COPD - advice?

[AhAgain]

Hi

My mum has COPD. She is also 6 years clear of lung cancer (stage 2, 1/2 right lung and several chest lymph nodes removed) and 12 months of remission for Stage 4 lung cancer (mastectomy, chemo and more lymph nodes removed. She is a 78 year old smoker (not sure how many now - am guessing a packet a day, but really don't know, could be less).

She sees a respiratory consultant fairly regularly and has regular cancer check ups. But she gets very frequent breathing problems since the mastectomy and lymph node removal last November. During the Winter, early Spring and Autumn it just seems to be a bout of "chestiness" every 2 weeks on average. Treatment seems to be first inhaled steroids and - if that doesn't work (a lot of the time it doesn't) - then antibiotics. She gets supplied proactively by the GP with antibiotics, but seems to be chugging her way through a LOT over the past 12 months. She just seems to accept this.

Is this common? Is there something we are missing? Are there other things that we can do? I am constantly worried (apart from a scant few months break over the Summer - the chestiness was much much more infrequent).

Thanks.

[Idefix]

This sounds fairly typical, op and this must be hard to hear.

Your mum needs to take her inhalers regularly and not just when she feels chesty. It may also be worth asking for a supply of abx at home which can be stared the moment that your mum feels she is having an exacerbation.

Whilst she continues to smoke your mum is likely to be steadily getting worse in terms of her copd. It is never too late to stop smoking.

Exercise can be a really helpful strategy and it may be possible to get your mum referred for a pulmonary rehabilitation programme.

Nutrition is also important so that your mum has the strength to function everyday. Constant breathless can really impact badly on nutritional intake.

I hope some of this information helps you to make sense of what is happening.

[AhAgain]

Thank you idefix. Actually very useful to hear (that she is not completely abnormal...).

Will find out if she takes the inhalers regularly (and encourage if she doesn't). It sounds as though she takes the steroids only when things begin to go downhill... you are right that regular use may help (I used five asthmatic - fingers crossed, haven't had a problem in 7 years). She has a supply of antibiotics at home - so she can start a course as needed and not get them prescribed.

I have tried for many years to encourage her to give up smoking: I seriously don't think she will - I have given up really. According to her she "needs it". She has IBS and Fibromyalgia as well as COPD and Stage 4 cancer in remission, plus she is 78. She sees it as one of her few joys. Giving up makes 100% sense to me, but she is brainwashed by over 60 years of addiction. I will raise it again, though. Could giving up smoking have any negative side effects (reactions)?

Will ask about the pulmonary rehabilitation - sounds like a good idea.

Nutrition is a constant battle anyway (with the IBS), but I keep plugging it and stress that she needs calories, nutrition and weight/fat to keep healthy and strong (she is currently under weight I believe). When she feels rough, her usual reaction is not to eat.

[lougle]

It's never too late to stop smoking, but in terms of cost/benefit, at the age of 78 with stage 4 cancer in remission, half her right lung removed, with what sounds like pretty established COPD, I can see why she may come to the conclusion that the cost of giving up smoking won't be outweighed by the benefit to her health. It may well be more than she can cope with.

Could she ask the GP for a dietician referral? There are some very good supplements now, such as Forticreme that pack a lot of calories into a small volume.