Friday Quiz: COPD and CO2 Retainers (February 12, 2009)
What Is COPD?
COPD, or chronic obstructive pulmonary (PULL-mun-ary) disease, is a progressive disease that makes it hard to breathe. "Progressive" means the disease gets worse over time.
Bonus question: What is a "CO2 Retainer"?
A CO2 retainer is a person who has become conditioned to chronically high levels of CO2.
Usually, increases and decreases in carbon dioxide levels detected by the central chemo receptors is what causes people to breathe. When a person is in respiratory failure, and the carbon dioxide level is high, decreasing levels of oxygen as detected by the peripheral chemo receptors then takes over as the drive to breathe.This is what happened to my father when he was admitted to the hospital with a suspected case of bacterial pneumonia. Since he was having trouble breathing, the attendants gave him 100% oxygen.
Unbeknownst to them, he was a "CO2 retainer," and so the 100% oxygen, rather than aid his breathing, essentially signalled his body to stop breathing.
As I understand it, it works like this in CO2 retainers: when levels of CO2 reach a certain high level, then the lungs are signaled to rid the body of excess CO2 by exhaling and inhaling, i.e. breathing. If CO2 levels are very low, as is the case when a patient is breathing 100% oxygen (recall that normal air is only 20% oxygen), then the body never gets a signal to breathe because, well, there's apparently no need to as CO2 levels are low.
Apparently not everyone buys into this theory; but in any event, my father basically stopped breathing, which triggered a reaction by the emergency room staff. Since it was late at night, my stepmother had gone home, so we don't know exactly what happened, but it seems a breathing tube was inserted down my Dad's throat to restore normal breathing.
My Dad is 82 and suffers from a host of chronic illnesses. He never smoked, so we surmise he contracted COPD as a result of living his entire life in the smog-laden Los Angeles basin. He has multiple myeloma and severe osteoporosis as well as COPD. Since he'd already had pneumonia last year, my stepmother was very worried, so his surviving offspring rallied round, my brother flying in from France and my sister and I making the much-less arduous 400-mile trek to their house.
My Dad was released from the hospital and is recovering pretty well at home, but all the issues of at-home assisted care are now on the table. My sister researched the Medicare coverage, and well, most of you middle-aged and elderly folk can fill in the blanks.
What can I say but the obvious: try to keep whatever health you currently possess by whatever preventative measures are still within reach.
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