From Mar 28 to April 3, 2015, I was admitted in hospital  for 7 days with pneumonia where I was given antibiotics by IV.  I was  in a private room as I was in isolation for 5 of the 7 days. On discharge, I was told I had to have oxygen full time at 1.5 L/M at rest and 3 L/M for forced exertion.
At home I have an oxygen making machine or concentrator and pumping station to fill up my own tanks. Each tank last 2.75 hours. I always carry two oxygen tanks in the basket of my walker when I go out to shopping centre, doctor appointments and etc.

My appointment with my respirologist on Jan 14/14

My lung function test revealed that my FEV1 increased from 19 (A year and a half ago) to 35. This was an awesome improvement. Last time My FEV1 was 35 was in 2009. I underwent a blind test where I walked for six minutes on Compressed Air and another six minute walk on 4 litres per minute flow of Oxygen. The comparison of results were not great enough to be used as evidence with my insurance company. However My respirologist will write my insurance company telling why I need oxygen on forced exertion. At rest I am fine. I told my respirologist that my Inguinal hernia was acting up and the results of an ultrasound test convinced my GP to refer me to a General Surgeon. My respirologist said there was no way he wanted me to have this surgery as it would be very painful and I would not be able to tolerate the effects of the strong pain medicine on my breathing. If the hernia was incarcerated and my life was at risk, then he would give his consent. I asked him if I could fly and he said I could with a portable Oxygen concentrator otherwise my oxygen blood saturation level would decrease to 80 which is not good. My next appointment would be in a year from now.

Was prescribed Oxygen for forced exertion (walking) on Nov 4/13 by my GP, Dated Nov 4/13

I have been very short of breath over the last year so my general practitioner prescribe oxygen for me, to be used only during forced exertion (walking). I am fine at rest as my oxygen saturation level is between 92 and 94 percent. On forced exertion, it has gone down to 85 percent. The proof that oxygen helped me was when I went to a shopping and walked without stopping for one half hour with my walker. This feat I have not been able to do for over a year. Unfortunately, I have to pay for it out of pocket as I do not qualify to have it subsidized by by the provincial assistive devices program (ADP). It cost me $ 398.00 per month or 4 4,728 per year.

MY HOSPITALIZATION AT QCH FOR FOUR DAYS: MAY 19-23/12 WITH COPD EXACERBATION AND PNEUMONIA BY PETER C ELLIS Dated June 5/12 SYMPTOMS Very short of breath, wheezing and difficulty walking. Oxygen level 88 % CHEST xray revealed pneumonia in upper right lung DROPLET for 3 days in a private room Isolation MEDICATIONS 50 mg Presidone daily through a syringe and Ceftriaxone 1000 mg every 24 hrs by IV PUFFERS: Spiriva once daily, four puffs of Ventolin every four hrs, four puffs of Atrovent every four hours, Advair 500 mgs twice daily FEED: I500 mg Isosource 1.5 three times daily Will see dietitican on June 8 at QCH as outpatient for Resource 2 feed (Higher calorie feed) HOME MEDICATIONS ON DISCHARGE: Antibiotic Cefuroxime 500 mg tablet twice daily for ten days. Continue 50mg Predisone daily for seven days and puffers as in hospital for seven days.

APOINTMENT WITH DRS D MCKIM AND DE BOUR AT THE REHABILITATION CENTRE ON MAY 15/12 BY PETER C ELLIS

APOINTMENT WITH DRS D MCKIM AND DE BOUR AT THE REHABILITATION CENTRE ON MAY 15/12 BY PETER C ELLIS SUMMARY : Main point of discussion was to find out what I would want done if I got very sick again like in 2009 and had to go to Emergency to be admitted to hospital. MY DECISION is to go on the ventilator for a week and if there was no hope of me recovering, My wish is for them to stop treatment, ending my days on earth. Dr Mckim conveyed my wishes to my wife too. POINTS I CONSIDERED IN MAKING ABOVE DECISION: -My lung condition has further deteriorated as compared to when I was admitted to the Queensway Carleton Hospital for six weeks from Aug 8 to Sept 17/2009. -My FEV! dropped 5 % from 35 % to 27 % of normal in 3 years. (FEV! - Now is 27 % of normal) (FEV1 - in Aug 2009 was 35 % of normal) -The possibility in having to be on a trac and on a ventilator for the rest of my life if I got very sick again, did not appeal to me at all. -My Shortness of Breath and Wheezing is much worse now than in 2009. -Walking and other physical exertion is more difficult now. -My present oxygen level in the blood is 91 % instead of my normal 94 %. DR”S IMMEDIATE RECOMMENDATIONS - - Increase Advair amount from 250 to 500 mcg - Will admit me to the pulmonary physio dept for exercise to increase my long volumes: Thread Mill, Bicycling, etc twice a week as an outpatient. - Next fall, Drs will put me on antibiotics to take on Mon. Wed. and Fri for the rest of my life to fight in infection in my lungs. - Drs. took a sample of my sputum which was green.

COPD EXACERBATION, MARCH 29, 2012

SYMPTOMS :

Coughing during the day and at night in bed, short of breath and lots of infamation in my chest.
Blood oxygen saturation level: 91 %

PRESCRIBED MEDICINES:

1. ANTIBIOTIC: Teva-Levofloxacin 750 mg. Take one daily after food for seven days

2. PREDNISONE 50mg: Take one daily after food for inflamation.

PEG TUBE SITE RELOCATION, MARCH 31,2012

MY PEG TUBE RELOCATION TO ANOTHER SITE
BY Peter C Ellis, Age 75, Dated March 31, 2012

REASON FOR NEW SITE:

My six year old PEG TUBE stoma was leaking off and on for four months, became infected and herniated for the second time within a year and popped out of its existing location on Jan 22/12. I went to Emergency immediately Sunday night, slept there overnite

SURGERY:

On Monday Jan 23/12 my gastroenterologist installed a new Peg Tube in a new site as old site was infected. My gastroenterologist used a children’s endoscopy scope because of my severe weakened post polio pharyngeal muscles. I then had x-rays done to verify there weren’t any perforations.

CARE OF EXISTING SIX YEAR OLD STOMA:

After being burned on my outer skin by my stomach acid coming through the old infected stoma for twelve days while feeding through the new site , I had a home care stoma specialized nurse come home to see me on Feb 3/12. She Installed a pouch over it to collect any further drainage. On Feb 10/12, the collecting pouch was removed.

Today my old stoma has completely healed and is closed.

LESSONS TO BE LEARNED FROM MY EXPERIENCE:

Make sure you have a pouch installed over existing stoma immediately after the surgery to collect the drainage to avoid the very painful stinging and burning of your outer skin like I had for twelve days.

MAINTENANCE OF MY NEW STOMA:

I change the gauze once every morning on rising, Cleanse the wound with saline solution, apply Calmoseptine pink cream with a cotton tip applicator, and cover it up with a new gauze.

CARE OF SKIN BURNS AROUND OLD STOMA: Apply Calmoseptine pink cream.

Signed: Peter C Ellis

Chart showing deteriation of My lung Function from 1998 to 2011 owing to COPD and late effects of polio

DATE FEV1 (L) % of Normal FVC (L) % of Normal Oygen

Jul-11 0.99 29% 3.00 64% 93-94 %
Jan-11 1.09 31% 2.97 61% 96%

Apr-10 1.01 29% 2.54 53% 92 % Ax
Jul-10 0.97 28% 2.88 61% 92% Ax

Nov-09 1.31 37% 2.85 59% 92 % Ax
Jan-09 1.26 35% 3.03 63% 92% Ax

May-08 1.28 36% 3.18 65% 91 % AX

Nov-07 1.49 42% 3.53 72% 92 % Ax
May-07 1.20 33% 3.04 62% 92% Ax

Nov-05 1.25 33% 3.42 72% 91 % AX

Jan-04 1.47 38% 4.09 85%
91 % AX
Oct-03 1.38 36% 3.21 68% 91 % AX

Jul-98 2.19 66% 3.4 71% 91 % AX


SUMMARY:

Amount of air expired in the first second (FEV1) has deteriorated from 66 % of
normal to 29 % of normal or in 13 years. Today I get short of breath if I do
physical exertion.
My total expired air volume has decreased from 71 % of normal to 64 % of normal
in 13 years.

COPD exacerbation in mid March 2011

My blood oxygen levels decreased to 90 and I was coughing more than normal. Had chest sounded by GP and chest x-ray but he did not think I had aspriration pneumonia. Was put on antibiotics for seven days.
PROGNOSIS: COPD exacerbation
HIGH RISK: I am a very high risk to get aspiration pneumonia.

My Walking Program

For the last nine months I have been walking almost every day in two different shopping centres in Ottawa, Ontario, Bayshore and Carlingwood Mall. It has really paid dividends for me. My balance, endurance, leg strength and lung function all have improved greatly. My blood oxygen levels increased from 92 to to 96.

Crushed T-11 and L-1 vertebrae in April, 2008 during an accidental fall in the bath tub

On easter weekend, April 2008 I accidently fell in the bottom of the bath tub and my spine absorbed the whole shock of the fall, crushing two vertebra T-11 and L-1. I was on morphine for three weeks at home. This was most painful and it took me nine months to a year to recover. I had 3 months of physiotherapy comprising tens treatments, hot packs, stretching and accupuncture. It did not help me at all. Went back to my chiropractor and he got me back to normal. From the day of this accident, I was prescribed and a tall Nexus walker in which I use all the time. Dated April 19, 2011.

Aspiration Pneumonia diagnosed in June, 2010

In June, 2010 I was diagnosed with aspiration pneumonia, which was confirmed by chest X-Ray. My GP put me on one strong antibiotic for ten days called Teva-Levoflaxacin. I took three 250 mgs tablets three times daily for a total of 750 mgs daily. It really helped me and I have been fine since then.

I also had my yearly Chest CT scan in June and saw my respirologist in mid July to find out that my bronchiectasis is getting worse and will continue to get worse because of all the previous infections, eight aspiration pneumonias and damage already done in my lungs.

However for the last month and a half I have been going to two different shopping malls to walk with my walker over 1-1/2 kms daily, which I never did before.

Came down with aspiration pneumonia in late February, 2010

In late February and early March of 2010, I was diagnosed by chest x-ray that I have aspiration pneumonia and was put on Cyprofloxin antibiotic for ten days and then was given two different antibiotics for another ten days, Mylan-Clarithromycin and Ratio-Axlavulanate. The latter two gave me diarreha and so I was tested for C-difficile. Will have another chest x-ray in six weeks.
CAUSE : I aspirated my saliva into my lungs as I have not eaten orally since Dec 2008.

My six week hospitalization for a lung infection and pneumonia from August 8 to Sept 17, 2009

For the first two weeks I was in Intensive care (ICU), was intubated for six days with ventilator and in induced coma where a respiratory therapist suctioned the mucus from my lungs. I lost 60 to 70 % of my strength.

The third week was spent on the medicine floor.

The fourth, fifth and sixth weeks were spent in Rehabilitation where I regained enough strength through exercises to be discharged to go home. I was on oxygen and antibiotics for five weeks. I really never thought I would get out of hospital during the first week in Rehab. I had two CT lung scans and one chest x-ray. I am almost back to normal now.

I have been walking with a walker since I fell in my bath tub and crushed L1 vertebrae last April. It has been six months since I fell and I am still having difficulties with my back. Had physio and am now going to my chiropractor twice a week. Had a total body bone scan and a lower back scan recently. Results of scan revealed that Vertebrae L1 has decreased in height by one half which makes me lean forward most of the time owing to the wedge effect of L1.

My Dressing supplies used to take care of my PEG Tube Stomina

MY DRESSING SUPPLIES FOR PEG TUBE STOMINA
BY: PC Ellis March 18, 2009
1. Medicom 2 in x 2 in all gauze sponges, 100 % cotton, 12 ply REF NO. 3002, http://www.medicom.ca
2. Dukal non-sterile gauze sponges, 2 in x 2 in.- 12 ply Ref no. 2128 http://www.dukal.com Dukal Corp. % Plant Ave., Hauppauge, NY 11788, tel no 631-6563800
3. Dukal 4 in x 4 in non sterile gauze sponges, 100% cotton – 8 ply Ref No. 4084 same as above info
4. TopplerSterile Drain Swabs 3 in by 3 in Ref No M12507 Made by Johnson & Johnson
5. Flexi-trak Anchoring device for catheters and tubes, 1-1/2 in by 4 in Ref No 0003-0374-40 Made by ConvaTec, Montreal , Qc 1-800-465-6302 Numero de commande 37449
6. Hypafix 5 cm by 10 m low allergy dressing retention sheet (tape) Ref No 71443-01 made by BSN medical GmbH in Hamburg, Germany
7. Micropore Surgical Tape 1 in by 10 yd Hypoallergenic Ref no 1530-1 Made by 3M Health Care, St.Paul, MN 55144-1000 USA 1-800-228-3957
8. Non-Sterile Cotton Tipped Aplicators, 3 in wood shaft
9. 500 ml Baxter 0.9 % Sodium Choride Irrigation solution Ref No JF7633 Made by Baxter Corp., Toronto Ontario

10 Dec, 2009: I am now using SeaSorb (made from sea weed) to protect the opening in my stomach which acts as a wick to soak up the discharge and am changing it once a day. Have home care nursing coming in twice a week.

My Enternal Fedding Supplies that I use

MY ENTERAL FEEDING SUPPLIES Mar 17, 2009 BY Peter C Ellis
1. COMPAT 1000 ml Vinyl Gravity Feed Bag with preattached Enternal Delivery Gravity tubing . Ref No 199216 MADE BY NESTLES at http://www.nestlenutrition.com/us Toll free no 1-877-DEVICE-8. Covered by Ontario ADP.
2. KENDALL KANGAROO 1000 ml Vinyl Gravity Feed Bag with preattached Enteral gravity feed tubing, ref no. 8884702500 MADE BY TYCO Healthcare Group, Mansfield, MA Toll free no 1-800-962-9888 at http://www.tycohealthcare.com. Covered by Ontario ADP.
3. COMPAT: 500 ml rigid feeding container with preattached Enteral gravity delivery tubing Ref no 8884702500 Made by NOVARTIS Nutrition Corporation in Minnepolis , Min., USA DISCONTINUED IN CANADA but still can be purchased in the USA at my expense
4. 60 ML KENDALL Syringe with tip cap ref no 1186000777 MADE BY TYCO Healthcare Group, Mansfield, MA Toll free no 1-800-962-9888 at http://www.tycohealthcare.com. Covered by Ontario ADP.
5. KENDALL Female lock connector tip for 60 ml syringe, ref no. 275008 MADE BY TYCO Healthcare Group, Mansfield, MA Toll free no 1-800-962-9888 at http://www.tycohealthcare.com. Covered by Ontario ADP.
6. 35 ML KENDALL Monoject Syringe with catheter tip. Ref no 1183500888 MADE BY TYCO Healthcare Group, Mansfield, MA Toll free no 1-800-962-9888 at http://www.tycohealthcare.com. Covered by Ontario ADP.
7. KENDALL ENTRISTAR (Y ADAPTER) PEG ENTERAL CONNECTOR, Ref No 8884-752042 MADE BY TYCO Healthcare Group, Mansfield, MA Toll free no 1-800-962-9888 at http://www.tycohealthcare.com.. Covered by Ontario ADP.
8. COMPAT Universal Y Port Adapter with Stretch-Lok Strap Ref No 087503 Made by NOVARTIS Nutrition Corporation in Minnepolis , Min., USA DISCONTINUED IN CANADA but still can be purchased in the USA at my expense
9. KENDALL KANGAROO Y-Site Extension Set Ref No. 8884705008 MADE BY TYCO Healthcare Group, Mansfield, MA Toll free no 1-800-962-9888 at http://www.tycohealthcare.com Covered by Ontario ADP.

ADP: Ontario Assistive Devices Program

Results of my Thoraic CT Scan on Dec 3, 2008

SUMMARY of RESULTS of LUNG CT SCAN on Dec 3 at QCH Feb 28, 2009
As told to me by Dr.E Kyrillos at The Family Medicine Clinic on Feb 20, 2009
GENERAL:
1 There is a cyst at the apex of segments 5 and 6 of the liver. The remainder of liver is unremarkable.
2 At the upper pole of right Kidney, there is a 1.9 cm lesion
3 In left lower lobe there is a 5 mm nodular density
4 In right lower lobe, there is a irregular speculated 1.2 cm mass and adjacent to this is a 6 mm nodule
OPINION :
There are 2 new irregular masses in lower lobe of right lung that were not present in prior CT Scan of July, 2008. Could be related to a typical infection such as MAI, However Neoplasm in not excluded therefore follow up CT Scan is recommended in 3 months (March)
Ultrasound test on right kidney is recommended to check or confirm that the lesion is not a solid renal mass
BATERIA FROM SPUTEM SAMPLE on Feb 20, 2009 revealed bacteria called PSEUDOMONAS AERUGINOSA
This bacteria can only be treated with five different antibiotics according to Dr Kyrillos
Was prescribed APO-CIPROFLOX 750 MG or Ciprofloxacin HCL 750 MG om Fed 26.
FOLLOW UP APPOINTMENT with DR E Kyrilos is to be made after next CT Scan and Ultrasound test on right kidney.

OC HOSPITAL STAY from Dec 7 to Dec 11, 2008

QCHospital Stay from Dec 7 to Dec 11, 2008

PNEUMONIA Taken by ambulance from my home to hospital early Sunday morning.

ADMITTED by Dr. S. Morrin, M.D.,F.R.C.P.(C) Internal Medicine, Hematology on Monday after spending day and night in Emergency. Was discharged on Thursday.

OXYGEN Was on oxygen for 4 days. O2 level on admittance was 88 % and when I left was 92 % while on oxygen O2 levels were 97 %
Took blood sample from artery to see if I was eligible for home oxygen and the respiratory therapist in hospital advised me not to have it at home.

CHEST XRAY in hospital on Dec 8

ANTIBIOTIC: 750 mgs of LEVAQUIN once daily in morning for 15 days total including 5 days in hospital

PHYSIOTHERAPY: Had chest physio to help me cough up and will have more treatments as an outpatient to teach my wife how to do this.

SPUTUM : Abundance of thick stringy white froth and very little yellow mucus

LUNG HYGIENE at home: Steam vaporizer with acapella

FOLLOWUP CT SCAN Ordered by Dr j Lemelin and was done on Dec 3 at QCH
Previous one was on July 18th at General Hospital. Have not been told results of it.

DIETITIAN REFERRAL I want to be referred to Bernice Wood, dietitian of ParaMed at 613-728-7080. Who has looked after me since I first had my Peg Rube installed 2-3/4 years ago.
Since hospitalization , I made a decision not to have anything orally again. Everything will go through my PEG Tube ie Vitamins, all medicines and all nourishment.
I am taking in 1800 calories a day or six cans a day. I am really suppose to have 2100 calories a day. I have lost 10 pounds since hospitalization.
I have decided to not to take anything orally as before: pint of beer, Aero dark chocolate bar because I have had 2 pneumonia within 6 months of each other.

MOUTH HYGEINE: Saw Speech language pathologist in hospital and she stressed good oral hygiene. Brushing my teeth twice a day and scraping my tongue. : Had bed side swallowing test in hospital

SPUTUM COLOUR Green. PLEASE test my sputum for infection.

Pneumonia and Resulting Lung function Tests

Last April 25, 2008 I had chest x-rays done and was prescribed antibiotics for seven days because I could hardly breathe and was coughing up yellow and green mucus. I was told to puff my ventolin four times daily for 3 days , 2 puffs per treatment or 8 puffs per day as well as take my spiriva once daily and flovent twice daily. Now I am coughing up only yellow mucus. Green mucus is a sign of infection and I had a very low grade fever for one and a half weeks.

I have been off the antibiotics for 2 weeks now and I am feeling much better.  

Yesterday on May 12, 2008 I saw my respirologist and he read my chest x-rays taken on April 25, 2008 and informed me that I had pneumonia in the lower right lobe and that my lung function had decreased 6 percent from 8 months ago.  My oxygen levels were still at 88 % as compared to 93 %, 8 months ago.

I will see him in one month for reevaluation and he is considering i be tested fot my oxygens levels during a sleep study. I may be a canditate for CPAP or BIPAP.

Physiotherapy for lower back and Lung Education

Last fall from Nov. 2007 to Jan 2008 I had 3 months of physio at the Rehabilitation Centre, together mixed with some lung education regarding the Anatomy of our Breathing and COPD Disease Management. Articles on these subjects have been posted below for your reference.