Dear COPD Coach,
I have a question regarding my husband’s COPD/Emphysema. He is on supplemental oxygen 24/7 at 5 liters now. He is 74 years old and also has diabetes and heart disease and is on Dialysis. Recently his COPD has kicked up and he is using 02 tanks to supplement his 02. We are using 14 “E” tanks a week. Is this a normal transition for people in end stage COPD/emphysema? My husband has troubles when taking steroids but was recently on a Prednisone taper which helped a little. He doesn’t retain C02 so higher level 02 is OK. Do other patients supplement with 02 tanks? Just wondering.
Your letter brings up some interesting questions, and an educational opportunity for our readers. It appears that your husband suffers from some of the more common comorbidities (medical conditions accompanying, or a result of having COPD). These comorbidities can often make treating COPD more difficult. Diabetes and heart disease are well-established as common comorbidities.
Secondly, you refer to end stage COPD. That is a term that is rarely used these days. Today, the term used is Stage 4. To many this may just seem like semantics, but to a person with COPD, end stage equates to terminal. In reality, Stage four simply means that the person’s FEV1 (a measure of their lung function ) is very low. It is during this stage that many complications arise and co-morbidities can become of greater concern. However, many people with COPD live for several years when in Stage 4 by closely watching their symptoms, and taking extraordinary care of themselves including seeking medical attention when called for.
It is certainly not uncommon for individuals with Stage 4 COPD to require higher dosages of supplemental oxygen than what their home concentrators can provide, especially after experiencing an exacerbation. The extra volume they require can be obtained through the pairing of “E” tanks or in some cases using combined home concentrators. I would advise you to contact your oxygen supplier and your pulmonologist to discuss the most efficient means to provide the oxygen your husband requires.
Unfortunately, mobility with higher oxygen requirement becomes difficult if not impossible, however, pairing 2 “E” tanks could provide some measure of mobility for your husband. I would also discuss this with your home supplier. Another possibility might be talking to your oxygen supplier about a second concentrator that also has home fill capabilities. This would allow you to be able to fill your own tanks and also provide high liter flow.
As you probably know, keeping vigilant as any symptoms that arise is paramount to your husband’s health. Catching the early signs of an exacerbation (times where your COPD flares up) become much more critical, especially in Stage 4. With each exacerbation, it is not uncommon for some lung function to be permanently lost. By catching the exacerbation early, this additional loss of lung function might certainly be mitigated. A good source for information as to what to look for is available in out Big Fat Reference Guide. Should you have any questions, please also feel free to contact our COPD Information Line at 866-316- COPD (2673).
We appreciate your letter, as well as your willingness to share your story with our readers.
The COPD Coach
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