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Please help evaluate

Hi there,

The below information are for my 68 years old father regarding his COPD condition during May this year. The condition is severe but would like to listen for 2nd opinion from doctor in this forum.

FEV1 = Base : 0.88, %Pred : 33%, Zscr : -4.1
FVC = Base : 2.18, %Pred : 60%, Zscr : -2.8
PEF = Base 140 l/min, %Pred : 29%, Zscr : -4.3
FEV1/FVC = Base : 40%, %Pred : 55%, Zscr : -5.7
FEF25-75 = Base : 0.40 l/s, %Pred : 17%, Zscr : -2.1
FEF25-75/FVC = 18/s

Just started using oxygen concentrator abou 1-2 weeks ago. Now, he is on portable oxygen concentration to ease his oxygen intake, about 2 Liter. And patient encounter several problems such as cold sweat and strengthless as compared to previous month. Sometimes his hands are shaking while his performing activities such as writing as so. And he is feeling less strength on the feet as well.

He is on nebulizer with Combivent about 1-2 times a day, Spiriva, and Seretide medication. Recent CT scan indicate TRO bronchiectasis & confirms Chronic emphysematous lung disease with no significant bronchiectasis.

With the oxymeter that we have at home, patient mentioned the oxygen level at rest is 90-93 and when at exertion even with the oxygen supply it is at 85-88. Patient is concerned that the oxygen level drops consistently everyday.

What can be done to improve and prevent further deterioration and what is the worse outcome and what other stage that he will be going through that we as family should expect in future ?
Is there any way to relief his condition with a surgery or anything which can prevent him from using wheelchair and enable him to perform daily activities in future ? Right now even bathing also the patient cannot do own his own already.

Thanks in advance.

2 Responses
242587 tn?1355424110
MEDICAL PROFESSIONAL
The pulmonary function test  results are consistent with Severe COPD, compounded by rest and exercise hypoxemia (oxygen deprivation).  Your note indicates that your Father’s condition has changed, and not for the better.  This raises for me the possibility that the addition of supplemental oxygen may have led to the retention of carbon dioxide in his arterial blood.  It would be prudent to have his ABG’s (arterial blood gases) checked at this time.

Achieving “prevention” or slowing of his symptoms of decline might be possible with his participation in a comprehensive Pulmonary Rehabilitation Program.  I suggest that you discuss this with his lung doctor, if he already sees such a specialist, and if not, that arrangements be him to be seen in consultation by a pulmonologist, ideally one with an interest in and access to a pulmonary rehab program.

Your father appears to be on optimum medication.  One final note:  Severe COPD is often accompanied by heart failure and such failure may not always be evident, decline mistakenly attributed to the COPD.  You should ask his doctors about the possibility that heart failure may be a factor contributing to his clinical decline.

Good luck
Avatar universal
Hi doctor,

Thank you for your reply and advices.

May i know, by using the Oxygen Concentrator, does it lead to redness on palm and face ? My father's palm and face had some certain degree of redness, he thought he was taking too much of oxygen, so when this happens he would usually stops for a few hours then continue back.

And i also noticed his hair scalp are reddish white color as well.

Is this the cause of oxygen or carbon dioxide ?

Thanks.

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