Chronic Obstructive Pulmonary Disease (COPD) is a term which is used to describe either chronic bronchitis or emphysema or, in some cases, both. In some cases, It is also referred to as Chronic Obstructive Airways Disease (COAD). In this condition, there is obstructed airflow to the lungs due to narrowing of the airways. Smoking is the main cause of this condition. Like I have previously mentioned, there are four stages of Chronic Obstructive Pulmonary Disease. Stage I is mild, stage II is moderate, stage III is severe and stage IV is the last stage of progression of this disease. Although the last stage is termed as the end stage, it does not mean that the patient has only a few more days on earth. Rather, end stage means that the aggravated symptoms of COPD are the most severe in this stage.
When the disease reaches the end stage, it is seen that the functioning of the lungs is on the decline. It is also noted that the quantity of carbon dioxide in the blood increases to alarming levels. When the levels of carbon dioxide increase, it has a narcotic effect on the patient and the patient tends to lose his consciousness way too often and has difficulty breathing and, in some cases, may stop breathing.
What are the Symptoms of 4th Stage COPD?
The most common sign is breathlessness, also termed as dyspnea. It is caused due to reduced supply of air to the lungs. The patient may feel breathless after a little activity and, in some cases, also while resting. This condition is most distressing for most people. In some cases, the patient may also be breathless, even after he speaks just a couple of words. As a matter of fact, most people fear this condition as much as they fear pain. To treat this condition, the patient has to undergo oxygen therapy.
There is severe cough. The patient expels phlegm every time he coughs. The color of phlegm changes to either yellow or green during the fourth stage. Many a time, blood may also be expelled along with the phlegm. The cough goes onto becoming a chronic condition. It is often seen that the patient may become breathless during a bout of cough as well.
Weakening of Pulmonary Function
When the condition reaches the end stage, it is seen that the lung function weakens considerably. If the results of the spirometry tests are less than 30%, then it is sign, that the condition is well into the fourth stage.
Weakening of the Heart
Since the lungs are not able to perform their tasks as expected, a lot of pressure is exerted on the heart. Due to the added pressure, it is seen that the right ventricle enlarges, the heart walls thicken and the chamber is not able to perform its work as efficiently as it would have under normal conditions. This may also lead to the heart beating rather faster than usual.
Weakness, Anemia and Anorexia
In the end stage, the patient finds it extremely difficult to eat and, most of the time, ends up eating very little. This, in turn, leads to weakness and anemia. The immune system is not able to perform to its fullest and it further leads to worsening of the condition of the patient. The patient may be fatigued and may find it very difficult to carry out even the routine day-to-day activities. Rapid weight loss is observed as the patient does not eat sufficiently.
Blue-gray Nails and Lips
Since the patient is not able to breathe, sufficient oxygen is not supplied to all parts of the body. This causes the nails of the hands and/or legs to turn blue-gray. In some cases, the lips of the patient may also turn blue-gray.
The patient may suffer from severe morning headaches as the body is deprived of oxygen and breathing is rather erratic during sleep. This leads to the patient retaining a lot of carbon dioxide in the body which, in turn, leads to headaches.
Swelling on the Body
Many times in the fourth stage, the patient may suffer from swelling of the legs and feet. It is caused due to increased pressure on the pulmonary artery and lowered efficiency of the right ventricle. This further leads to decreased supply of blood to the kidneys and liver which, in turn, gives rise to edema. The worst part of this stage is when the liver swells due to accumulation of fluid in and around the abdominal region.
These are some of the prominent symptoms of end stage COPD. It is best to consult your healthcare professional for the right line of treatment and medication. Depending upon the condition of the patient, the physicians may, in some cases, recommend surgery.