What stage are we in

My dad is 76 years old. He was told he had emphysema about 17 years ago, at which time he immediatly quit smoking.He was also a fireman for 20 years and worked with paint at his job, all of which contributed. He has been on oxygen 24/7 for quite some time. He is on several inhailers, breathing treatments daily, and steroids periodically. His lower legs, below the knees have been discolored for quite some time and seem to be getting worse. His previous doctor said his oxygen is up as far as it can go and that there is nothing else he can do. However a new Dr. took over the practice and said we can keep trying new meds. to try to make him feel more comfortable. He tries to go to the store periodically, but can't walk for very long. Lately he has been having "bad days" (He has a hard time breathing when walking from one room to another, his chest hurts when walking very far-just in the past couple months) For the past several months, he has been unable to take a bath, he throughly washes himself off at the sink(He is very proud and wont let anybody help)   He told my mom that the steam makes it hard to breath. When I ask my mom what the doctor says, she just says that Its worse and its not going to get better. Can you give me a rough idea of where we are in the stages and an approximate time frame.

[National Jewish Health]

The inhalers your father is on should include 2 long-acting bronchodilators Spiriva® HandiHaler® (tiotropium bromide inhalation powder) and Serevent® Inhalation Aerosol (salmeterol xinafoate) or Foradil® Aerolizer™ (formoterol fumarate inhalation powder) along with an inhaled steroid.  If his blood oxygen levels are low, despite relatively high flow 4 to 6 liters/minute nasal oxygen, especially with exertion, his doctors might want to consider having him use a trans-tracheal oxygen system.

You should ask his doctors what is causing the leg discoloration.  It could be impaired circulation or a reflection of low oxygen levels.

Also, at his age of 76, it should not be assumed that his health problem can all be attributable to the emphysema.  He could have superimposed heart failure and/or clots to his lungs, the latter especially if the circulation in his legs is poor.  The chest pain you describe could be angina pectoris, yet another sign of heart disease.

It would be best to determine the “stage” of his lung disease and the associated prognosis, after his heart has been checked out and his lung therapy optimized.

Good luck.