Severe weakness

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Hi.  I'm looking for information and I hope support.  A friend who is now 81 was diagnosed COPD and Congestive Heart Failure 30 months ago.  He had gone to hospital thinking bronchitis or maybe pneumonia.  They sent him home with night time oxygen ordered.  In January this year he got pneumonia, back to hospital, they assigned oxygen 24/7, and he has been fine with that.  About 10 days ago in what I would describe as "out of the blue" he lost the ability to stand or walk for over about 15 seconds.  Truly collapses to the floor and must be helped up.  Off to hospital again where, against most friends and his doctors, he chose to come home under hospice care.  He now reclines on the sofa non-stop except for toilet use.  We are using a walker, and he hasn't the strength to walk 20 or so steps. He will collapse to the floor.  That severe weakness is very bothersome to us all.  Three months ago he was going up ladders.  Any thoughts or ideas or reassurance that he is normal would help.  Thanks.

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  • Posted

    This could well be late stage COPD and my understanding is that medical staff are very relucant to tell patients this.   If he wants to know what's going on either he or someone on his behalf will have to ask some direct questions.

    I'm sorry but I can't give you any reassurance except that although increasing weakness does happen in late stages of COPD I don't know if it results in collapsing to the floor, although it would seem possible that's the cause.

    However, a definite answer can only be given by his treating doctors.

     

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    • Posted

      Thanks for these thoughts, they mirror mine.  However, the speed this has moved is what has me so concerned. Fourteen days ago or so, he was relatively active for a person with COPD on oxygen.  Puttered about, did some paperwork, light housecleaning, light cooking.  Then he fell.  I guess two weeks ago today, and wasn't able to get himself up.  Fell isn't quite the right word, he slumped down to the floor.  Again later that day, and once the next.  But these falls were interspersed with being able to stand and walk short distancesof a few feet  Yes, he was diagnosed in 2013, and slept with oxygen since then, but he seemed to have certainly adequate if not better strength than one might expect.  It's the speed of the onset of this weakness that has me really confused.  Like he shot through Stage 2 and 3 COPD in a few days and is at Stage 4.  If he was masking how sick and/or weak he was from all of us, it could make sense, and he is stubborn enough to try to do that, but I'd be amazed if he managed it.  However, it would explain what is going on.  Our healthcare professionals are now the hospice team and they haven't known much about this recent concern.  He was in the hospital until Thursday night, came home, met with them Friday then off for the weekend they went.  I'll see them tomorrow.  And yes, although I am very concerned, I don't think this is something to bother them about.  There was only one instance between them joining our team and starting the weekend where he fell, and they didn't seem overly concerned.  Thanks for your thoughts, and any more you may have.
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    • Posted

      If he only came out of hospital on Thursday last, it could still be he is recovering from pneumonia and still has a lung infection, he is bound to have a deteriorated lung functioning, and could easily still be very weak which would account for him collapsing,  however he can recover from both pneumonia and lung infection and with care recover some of his strength and mobility and lung functioning.

      https://patient.info/health/pneumonia-leaflet

       

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    • Posted

      Thanks for this reply and the pneumonia leaflet.  I think the pneumonia and major infection is gone, but the remaining weakness isn't yet.  Some time will tell.  The next two replies are interesting, first one is from you.  Again thanks.
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    • Posted

      I'm now wondering if this is a case of muscle atrophy from inactivity:  leg muscles in particular lose their strength very quickly if someone is bedridden for as short a period as a week.   If this is the case, a physio could give him leg exercises to do while he's sitting and then gradually build up.   Just a thought, but he'll need to be the one to look into it himself
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  • Posted

    I wouldn't say this is normal of copd symptoms even in late stage, although people I have known in late stage copd had not reached 81 years.  Perhaps because of his age and CHF as well as COPD and recent hospitalisation, pneumonia etc. is the reason he was recommended for hospice care.

    Perhaps your friend has been told the reason why this is now happening but he just hasn't shared with you what the doctors have told him.

    Hard for any of us to say not being a doctor who has examined your friend, or seen his diagnostic results,  but at a guess and it would be a guess, I would say it may be something else other than COPD or a combination of health issues going on with your friend at this time.  The best persons to chat with about these recent problematic symptoms are his doctors, they may already know the cause and if not further tests can be carried out to determine what may be causing this.

    On the other hand if your friend has become so weak because of the pneumonia episodes and his muscles have deteriorated you will need to get some physio help through the GP to help him back to strengthen his muscles again. 

    Whatever the problem it needs identifying and treating wherever possible, if left he will likely deteriorate further, not just in mobility health but lung and cardiac health as well.

    Having said all that, the doctos and medical team have recognised he needs hospice care at home, so perhaps everything is already being taken into account with his care and his health needs at this time.  But for sure, for your own peace of mind and for your friends if he doesn't already know why his legs are now giving way, do ask for further tests to be done to determine why the muscle weakness in his legs.  You don't mention breathlessness, is he experiencing this also?  Does he go blue before he collapses etc,  all these things the doctor needs to be made aware of.

    Best wishes to you both

    V

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    • Posted

      Yes to extreme breathlessness when he is exerting himself, which of course includes these walking attempts.  Somewhere I just read about muscle wasting and copd, going to try to re-find that and study it a bit more. Doctors have pretty much washed their hands and he is in hospice care completely now, and they have just come to the table (Friday) so they are playing catch-up  Will obviously keep posting.  So glad I found this page.
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    • Posted

      I'm going to check that out too now you've mentioned a possible connection between muscle wastage and COPD:  I'd always assumed it was due to inactivity as a consequence of COPD, not to the condition itself (see my earlier post before I read your post above).

      I've known a few people with severe weakness and muscle wastage after they've been confined to bed for reasons other than COPD, but I guess as the condition progresses maybe our muscles get so much less oxygen they waste away?    I guess it's a possibility

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  • Posted

    I knew a guy who was 78 and had smoked all his life from the age of 17.  He had no problems and was out walking his dogs miles every day. 

    Then virtually overnight  he could barely walk and was incredibly breathless.   He was diagosed with severe copd and put on oxygen.   About 6 months later he was also diagnosed with lung cancer.  Within 10 days he had died. 

    I am not saying for a minute that's what your friend has,  but I told you this to demonstrate how in a few unlucky people it seems to progesss very quickly,  but I do think age has a lot to do with it.    A lot of people also ignore symptoms too putting it down to smoking and getting older.   So by the time they are diagnosed it is too late to do very much for them.   I hope your  friend stablises and has more years yet.  x

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    • Posted

      I think there is a lot of sense in what you are saying.  Thank you.
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    • Posted

      Of course I'm guessing, but I'd reckon it would've been the lung cancer which advanced so fast and not necessarily the COPD which is usually very slow and can take decades before it becomes terminal, depending of course at what stage it's diagnosed.
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    • Posted

      No.  He had a chest x-ray on diagnosis of copd and it showed no sign of lung cancer then.  He was diagnosed as severe copd and swore he had had no symptoms previously.  He packed in smoking on his copd diagnosis. 

      I know someone from another site who was a smoker but didn't know she had been diagnosed with copd 2 years previously.  She had no symptoms until she suddenly turned blue at work  one day and nearly died.   She was diagnosed with a 22% lung function.  She was told she had 3 months if she didn't pack the fags in and 3 years if she did.   She did straightaway.   She is now nearly 6 years past this date but her lung function has dropped to 14% now.  

      I agree it's not the norm for copd to progress so quickly but it can happen.  x

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    • Posted

      I had no idea COPD could present itself in that way and am VERY grateful I had symptoms which led to me being diagnosed in the early stages.

      I do wonder though whether some older people attribute symptoms of coughing, breathlessness and fatigue to "smokers' cough" or normal ageing, because I know a couple of elderly people who keep smoking no matter what with all sorts of self-deception about their symptoms.

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    • Posted

      Maybe.   I still smoke as you know but I certaintly don't suffer with self deception about my symptoms or my illness.
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    • Posted

      I had in fact forgotten that and it was a general comment, and true.

      Sorry to say it, but if you're still smoking with COPD you're addicted and self-deception is integral to addiction ...... not having a go at you, please don't think that, just pointing out something important.

      Again, not having a go at you personally, but it's the nature of self-deception that we don't always know we're doing it

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    • Posted

      Well my guy smoked years ago then slowed down to maybe a pack a week but only quit that with the first pneumonia diagnosis.  He's the sort who woulod keep going, chalking up various pains and coughs and shortness of breath to advanced age or " what can you expect, I'll be 80".  That sort of thing.  This makes more sense if he just stubbornly marched through what for most people would be stages 1 and 2 and maybe a good bit of 3.  Thanks.
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    • Posted

      Well that's his choice I guess: cutting down to even a pack a week after years of smoking is pointless anyway, it looks as if the damage was already done.    I'm in early stage COPD & stopped smoking a couple of years before diagnosis after smoking for almost my entire adult life, and even a small amount of other people's cigarette smoke affects my breathing now
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    • Posted

      No self deception about me so I am afraid you are incorrect there.   For me is it is the awful addiction of nicotine and the reluctance to go through hell to get off it.   It's purely physical not mental with me.  

      As an ex smoker it would be much more helpful to tell me I am strong enough to overcome it and promise to help as much as you can.   Finding flaws in characters hardly enourages anyone with an addiction does it?   I need support not judgement.

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    • Posted

      All later years of smoking less count as if still smoking the greater quantity for all those years -- at least that's what all the pumps in my area say.
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