COPD Management

CASE SUMMARY: Mr. Dwayne Johnson, a 59-year-old male, presents with complaints of shortness of breath upon exertion that impacts daily living and decreases quality of living. He would enjoy being able to spend time outdoors with his grandchildren and gardening. He reports long term use of ibuprofen for pain caused by cervical radiculopathy and chronic cough. Medical history includes co-morbid diagnosis of cardiovascular disease with a myocardial infarction with stent placement seven years, and an additional stent placed 2 years ago. Patient has history of 40 pack-year cigarette smoking, had stopped smoking post MI, but currently is smoking about five cigarettes a day, and consumes about three alcoholic beverages daily. Familial history positive for COPD and CAD. Patient will receive flu and pneumonia vaccines, and referral for Pulmonary Rehabilitation. Population Health Nurse for health coaching for goal setting and to continue with in office education regarding dietary changes to improve respiratory and overall health, education on smoking cessation, education on cessation of alcohol consumption. Patient will discontinue use of ibuprofen for cervical radiculopathy pain and begin use of acetaminophen with referral to neurosurgeon and pain management specialist for evaluation. Follow-up appointment in four weeks to evaluate effectiveness of umeclidiminium and monitor for side effects.