lung nodules now found in nose too

[chirp]

My Husband has COPD and has been on oxygen for about two months. His pulmonary doctor has been keeping an eye on a cluster of nodules on his lung.(CT scans every couple of months) a few weeks ago, his primary doctor noticed some nodules in his nose as well.  His personality is changing rapidly. He has extreme violent episodes he never had before. I know that some depression is normal but this is not depression, this is rage and way out of character for my husband.I am wondering if these changes could be from the 02,(he is on and off all day and on all night) I also wonder if the nudules spread from his lungs to his brain? I know I sound ignorant but I need help.The doctors seem to be dragging their feet. My husband's father had lung cancer and brain cancer which causes me to worry all the more.

[National Jewish]

You have good reason to be concerned, both about the nodules and about the drastic change in your husband's personality and you are correct in concluding that rage is not usually a manifestation of depression.  Behavioral change can also be caused by low blood oxygen levels but not by the administration of oxygen, with one exception.  The exception is that too much supplemental oxygen can depress respiration and result in rising carbon dioxide levels in the blood and brain.  Elevation of carbon dioxide, especially in the presence of low oxygen levels when he removes the oxygen source, can account for behavioral change and a variety of central nervous system signs and symptoms, eventually leading to confusion, stupor and coma.

Your husband's arterial blood gas levels should be checked immediately.  This can be done quickly and easily at any emergency room/hospital and may provide the answer.  If this is not the cause his doctors should look to his brain for what is referred to as an organic cause.  Possibilities would include impaired circulation, tumor or infection in the brain, the last two may or may not be related to the lung nodules.

What you describe falls in the category of Confusional States and Delirium, for which there are many causes.  This is a medical emergency and he should have a thorough evaluation as soon as possible.

When the cause of his mental changes have been diagnosed and treated, attention can then be directed to diagnosis of the nodules in his nose and lungs.

Feel free to share this information with his doctors.