c.o.p.d and having anxiety attacks every morning when you wake up?

Question

My mam was diagnosed with severe copd a year to this month out of the blue twice we were asked to consider donating her organs it was totally un exspected as you can imagine,she showed no signs of any breathing problems at all it was all of a shock. She has been back in hospital once an exabation which they sorted her out now what is worrying me is almost every morning when she wakes up she has these attacks even after she has had all the medications inhalours the drs said she is on the highest possible cant give her any more, she wont come down stairs because of the worry getting back up its such a struggle iv been onto the health care they said it would be 6 month waiting list for a stair lift i dont know wether she has that long please give me some advice i have read every possible website going on what people have witnessed or gone through i know every situation is different can anyone enlighten me on what to exspect and when and what to do many thanks in advance

Answer 1

Sorry I'm going to write so much but I truly feel bad for you and your Mom. My husband fought a long battle with emphysema. He was in the hospital, on and off the vent, for 22 months. A previous answerer said don't be afraid to ask the doctor anything. And really, don't hesitate to ask anything, not anything at all. I am not an agressive person but, being my husbands only advocate during his hosp stay, I asked questions all the time about the treatment they were giving (or not giving) him. People react differently to the same medications and sometimes you've got to get your opinion across that the Docs should try another way (even the Pulmonary Docs). The inhalers can sometimes cause a hyper/nervous feeling. And, of course, the air hunger by itself would cause anyone to panic. Your Mom has to take it slow and, if she can, try to breath slow and steady at all times no matter what she is doing (do you know about pursed lip breathing? It's important). My husband always felt greatly relieved to have a table fan blowing directly at his face. It may have been somewhat physcological help but it was clearly obvious that it relieved him. He even kept it going in the hospital while on the vent. I wish, so much, there was a
better way to treat COPD as I know it is so difficult for you and your Mom to deal with. Pray if you have a mind to. Looking back over the last two years I realize that God did listen to me and answered my prayers. But in the end he had to take my husband. My saving grace is that my husband is not struggling anymore. He's free to run around, golf or do whatever he wants now. Yes, it sounds corny but it gives me a bit of peace. Good Luck to you...take it day by day and just do, each day, the best that you can.

Answer 2

Is there any possible way you can set up a room downstairs for her? I visit homes, many times with a COPD patient. Families have changed their dining rooms into bedrooms so their family member can be downstairs with them.

Is your mother on morphine? Yes it is a resp depressant, but it can also help relax the smooth muscle and help relieve that feeling of suffocating. It sounds as though your mother should be in a palliative care program (similiar to hospice, but allows some vigorous treatment).

She very welll could be on the highest dosages of the medications, but sometimes a different combination helps with the air hunger. Is she on oxygen, because she should be. Is there a pulmonologist she can see? Can you get a second opinion? Sometimes people are afraid to insult their physician by asking to see a different doctor, but it's your mom's life and it sounds as though she needs a different treatment plan. Get up all your nerve and call the doc office, or meet with the doc and tell him/her that she is very uncomfortable, that her quality of life is not good, and she and you would like her to see another doctor for possible help.

It is a dreadful disease, and the end stages are sadly difficult for the patient and family. I wish her and you luck.

Answer 3

COPD is a terrible disease to have to watch a family member fight through. There is no cure, only treatment. If you are not satisfied with your mother's doctor then you need another one, preferably a pulmonologist. I have seen many good pulmonologists keep people off ventilators and extend their lives by many years. I assume she is already on oxygen at home. She needs nebulizer treatments as well as inhalers. she also ,if it is advanced COPD, needs steroids. No smoking by her or anyone else around her. She will need an anti anxiety agent, mild at first ,to decrease her anxiety and assisit in breathing. May God be with you and your Mom.

Answer 4

I wonder if she had oxygen if she would feel better..
Or if she's on it, did you forget to mention it?

I have stage 3 COPD, One of my triggers is high humidity, So I watch the weather , If rain/snow is headed my way I sleep with my oxygen on It makes a huge difference..

I went to the hospital 5 times with exacerbated copd

My morning anxiety attacks stopped when I started with oxygen

Answer 5

My 57 year old Mother also has COPD ( Chronic Obstructive Pulmonary Disease) She is now on oxygen and in a wheel chair due to it. She also had "anxiety" attacks in the mornings. It wasnt really an anxiety attack , she would get up to fast and lose her breath and things would go from there.
Your Mother may be getting up out of bed too fast . She has to pace herself ,When she first wakes up she should lay there for about 5-10 minutes so her body can adjust to be awake.
Secondly , she needs to slowly sit up and stay like that for 5-10 minutes. Then she should stand slowly and stay standing for atleast 5 minutes to get her balance and her breath(if she is having trouble breathing.) Then she can try and walk to where she is going.( She may need to take a couple of breaks while walking to and from other rooms. Make sure there are chairs in the hallway that she can sit in.
I have included some info from the american lung association for you to read.
Chronic obstructive pulmonary disease (COPD) is a term referring to two lung diseases, chronic bronchitis and emphysema, that are characterized by obstruction to airflow that interferes with normal breathing. Both of these conditions frequently co-exist, hence physicians prefer the term COPD. It does not include other obstructive diseases such as asthma.

COPD is the fourth leading cause of death in America, claiming the lives of 122,283 Americans in 2003 and the number of women dying from the disease has surpassed the number seen in men.1
This is the fourth consecutive year in which women have exceeded men in the number of deaths attributable to COPD. In 2003, over 63,000 females died compared to 59,000 males.2
Smoking is the primary risk factor for COPD. Approximately 80 to 90 percent of COPD deaths are caused by smoking. Female smokers are nearly 13 times as likely to die from COPD as women who have never smoked. Male smokers are nearly 12 times as likely to die from COPD as men who have never smoked.3
Other risk factors of COPD include air pollution, second-hand smoke, history of childhood respiratory infections and heredity. Occupational exposure to certain industrial pollutants also increases the odds for COPD. A recent study found that the fraction of COPD attributed to work was estimated as 19.2% overall and 31.1% among never smokers.4
In 2004, 11.4 million U.S. adults (aged 18 and over) were estimated to have COPD.5 However, close to 24 million U.S. adults have evidence of impaired lung function, indicating an under diagnosis of COPD.6
An estimated 638,000 hospital discharges were reported; a discharge rate of 21.8 per 100,000 population. COPD is an important cause of hospitalization in our aged population. Approximately 65% of discharges were in the 65 years and older population in 2004.7
In 2004, the cost to the nation for COPD was approximately $37.2 billion, including healthcare expenditures of $20.9 billion in direct health care expenditures, $7.4 billion in indirect morbidity costs and $8.9 billion in indirect mortality costs.8
Chronic bronchitis is the inflammation and eventual scarring of the lining of the bronchial tubes. When the bronchi are inflamed and/or infected, less air is able to flow to and from the lungs and a heavy mucus or phlegm is coughed up. The condition is defined by the presence of a mucus-producing cough most days of the month, three months of a year for two successive years without other underlying disease to explain the cough.
This inflammation eventually leads to scarring of the lining of the bronchial tubes. Once the bronchial tubes have been irritated over a long period of time, excessive mucus is produced constantly, the lining of the bronchial tubes becomes thickened, an irritating cough develops, and air flow may be hampered, the lungs become scarred. The bronchial tubes then make an ideal breeding place for bacterial infections within the airways, which eventually impedes airflow.9
In 2004, an estimated 9 million Americans reported a physician diagnosis of chronic bronchitis. Chronic bronchitis affects people of all ages, but is higher in those over 45 years old.10
Females are more than twice as likely to be diagnosed with chronic bronchitis as males. In 2004, 2.8 million males had a diagnosis of chronic bronchitis compared to 6.3 million females.11
Symptoms of chronic bronchitis include chronic cough, increased mucus, frequent clearing of the throat and shortness of breath.12
Chronic bronchitis doesn't strike suddenly and is often neglected by individuals until it is in an advanced state, because people mistakenly believe that the disease is not life-threatening. By the time a patient goes to his or her doctor the lungs have frequently been seriously injured. Then the patient may be in danger of developing serious respiratory problems or heart failure.
Emphysema begins with the destruction of air sacs (alveoli) in the lungs where oxygen from the air is exchanged for carbon dioxide in the blood. The walls of the air sacs are thin and fragile. Damage to the air sacs is irreversible and results in permanent "holes" in the tissues of the lower lungs. As air sacs are destroyed, the lungs are able to transfer less and less oxygen to the bloodstream, causing shortness of breath. The lungs also lose their elasticity, which is important to keep airways open. The patient experiences great difficulty exhaling.13
Emphysema doesn't develop suddenly. It comes on very gradually. Years of exposure to the irritation of cigarette smoke usually precede the development of emphysema. Of the estimated 3.6 million Americans ever diagnosed with emphysema, 91 percent were 45 or older.14
Of the emphysema sufferers, 54.8 percent are male and 45.2 percent are female. However, within in the past year, the prevalence rate for women has seen a 20 percent increase where as men have seen a decreased of 19 percent.15
Symptoms of emphysema include cough, shortness of breath and a limited exercise tolerance. Diagnosis is made by pulmonary function tests, along with the patient's history, examination and other tests.16
Alpha1 antitrypsin deficiency-related (AAT) emphysema is caused by the inherited deficiency of a protein called alpha1-antitrypsin (AAT) or alpha1-protease inhibitor. AAT, produced by the liver, is a "lung protector." In the absence of AAT, emphysema is almost inevitable. It is responsible for 5% or less of the emphysema in the United States.17
An estimated 100,000 Americans, primarily of northern European descent, have AAT deficiency emphysema. Another 25 million Americans carry a single deficient gene that causes Alpha-1 and may pass the gene onto their children.18
Symptoms of AAT deficiency emphysema usually begin between 32 and 41 years of age and include shortness of breath and decreased exercise capacity. Smoking significantly increases the severity of emphysema in AAT-deficient individuals.19
Blood screening is primarily used to diagnose whether a person is a carrier or AAT-deficient. If children are diagnosed as AAT-deficient through blood screening, they may undergo a liver transplant.20 In addition, a DNA-based cheek swab test has been recently developed for the diagnosis of AAT-deficiency.21
A recent study suggested that there are at least 116 million carriers among all racial groups, worldwide.22
COPD Treatment

The quality of life for a person suffering from COPD diminishes as the disease progresses. At the onset, there is minimal shortness of breath. People with COPD may eventually require supplemental oxygen and may have to rely on mechanical respiratory assistance.23
A recent American Lung Association survey revealed that half of all COPD patients (51%) say their condition limits their ability to work. It also limits them in normal physical exertion (70%), household chores (56%), social activities (53%), sleeping (50%) and family activities (46%).24
None of the existing medications for COPD has been shown to modify the long-term decline in lung function that is the hallmark of this disease. Therefore, the goal of pharmacotherapy for COPD is to provide relief of symptoms and prevent complications and/or progression of the disease with a minimum of side effects.25
Bronchodilator medications (prescription drugs that relax and open air passages in the lungs) are central to the symptomatic management of COPD. They can be inhaled as aerosol sprays or taken orally.26
Additional treatment includes antibiotics, oxygen therapy, and systemic glucocorticosteroids. The efficacy of inhaled glucocorticosteroids continues to be under study, however short-term benefit has been demonstrated. Chronic treatment with systemic steroids involves the risk of serious side effects; therefore these are used mostly for acute exacerbations.27
Pneumonia and influenza vaccines should be given to COPD patients.28 Those with COPD should also live a healthy lifestyle by exercising, avoiding cigarette smoke and other air pollutants, and eating well.29
Pulmonary rehabilitation is a preventive health-care program provided by a team of health professionals to help people cope physically, psychologically, and socially with COPD.30
Lung transplantation is being performed in increasing numbers and may be an option for people who suffer from severe emphysema. Additionally, lung volume reduction surgery (LVRS) has shown promise and is being performed with increasing frequency. However, a recent study found that emphysema patients who have severe lung obstruction with either limited ability to exchange gas when breathing or damage that is evenly distributed throughout their lungs are at high risk of death from the procedure.31
In August 2003, the Centers for Medicare and Medicaid Services (CMS) announced that they intend to cover LVRS for people with non-high risk severe emphysema, who meet the criteria stated in the National Emphysema Treatment Trial (NETT). In addition, CMS has decided that LVRS is "reasonable and necessary" only for qualified patients that undergo therapy before and after the surgery. CMS is currently composing accreditation standards for LVRS facilities and will use these standards to determine where the surgery will be covered.32
Treatments for AAT deficiency emphysema including AAT replacement therapy (a life-long process) and gene therapy are currently being evaluated. It is hoped that a clinical trial on gene therapy will take place within the decade.33
For help with treatment decisions online, click through the COPD Lung Profiler™.

For more information on COPD, please review the Chronic Bronchitis and Emphysema Morbidity and Mortality Trend Report in the Data and Statistics section of our website or call the American Lung Association at 1-800-LUNG-USA (1-800-586-4872).

Visit our online COPD Center -- find information and resources for the patients with Chronic Obstructive Pulmonary Disease (COPD) and their caregivers.

Join one of our Better Breathers Clubs -- There are more than 475 Better Breather Club support groups nationwide for people with chronic respiratory disease, including COPD

Set Up A Lotsa Helping Hands Site -- Help Manage Caregiver Support Online

Call the Lung HelpLine -- Call 1-800-LUNGUSA and speak with a Respirtory Therapist.

http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=38502

http://www.lungusa.org/site/pp.asp?c=gtISK4OWG&b=40692


I hope this helps , I know how hard it is to care for a Mom that has COPD .
Good Luck to you !