my fiancee was diagnosed with stage 3 COPD, emphysema, and black mold poisoning

I think he needs counseling pretty desperately, because it sounds to me like he's committing slow suicide by inaction. He seems to be clinically depressed.

If he won't go (and that's highly unlikely, as you're saying he won't even go to a regular doctor, even though he's suffering), then at least go alone, and learn to cope or figure out what you want to do. Because it's looking, at least from this end, more likely that you'll be planning this guy's funeral than your wedding. I'm sorry.

Thank you. I've been worried I might be planning his funeral instead of our wedding. We have a total of 4 kids and I don't want to be completely lost when he dies and not know what to do. My biggest worry is that since he isnt taking care of himself how much longer he's going to last. I know the drs gave him 2 years and that was almost a yr and a half ago. I'm so worried about waking up one morning and him not wake up at all...

Oh, man, I'm so sorry.

How old are your children, if I may ask (just generalities like preschool, infant, teen, grownup, that sort of thing, is fine)? I'm only asking to gauge if they can understand what's going on and can be people you can lean on, at least a little bit, throughout all of this.

Hang in there.

7 months, 2, 5, and 12

Oh, man.

I was thinking - there are a few things you can do.

Not to seem unfeeling or mercenary, but it seems likely that, with or without treatment, he won't be seeing 2015. He's certainly making that happen with his inaction. But there's little to no reason for him to be uncomfortable. Talk to him - and to his doctor - and see if he qualifies for hospice care. He might, and they generally provide much more liberal pain management treatment. This would not be anything to cure him, just painkillers if he needed them. Plus you might qualify for some sort of help, perhaps nursing care to assist in caring for him. Because, whether anyone wants to admit this or not, he is hurtling headlong into full-blown disability before his death. To be practical about this, you need to be able to (you need not tell me this, just, think about these things) answer such questions as –

1. Can you lift him?
   
2. Can you assist him with toileting issues?
   
3. Can you do this with three preschoolers in the house?

I'm guessing that the answer to the third question, despite your best intentions, will likely be no. It's not shameful. This is human. And if you need help, you need to line that up.

You'll also need to talk to him. It might mean a fight, and I'm sorry. But the clock is ticking and you've got young children together. Even if he does not care one whit about himself, and even if he can't see what his behavior may be doing to you, you can appeal to him about his children. So ask - what are your plans for the kids? I am talking about estate planning here. Even if the assumption is that they will inherit 100% of his assets, if you can clear some of this up early you might be able to save yourself some tax headaches later. And find out - does he qualify for a pension? Insurance from his employer? Anything? And find out - would the death benefits be better if you were married at the time of his death, or not?

I realize how mercenary this sounds, but it's about time someone got practical here. And I know that may make you look like a golddigger (hardly the case if you've been together long enough to have a tween child together) or unfeeling. But after he's gone - and like I said, the clock is ticking rather loudly - when your kids need shoes, it'll be better if you can get (just throwing out fake numbers here as an example) $1600/month for their care and feeding instead of $1200/month. This isn't money for you to go on vacation to Aruba. This is to keep a roof over you and your kids' heads. So you both need to find this out, and act accordingly. If it would be better for you two to be married, then do whatever paperwork is required and get to a courthouse and get married ASAP. Screw the party, or have one later. This is more important.

Again, I am sorry you're going through this, and I know these issues are fraught and they can be upsetting. But from my chair it looks like the time for niceties and delicacies has long passed. Get down to brass tacks and protect your children's futures as well as you can, while at the same time helping him get pain relief and care for what will be his final days.

Thank you so much for that. It made me feel a little better with that being said.

Sorry about your situation. Let me provide a comment from someone who has a license/degree in respiratory therapy.

First, I see this situation very frequently. I'm sure he has already taken a PFT, and probably did not do well. You have a list of things that could make him better (O2, meds, activity) AND a list of things that make it worse (smoking, no meds, no O2). Plus, you can't smoke with O2 around anyway.

You can't force someone to take care of themselves. Essentially, he has made a decision not to change his lifestyle, and he will eventually be unable to breathe on his own.

The types of things you realistically need to concern yourself with are his wishes regarding artificial resuscitation (he'll decline), and basically get your affairs in order if not already done. Try to make peace with the situation and try to enjoy him as much as you can while you still have him.

One thing I'm surprised is that the Dr gave him an expected length of time to survive. 2 years is kind of a long time in the world of respiratory, in my experience if it is longer than 6 months nothing is said on longevity.

Since you are not yet married, that should be a priority for several reasons.

1. At some point you will need to be able to make decisions for him to ensure his wishes are carried out.

2. You will probably want to be with him during his last days. Usually, they only allow immediate family and some hospitals will staunchly stick to their rules. If need be, introduce yourself as Mrs. rather than as fiancé.

3. You won't have any legal standing to receive any death benefits etc., if he doesn't spell it out in a will beforehand.

It doesn't need to be anything fancy, just get the marriage license and go to a justice of the peace at the local courthouse.

So do you think the drs are wrong about the 2 years to live?

What I'm saying is that pulmonologists I work with would not give such a distant, yet specific approximation. It's like saying the Cleveland Browns will win the Superbowl in 2019.

Pancreas cancer is something that can be estimated pretty accurately as far as time. Lung ailments are not, especially COPD/emphysema...unless you are on death's door (6 months).

I would ask the doctor specifically why they gave they timeline. For the COPD/emphysema, they are going to monitor that via PFT in a Plethysmograph. Then, they can compare his peak expiratory volumes and flows over time. If you can, get a copy of the results and educate yourself on what those numbers mean. That is the single most important tool in monitoring COPD. Since Emphysema is a type of COPD, he doesn't have 2 separate ailments. COPD is more general and covers other obstructive diseases in addition to emphysema.

I and many of us here have had a loved one die with this.
And have friends still going on.

Getting things in order is a good idea, especially if your fiancee is still smoking away and foregoing oxygen.
It is my observation that one can take oxygen as directed and then smoke in between, which I can understand as a smoker of long long ago.

I don't know anything re black mold and this, sounds not good.

hbethm, I truly feel for you, but please don't take the word of someone you don't know, over the doctors. It's grasping at straws.
How could someone here, who haven't examined your fiance, and who aren't doctors ourselves, tell you if his physicians are wrong.

I know, I know that's what you want to hear. I'm sorry.

Butrflynet gave excellent advice. It might make things much easier for both of you if you get married now.

As his spouse, you will have many more rights.