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Emphysema stages
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Emphysema stages

My father-in-law is 83 yrs old.  He was been diagonsed with Emphysema/COPD about 10 years ago.  He has been having many coughing spells, dizziness and a lot of pain in his shoulder, neck and lower back.  He was put in the hospitial today to see if they can find out what's going on.  I'm wondering where I could get some info about the end stages of this disease.  We don't know if the back, shoulder pain is part of the disease progressing?
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While it is possible that your father-in-law’s symptoms may be related to progression of the emphysema/chronic obstructive pulmonary disease (COPD) it is also possible that he is breathing in a very energy draining way; using the accessory muscles in his neck, shoulders, and in between his ribs.  The diaphragm is a much larger muscle, so it is much more energy efficient to breathe through the diaphragm rather than the chest.  Dizziness can occur with hyperventilation.  Your father-in-law may be helped by trying to make his breaths slower and deeper.

Diaphragmatic breathing can help your father-in-law move more air in and out of his lungs.  This is the most efficient way to breathe and may improve his symptoms.  Learning this technique will help him to breathe slowly, regularly, gently, and smoothly all of the time.  Here are the instructions:
• Breathe in slowly and deeply through the nose.
• While breathing in, count 1, 2 and push the stomach out.
• Place a hand on the stomach to feel the stomach going out.  This promotes the use of the diaphragm and the lower respiratory muscles.
• Breathe out slowly and deeply through the mouth.  Imagine that you are breathing out through a straw by “pursing” the lips.
• While slowly breathing out all the way, count 1, 2, 3, 4 and let the stomach relax.  Place a hand on the stomach to feel the stomach going in.
Possibly staff at the hospital can help your father-in-law with diaphragmatic breathing, which may be part of a pulmonary rehabilitation program.  Another source of help is an introductory yoga class or checking out a videotape on yoga that focuses on breathing and relaxation.

Each stage of emphysema is based on symptoms and measured loss of lung function, especially the forced expiratory volume in the first second (FEV1).  The FEV1 is the amount of air that a person can forcefully blow out in the first second of exhaling, which is measured as part of a simple breathing test called spirometry.  It is an indicator of airway obstruction and how far the disease has progressed.  Normal is 80% or greater of the predicted value.  The predicted value for a given individual is based on age, gender, height, and race or ethnicity.

There are 4 stages of emphysema/COPD:
At risk   Stage 0 Normal pulmonary function
Mild   Stage I Mild reduction in air flow
Moderate   Stage II FEV1 50 to 80% of predicted
Severe   Stage III FEV1 30 to 50% of predicted
Very Severe Stage IV FEV1 less than 30% of predicted
Very severe or stage IV would be the end stages of emphysema/COPD.  It is very difficult to tell you how your father-in-law will be affected because every person is affected so differently.

To learn more please read our COPD information by copying and pasting this address

http://www.nationaljewish.org/disease-info/diseases/copd/index.aspx

into the address window of your internet browser.
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