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

Case study ( 4575 views as of May 22, 2024 )

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.


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 "

  • You're correct that asthma can manifest in various ways and symptoms may differ among individuals. Wheezing, chest tightness, shortness of breath, and chronic cough are common symptoms experienced by people with asthma. These symptoms can be triggered by exposure to certain irritants, allergens, cold air, or other specific factors. Asthma can indeed have a genetic component, and if one family member has asthma, there is a higher likelihood that other family members may also develop the condition. If you experience symptoms that suggest asthma or suspect you may have asthma, it is important to consult your family doctor for an evaluation. They can assess your symptoms, medical history, and perform necessary tests to confirm the diagnosis. Based on the severity and frequency of your symptoms, your doctor will determine the appropriate treatment plan. For individuals with more difficult-to-treat asthma or complex cases, referral to a respiratory therapist or a specialist in respiratory medicine may be necessary. These healthcare professionals have specialized knowledge and expertise in managing respiratory conditions, including asthma, and can provide additional support, guidance, and advanced treatment options. Remember, early diagnosis and appropriate management of asthma can significantly improve your quality of life and help you effectively control your symptoms. Regular follow-ups with your healthcare provider are important to monitor your condition, adjust treatment as needed, and ensure optimal asthma control.
  • Absolutely, quitting smoking is crucial for improving lung health and reducing the risk of various respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD). Smoking is a leading cause of lung cancer and can significantly worsen symptoms and progression of respiratory conditions. If you have a respiratory disease and are a smoker, it is highly recommended to seek assistance from your family physician to quit smoking. They can provide valuable support, guidance, and resources to help you successfully quit smoking. There are various strategies and medications available that can greatly increase your chances of quitting successfully. Your family physician can assess your specific situation, discuss the available options, and tailor a quit plan that suits your needs. They can also monitor your progress and provide ongoing support to help you stay smoke-free. Remember, quitting smoking not only benefits your own lung health but also improves the overall health and well-being of those around you. It's never too late to quit, and the sooner you quit, the greater the benefits for your respiratory health.
  • 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.
    • 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
    • @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?
  • 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?
    • 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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