Lung Disorders & Ventilators/respirators

[debmidge]

Let me begin by stating the case

68 yr old woman with one lung - cannot breathe on her own -

must be connected to machine to assist her in breathing.

12 years old this woman had one lung removed due to lung cancer.

Did not do chemo or radiation and apparently survived cancer.

Has oxygen at home to take at night.

Fast forward to now: collapsed as a result of the home oxygen not being enough

and ER intubated her; now she has trach tube permanently installed and must

use machine to assist her in breathing.

It's been about 3 weeks and she made some improvement but not enough to

get off the machine.

Anyone know about this form of therapy/machine. What's the prognosis? The pulmonary

doctor after 4 weeks still hasn't provided a satisfactory answer as to what is going on

with her remaining lung: COPD, emphysema, etc.

Can someone really live the rest of their life on a machine like this?

I want to end this by saying yes, she was a medium use smoker from age 14 to age 57 and this is what is has done to her.

[Respira]

First I need to know is she on a ventilator (a machine that actually pushes air into the lungs and the trache is directly connected to a hose that goes to the machine) or is she on a flow by set up (a machine that sends oxygen enriched air past the trache but is not directly connected to the trache).

People can do just fine with one lung.

Since she is elderly and in all probability has COPD, the trache is a good thing. It eases the work of breathing. There is a pressure differential from the mouth to the lungs that is greater than the pressure differential from the trache opening to the lungs. So with a trache the patient can take in a breath with less effort and work.

If she is directly connected to the ventilator and the machine is doing the work of breathing for her for now, there is a chance that she will be able to improve enough to eventually be put on a flow by set up.

If she is on a flow by set up already, that is great! She may be able to wean off the flow by during the daytime and only use it at night. It really depends on how her SAT's are.

When you say she collapsed, did you mean she collapsed or her lung collapsed? Was there anything else going on like pneumonia? Without knowing what precipitated the whole event it would be hard to give a prognosis.

There are exercises she can do to increase the strength of her diaphragm and help her inflate her lung to it's capacity.

And yes people live on ventilators for many many years.

[debmidge]

COULDN'T GET IN MY ORIGINAL POST TO EDIT IT

12 YEARS AGO (NOT 12 YEARS OLD) SHE HAD HER ONE LUNG REMOVED

[debmidge]

First I need to know is she on a ventilator (a machine that actually pushes air into the lungs and the trache is directly connected to a hose that goes to the machine) or is she on a flow by set up (a machine that sends oxygen enriched air past the trache but is not directly connected to the trache).

People can do just fine with one lung.

Since she is elderly and in all probability has COPD, the trache is a good thing. It eases the work of breathing. There is a pressure differential from the mouth to the lungs that is greater than the pressure differential from the trache opening to the lungs. So with a trache the patient can take in a breath with less effort and work.

If she is directly connected to the ventilator and the machine is doing the work of breathing for her for now, there is a chance that she will be able to improve enough to eventually be put on a flow by set up.

If she is on a flow by set up already, that is great! She may be able to wean off the flow by during the daytime and only use it at night. It really depends on how her SAT's are.

When you say she collapsed, did you mean she collapsed or her lung collapsed? Was there anything else going on like pneumonia? Without knowing what precipitated the whole event it would be hard to give a prognosis.

There are exercises she can do to increase the strength of her diaphragm and help her inflate her lung to it's capacity.

And yes people live on ventilators for many many years.

It appears she is on ventilator - directly connected -

nurse says it's to assist her in breathing and says she is starting to get

dependent on the machine (they were trying to wean her off the machine).

I am not sure what a "flow by set up" means. Is it a smaller machine?

Or the same machine but set at lower levels?

The hospital moved her the other day from one room to another

(as her first roommate died) and it disturbed

her and they had to re-adjust her machine to breathe more for her.

She is also saying Kooky things; which she said about 6 weeks ago when

she first was admitted but then her blood oxygen level was low;

now she's saying kooky things and her blood oxygen levels are Ok.

I do not know what a SAT means....

Her lung did not collapse; she collapsed (passed out) but managed to

call "911" herself (she lives alone).

She did not have pneumonia or any other health condition - but had a small

oxygen unit at home.

We do not even have a diagnosis (she's my aunt). The only thing the pulmonary

doctor tells her is that she's "coming along."

I asked her Nurse? if there were any exercises she could do and the nurse said No.

She's a young 68 years old - at her proper weight. The hospital installed a

feeding tube directly into her stomach. They are going to give her a swallow

test next week

Even if she is off the ventilator, she's going to have to go to a nursing home

due to the kooky things she's says (she said that the lady in the next bed

was shot by mistake by my Aunt's ex-husband and that he also shot

another person who is in that hospital and he's coming after my Aunt. They

have been divorced for 30 years and he was abusive and had legal guns

around the home and used to threaten her).

My last question: was told by nurse also that not every hospital nor nursing

home can care for trache patients.......Obviously this can't be done at home

unless you have a lot of money for caretakers - she is also an active alcoholic

(even with one lung) so I nix the "at home" idea big time.

Do you know of a website I can go to for more info?

Thanks

Deb

[Nancym]

She is also saying Kooky things; which she said about 6 weeks ago when

she first was admitted but then her blood oxygen level was low;

now she's saying kooky things and her blood oxygen levels are Ok.

My Mom passed away from COPD and heart issues. I believe that part of the issue is the brain just isn't getting enough oxygen and so it starts to deteriorate. Also, because the body is starved of oxygen it can cause some anxiety too, or at least that is what I believe caused the anxiety. It's a tough thing to face. I wish you both strength and good fortune.

My Mom never smoked a cigarette in her life.

[Respira]

"I do not know what a SAT means...."

SAT is the level of oxygen in the blood, commonly measured by a pulse ox on the finger.

"I asked her Nurse? if there were any exercises she could do and the nurse said No.

She's a young 68 years old - at her proper weight."

The kind of exercises I was talking about were not for weight but to strengthen her respiratory muscles. Try and talk to the Respiratory therapist at the hospital. The therapist will be able to demonstrate the different techniques used to strengthen her respiratory muscles after she is weaned off the ventilator.

"Breathing exercises can help persons with chronic airway obstruction. They help people have better control over breathing, even when they are under stress. They may also improve exercise performance. Often you will be asked to do them before and after heart or lung surgery. They also help prevent pneumonia in bedridden patients.

The goal of these exercises is to make use of the entire lung and keep the chest muscles active. The main technique is to prolong one's exhalation or outward breath. A therapist can teach a patient the methods. The person can then perform them at home. Learning in front of a mirror is useful. Ideally, one performs them ten times a session, three or four times a day. The exercises focus on three areas: the upper chest, the lower side ribs, and the diaphragm. The diaphragm is the large muscle below the lungs that drops when we inhale.

By placing hands on certain spots, the therapist shows how to inhale deeply and expand that area only. For example, you may try to expand the upper chest but not the lower. Next, you may try to expand the ribs to the side, but not the upper chest. For each exercise, the person should focus on the chosen area and not use neck, shoulder, or other muscles.

Breathing from the diaphragm causes the front lower ribs to flare out. To practice this, lie on your back with bent knees supported by pillows. Place your fingers on your belly just below your ribcage. As you inhale deeply, your belly and lower ribs should rise while your chest remains fairly still. Inhale for a count of three and exhale for a count of six. You should prolong breathing out with lips slightly pursed(not applicable for patients with tracheostomy). With practice, you should be able to do a dozen such breaths without tiring. When you have mastered this, try it standing. Finally, practice it while walking or even climbing stairs. You may also try it with lips pursed while you breathe in.

The next step is deep breathing. You sit or stand, pull your elbows back firmly, and inhale deeply. Hold your breath for a count of five before exhaling slowly and completely. If you have chronic airway obstruction, ask your healthcare provider which exercises will work for you."

Some sites that may be helpful...

Open Original Shared Link

Open Original Shared Link

Open Original Shared Link

Open Original Shared Link

[debmidge]

""I asked her Nurse? if there were any exercises she could do and the nurse said No.

She's a young 68 years old - at her proper weight."

The kind of exercises I was talking about were not for weight but to strengthen her respiratory muscles. Try and talk to the Respiratory therapist at the hospital. The therapist will be able to demonstrate the different techniques used to strengthen her respiratory muscles after she is weaned off the ventilator.

"Breathing exercises can help persons with chronic airway obstruction. They help people have better control over breathing, even when they are under stress. They may also improve exercise performance. Often you will be asked to do them before and after heart or lung surgery. They also help prevent pneumonia in bedridden patients.

The goal of these exercises is to make use of the entire lung and keep the chest muscles active. The main technique is to prolong one's exhalation or outward breath. A therapist can teach a patient the methods. The person can then perform them at home. Learning in front of a mirror is useful. Ideally, one performs them ten times a session, three or four times a day. The exercises focus on three areas: the upper chest, the lower side ribs, and the diaphragm. The diaphragm is the large muscle below the lungs that drops when we inhale.

By placing hands on certain spots, the therapist shows how to inhale deeply and expand that area only. For example, you may try to expand the upper chest but not the lower. Next, you may try to expand the ribs to the side, but not the upper chest. For each exercise, the person should focus on the chosen area and not use neck, shoulder, or other muscles.

Breathing from the diaphragm causes the front lower ribs to flare out. To practice this, lie on your back with bent knees supported by pillows. Place your fingers on your belly just below your ribcage. As you inhale deeply, your belly and lower ribs should rise while your chest remains fairly still. Inhale for a count of three and exhale for a count of six. You should prolong breathing out with lips slightly pursed(not applicable for patients with tracheostomy). With practice, you should be able to do a dozen such breaths without tiring. When you have mastered this, try it standing. Finally, practice it while walking or even climbing stairs. You may also try it with lips pursed while you breathe in.

The next step is deep breathing. You sit or stand, pull your elbows back firmly, and inhale deeply. Hold your breath for a count of five before exhaling slowly and completely. If you have chronic airway obstruction, ask your healthcare provider which exercises will work for you."

Some sites that may be helpful...

Open Original Shared Link

Open Original Shared Link

Open Original Shared Link

Open Original Shared Link

This is what I meant when I asked the nurse? or resp. therapist ? that day in hospital...if there was something the patient can do - like exercises - to help improve breathing. But after reading what you wrote, my Aunt is not ready for this but they should be making her do something to get to this point. She's still too weak.