My questions is concerning my 32y husband.He was involved in an ATV accident almost a year ago and did some serious damage to his left chest requiring a 21 day hospital stay along with a thorocatomy to remove his pluera, bone fragments and blood clots. He was improving then this past Sept delveloped HAPE while camping and since has declined. He did a follow up with his pumlonist who did a bronch which came back normal but his last spirometry showed FVC 44% and FEV1 38%. He did not tell him anything besides he has an obstuction and try taking Advair and Duoneb. My actual question is does he trully have COPD or is his lung deterioration due to damage from the accident and what can be done for him? He is a smoker (stupid he knows) for 16 years, does have SOB even with walking around house, Echo showed Pap at 31, uses o2 during sleep due to o2 readings of high 70's.
Thanks for your time!
Very sorry to hear of your husband’s decline. You have provided nicely detailed information but his is a very complex problem. Two factors may bear directly on his development of HAPE: The first is a documented increase incidence of patent foramen ovale (an abnormal opening between the two upper chambers of the heart) that can result in a reduction in blood oxygen levels (Hypoxia) and/or pulmonary hypertension and the second is the fact that persons who develop HAPE are much more prone to develop pulmonary hypertension (PH) in response to low oxygen levels at high altitude than the general population. The latter might still be significant if, for whatever reason, your husband experiences sustained low blood oxygen levels resulting in frequent periods of PH, greater than the level you mention of 31. All the more reason for his doctors to confirm the amount of supplemental oxygen needed to result in normal blood oxygen levels, 24 hours a day and especially with sleep.
The minimal PFT results you mention do not suggest COPD and may be the result of restrictive lung disease secondary to his horrific accident.
I suggest that you ask the Pulmonologist to clarify the significance of his pulmonary functions and describe the site and nature of the “obstruction” you mention.
Finally you might want to consider seeking a second opinion from a pulmonologist with a special interest in pulmonary hypertension. Most academic medical centers have PH Clinics and that is where such experts are to be found.
Feel free to share this response with his doctors.
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