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Avatar universal

just wondering what to look for

My mother has COPD, including emphysema from smoking. She is still sneaking cigarettes (Sherman's and those black box clove things). We moved her in with us due to other health problems and her lack of energy from the COPD. Now I'm stuck with her (yes, that doesn't sound very nice of me but you try living with your annoying mother for 2 years and you will say it too) and am wondering how this whole thing is going to play out over the next few years. She is always out of breath when she gets up in the morning, even though she has been on an oxygen concentrator all night. I know from reading that eventually there will be a CO2 problem when her lungs can't get rid of it anymore. I'm just wondering what the early signs of CO2 poisoning are. I know there is supposed to be confusion and such as it progresses. Mom doesn't seem to have that, just slipping memory and lack of energy, plus the shortness of breath. I guess what I'm really trying to do is gauge the progression of her disease, since she regularly lies to her doctor. At her worst (the last time she was hospitalized, two years ago), she makes a funny sound when she exhales. She hasn't done that much this year, which seems like a good thing, but I've begun noticing that morning breathlessness and am wondering if she is better, worse, or about the same. And no, I can't ask her, because she lies to me and we don't get along that well (mostly due to her living with me and being very dependent on me before she moved in, while maintaining a pissy independence that has more to do with denial than her actually doing stuff for herself).
27 Responses
628679 tn?1231310902
The morning hypoxia is not really something you can go by, in my case it was the very first sign there was a problem. Two hours and a couple of cups of coffee later I'd be fine.

As for the hypercapnia (CO2 retention), that is almost certainly already going on, and here is the best guideline I have found: Symptoms of early hypercapnia, where arterial carbon dioxide pressure, PaCO2, is elevated but not extremely so, include flushed skin, full pulse, extrasystoles, muscle twitches, hand flaps, reduced neural activity, and possibly a raised blood pressure. In severe hypercapnia (generally PaCO2 greater than 100 hPa or 75 mmHg), symptomatology progresses to disorientation, panic, hyperventilation, convulsions, unconsciousness, and eventually death.

Hopefully, some of the families of COPD patients on here can help you with achieving household harmony. :)
Avatar universal
Thank you. I will keep my eye out for that stuff.
Living with a COPD person can be frustrating, especially if it is a parent. She has to have a bunch of stuff out in the open, at waist to eye level, so as to not use energy doing anything. Since she is already a clutterer and I am a neat freak, we have a basic living difference. I try to keep her stuff contained to her areas while she is constantly expanding. Plus she picked up some really bad habits when she was living alone, especially reusing dishes and cups to avoid washing them, which is just stupid considering that she doesn't have much of an immune system due to lymphoma that is in remission.
She has a history of hiding increasing health problems until ending up in the hospital, which is why I just watch her for symptoms. I just feel kind of lost in this neverending situation, not knowing if she is really getting worse slowly or currently holding her own. I do know that eventually the disease will reach a point that causes her to be noticeably struggling and more dependent. The other aspects of her health improved so much when we moved her in, that I went from thinking she only had a couple of years left at best to wondering if she will outlive me because I'm going to throw myself off a cliff due to living with my mother indefinitely.
Most of this stuff I just complain about occasionally over at the caretakers forum, but I really do need visual assessment information and I thank you for that again.
510964 tn?1221342406
If you don't mind me asking how old is your mother? I would hold a family meeting to distribute the chores aroung the house. You need to let her do as much as you can for herself. It helps her with her exercise and her breathing no matter if it takes all day or 5 minutes. Your not helping her by catering to her. Maybe a little sitting area in her bedroom with her T.V. and her recliner her little antiques around her would keep her comfortable and confined more often in her space.Drop her at the adult center for your day off it helps I've been there I know what your going through. My mother was a spoiled grownup child,she was killing me slowly.I finnally looked her in the eyes and told her if I die your going to end up without any help so if this continues I will put you in an adult home tha way I'll be alive and can come visit everyday.Now she helps me with house work is tired by 7;30 in bed asleep and gives me alone time. P.S. I didn't have monies to put her in HOME but she didn't have to know that. Hope something helps Good Luck
Avatar universal
Mom is 75. I appreciate your suggestions, but they won't work with my mother. She stopped doing ANY chores years ago, when she was still living alone. She wouldn't even walk down the stairs to take her dog out to pee. The poor dog ended up peeing on the floor sometimes because she couldn't wait anymore. Any time ANYBODY came by her apartment, she asked them to take the dog down to pee.
After she got out of the hospital and nursing facility last time, she went through a 6 week pulmonary rehab program with the top therapist in the country. The day she finished it, she stopped doing all the extra exercise and started smoking again. She will not change, and I can't deal with the kind of uproar and hostility that would occur if I tried to MAKE her do something besides crossword puzzles. And my mother wouldn't be caught dead in an adult center.
I am resigned to the "annoying roommate" problem and being the housekeeper, cook, etc. My younger sister has been helping me with coping strategies for the anger and hostility I feel from this neverending situation. Mostly I'm just enduring, but also wondering when the next step down in health will cause a change in the situation. I just have to wait and see, and try not to let her get me down.
Avatar universal
I feel so sorry for you, you need to get out more maybe for the week end, and if she cant stay alone you said you had a sister. Tell her to step up. My mother died of lung cancer, i kept her home awhile, so I know what your talking about, my brother just had surgery for lung cancer(63) my sister has copd(54) and I have copd(57) we all caused it from smoking, we have all quit, to little to late LOL  so I try not to take out my days of hatfulness out on my family. And I will never allow myself to live with my kids. But thats me. But from exsperience if you dont take care of yourself and get a break once in awhile you will grow to hate her then love her. and wish it was all over.That sounds terrible but its the truth. I can tell you it will get worse and unless you have some support it will be very hard to deal with. Ill be praying for you and your mom. Quinncy1
Avatar universal
Unfortunately my sister lives in Alaska (both sisters actually). I've tried talking mom into going up there for a while (she was born there and still has two sisters up there), but she doesn't want to travel anymore, except for one more "fun" trip to Europe next year, with sister and her husband doing all the hauling and arranging with wheelchairs and portable oxygen concentrator.
Part of mom's problem is that several times she has thought she was going to die, but she's still here. waiting. That's what it feels like anyway. First the two rounds of cancer, either of which could have killed her but didn't. Then severe GI problems, resulting in her getting down to 74 pounds and repeated hospitalizations. But she bounced back from all of it and is now "relatively" healthy except for the copd. She weighs over 90 pounds now and hasn't been catching every bug that comes along. Just slow progression on the copd.
Because she is still smoking, and because she hides symptoms whenever possible, my only real clue that she has progressed further with the illness will probably be some sort of respiratory incident this winter, hopefully not another round of pneumonia. Part of me is thinking she will never make it to the late stages of emphysema because she will have some fatal respiratory event before she gets that far. Her lungs are weak already, and she went through several emergency hospitalizations a few years ago due to respiratory distress.
So here I have a relatively healthy "sick" mom, with all of her faculties and none of her energy, who sneaks cigarettes all day long, as well as wearing a patch, who won't give me any info if she is feeling worse, and who will either die abruptly from one of the acute respiratory incidents or will simply decline over who knows how many years, needing more and more help.
So my "reward" for putting my life on hold to move her in with us will be to watch her die up close instead of hearing it from a phone call. yay.
Avatar universal
On 9/6/08 I had a respiratory arrest...my lungs were completely filled with CO2 so there was no more room for any oxygen. Had just enough time to call 911 and was brought back.  All the symptoms your mother has, I had.  I was diagnosed with COPD 2 years ago and continued to smoke. I started losing weight at the beginning of the year no matter how much I ate. I was surprised to find out that all the calories I was taking in were being used just to breathe.  I just turned 65 on 10/7 and haven't had a smoke since my arrest. It's a shame I had to die to quit smoking!!! But, it worked. If your mother won't quit smoking there is nothing you can do or say that will make her quit. I knew I wasn't supposed to smoke and the week before my arrest I was working on a wean off program (which was just another excuse to not quit completely). Just before I arrested my symptoms were continous wheezing, coughing my guts out every morning bringing up gobs of mucus (sounds gross & it was), memory lapses, only enough energy to go to work and any energy I had at work was being used up quicker as each day went by. From what you describe I question if your thoughts about what you have to watch for in the next few years is an accurate question. It sounds like your mother isn't destined to make it that long. Sorry to be so blunt, but I've been there, seen it, done it. But didn't have enough other serious medical problems to hinder my recovery from the COPD. I wish you the best - you are in the same position my children were and I am so sorry now for what I put them thru but I am lucky enough that I was able to tell them how badly I feel for that.
Avatar universal
I am going to do some tought love talking. If you don't want to read it, fine with me. You say your mother goes no-where. Won't go outside. SO.......who is buying her cigarettes?
She has to be getting them from somewhere. I sincerely hpe you are not!! Is a friend bringing them in for her?  Tell that friend she cannot visit your house if she/he is bringing in cigarettes. I know that can be a hard and frustrating thing to do, and you would probably catch he** from your mom. But you can give her the choice of moving out if she doesn't like your putting your foot down. I wish I had my mom alive to be tough with. She died of complications of Alzheimers. Much more heartbreaking than any other disease I know of.

I really sense your frustration. Can you hire someone to come in and mom-sit? You aren't doing your own health any good, too much stress can cause a great many ills.

Best Wishes.
Avatar universal
Again, I really appreciate the comments and suggestions. Let me explain about my mother. She does go places sometimes (has a few regular social things), and has her own car. She drives about 5 miles per month. Won't give up the car but avoids driving whenever possible and won't go further than the store around the corner or her friend around another corner. She has a dog, so is forced to take short walks every day (she tried to get me to do it and I refuse to take care of her dog). We signed a no smoking contract for our rental home, so she has been forced since we moved in to walk around the block to smoke (she also smokes on the front porch but my husband harrasses her whenever he sees her doing that). My husband and I joke that at least the dog and her stupid cigarettes force her to walk, though having a cigarette every time she walks around the block pretty much cancels out the exercise.
If we leave for a few days, mom is fine on her own, but her habits are so bad that I don't like to be gone more than a few days. If I am not here, she will eat and drink from dirty plates and cups, and eat room temp food that she has let sit out. Plus she trashes the house with her little piles and dirty dishes and dabs of uncovered food in the fridge. Plus, when I was gone for several weeks in the summer (I spent a month arranging help, putting food in freezer, getting a housekeeper, etc) she started smoking in the house. These are all the behaviors that caused her to get so run down and sick before we moved her in with us.
She goes around the corner to the store for her cigarettes. She knows better than to ask me to get them. For a while, when she was still trying to pretend she wasn't smoking, I would throw away her cigarettes and steal her lighters, but I've given up. She is going to kill herself with the stupid things no matter what I say or do. She is strong willed and addicted. And in denial about what a lousy way to die emphysema is.
She's not one of those vague little old ladies I can drop at the senior center. She won't do ANYTHING that smacks of senior babysitting. I'm just thankful that apparently my sister got through to her about sitting in the living room all day and evening every day, which wasn't exactly fair to my husband and me. Now she spends more time in her room (she has satellite tv, dvd, etc), and I fixed up a hideout in the garage to help me get through winter.
Basically I'm stuck with an annoying roommate mom in a really small house until she dies. I did look up more emphysema info, and at least it is more likely that she will just keel over from respiratory arrest than have a long drawn out decline (she's that "pink puffer" type that is skinny, with 3 respiratory collapses already). Basically, she's just sitting around doing crossword puzzles and waiting to die. She does still do a little gardening, but mostly just makes more yard work for me.
I'm really just frustrated that I'm stuck indefinitely in a situation that is best for my mom but not for us, that the only way out is for her to die, and that I just have to live with a stable but annoying situation, that I won't have a sex life until she's gone, that everything I do and every decision I make has to take her into account, that all my holidays will be taken over by her, that having visitors is not fun (she always asks my visitors to run errands, or asks me because I tend to go out more when I have visitors), that I have to put up with  her stupid barking dog because she is also a lousy pet owner, that I have to live with a mom that I prefer would live in a different town than I do.
I feel bad that this situation has caused me to have mostly negative feelings about my mother. I am dealing with it better now than I did last winter. I have to. Like you said, stress is a killer, and I have been working on stress coping strategies to keep myself sane and healthy.
Avatar universal
You have your hands full! Your last post was very enlightening for many reasons. First, I sounds like you are allowing Mom to control you..why? Guilt? Pity? Fear? Your first step might be to take the control back.
AA has a prayer that fits your situation: "God grant me the serentiy to accept the things I cannot change and the courage to change the things I can"  Mom is not going to let you change very many things about her, so you need ot accept that nothing you can do or say will make her any different.  But, you can change how you react to her!
You absolutely need to make and take time for yourself.  You said Mom won't do anything that smacks of senior babysitting. Well, she is living in your home ( messing it up, eating your food, etc.  If you want to do something to get out and about and bring in a senior "babysitter" she has nothing to say about it.  It's your home; it's your decision.
Forget about preaching at her about smoking, throwing them away...just stand your ground about where she is allowed to smoke (just make sure it's as far away from the house as she can handle).
I'm curious if Mom has always been a sloppy, careless, selfish person or is this what she has become since the COPD got bad?  If this is newish, then it sounds as tho she has given up mentally & physically.  I got that way about a year before my arrest: I just seemed to not care and everytime the kids would harp at me about the smoking I would tell them they weren't telling me anything I wasn't telling myself everyday.  Cigarettes are more addictive then heroin. Did you know they put ammonia in them in order to give a good buzz when you first inhale?  I tried quitting over 25 times and it took dying to finally make it work.  Fortunately, at 65, and fast responders I lived.
Anyway, back to you.....as hard as it might be, you have to put yourself in the #1 position because it is only going to get worse from the sounds of it.
Check with a senior citizen orgaization in your area and see if they have volunteers who can be in the house so you can get out...go see a movie, go shopping, get out and breathe and take time for yourself.  
Think about it....
Avatar universal
As mutterwood said, you are not going to change her, only she can change herself. Further in that line, she does sound like she is depressed, not doing anything much. Does she have regular dr visits? Have you discussed this with her doctor? He does need to know she is still smoking.

A little about myself.....I had quit smoking for 3 years, when I married my husband. We had 5 wonderful years, but he was a smoker, and I went back to smoking. He had smoked since he was 12, and was 61 when I married him. If you can't beat um, join um. So I did, to my daily regret. He became ill one morning , got up unable to walk. He looked like a stroke victim, except no drawn facial features. Rushed him in to dr, couldn't walk, left side almost totally paralyzed. After MRI's the next day, he was diagnosed with lung, lymph node, 2 brain tumors, and spinal tumor cancers. By the time he died 12 weeks later, he added bone cancer and liver cancer to the list.  After his diagnosis, I asked his cancer dr if he needed to quit smoking. He said flat out NO, it wouldn't make any difference, only stress out what time he had left.  It was the worst 12 weeks of my life, watching the man I considered my sould mate die. After 28 years of an abusive marrage, I only got 5 years with a man who loved and accepted me as no other person will ever do.      Addictions are he**. Even when he was so doped up as to be almost comatose, he would reach for a cigarette and hold it..not lit mind you, but just hold it.   Now I am on the verge of being diagnosed with COPD myself. I daily pray that I can soon put down that pack for good. But even after all I have been thru, and will likely be going through, I still can't quit again.

On some level I know you love your mother very much.or you wouldn't be so angry at her actions. Her habits of being messy, eating habits, no exercise, not taking care of her own dog, are not the real issue. The issue is she is killing herself slowly. And you feel like she is cheating herself, and you. It's like with a marriage. Usually the things people fight about, are not really the real issue. I hope you understand what I am trying to say.

I don't know of any way to help you out of this situation. It's so easy for those of us on the sidelines to say do this, or do that, but we aren't in your shoes. Do you have a minister you can talk to?  Or maybe your mom's friends? Do her friends help you, or side with her? Point out to them if they really are her friend, they could help her more. Could she go stay with them for a week or so, for some relief time for you? Anyway, just some thoughts on coping.  Take care of yourself, and bless you for caring for your mother. Wish I had mine to care for, but wasn't in God's plan.

Hugs & Prayers.
Avatar universal
Thanks folks. I didn't really mean to start this. I was mostly concerned about staying up on possible symptoms. My situation is not nearly as bad as many I've read about. I'm still really just dealing with an annoying roommate who happens to be my mother.

Some clarifications. The house is not "my" house. We moved back here because my husband got a good job and my mother was in and out of the hospital. We decided that the best thing to do would be to get a house large enough for the three of us. We knew it would be a challenge to have the three of us live together, but felt we had no good choice. Previously, before we moved away for 2 years, I had been constantly going over to mom's place to take her food, clean her kitchen, etc. Hated it. Hated her dark, dirty, smoky apartment and her filthy fridge. Hated that she smoked when I was there even though she knew i hated it (I simply left the minute she lit up, but it never stopped her from lighting up the next time). So basically I was stuck dealing with two separate households, doing everything I am now doing anyway.

We knew the biggest hits would be privacy (we've only been married three years) and personal space, and my biggest challenges would be mom's bad habits. Having been letting my husband get his career established has left me mostly unemployed for the last few years (I'm a college geology instructor) so I volunteered to be the housewife/caretaker for this "experiment". I've been trying to get a part time job to take me away from the house, but times are tough and I don't want a job that is more stressful than home, which would defeat the purpose of the job. So I put up with the boredom of being a "housewife" and I take the dominant role of household support person.

About those control issues. Mom and I are both very strong willed people. We love each other and have mostly gotten along over the years, but have clashed badly on a few things. We don't have many of the same interests, so I really don't WANT to spend much time with mom but I'm stuck in the same space with her. Because we are all equally members of this household, rather than mom moving into "our" house, there is no such thing as simply telling her that things will be a certain way. Other than compliance with the no smoking contract we don't have "rules" around here. So her "control" over me is more about proximity with a living style I don't like (and vice versa, she doesn't like that I like tidy) than her forcing me to do something I don't want. I went into this with open eyes. I knew I would feel encroached upon by her lifestyle, would feel resentment about no sex life, would just feel like I didn't want to be around her. But after discussing a long time with my sisters and husband, we all concluded that this is the only way to extend mom's life. I TRIED to get mom to consider spending a few months every year up in Alaska with my little sister, but she's got this inertia thing going now and won't budge.

As for depression, that is certainly a possibility, but it is not running the show. I know that she has gone through depression about her illnesses and anger over the cancer cutting short her career, but she seemed to have worked through most of that a few years ago. What's left is this inertia of hers, this "I'm going to just mostly sit around and do crossword puzzles because I didn't die when I was supposed to and everything takes so much energy now." And there's some weird stuff going on with her writing. After she was forced to retire because of cancer, she started trying to write various novels. Some of her stuff is pretty good, but she has never been able to get a publisher to accept it. Several years ago she started writing a semi-fictional "novel" of her childhood, and it is really quite good (I did some editing for her). But she "decided" that she wasn't going to die until she finished the book. Unfortunately, she also decided she couldn't write without chain smoking and drinking margaritas while she wrote. So she started doing a seven day a week writing thing where she would sit for hours in her little dark apartment, smoking like a chimney, drinking, and eating spoiled food. That's when she started getting so sick. Well, since we moved her in with us, she hasn't worked on her book (remember how important it apparently was to her). She has convinced herself that she can't write without smoking, and we won't let her smoke in the house, so she doesn't write. And of course we can't talk about this because we then get in a fight about her smoking.

I have encouraged her to get out and spend more time with her friends, but she limits her out of house stuff due to energy levels. And she never stays away long enough when she does leave. I'm always SO relieved when she leaves and SO disappointed when she comes back 2 hours later, just when I'm really getting to enjoy her absence. And since I've mostly been stuck at home since we came back and did this, I have even less of a social life than she does. I do take myself out to lunch and such to get away from her, and I take walks and drives. We go camping but I constantly worry that she is going to let one of our cats out and not notice, plus I know I'll come back to her little piles and dirty dishes, so I don't get the relief I should.

The physical living situation is not going to change as long as she lives with us. My whole approach is to keep my anger and anxiety down and use as many coping strategies as I can. As winter approaches I need to take more steps to get out of the house and away from her, as well as using my garage hideaway when I'm home.

I WISH it didn't have to be this way. I WISH I still enjoyed doing a few things with mom instead of wanting her OUT of my life. I WISH my only way out wasn't her death. But family needs to be taken care of and I'm the one here so I have to do it.
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