My mom (80) has COPD (emphysema), lung cancer survivor but also has CHF. Her shortness of breath has gotten continually worse. She is afraid to use her incentive spirometer (her speech person was helping her with that but his time with her is done, he was part of home care after her hospital stay) because her breathing has been so rough. She uses an Albuterol inhaler. Last time we went to the ER in July she was treated for low sodium but no one ever gave us guidance on the breathing. We were hopeful that getting the sodium back up would resolve it. It did not.
Her doctor has not been helpful. Her resting O2 saturation is good in high 90s. We have one of those finger devices at home. He said yesterday we can test it by having her move around and take it after that and then discuss if she needs to be on supplemental oxygen. We are going to try that today. Doesn't seem very scientific.
How do we determine who is best suited to treat her... A pulmonologist? A cardiologist? A respiratory therapist? This doctor is awful he just wants to get her out and onto the next but she's been seeing him for 30 years etc etc. The first opening for the geriatric practice in our area (she actually agreed to see them) is November 27. She has an appt with a cardiologist on October 30.
I'm so discouraged every visit is a dead end or delay. Any suggestions?
She needs a specialist, a Pulmonologist and Cardiologist. Not sure how much either are going to be able to help her. CHF means the heart muscle is loosing the ability to pump blood thru her body. Shortness of breath could be the emphysema. IMO she should have gotten referrals long ago.
Best of luck.
She has a failing heart (CHF means Congestive HEART FAILURE). That isn't going to get better.
When your mother sees the doctor he will listen to the lungs. He is trained to hear rales or fluid in the lungs. He will pretty much know right away if this is fluid or absence of good breath sounds (COPD).
Your doctor has already prescribed what will help with her chronic conditions.
There is little else that can be done.
There is no cure for these things which will slowly worsen with age and which eventually will mean the end of a long life.
You may need to look at more acceptance that this is an end of life situation, what is comfort for her, and how to promote comfort. This is more a gerontology and Hospice situation that the choice of a doctor.
If you are seeing sats in the 90s resting you are VERY LUCKY INDEED.
Any movement, yes, will tax both a failing heart and failing lungs.
If you wish to pursue constant care then you are correct that a cardiologist treats the heart and a pulmonologist treats the lungs.
I wish you luck, but I am certain you will have researched this and you will understand all I tell you.
I have discussed with a Social Worker (very experienced in aging) about this issue. A specialist is required for diagnosis. But then..? If stable.. the value/benefit/burden/cost of checkups vs no checkup.
The SW suggested a Geriatrian to manage the ongoing & chronic conditions. One Doctor instead of running all arpund town. I am looking into this direction. I mention it in case it is useful for you too.
My former employer has COPD (she's 75 now). She has been going to her pulmonologist to learn breathing exercises from the beginning of her diagnosis. They monitor her progress and are looped in if she has any illnesses or emergency issues that affect her breathing. If your Mom isn't doing this she probably should. That being said, my employee can still drive herself places, so not sure if your Mom can get anywhere easily. This may be the limiting factor.
Anything wrong with the lungs effects the heart , making it work harder . Lungs and heart are both failing now .
Cardiologist for heart , pulmonologist for lungs , but these problems can only attempt to be managed . At some point the failure will take over completely which will be time for hospice and keep Mom comfortable .