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  • Q&A with Australian Health Practitioners

    I have severe emphysema, diagnosed 17yrs ago. I have severe dyspnea.

    I have been trying to find out more about lung reduction surgery cos my dyspnea is very severe & ongoing at this point. I'm a pensioner, 57yrs old. I have no health insurance. I'm sure I could live longer if I had this surgery. What does it take to get on the list for the surgery under Medicare? I am having a hard time finding doctors who take me seriously, as Emphysema is largely overlooked; despite being a very scary disease & a horrible way to die. I don't understand why! I can barely walk 30 metres, and with the feeling that my lungs can't fill, my anxiety goes through the roof & I can't calm down. I'm afraid to be out in public; & spend most days in bed. I feel like I have no life. I also suffer from lifelong mental illness of depression, ADD, anxiety & panic attacks which make it worse! How can I fight for my right to get this surgery before I die?
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    Dr Nicholas Wilsmore

    Respiratory & Sleep Medicine Physician

    Dr. Wilsmore in an Australian trained specialist, with International fellowship expertise in Interventional Pulmonology. Nick has unique expertise in the interventional diagnosis and management of ... View Profile

    I am very sorry to hear about your suffering. COPD with severe breathlessness is certainly a significant issue, which can result in a profound reduction in quality of life (QOL) for those patients suffering from it.

    Lung volume reduction, whether by surgical, or endoscopic means, is an option to reduce breathlessness, improve lung function, improve QOL and potentially prolong life expectancy, in carefully selected patients with COPD. It is important to note from the outset, that the majority of patients with COPD will not be suitable for these procedures, as there needs to be a specific constellation of anatomical and physiological findings, for a patient to benefit from the intervention. It is vitally important that prior to any assessment for lung volume reduction that the patient has quit smoking, is adherant to their prescribed inhaled medications, and has completed a full course of pulmonary rehabilitation. 

    Assuming that the above has been addressed, the most important test to assess potential suitability for lung volume reduction is the performance of lung volume measurements through a Body Plethysmograph. Most lung funciton laboratories within public hospitals will have this equipment. If this test demonstrates the presence of "gas trapping", then further assessment for lung volume reduction is sensible. 

    The majority of lung volume reduction performed these days is via endoscopic means (i.e. through a camera), with either valves or coils. This is a signicantly safer means of achieving the benefits of lung volume reduction, without resorting to surgery. If there is gas trapping evident on the lung volume measurements, then a dedicated CT scan of the chest will allow further assessment of suitablity for valves, coils or surgical lung volume reduction. Lung transplantation should also be a consideration in a patient of your age group, if not already considered previously. 

    I hope that this has been helpful. All states of Australia currently have practitioners skilled in the performance of endoscopic lung volume reduction for COPD. 

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    Lauralee McLaughlin

    Healthshare Member

    Can you please tell me; as close as you can - when I'll probably die of this disease?

    Our healthcare system has been getting worse; and the first few times I called ambulance approx 5yrs ago - they had NO idea what it was and put me on psych floor.

    Of course I've quit smoking & take my medicines religiously - but as a child I've watch almost all the family members in my mother's side die of this horrible death and it doesn't seem to have the impact on healthcare pros it once did - dunno; maybe cos they consider it self inflicted.

    All I know is that I have had it years longer than anyone in my family ever had before dying from it..

    The majority had it between 10-15yrs.  I passed that milestone long ago!

    It is so extremely frightening, because I feeling I'm being suffocated to death just by getting up & walking to another room.

    I try to stay possitive, but I really don't have more than 1wk a month out of 4 of I'm lucky.

    I'm a widow, have no children or family. I have to be honest with you that as the pain gets worse & I never can have even 1 good day (it also makes it hard to get health care!) - then I intend to use my god-given right to choose my own time of dying with dignity.  I still plan to leave organs, eyes, kidneys, skin, blood, etc for use of helping another.

    If course, it'll take a doctor to work.with me (and respect my DNR) as well as keep me alive if necessary so viable body parts are not wasted!

    I am willing to go through the pain for the greater good; but not to stay alive like the person I've become.

    I know it's happening soon; but don't know what to do about it.

    No-one pays attention enough and I'm only able to get an appointment once every 6-8mos! 

    I know I wouldn't last more than 2 yrs max.

    Thank you for your help;.and if you know someone I can call to consult with (I live in Westmead); please, I get it you - send along their office phone #.

    Blessed Be, 

    Lauralee McLaughlin

    33 Moree Ave

    Westmead, NSW 2145

    0450 499 130

    llnovabug@gmail.com

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