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Suggest treatment for severe pulmonary hypertension

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Posted on Wed, 20 Jul 2016
Question: I just left my husband in a nursing home, after he spent a day in the hospital. He has last stage COPD, atrial fibrillation, "severe" pulmonary hypertension, severe hypercapnia and fluid overload. He is 78 years old and is quite confused. He fell about 3 weeks ago and got a compression fracture of a thoracic vertebra, then fell again 2 nights ago and could not get up because of the pain. He has been losing bowel and bladder continence for about a year. There are many other more minor incidents and ailments I won't go into. The doctor suggested the nursing home to see if he could regain enough strength to go home. He said if, after 1-2 weeks, his breathing had not improved, we would have to consider Hospice.

Knowing my husband as I do, I believe he has only weeks, not months or years left. There is no realistic hope that this new breathing machine (a step above a bipap) will improve his breathing to any useful degree. I realize you don't have the figures or results of various tests, but I wonder if you would generally agree with my estimation of his remaining life.
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Answered by Dr. Divakara (42 minutes later)
Brief Answer:
I feel he may pull upto 1-2 months.

Detailed Answer:
HI

Thanks for posting your query.

I went though your query and I can understand your concern. See COPD is a slowly developing disease , so even before he started noticing symptoms of COPD , the disease was affecting in his body few years before itself. So any disease that runs its course over years , the body starts adjusting with the disease and with the limited available health.

So , even though your husband is in terminal stages his body can still tolerate these condition and with the help of Bipap he can still live for few more months than weeks . ( This is as of COPD is concerned )

But if we consider his Atrial fibrillation , then I need to know the severity of that. If his heart rate is extremely high then yes , his chances of survival is 1-2 weeks . But if his heart rate is in normal range then he may carry on for months.

Hope this information was useful to you.
Any clarifications feel free to ask.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Divakara

Internal Medicine Specialist

Practicing since :2006

Answered : 2358 Questions

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Suggest treatment for severe pulmonary hypertension

Brief Answer: I feel he may pull upto 1-2 months. Detailed Answer: HI Thanks for posting your query. I went though your query and I can understand your concern. See COPD is a slowly developing disease , so even before he started noticing symptoms of COPD , the disease was affecting in his body few years before itself. So any disease that runs its course over years , the body starts adjusting with the disease and with the limited available health. So , even though your husband is in terminal stages his body can still tolerate these condition and with the help of Bipap he can still live for few more months than weeks . ( This is as of COPD is concerned ) But if we consider his Atrial fibrillation , then I need to know the severity of that. If his heart rate is extremely high then yes , his chances of survival is 1-2 weeks . But if his heart rate is in normal range then he may carry on for months. Hope this information was useful to you. Any clarifications feel free to ask. Regards.