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What Is The Cause And Treatment For COPD?

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Posted on Sat, 19 Apr 2014
Question: My friend was diagnosed w emphasma n COPD 4-5 years ago. Was a smoker at 16 n quit 4 yrs ago, he is 71 yrs of age In Aug. his left lung has a dark spot at the bottom, has never changed. Used to work in old buildings n has been exposed to lead but doesn't have Misothemia. He has a good heart the dr said. he was initially put on symbicort,, and all the usually inhalers. He has been extremely passive for the last 2 yrs, sleeping 16 - 18 hrs a day, his Dr didn't seem concerned. Last yr Dr put him on Pro Air , n XXXXXXX PressAir, when he was hospitalized w MERSA. XXXXXXX 21st2014 he had a total shoulder replacement, at which time he was put on 2lts oxygen 24-7. It's been 2 months, he takes his oxygen off sometimes for 1/2 hr, then he's very tired n winded. He does very little coughing n not much mucus. He is loosing weight since the surgery, about 5 lbs, isn't eating quite as much. I have been his caretaker for 8 yrs., I am 65 yrs old n have quite a few health problems of my own. He is considering getting the other shoulder done next XXXXXXX My questions are..... I know he will get worse, what level would you say he's at.....3...4 ? What can it expect next ? What would you say his life expectancy is, generalized? This is very important . I'm trying to decide when to go live w my children, that live in another state. His daughter needs to know whether she should transfer closer, she n I are not close.
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Answered by Dr. Arnab Maji (1 hour later)
Brief Answer: COPD and health status Detailed Answer: Hello, I admire your concern about your friend. Chronic Obstructive Pulmonary Disease (COPD) is a gradually progressive disease irrespective of optimum treatment and as per your history, I think, his COPD has progressed a lot probably in grade 3 or 4 that can be confirmly said only after some spirometric tests (Pulmonary Function Test) and risk assessment. If he falls in grade C or D of COPD his life expectency will be less with frequent exacerbations and hospitalisation. Another issue which is needed to be considered here is the presence of underlying co-morbidities which should be properly addressed. His left lung has a dark spot at the bottom which needs to be explored through computed tomography (CT) scan of thorax and if possible should go for fine-needle aspiration cytology (FNAC) and/or biopsy to exclude malignancy. I think probably he has grade 4 disease which can be told after spirometry and risk assessment and if it is then 3 year mortality rate will be around 20%. He may need long-term oxygen therapy. His daughter can transfer him closer because he needs some assistance all the time to lead life. Another issue is that he needs proper evaluation of his lung condition before shoulder surgery to assess the pre-operative fitness. Consult a pulmonologist (chest specialist) and go through proper evaluation, spirometry, risk assessment for life expectancy, mortality rate and co-morbidities and optimisation of treatment. If you have further queries you may write back to me. Thank you. Regards Dr Arnab Maji
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Arnab Maji

Pulmonologist

Practicing since :2009

Answered : 661 Questions

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What Is The Cause And Treatment For COPD?

Brief Answer: COPD and health status Detailed Answer: Hello, I admire your concern about your friend. Chronic Obstructive Pulmonary Disease (COPD) is a gradually progressive disease irrespective of optimum treatment and as per your history, I think, his COPD has progressed a lot probably in grade 3 or 4 that can be confirmly said only after some spirometric tests (Pulmonary Function Test) and risk assessment. If he falls in grade C or D of COPD his life expectency will be less with frequent exacerbations and hospitalisation. Another issue which is needed to be considered here is the presence of underlying co-morbidities which should be properly addressed. His left lung has a dark spot at the bottom which needs to be explored through computed tomography (CT) scan of thorax and if possible should go for fine-needle aspiration cytology (FNAC) and/or biopsy to exclude malignancy. I think probably he has grade 4 disease which can be told after spirometry and risk assessment and if it is then 3 year mortality rate will be around 20%. He may need long-term oxygen therapy. His daughter can transfer him closer because he needs some assistance all the time to lead life. Another issue is that he needs proper evaluation of his lung condition before shoulder surgery to assess the pre-operative fitness. Consult a pulmonologist (chest specialist) and go through proper evaluation, spirometry, risk assessment for life expectancy, mortality rate and co-morbidities and optimisation of treatment. If you have further queries you may write back to me. Thank you. Regards Dr Arnab Maji