Hello In copd patients , lung infections are common with infection of the layer covering the lung known as pleura causing pleurisy. She must had many hospital admission , due to pneumonia/pleurisy , recurrent infections can cause pleurisy Other causes of pleurisy could be tuberculosis , inflammatory pleuritis etc She needs steroid long term to suppress copd+pleurisy Right heart weakness is also common in copd , and pain can come in stomach area , so an echo is also required with autoimmune screeing Long term oxygen therapy LTOT with a machine used at night known as BIPAP can help alot , with chest exercises to improve breathing (physiotherapy) Potassium iintake can also make chest mescles improved , i hope x-ray doesnot have fluid in lungs Hope this helps