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My husband has COPD with emphysema, bullous, lung fibrosis and had a heart attack and 3 stints in last 6 months. The Dr has not told us what stage he is in. He tires easily. He still smokes and drinks beer everyday. He cries a lot and tells me he knows he is dying. What can I do to help him?

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I don’t know any answers, I’m 59 yrs young and my husband is 65 in beginning stages of COPD. His younger brother by one year just passed a month ago from COPD. His whole family smoked, his father passed at young age of 63 from emphysema. I’ve seen 2 family members on my side pass from effects of smoking. Seeing as how his quality of life has changed so drastically in the past year is sad. He was vibrant, active, healthy person. Camped, fished, hunted, very good provider for his family. Depression overcomes at times, I’m at a loss as to what to do most times. I’m thankful for this forum as I can see we are not alone. I feel I have someone shoulder to lean on, thank you and bless you all.
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His pulmonologist should have an idea of his life expectancy due to the destruction of his lungs from nicotine, unless he deceases of alcohol poisoning first-point blank.
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Your husband could also develop CO2 retention along with COPD my mom did and it's devastating to watch. You should have the doctor check his blood gas levels ASAP my mom only had 2 years after she started with CO2 retention. I'm sorry to hear he still smokes and drinks with all that is going on. You must be exhausted watching it and not being able to do anything.
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One of the many things I've learned in the last couple of years is that WE DO NOT KNOW THE FUTURE. We can predict. We can plan. We can listen to the doctors. We can see what's happened in other's lives, but we do not know what will happen. I wish you luck. I hope your husband quits smoking.
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I am an RN and patient so I thought I'd pipe in. I know COPD is irreversible but there is now research showing that stopping smoking may not stop the progression of this terrible disease. That said, it is a terrible feeling-being 58 and realizing you can't make it through Walmart anymore. I still smoke a few cigarettes a day but I also suffer from a number of other conditions including Chronic pain so I also smoke or vape Cannabis and have for years. So I'm a 2fer. Quit smoking tobacco and I still need the Cannabis to get out of bed and throughout the day. My state is behind the rest of the country. I dream of cannabis gummies, lol. As far as your husband goes, yes, antidepressants and therapy do help but it sounds like he might have other issues only you would know. Oregon and now Washington state have made physician assisted suicide legal. This is not Kevorkian, its simply having a lethal dose of a medication legally prescribed under very stringent conditions. The other 48 states just have to suffer it out or take matters into their own hands. As a nurse, I'm not riding this COPD thing to the end. My physicians and family are aware of my wishes however none will be involved. There are many accidental overdoses amongst respiratory patients. All of the suggestions from the others are spot on, but start thinking of your future, also because it's inevitable you will have change coming and it doesn't sound as if your husband is able to help you do it. Sorry if some feel this is blunt but these are all things to be considered. Thanks
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Granyoung, you asked about Life Expectancy. My 78 yo dad is a lifetime smoker with COPD. He also won't use his inhalers. I still think my dad could live another 10 years. COPD/emphysema aren't quick moving killers. Mostly what happens is the person who suffers the condition feels poorly when they try to do any activity that exerts their breathing and then they end up resting most of the time due to feeling poorly.

This is why hospice likely may not be an option for many years yet, if ever, but you don't need hospice to ask the doc for Rx for an anti anxiety medication that will help hubs to not have as strong of cravings, and also relieve some anxiety. He may live for many years. (((hugs)))
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Granyoung, let him smoke and drink beer. It won't hurt him now. The damage is done. All you can do is comfort him when he gets upset at how he feels, and the prospect of dying soon.

If there are any people of faith around you, perhaps someone to comfort him about Life and Death process would be helpful. Perhaps calling in a local pastor (one who is very kind and understanding) may help to calm his fears.

This is a tough time for you, too. Maybe you could both use some help from your local churches or other local outreach organizations. Is hospice an option? Ask the doctor. Maybe a mild sedative or painkiller would help... but I don't know how it interacts with COPD. As a former smoker, I know that the benzodiazepines (Valium, Xanax, Klonopin, et al) help to alleviate cravings for smoking...

Ask the doctor about some anti anxiety medication for hubs to make this time easier on both of you. (((hugs)))
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Lost my answer and I hate retyping so I"ll make it short. I never smoked and I have COPD. I can't use any of the treatments because they are not compatible with the life preserving drugs I must take for my damaged heart. They say I have valvular heart disease due to rheumatic fever. Never knew I had it and certainly did not go out and try to get it. These are just facts of life and we all must deal with them as best we can.
As a young adult smoke was all around us, it was the social norm and no one knew it was going to kill them. Smoke filled rooms were impossible to escape and lighting up in a restaurant or other public place was not frowned on. You could even smoke in your hospital bed as long as you did not set it on fire.
That was in the past so don't try and punish people who are suffering now. Smoking and alcoholism are addictions and you can't cure those just by spanking people or taking away the cigarettes. For one thing the person has to want to overcome this and if it brings comfort at the end of life they are not going to stop and at this point it probably won't improve their prognosis.
As a side note many people with ADHD find that smoking helps calm them. They probably don't know they have ADHD and maybe wouldn't seek treatment and if they did may not be able to afford the inflated prices for the medications. Drug companies have become the evil controllers of peoples' health.
This poor man is suffering at he end of life whether he is responsible for his own misery or not it was probably caused by ignorance and all the good advise and prohibition in the world won't change anything now. He needs compassion not lectures. A good place to start is addressing his depression and supporting him in any way possible and that does not include taking away his props.
That is really the only way his wife can help him, he is beyond changing his ways.
Now if I suggested hospice and morphine to ease his breathing symptoms I know all the anti hospice people would come out of the woodwork and I am just so tired of that. I know people have had bad experiences and I don't doubt the truth of their stories but we all get bad experiences one way or another and healthcare is no exception.
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And that helps how?
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I don't know about the spanking part but yes, it serves him right for smoking at all and bringing himself to this point where he just won't quit despite his condition and still taking breathing treatments that clearly won't help in the end, I'm speaking from my observations and what I noticed and serves all of them right if they continue smoking when they need treatment and still won't quit. The most recent one died in January 2016 shortly after surgery and they told him he needs to quit smoking and he wouldn't quit so yes, it serves even him right when you continue doing what's slowly killing you. You don't have to believe me but look on YouTube and it will tell you time after time after time each person's story of their past when they smoked and each one of them is dying. Yes, they'll tell you smoking did it and some of them will even tell you they continued smoking when they should have quit despite their conditions they continued and yes, they should feel really bad and most of them actually do but only a select few don't. In certain cases where people will quit smoking or drinking when they need to despite their condition, I don't feel a bit sorry for anyone of them if they don't follow doctor's orders and actually quit. If they  continue and afterwords have something bad happen to them, they can blame themselves because it was their choice to put the booze down their throat or light up that smoke. My parents were alcoholics and I didn't feel a bit sorry for them either, I don't feel a bit sorry for anyone who won't take preventative measures when their diagnosed and still continue with what slowly killing them and causing the problem they are having after a doctor has already said this is causing the problem. If you continue smoking or drinking after the warning from a doctor, you won't get sympathy from me if you continue doing what the doctor tells you is killing you. 

You asked a straight question and you're getting a straight answer. When you play with fire, you get burned, so don't play with fire if you don't want to get burned. This is exactly what smoking and drinking does to people in the end, they get burned when they pay for it with their lives after their health has been jeopardized. Of all the people I knew who died from this kind of thing, if they were alive today I would tell each and everyone of them to their face is that it serves them right because all but one of them continued smoking after diagnosis, and that one person had the brains enough to quit when the others didn't. Oh yes, if I were ever in the position of guardianship in one of such of these types of cases, those wards would definitely not have their cake and eat it too, it's pick one or the other but you're not having both
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So Granyoung should spank her husband and tell him it darn well serves him right, should she?

She asked how she could help him. For him, it's a little late in the day for tough love.
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I strongly agree with having things in order and preparing for the worst  when people are going down the wrong path and slowly killing themselves because that's exactly what's happening. You can't hit yourself in the head with a hammer and then ask for an aspirin only to pick up another hammer and do it again, it just don't work the way you want it too because the results never change, so you can't keep hitting yourself in the head with a hammer and taking an aspirin hoping for different results next time because it won't happen. I sure hope there's enough doctors out there who will crack down on this kind of thing on those who continue smoking despite respiratory conditions because I think they need to start cracking down really hard on those people. They need to feel bad for what they did to themselves because they brought it on themselves and I hate to have to be so honest but I have to because I saw what smoking does to people more than once and those cases are dead. What I witnessed is exactly why I think someone needs to start cracking down hard on these cases, and I hope the right people out there are reading this and do something about this type of epidemic.
Oh yes, by the way, It looks like the Trump world is actually going to be a better one than people realize. I'm all for his efforts to protect America and its citizens and I strongly agree on where he stands because I follow the news on what's going on. Hopefully he will initiate cracking down really hard on stuff that needs cracking down on
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There comes a time in life when all your friends, all your relatives have: died. moved 'down south'. retired. are travelling. have their OWN sh*t going on. You may or may not have children, and they may or may not be loving Waltons types who tearfully take mom or dad in to live with them as they decline. Or you may or may not have a long-suffering spouse who is or is not willing to shoulder the burden of caring for your decrepit body. (and he or she have their own health issues.) Now, with all of this: is it any wonder people don't want to just drop all their 'bad habits', stop smoking, stop eating garbage, start exercising, start running 5 miles a day? FOR WHAT? I say, talk to them, offer to help, talk to their doctors, but when all is said and done and they continue - prepare for the worst. Make sure all legal things are done! Living will, DNR, POA, all that. Make sure finances are in order. It's important to you, the survivor! And make them as comfortable as possible as they exit this sad life, this ugly Trump world.
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Take the alcohol and nicotine away. Seek out the help of Reformers Unanimous, which is a bible-based addiction support group. Go to ReformU.com to see where a chapter meets in his area.
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My mom had COPD. The things that helped her the most were: Xanax for the anxiety that accompanies this condition, her breathing treatments, Ensure Plus for the weight loss, and a nicotine patch so that she could at least cut way back on her smoking. She got plenty of info on quitting smoking and would manage to have short stints where she was smoke free. After 40 years of addiction, she didn't stay that way. That's OK. What's done is done. Becoming a control freak and making people feel bad about taking medicine that helps them (even if they are still smoking) doesn't help at all. It will succeed in making your terminally ill loved one miserable but it won't prolong their life at this point. It most certainly is not a "waste". Antidepressants can also help with this difficult time. COPD is not a death sentence for next month. I've known people who continued to smoke some and went on to live many years (10?). Each patient is different. Staying calm (especially considering the heart problems) will be really important.
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I can tell you right now that he's not going to live much longer if he still smoking. I can tell just from your description he's on his way out. I used to know a chain smoker. He had a cigarette in his mouth every few minutes of the day. No sooner then he finished one, he lit up again and again and again throughout the day. He had a heart attack while mowing lawn one day and he had about three stents put in. He was sure he was going to quit smoking but he went from vaping he was sure would help him quit, but sadly he started right back up again, working his way up to however many packs a day he could smoke. He only lived for several months or so after surgery before he dropped dead. He had no money when he died because he smoked it all away and lived large at his girlfriends expense until she evicted him from her apartment and he moved in on someone else. I felt sad that he also took advantage of his aging parents but they were the ones to pay for his cremation. The nebulizer and breathing treatments did him little good if he just wouldn't quit smoking.

I also knew someone else who smoked for 50 years but I don't know when his lungs went bad. He long since quit but I don't know when. He also had COPD and was on rescue inhalers and a nebulizer. I think he could've lived so much longer and better had he only taken better care of himself.

I actually think they could've both live much longer. However, that didn't happen. If your husband still smokes and you really want to help him, take the smokes and crush them, toss them into the trash and take out the trash. Don't buy any more smokes and don't give him any more money because you know he'll just smoke it away anyway. Also dump the booze down the drain and again, drop empty bottles into the trash and take out the trash and don't give him any more money because you know he'll just drink it away.

If he insists on smoking and drinking, then breathing treatments of any kind are just not going to help him and you should tell him that. I thought the doctor took this one guy I used to know off of the breathing treatments but come to find out it was actually his girlfriend who did but I don't know how she did it, she just did.
What you need to do is give your husband the ultimatum: Either quit smoking or no more breathing treatments. I would become his guardian if I were you, you can make medical decisions as a guardian, and you can make him quit. He's going to have to quit one way or another. Either he quits and resumes breathing treatment, or he continues smoking and no more breathing treatments, this is the ultimatum I personally would give because he's only defeating the purpose of the breathing treatment by continuing to smoke, and that's the truth and that's where I firmly stand. I saw what happens to chain-smokers who won't quit and it's not fair to other patients needing those breathing treatments if someone who won't quit smoking is taking up that medicine. I think this man's girlfriend saw things exactly as I see them, because it's really not fair to other patients who actually need the medicine and some chain smoker comes along and wastes that medicine and defeats it's purpose by continuing to smoke knowing what it's doing to their lungs.

In fact, many years ago I also knew someone else who was on oxygen and still smoked. Several times I watched her shut off her oxygen just to light up. Not fair to other patients who could've easily used that oxygen she was wasting by continuing to smoke. Needless to say, she died of emphysema. If you're going to smoke, don't waste resources other patients need, it's not fair to them or the medical professionals distributing it if you're just going to keep on smoking, it's not right, it's also very wrong if you're not going to do nothing to help yourself. Those resources are only for patients willing to take steps toward helping themselves and not making an already bad problem worse by continuing to do what's hurting them.

Multiple times I saw what smoking does to people, and I for one must speak up and take a firm stand and tell it how it is. I must speak up and say what I saw
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I agree with the depression and if this is the case it should be addressed.
And while we are talking about your Husband...you may want to talk to someone as well, depression in caregivers is a very important subject that is often ignored, overlooked or just not addressed as many think it is not "important"
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Depression is a huge problem with COPD; I watched it with my beloved mom. In her case, and maybe this will be instructive to you, it made it impossible for her to proactively do anything to improve her health because she just didn't see that anything would matter or make things better. I felt compelled to give her ideas--quit smoking! Try to get outside for a walk! Try some herbs to help clear the toxins from your lungs!--but when you don't feel anything matters, how can you try new things that might be challenging even for a more mentally healthy person?

I now wish I had spent less time trying to fix things for my mom, and more time just telling her how incredibly much I loved her and how much it meant to me to have her here on this planet. Maybe being impressed upon with her value to others would have at least given her the motivation to take an antidepressant, which might have made the other things easier. If your husband could be moved to try an antidepressant, you might have more luck with some of the other excellent suggestions here. Warm wishes to you both.
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As far as I know no one has an "expiration date" tattooed on the bottom of their foot.
Everyone is different even with the same diagnosis.
The best you can do is accept that this is a life limiting disease and make the best of what you have.
Adjust to what your husband can now do and enjoy that. As his condition becomes worse he will be able to do less and less so relish what you have now.
Help him accept what is going on.
Trying to get him to stop smoking will only frustrate the heck out of you and probably make him dig in his heels even more. And in reality what will stopping now do? Is another week going to make a difference? a month?
He knows he should stop, I am sure you have told him, his doctor has told him so this is nothing new. The only person that can get him to stop is him. And he has to want to do it for himself. (Just make sure he is not smoking when he is on oxygen)
As to the "stages" I went through looking up stages when my Husband was diagnosed with Alzheimer's. I have come to the conclusion there are no real defined areas of "stages" as I said at the start everyone is different and your husband may have signs in all stages but no signs in some of them. So do you pick the sign or symptom he has in the final stage and say that is where he is or do you say ..well he is not having the 2 symptoms in the first stage does that mean he is still in stage 1?
I gave up on "stages" and accepted the decline my Husband had and was grateful that he did things longer than many but was sad by the fact that he stopped some things far sooner than I would have hoped.
The best thing you can do is help your husband through the difficult times and allow both of you to accept help when it is needed.
Call Hospice before you think either of you need it as I am sure he would qualify before you would think he would. Accept the help and support that they will provide. If he is a Veteran contact the VA and find out if there are any programs that might help, and if his condition may be related to any Service injury. (this would be a great help for you both)
Oh, and the fact that he tells you he knows he is dying...we all are...no one gets out alive, we begin dying the day we are born.
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COPD is a complex and irreversible condition most often caused by smoking. The lung walls become stiff and brittle and continually expand so that the patient must take in more air with each breath in order to maintain enough oxygen ultimately gasping for air that can often be similar to the sensation of drowning. The main problem is that the lungs are not able to contract when exhaling so the patient's breathing and breath support is forever compromised. The lungs stay permanently in this expanded state and only get more stiff, brittle, and the mucus layer loses its supple and flexible quality. The lungs become exceedingly enlarged so that the patient can never take in enough air. The lungs continue to fill up with a limited supply of new air as the old air remains trapped in the ever expanding, hard, stiffened lungs. Patients are frequently relegated to wheel chairs as they are unable to walk or exercise in any productive way. They are forced to eat a puréed or liquid diet as they can no longer control the chew, swallow, breathe sequence without risking aspiration. Most patients are forced to deal with portable oxygen tanks which further restricts the individual's mobility. Your husband needs to see a pulmonologist who will speak honestly and frankly to him about why he is continuing to jeopardize his life in a most painful and depressing way - especially by continuing to smoke and drink beer. Again, COPD is irreversible but he may be able to slightly slow the progression of his diseases by quickly giving up his unhealthy habits.
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Without knowing your husband's exact medical condition it is difficult to give helpful advice.
He may actually be dying, so getting some real information out of his Drs will help you both even though it may not be what you want to hear. getting the truth out of a Dr can often be like pulling teeth but don't give up.
Stopping smoking is always a good thing to do and always improves health. However if he is actually in the last stage of his life and smoking brings comfort leave him alone he knows the risks. Same applies to the beer as long as he does not over indulge and become unmanageable let him be, again he already knows the risks of alcoholism so leave him alone. Of course continue to provide healthy meals and encourage him in a healthy life style but otherwise offer comfort in any way you can without becoming a victim yourself.
Accepting one's approaching death is something that most people don't do well. Paramount is the fear of the unknown but some are able to rise above this and put their lives in the hands of the Lord. 
Fear of the actual dying process is also in the forefront of the minds of many and this can bring huge depression. In your husband's case he almost certainly knows that his COPD will get worse and breathing will become even more difficult, his heart will also probably begin to fail and fluid will build up in his body. His kidneys and liver may also fail which will have unpleasant side effects. 
What can you actually do to help?
First of all recognize the realities and make preparations for his inevitable passing whenever it occurs. See an attorney and get all the legal paper work in order. Make sure his will is current and you have the proper authority to handle finances and medical decisions. Would he for instance want to go to the hospital and be put on life support? Does he want to be a DNR? How about IVs and forms of artificial feeding. Choose your funeral home and make those arrangements. Check any life insurance policies and make sure premiums are up to date. This may be a good time to consult with hospice. If there is a choice in your area interview several. Consult his Dr about the continual crying that is distressing both to him and you. There are plenty of antidepressants around that can make a difference. Also think about asking for morphine if he has trouble breathing. Many people are against it's use and I do respect that point of view but the reality is that it does relieve the feelings of breathlessness and very small doses do not put people in a coma. Remember you and he always have the final say about any treatment.
This is not going to be an easy time for either of you and if he does not have the will to continue living, and he may have very good reasons, it is certain that he will not. This is not something you can "fix" however many helpful suggestions you recieve. Only your husband can improve his situation
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Your husband needs to get help with some talking therapy. He sounds depressed, and you need to find out if he is and why. There maybe more to this, than his illness. If he is depressed and gets help, this should help him with his illness too. Speak to his doctor.
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If your husband continues as is he will prove himself right: he will die. Quite quickly. I'm sorry to be blunt, but it's obvious and avoiding reality is no help to him.

Believe me, the consequences of emphysema can get a heck of a lot worse than bullae and still not kill him.
But if he cuts back hard on the booze, stops smoking completely, starts taking exercise, follows his doctor's prescriptions to the letter, loses weight and so on and so on, he can still hugely improve his chances of survival.

Are you sure that is what he wants?
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My husband has heart disease and eating oatmeal and watching his diet has really helped his cholesterol level and overall health. To say diet is important is an understatement.
SIL has COPD and uses oxygen sometimes....still smokes, is physically very inactive and lives with her 86 yr old mother. Stopping smoking is the most important thing you can do. When I stopped smoking 21 years ago after a 21 yr. habit at a pack a day, sometimes more...I did it cold turkey and kept telling myself "I am not a smoker...why would I want a cigarette?" I took my mind back to when I didn't smoke, and concentrated on things I liked back then...foods, books, colors, etc. This mind set helped me to overcome my cravings and I never touched another cigarette also telling myself that I had my ration of cigarettes to last a lifetime so I could not have any more. This mental tactic worked for me. If he cannot entirely quit...at least try to get him to cut down.
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One of my relatives with heart disease has had incredible results using Dr Esselstyn 's methods for heart disease reversal, which can pull some of the cholesterol out of the clogs. Statins and other meds are still used, as this complements statins, stints, etc. As a result, most of my family has started following his diet to some extent, and the young men of the family - the ones most likely to have heart disease at an early age - have total cholesterols below 100. The Engine 2 7 Day rescue diet is a starting point also, but Dr Esselstyn addresses heart disease and other disease directly. Might want to look him up and see if his practice is in your area or look at his most recent book.
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I'm sorry you and your husband are going through this. Almost everything we read or hear about tells us that no matter what our health condition that to stop smoking is the single best thing to do. But I remember reading in the 70's that to stop smoking is extremely difficult and I've always believed that. At the same time I've seen many quit. If your doctor can't tell you your husbands prognosis we, on this site, surely can not. Heart disease is the leading cause of death in our country, maybe the world. A radical change of diet and habits could change his life expectancy. He has to want it enough to get the help and follow through and usually that means a radical life style change for the entire family. Having said that I don't think people realize how just a few steps in the healthy direction can really make a big difference. Walking 10 min a day this week and 15 min a day next week up to 20 or 30 min can really help. Losing 10% of body weight can cause the "bad" numbers to get much better. Is your husband on oxygen? Does he try to limit the number of drinks or cigarettes he has per day? Has he tried antidepressants? Regardless of whether he (and you) choose to make a concerted effort for him to get better, at least decide to live each day he has left to the best of your ability. Talk to his dr about antidepressants and/or anxiety meds. Ask about physical or occupational therapy. Have his B vitamins checked. B 12 supplementation might make him feel a lot better. Remember his heart dr is probably just focused on his heart. Also include his primary, pulmonary and a physciatrist in the mix. Some people will not want to make the effort and that is their right but again, a small effort can make him feel better and perhaps able to make a little more of an effort. Take care of yourself as well. It won't help him to forgo your own healthcare. Come back and let us know how you are going.
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