Ask Dr. Nandi: Former First Lady Barbara Bush in failing health

Posted: 5:33 PM, Apr 16, 2018
Updated: 2018-04-16 21:33:38Z

Former First Lady Barbara Bush is in failing health and has chosen to leave the hospital and not seek further medical treatment. She has been battling COPD and congestive heart failure. 

These two conditions cause different breathing problems, but both can make you short of breath even for simple things like walking or climbing stairs. 

When you have Congestive Heart Failure, your heart can’t pump enough blood and this affects the kidneys. They can’t do their job of getting rid of excess fluid which then builds up in the lungs, liver and legs.   

The other illness, COPD or Chronic Obstructive Pulmonary Disease is a restriction of airflow in and out of the lungs. You basically are not getting enough oxygen in and you’re not getting enough carbon dioxide out.

Sadly, COPD is the third leading cause of death here in the US. 

There are treatments for both of these conditions. With COPD, inhaled medications help to open up the lung’s airways to help you breathe better. And for heart failure, there are several types of drugs used like beta-blockers as well as diuretics that help make you urinate more frequently to get rid of excess fluid. 

Lifestyle changes are also needed, like quitting smoking, avoid air pollutants, get regular exercise and cut back on sodium. 

Unfortunately heart failure cannot be reversed and COPD is a progressive disease with no cure.

This is certainly a tough decision and the answer will vary from person to person. But it basically boils down to quality of life. 

If treatments are not curing or controlling an illness, and there is nothing left to do medically, then it’s time to have end-of-life conversations with physicians and loved ones. 

COPD and heart failure can act up at the same time and cause distress like rapid heartbeat, wheezing and chest tightness.

The last stage of COPD can severely affect your quality of life, leaving patients unable to complete simple tasks like taking a shower or cooking a meal. 

Former First Lady Barbara Bush is, in my opinion, a true health hero and I very much respect her for taking on and making a very difficult decision.