Hi Diane,
I'm so sorry that you have Stage 4 lung cancer and severe shortness of breath. It's good that you have oxygen and the nebulizer. By the way, if your oxygen ever just doesn't feel like you are getting any air from it, put the part of the tube that you put in your nose in a glass of water. If there is air coming through the tube it will bubble up in the water. That way, you know it's working right. Also save all your old oxygen tubes that work even if you get new ones. You never know when a new one may get a small pinpoint hole in them and not work. That way, you will have spare ones to use. These kinds of things always seem to happen when you are not prepared for it.

One thing you may want to do is to look up the side effects of all of your medications and treatments like the chemotherapy. Some of them may be causing or increasing your shortness of breath. If you find that something is affecting your breathlessness don't stop taking it until you talk to your doctor. This is because your body is used to the medication and the reaction to just stopping it abruptly could be harmful to you. Your doctor will know what to do about it.

My husband also had Stage 4 lung cancer and at the end he had severe shortness of breath. However, due to several bad issues with Keytruda and Chemotherapy treatments he refused all treatment like those. He lived 14 years with lung cancer and eventually just had oxygen, nebulizers and inhalers plus his regular medications. He died in 2024 at age 83. We found that it helped to have a quiet life style. Basically don't be around a lot of people where you can catch the flu or something. Your body already has enough problems to deal with. We also ate healthy. For us that mneant eating good quality red meat and vegetables. Everything was made from scratch; no frozen dinners or eating out. Also drinking a lot of water helped my husband immensely. Your body needs all the help it can get and water makes everything work in it.

We didn't have hospice. We didn't want strangers coming into our home. I had worked in the healthcare field when I was younger and also took care of my Mom for 10 years when she had pulmonary emphysema so I could do a lot of what hospice would do for my husband. However, they can be very helpful.

One thing that helped us the most was prayer. God was there for us through the whole ordeal. Just talk to him like he's your best friend and he is! He made you and he can fix you. You asked if you were nearing the end. Apparently, the doctor thinks so or he wouldn't have mentioned hospice. That doesn't necessarily mean that you are. Only God knows that information. God stated in the Bible, "I give life and I take it away." So, don't worry about it and leave everything up to God. Enjoy each day that you have and be thankful for it. Feel free to ask any questions of me. I'll try and answer what I can.
I'll say a prayer for you.
I wish you the best.
PML