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Had lungectomy. Have COPD. swollen feet and ankles. Taking lasix and losarten. Suffer breathlessness. Help?

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Pulmonologist
Practicing since : 2003
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thank you.............i am 82 years old. i had a lungectomy 9 years ago, and this left me with copd which is getting worse.....in addition, i have a stiff heart, with all the accompanying swollen feet and ankles, and swollen abdomen. i have been taking lasix for years, as well as verapamil..we recently added losarten.......i take spirivava daily, and ventolin for amergencies...........i try to exercise for an hour 3 times a week---but at this point i cannot walk more than i/third of a block w';out getting out of breath and having to rest............allo of this is getting progressively worse, and i wonder what else i can do before i have to spend my life in a whellchair....thank you for your help.
by the way, i have absolutely no energy, and even getting dressed is exhausting and causes breathlessness. thank you for your advice.

Posted Wed, 7 Aug 2013 in Lung and Chest disorders
 
 
Answered by Dr. Gyanshankar Mishra 2 hours later
Hi,
Thanks for posting the query on XXXXXXX After going through your query, I would like to comment the following:

1. You seem to have undergone pneumonectomy for emphysematous lung disease. Now you seem to be symptomatic with symptoms consistent with COPD with cor pulmonale.

2. Considering your age, our target of treatment should be to get an acceptable qulity of life.

3. You need to take inhalers / nebulisation regularly along with oral medications. Pulmonary rehabilitation programme can be worked out for you in consultation with your pulmonologist.

4. Long term oxygen therapy will really help relieve your symptoms. Also pneumococcal and flu vaccines need to be taken for prevention of infections.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: Had lungectomy. Have COPD. swollen feet and ankles. Taking lasix and losarten. Suffer breathlessness. Help? 12 hours later
thank you doctor XXXXXXX the lungectomy was for cancer-not a pheumological or emphysema problem....and i cofused the dates: endometrial ca---1990; lung ca---2004; ischemix colitis resection --2008; colon cancer resection 2009......i do take flu and pneumococcal injections yearly; and i do use inhalers --spiriva daily; and ventolin in emergencies......i had a clot post colon resection in 2009; and 'stiff heart' for which i am taking losartten is a newish addition to the menu...................i will discuss oxygen therapy w my pulmonologist---and i wonder if i am doing too much or too little exercise........copd is limiting as far as getting out and about is concerned---and ibs flare-ups are no fun either.....

is the stiff heart complicating my breathing as well, and what ought to be considered to improve matters in that area.......meanwhile, thank you again for your interest and concern.

sincerely,
XXXXXX
 
 
Answered by Dr. Gyanshankar Mishra 5 hours later
Hi,
Thanks for the follow up info.

1. As I have said in my previous post , your current symptoms are consistent with COPD with cor pulmonale (right heart failure). Since pneumonectomy places an additional workload on the remaining lung, it is natural for it to undergo hyperinflation or post pneumonectomy COPD.

2. If pneumonectomy was done for lung cancer , then a strict follow up is very important to rule out any recurrence. You had cancer involvement of 3 organs hence the possibility of metastasis cannot be ruled out at that time.

3. Yes, the stiff heart does add to the breathing work. A tailor made pulmonary rehabilitation programme can be of utility to you. Long term oxygen therapy will definitely help you. Also do get your arterial blood gas analysis to rule out any evidence of chronic respiratory failure.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: Had lungectomy. Have COPD. swollen feet and ankles. Taking lasix and losarten. Suffer breathlessness. Help? 16 hours later
thank you very much, dr XXXXXXX
 
 
Answered by Dr. Gyanshankar Mishra 18 minutes later
Hi,
Thanks for the appreciation.
Feel free to post any further queries.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
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