Chronic Pulmonary Obstructive Disease " Filomena is an 82-year-old resident of an independent living facility "

Case study ( 1043 views as of September 21, 2017 )

Filomena is an 82-year-old resident of an independent living facility. She caught a cold that has been 'going around' for the last few weeks, and now feels like she is more short of breath than usual and is coughing more than usual for her. She normally gets around with a walker, and tries to participate in community activities most days, but for the last few weeks hasn't been able to move between more than her couch, the bedroom and the bathroom. Her family has been bringing in groceries.

Filomena has had a heart attach in the past, and required an angiogram with 2 stents. She has non-insulin dependent diabetes, and life-long asthma, that has now been re-classfied as Chronic Obstructive Pulmonary Disease (COPD). She takes a daily puffer with a long-acting beta-agonist, and a steroid combined, and has a 'blue puffer' that she uses only when she needs it.

Shortness of breath in an older patient, particularly in females, can be many things. At the very least, she needs to see her primary care provider, but many patients with Filomena's symptoms are first assessed in an emergency department or urgent care clinic. Ruling out cardiac causes for her symptoms would be prudent, and excluding serious bacterial infections would be common. If it is determined that the problem is a flare-up of her lung disease following the recent 'cold', then additional medications may be prescribed.

Filomena may also benefit from follow-up and teaching from respiratory illness specialists. Also, her decline in function is important to consider, and she may benefit from other services focused on maintaining independence and quality of life for elderly patients.

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Conversation based on: Chronic Pulmonary Obstructive Disease " Filomena is an 82-year-old resident of an independent living facility "

Chronic Pulmonary Obstructive Disease " Filomena is an 82-year-old resident of an independent living facility "

  • My mother had Chronic Pulmonary Obstructive Disease. She received very little follow up after her diagnosis and very few treatment options. It was very frustrating and eventually she developed lung cancer.
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    • She developed small cell lung cancer that was incredibly difficult to diagnose as it didn't present in a typical manner. We assumed the COPD evolved in to the cancer but by the time a diagnosis was made it was so advanced they didn't really look in to things
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    • @K.Michael - what did the doctors say about the development of lung cancer? Did they say there was any connection between that diagnosis and the COPD?
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  • How large is the role of inflammatory immune responses in COPD? Would it be worth looking into ways to improve Filomena's immune system function? I know macronutrient composition of the diet can affect respiration efficiency as well, higher proportions of carbohydrates improving efficiency. Would this also be something to consider for Filomena's treatment?
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    • There are definitely foods that have anti-inflammatory properties and I would think some of these would be beneficial to Filomena in managing her COPD. Her advanced age also needs to be considered, and it is quite likely she already has a diet lacking in many required nutrients. She should speak with a dietitian through her community or through the cardiac rehabilitation program at her hospital or local recreational centre.
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