Suggest treatment for emphysema and congestive heart failure

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Posted on Mon, 12 Jan 2015 in Lung and Chest disorders
Question: I have advanced emphysema and congestive heart failure. I have known this since 2007. My symptoms are now noticeable worse if not on a daily basis then at least on a weekly basis. I need to know, understand, and prepare for what the end of my life will be like.

I would like to add that I have suffered four MI's, have nine stents in place and almost passed away a year ago this month with a 100% arterial blockage on the left side of my heart. I do not anticipate these events to subside.

I would add that I am XXXXXXX do not use oxygen, but I am extremely short of breath and stamina.
doctor
Answered by Dr. Kaushal Bhavsar 39 minutes later
Brief Answer:
Chest physiotherapy and home oxygen is needed.

Detailed Answer:
Hello dear, thanks for your question on HCM.

With COPD (Chronic obstructive pulmonary disease) and congestive cardiac failure (CCF) your end may be sudden cardiac death at home or in the cardiac iCU (Intensive care unit).
The reason for this is compromised cardiorespiratory function.

With every MI (Myocardial Infarction) attack, cardiac damage increases and so functions are reduced. So pumping of blood will not be as efficient as previously.
This causes retention of fluids in body parts like lower limbs, abdomen (Ascites), lungs (Pulmonary Edema) etc. So to overcome this fluid retention, diuretics are essential part of management in CCF.

With chronic diuretic use, resistance tends to develop. In my opinion you may be benefited by spironolactone. Ask your doctor about it.

You can also start oral inotropic drug (digoxin). It will increase pumping function of heart.
You should also start chest physiotherapy and low dose home oxygen, as both will be useful in COPD and CCF.

By above things you can get more symptomatic relief. End of life is unavoidable, but we can definitely reduce the suffering and improve quality of remaining life.

Hope I have solved your query.
I will be happy to help you further.
Wish you good health.
Thanks.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Kaushal Bhavsar 30 minutes later
Dear Dr. XXXXXXX Bhavsar,

Thank you for your generalized reply. Now let's get more specific into end of life scenarios. I have always lived life on my terms. XXXXXXX Wallace is quoted as saying, "Every man dies, but not every man truly lives."

I live everyday on my terms, I provide for my family, and lastly, I have no intention of dying in a hospital. So please be specific as to what can/may be used to improve my quality of life and ease the suffering of death in my home surrounded by my family as my time grows short.
doctor
Answered by Dr. Kaushal Bhavsar 7 minutes later
Brief Answer:
Chest physiotherapy and oxygen at home.

Detailed Answer:
Hello dear, thanks for your follow up question.


Try to follow these for reduced suffering s.
1. Avoid too much fluid intake. Restrict it to less than 1.2 to 1.5 liters per day.
2. Start salt restricted diet.
3. Low fat and high fiber diet will be useful.
4. Chest physiotherapy and home oxygenation are also beneficial.
5. Avoid mental stress. Just create new environment surroundings you as you like.

Yes, you should live your life truly.

Hope I have solved your query.
If you are not having further queries, please close the conversation and rate the answer.
Wish you good health.
Thanks.
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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Answered by
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Dr. Kaushal Bhavsar

Pulmonologist

Practicing since :2008

Answered : 14628 Questions

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