What You Asked the Experts!
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In preparation for COPD Awareness Month, we asked YOU what you’d ask the experts! Here are the questions – and responses! – the community wanted to learn about.

Question 1:

What are the symptoms of CO2 being too high? What can I do to prevent it?

Response from John Bottrell, RRT:

CO2 is a waste product during cellular respiration. When you inhale oxygen, you exhale CO2. We call this ventilation. When you are breathing normal, when your lungs are healthy, your CO2 levels stay at normal levels. Due to the disease process, some people with COPD have higher CO2 levels than healthy people. Your doctor will know what is a normal CO2 level for you.

That said, if your CO2 becomes higher than what is normal for you, symptoms may occur. Early symptoms may include confusion and sleepiness. As CO2 increases to critical levels, it can slow down your drive to breathe. It can make you feel very sleepy, even lethargic. It can even cause you to stop breathing.

There are strategies to help you keep your CO2 at your normal levels. This begins by seeing your COPD doctor on a regular basis. Make sure to do what your doctor recommends. This includes quitting smoking. Such a strategy may include bronchodilators (Ventolin, Duoneb). They can help keep your airways open. Machines like CPAP and BiPAP make sure your airways stay open. BiPAP makes sure you take a deep enough breath to blow off CO2. Most people only need to use CPAP or BiPAP when they are sleeping, if at all. I’m just mentioning these because they are options your doctor might recommend.

Another strategy involves working with your doctor to create a COPD Action Plan. Such a plan will help you decide what actions to take when you experience symptoms of COPD. It can help you and/or your caregivers know when to seek help. The earlier you seek help, the more likely you are to prevent high CO2 levels.

Response from Lyn Harper, MPA, BSRT, RRT:

Initially a person may experience dizziness, headache, and confusion. If untreated, you may also begin to feel very sleepy and lethargic, as well as being short of breath. Obviously everyone reacts differently, in fact over time some people adapt to a higher CO2 level and this becomes their “baseline”. Our bodies have a remarkable ability to adjust to a “new normal”, which can sometimes happen.

To prevent this, especially if you have COPD, there are a few things you can do:

  • Avoid too much oxygen. Regulated oxygen therapy to keep the blood oxygen level where your doctor feels is the right place for you will minimize the risk of hypercapnia (high CO2).
  • If you smoke, stop smoking. Smoking inhibits your normal lung function in removing CO2.
  • Try to get enough exercise- even if it’s minimal. Some is better than none.
  • Keep to a healthy weight as much as possible. Obesity can contribute to high CO2 levels.

Response from Leon Lebowitz, RRT:

Some types of COPD are characterized by a chronic elevation of carbon dioxide (CO2), while others have relatively normal levels of CO2. Symptoms of an elevated carbon dioxide level can include an increased respiratory rate, shortness of breath or feeling unable to catch one’s breath, fatigue, lethargy or feeling drowsy, and even falling asleep unexpectedly. An elevated CO2 can also result in a change in a patient’s mentation or their mental acuity, headaches, and even an elevated heart rate. Another example is feeling warm to the touch or flushed4.

It’s important to remember that not all patients will respond identically to rising CO2 levels. The symptoms can depend on the specific type of COPD that you have and even the severity of the condition.

To prevent an elevated CO2, it’s important to take care of yourself and your COPD. Stay on your treatment plan and medication regimen. Speak with your physician as to what your individual response to a rising CO2 is in your particular case. If you experience any of the characteristic symptoms and they are persistent or especially if they worsen, it’s time to seek help. It’s always better to seek help early rather than to delay intervention. Early intervention, when timed correctly, may help to prevent significantly worsening conditions and even a full blown exacerbation with the potential for a hospital admission.

Question 2:

Been reading about great results with cannabis. Your take on this?

Response from John Bottrell, RRT:

So, this is just my opinion based on limited research. You’re definitely going to find some sites on the web supporting the use of marijuana for COPD. Some studies show it reduces airway inflammation. Some show it opens airways. Some show it improves lung function. Some people use these limited studies as evidence to support the use of marijuana for COPD. But, these are only limited studies. Plus, there are just as many studies showing that marijuana does the opposite, that it makes COPD worse. There are also better, safer medicines that do the same things on the market. So, my opinion is this: if it were proven to benefit people with COPD, doctors would prescribe it on a regular basis. And they don’t. At the present time, I would consider it more of an alternative medicine like salt lamps. It’s something you can try if you want (if it’s legal in your state). But, I would advise talking to your physician before trying any alternative medicine. That’s my take on this sensitive subject matter.

Response from Lyn Harper, MPA, BSRT, RRT:

Since breathing is already a problem when you have COPD, it’s probably best to stick with smokeless forms of cannabis – but that would be a personal decision. As discussed in a previous article on this site, smokeless forms may include tinctures, vaporizers, and certain edible products.

There has been research that links certain immune boosting properties to cannabis as well – which would be a great benefit for someone with COPD. Others have noted relief from pain, an ability to get a better night’s sleep, and help in reducing mucous production. There is no question that many people who have tried it advocate for its health benefits.

That wraps up the questions we received from the community for this year’s awareness month! Thank you for participating! Whether you liked, shared, commented, read, or just stopped by, we appreciate your being here for COPD Awareness Month, and beyond!

view references
  1. Confusion, A Visible Sign of Increased CO2 https://copd.net/caregiver/confusion-a-visible-sign-of-increased-co2/ (Accessed November 2017)
  2. How Healthy Lungs Function https://copd.net/basics/lung-function/ (Accessed November 2017)
  3. What Is An Arterial Blood Gas (ABG)? https://copd.net/clinical/what-is-an-abg/ (Accessed November 2017)
  4. Carbon Dioxide Retention in Patients with Chronic Obstructive Pulmonary Disease https://lungfoundation.com.au/carbon-dioxide-retention-in-patients-with-chronic-obstructive-pulmonary-disease/ (Accessed November 2017)
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