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Sometimes it’s Not COPD

It was April 2011 when my Mom complained that she couldn’t breathe very well and felt weak. She had no fever, but had just completed a course of antibiotics due to allergy drainage. She almost always requires a second dose, so I contacted her pulmonologist asking for more to be authorized. Once the pharmacy called, I picked up the medication and immediately gave her some. The next morning she was no better, and did not sleep well. I again contacted her doctor and he had me take her to the emergency room.

When she gets like this (usually two to four times a year), I call an ambulance service, so that the ER will begin treatment immediately. This saves time on any waiting room delays. Because of her COPD diagnosis and the symptoms she exhibited, the ER staff took blood, put in an IV to administer fluids and meds, took a chest x-ray, and so forth; all the standard procedures for a COPD exacerbation. Only this time, nothing was helping and she continued to deteriorate.

She was ordered to use a BiPAP machine to force the oxygen into her lungs because her O2 level was 88. She still worsened and ended up in ICU the next day. She stayed there for another 3 days until the hospital doctor requested a thorough and complete blood work. And there it was, finally—she was emitting cardiac enzymes. She was having or had just had a heart attack. Immediately her cardiologist was called in and he scheduled her for an angiogram the next morning.

Being 83 years old, she and I discussed the possible outcomes of the angiogram and what she was willing to do. She had open-heart surgery in 2003 and had no desire to go through that again. She was leery of having a stent placed but after we discussed it and listened to her cardiologist, she agreed to have a stint if she had blockage and if it was possible to place one in the blocked artery. (Lots of “ifs”).

The next morning she went into surgery, and about five hours later, the surgeon called for me. It turned out she did have a blockage and he was able to place the stent to open it. Everything went well and she would be back in her room shortly. I was amazed with the speed of the process. Having gone through two angiograms with her, I knew she would be in some pain.

I cautiously entered her room in case she was sleeping, but lo and behold, she was sitting up and looked better than she had in days. Her breathing was much calmer and her pulse was back down—as was her blood pressure. It was her heart and not her lungs causing the symptoms. I learned a very valuable lesson from this: never ever assume anything. What seems apparent may not be the case.

Your heart is the organ that pumps the blood that runs throughout your body and into your lungs to be oxygenated. If the heart is not functioning well, the lungs do not oxygenate well either. My mom's cardiologist asked me why I didn’t call him when she was admitted and I explained I (and everyone else) had else assumed it was her COPD causing the symptoms. It had not occurred to me or the others that it could be another issue creating the problem with her breathing. We were fortunate that the hospital doctor requested new blood work; one that included a full panel of tests.

Sometimes you can get too caught up in treating one ailment, you forget that there are other concerns that could trigger similar symptoms to a COPD exacerbation. Never overlook or discount anything when it comes to caregiving, expect the unexpected.

 

Health Advocate

 
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