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  • Posted

    morning Paula! It's a very complicated & awkward situation your living with right now I'm  afraid to say but it has to be said it  seams from what we are reading here that your Mother must be in the late stages of this horrid disease I could be wrong but sometimes some people with c.o.p.d can deteriate quickly especially if they have other conflicting health conditions witch will contribute towards the progression of this disease unfortunatly! I'm sure the district nurse could point you in the direction towards getting some further support to help with your Mother! I would think so or perhaps a local hopice could help in how you can get some extra support at home Im sure there must be, I hope you can get some much needed help I hope so, mean while don't forget your self either please take care! 
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