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There are two staging protocols for COPD, the GOLD Standard and the BODE Index. GOLD, which is the Global Initiative for Chronic Obstructive Lung Disease, is the most common however BODE Index is a more accurate measure for determining the stages of COPD because of the additional patient information it takes into account.
Prognosis for COPD and emphysema patients has a lot to do with whether they still smoke or not, how healthy their diet is, how long they smoked and what age they started. Different people react differently to the conventional treatments prescribed by doctors. For that reason some people can survive much longer than others utilizing these prescription medications even though none of them stop the progress of COPD or cure the disease.
Prognosis for COPD and emphysema patients has a lot to do with whether they still smoke or not, how healthy their diet is, how long they smoked and what age they started. Different people react differently to the conventional treatments prescribed by doctors. For that reason some people can survive much longer than others utilizing these prescription medications even though none of them were developed to stop the progress of emphysema and COPD or cure the disease.
One thing that really irritated me was this Spirometry test. It was not the test itself but how the doctor's staff handled it. They performed the test and then brought the results to my mother. Instead of the doctor presenting the results to my mother they had some office girl telling her that she now had the lungs of a 111 year old and essentially that it was all her fault for having been a smoker.
I noticed the results of this test did not do anything except quantify some additional data regarding my mother's condition. It did not however, change any of the treatment protocols.
One thing it did that really got to me was that it made my mother very depressed. They were so insistant in laying all the blame on her for smoking.
When we got home after that visit I started cooking something for dinner. My mother would generally come in and see what was cooking but this day she did not. I went in her room and found her sitting on her bed with a long face. I asked her what was wrong and she told me, "I can't believe I did this to myself."
This was the first and only time she ever said anything like this but I think it stayed in the back of her mind that she was getting what she deserved. I wanted to slap the office girl that did this to my mother. It had not provided any help in any way. Here again they were wonderful at quantifying parameters related to my mother's emphysema and COPD. They just had no idea what to do with the information.
Advair™ came in a purple disk. It was to be used twice a day and my mother did this without fail for over two years. I found after researching this treatment that it contained fluticasone, a steroid. Clicking the drug name above provides the link to the Advair home page. There is a guide at the bottom that provides some good information on this drug if you decide to take it.
Advair stopped providing the temporary relief it once had after my mother had deteriorated down to End Stage Emphysema or Stage IV Emphysema.
The Pulmonary Specialist prescribed Spiriva™ at the same time he prescribed Advair™ and Albuterol Sulfate nebulizer treatments. Using Spiriva™ involved putting the pill into the crusher and then inhaling the powder that was inside the pill. I was happy to see this treatment did not contain a steroid but it did contain bromide. I knew that bromide toxicity could be an issue so I was still concerned about this drug even though it did not contain a steroid.
The albuterol sulfate was for use in the nebulizer. These treatments took about 15 minutes and seemed to provide some welcomed relief early on. After almost two years it stopped providing any noticeable relief and my mother refused to use it which stopped all nebulizer treatments. After a quick call to the doctor we had a new prescription for DuoNeb™ which was supposed to work better for her.
For the first two or so years the Combivent™ rescue inhaler helped my mother through numerous exacerbations (shortness of breath episodes). This rescue inhaler would generally last two weeks or so. As my mother's COPD progressed the Combivent™ provided less and less relief.
After two and a half years the Combivent™ would only provide a tiny bit of relief and the entire contents of the inhaler would only last about two hours. This was when my mother was in End Stage Emphysema, weighed only 77 pounds and required 4 liters of supplemental oxygen 24/7 and needed the relief more than ever!
It seemed every medication and treatment, with the exception of albuterol sulfate, contained either a steroid, was a steroid or contained bromide, all of which posed potential health hazards with continued use.
Therefore, if you are to survive COPD you must use some additional treatment or treatments. With this in mind, medical personnel continue pushing the use of these drugs even though they provide nothing more than a temporarily masking of symptoms.
In summary, the prescribed medications provided much needed "temporary relief" but as soon as the drug wore off my mother was right back where she was before taking the drug. There were no permanent improvements.
The doctor never discussed what my mother was to expect they just did tests and scheduled her every 3 months until she deteriorated down to End Stage Emphysema. Once she reached this very scary level of decline the doctors began scheduling her appointments in 6 month intervals not expecting to see her again.
They were both shocked when she appeared after 6 months having re-gained 8 of the 26 pounds she had lost and only requiring 3 liters of supplemental oxygen instead of 4 which she was handling with no distress!
The thing that amazed me was neither one of my mothers doctors could believe that something other than the prescribed medications had provided this improvement! I can only guess that they had both been sufficiently brainwashed by the pharmaceutical company reps into thinking the drugs worked.
It reminds me of a saying by Mark Twain,
"It is easier to fool someone than to convince them they've been fooled."
The doctors just could not believe that it was something other than their drugs that had provided this improvement. I asked the Pulmonary Specialist how many patients he had that were suffering with COPD. He gave me the number, somewhere around 800, I believe. I then asked him how many of them were getting better and showing permanent improvements. He was dumbfounded so I said, "ONE! You have ONE patient that is getting better and showing permanent improvements and she stopped using the drugs one at a time in End Stage because they all eventually stopped working!"
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