Mr. Smith is a 72 yo male with COPD, worsening gradually over the past year despite compliant 
use of XYZ meds, nebulizers and rescue inhalers. PFT’s (attached) demonstrate the decline in 
lung function over the last 12 months. Now with the constant use of 2-3L NC O2 at home for the 
last month, he still can no longer walk to the bathroom, about 30 feet from his bed without 
significant SOB and overall discomfort. The kitchen is further from his bed. He says his bed/bath 
doorways and halls are wide enough for a scooter that will bring him to his toilet, sink and 
kitchen, all of which are on the same floor. VS 138/84, Ht rate 88 RR 16 at rest on 3L NC 
Vision- sufficient to read newspaper with glasses on 
Cognition- OX3. Able to answer my questions without difficulty. 
Ht XX Wt YY 
Ambulation – Sit to stand was done without difficulty. Patient attempted to ambulate 50’ in 
hallway, but needed to stop and rest 2 x’s before he could accomplish. HR at first stop point 
(about 25’) was 115 and RR was 32. Patient became slightly diaphoretic. 
Lung exam – Hyperresonant percussion and distant breath sounds throughout. Occ wheezes. 
Neuro- Hand grips of normal strength bilat. Patient able to maintain sit balance when laterally 
poked. Steps carefully around objects in the room. 
Alternative MAE equipment – Pt has attempted to use cane, walker or manual wheelchair 
unsuccessfully due to extreme fatigue with slight exertion described above.
user