A typical ramp up of mom’s CO2 would seem to come on after mom had been having a time of severe shortness of breath. Most times, she knew without a doubt that she was getting worse and would try to hide it. She almost always argued with us about going to the hospital, and I would say that close to 100% of the time, we would eventually end up at the hospital anyway. I remember many conversations that would end with, “do you want me to call an ambulance, or would you like to go to the car?” The more you get to know how your loved one normally would respond to questions and situations, the more confident you will become in taking charge of the situation when necessary.
I learned through the years that some of the common signs of high CO2 levels are sleepiness, fatigue, and shortness of breath. Unfortunately those are also common symptoms of COPD, so it can be difficult to catch a spike in the carbon dioxide levels. The thing that I, personally, always looked for was her level of comprehension. It seemed like when things would get really bad, she would have a very hard time understanding simple things. There were many times that I noticed doctors and nurses would ask her what year it was, who was president and what day of the week it was. If she could not answer those kinds of simple questions, we knew that there was a good chance that her CO2 levels were very high.
I remember one night when mom was staying with me. When I entered her room, I noticed that she was having a very difficult time breathing. I began to help her get a breathing treatment and tried to help her calm down as much as possible. Her response was, “how did you know that I needed you?” It was as if she didn’t remember being at my house. She was confused. It was also easy to see that her shortness of breath was becoming increasingly worse.
If you see that your loved one is going through extreme confusion along with severe shortness of breath, it is extremely important that you at the very least, call your doctor’s office triage nurse. There were quite a few times over the course of mom’s journey with COPD that we had to work hard to convince her to go to the hospital because she was just too confused and did not understand the severity of the situation.
It is also important to understand that over time the CO2 levels in a COPD patient will increase. It is just what happens with this disease. What might be a level that would kill the average person, could be a “normal” level for your loved one. The body is an amazing creation. It will learn to adjust to the increased levels of CO2, if it is introduced over a long period of time.
You are one of the best lines of defense for your loved one. It is up to you, as the caregiver, to pay attention to actions and verbal clues. Once you have seen the effects of having high carbon dioxide levels, you will remember what that situation looks like. Then you will be able to respond even better. Remember not to take anything personal during these kinds of situations. Emotions can become raw, but more importantly, your loved one is not comprehending things as well as normal. There is a chance that your loved one may not remember very much about the situation once he or she is feeling better, and that is sometimes something that we caregivers wish we could have too.