Treating Advanced Illness - Advanced Lung Disease: Smoking Cessation
Content provided by the Faculty of the Harvard Medical School
Treating advanced illness
Doctors have many ways of easing the symptoms of advanced lung disease. Oxygen therapy can help you breathe and increase the amount of oxygen that gets into your body. If you have been on intermittent oxygen therapy, your doctor may recommend continuous therapy. Taking oxygen at night can help you sleep better. If you have severe shortness of breath that is not helped by oxygen therapy, your doctor may prescribe a narcotic pain reliever such as morphine to make it easier to breathe. But morphine and similar drugs are used only when nothing else works because they depress breathing and, therefore, can make it even harder for your lungs to eliminate carbon dioxide. If you are young enough for surgery, your doctor might recommend lung volume reduction surgery or a lung transplant (see "Surgery").
You might also need other medicine to treat heart complications from COPD. In particular, you may need diuretics, such as thiazides or furosemide, if you have swelling and your body needs help getting rid of excess fluid.
If you develop acute respiratory failure, you may need a machine that takes over your breathing, called a ventilator or respirator. The ventilator will either be endotracheal (a tube going down your throat to your lungs) or noninvasive (a mask on your face). Using a ventilator can be lifesaving because it can give you time to heal and recover the ability to breathe on your own. But if you are extremely ill, a ventilator may prolong life for only days or weeks in an intensive care unit, with little chance of survival or a meaningful life afterward. You'll need to think about these issues while you are still healthy enough to consider the circumstances in which you would and would not want to use a ventilator. Talk over the options and likely scenarios with your doctor and your family. Then, make your wishes known in an advance directive — written instructions for your medical care should you become unable to make decisions for yourself (see "Artificial ventilation").
Artificial ventilationMany people with advanced COPD will eventually have to decide whether to use a mechanical ventilator. The decision is complex. Being on a ventilator may literally be the only option to save your life — and help you return to better health. Using a ventilator requires having a tube placed through your mouth or nose and down your windpipe. Once the tube is in place, you won't be able to speak. If the tube has to remain in place for a long time, you may need a tracheostomy, a surgical opening made in your throat for the tube. If you have advanced lung disease, discuss your feelings about artificial ventilation before the need arises. Consider asking your doctor these questions:
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| Last updated: | May 23, 2007 |
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Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.
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