Exacerbation/Bi-pap

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Hi everyone,

My Dad had an exacerbation at the weekend which has landed him in hospital.

He is a c02 retainer and had spent the last couple of weeks trying to shake a chest infection. The community respiratory nurses did their best to avoid hospital with antibiotics/steroids/nebuliser but unfortunately his admission couldn't be avoided. (His last exacerbation was 2 years ago and he ended up in ICU).

I understand that a flare up like this will set him back a bit health wise but would like to have a better understanding as to what the future might look like.

He currently uses his Bi-pap machine 8 hours a night. Could this possibly be increased?

When speaking to anyone about COPD people assume that my Dad will end up on oxygen but that's not necessarily the case as he retains c02.

Does anyone have any experience they can share?

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    Hi Jo

    What you are asking is not something any one can answer accurately just from their own personal experience which won't necessarily be the same for your Dad.

    Your Dad was stable for 2 years that is a good sign, hopefully when he recovers from this recent exacerbation he can enjoy some stability for many more years.  To achieve that he would have to look after his lungs well and take medication as prescribed, avoid people who may be infected with colds or the flue virus, avoid smoke inhalation etc.  Awareness of the things that help maintain stability and avoid exacerbations are covered on a pulmonary rehabilitation course.  If you Dad has deconditioned he can ask for a referral to a PR course.  Information on this and much more can be found here on patient UK and also on the British Lung Foundation Website, if you or your Dad wish to read up on management of COPD.

    BiPAP (also referred to as BPAP) stands for Bilevel Positive Airway Pressure, and is very similar in function and design to a CPAP machine (continuous positive airway pressure). Similar to a CPAP machine, A BiPAPmachine is a non-invasive form of therapy for patients suffering from sleep apnea.  It is used when paitients are asleep to help keep the airways open and stop the back of the throat collapsing as the patient relaxes in sleep, so to use it through the day would not be necessary and the pressure would be fixed by the hospital, but you can ask more about this at the hospital or through your Dad's consultant at the hospital.

    My knowledge of BPAP is limited so there may be a way to use it during the day time.

    Oxygen is only prescribed for patients whose blood oxygen levels are low, this is determined by an arteriel blood gas test ABG, I expect the hospital would have done this if your Dad showed symptoms (going blue around the mouth) or if he was in distress trying to breathe.  Again you could ask your Dad's consultant if this test had been done.

    http://patient.info/doctor/pulmonary-rehabilitation

    Hope some of this information is of help to you.

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    • Posted

      Sorry that posted before I had finished.

      I wanted to say hope your Dad is feeling better soon.

      Best wishes V

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    • Posted

      Jo, so sorry about your Dad.  I understand and Vee is correct in telling you that what each of us with COPD experience is different.  What may be true for one is not necessarily true for another.  My last episode of Emercency CCU was in May and June of this year.  that was the third time in a year that I had ended up with Pneumoccal Pneumonia with Sepsis and Staff infection..  I have suffered from Bronchitis since a small child but being a long time smoker did not help my situation, it was finally determined by a lung saline wash, biopsies and multiple tests that my COPD was in a severe range.  I really didn't know whether I would make it out of the hospital and if I did for how long was very uncertain.  Since then, I have been tested over and over again, I have been equipped with more nebulizer medications than I use (because at present I rarely need the nebulizer)  humidity and heat will bring on wheezing at which time I will use the nebulizer.  My present problem has been headaches upon waking which seem to last all day.  They have done more testing spirometry, blood tests and twice in the last week have done an overnight pulseoxygen test that will test for the amounts of Oxygen and the exhaling of carbon dioxide I am giving off.  I am not intaking enough and am not expelling enough...so I have now been set up for them to bring in oxygen both a portable for use when needed outside of the home, and oxygen at night for sleeping.  We will see if this will help.  I have spent the summer swimming laps in the pool under water so that I have to wait til the end of my lap to expel and breath in.  It ha shelped energy levels tremendously, but those days are coming to an end, so I now must find something else to work my lungs and keep things in a state of continual workouts.  Your Dad may need to do the same thing...Find something that he needs and enjoys that will give hima workout but not exhaust him.  He needs to stay out of frigid temperatures and if he is in a cold area of this old world, tell him to wear a scarf around his nose and mouth which will help with the frigid temperatures entering his lungs.  stay out of congested areas....the best place for any of us with lung problems is a dry non humid area....the desert, but unfortunately that is not where our family is and family is very important to me.  I need to see my grandchildren grow into productive young men, spend time with our sons,  Tell your Dad to keep his faith, stay strong, exercise use his oxygen when needed.  Do not let him sit idle.  That is not good at all.  He needs to walk, I don't know his age but I am 65 and if he's gone 2 years without hospitalization that is awesome.  I pray I don't have to see another one this fall or winter.  I have now entered my 4th month without smoking and do not allow anyone in my home that smokes, has any colds, allergies, or other viral or bacterial infections.  When in doctors offices or hospitals I do not touch the triad area of my face eyes, nose and mouth....I do not allow shoes in my house...People must leave them at the front door and I leave paper slippers at the front in a basket for them to wear in my home.  they can slip them over their socks.  Your feet carry more germs than anything you can imagine.  As we walk in such awful places, streets, with pigeons, birds of all kinds, mosquitoes squirrels, rats, mice...you name it we walk all over what they leave behind.  So, use caution perhaps I am over cautious, but that is my choice.  I choose to live as long and healthy as I can.  It's each persons choice.  He must be proactive in his own health.  I know he is appreciative of all that you are doing for him.  Keep us posted on his health.  I am in the U.S.  and things are done a little differently than in other parts of the world.  Take Care.  God speed.  Breathless 

       

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