Compassion and COPD

Hey folks



My final assessment yesterday was with a middle aged man currently having an infective exacerbation of his COPD. I had not seen him before, but from his notes gathered that his history of increasing shortness of breath and reduced exercise tolerance co-incided with an exacerbation of his haemorrhoids, with were very painful.



Upone some subjective questioning it came out that his haemorrhoids were preventing him from being comfortable in any position, particulary sitting and standing. A modified high side-lying positiong was the most easing of his pain. On top of this he had not opened his bowels for a few days, and when he does it is obviouslety painful. These facts alone were making this guy quite distressed and anxious, and it he was still waiting for a decisiong as to best manage his problem, as the surgeon would not operate and medical management had been unsuccessful as yet.



The anxiety and worry this man had over his pain and discomfort were reulting in him becoming more and more short of breath, and in general worsening his COPD symptoms. It had been my plan to re-assess some important signs then begin my treatment of techniques to reduce SOB, a walk with his O2 and some UL exercises, while assessing his mobility. We did manage a walk, which was interrupted by a sudden desire to defecate (false alarm). This in turn made him more upset. He bacme quite teary and upset after this, expressing his concern over his haemorrhoids, which to him were his primary problem, but it seemed as if others were just brushing over it. And he felt, as did we, that his COPD symptoms were as bad as they are because of this primary problem. I instinctively tried to comfort him, but was glad my supervisor was thereas she knew exactly what to say. These people with chronic lung disease have a very specific set of problems and associated anxiety and depression and I learnt a lot from my supervisor with regard to what to say to ease these feelings and make them feel more comfortable.