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He is 56 yrs old, a smoker for 45 yrs and is 366 lbs. He is on 4 liters oxygen constantly and blood oxygen stays only in low 80's.

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It doesn't sound as though he has a very good quality of life.

Have you considered a hospice evaluation? Has his doctor discussed that with you?
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Agree with Barb. In his case it’s quality of life. No one can predict life expectancy.
What’s his level on activity?
If you can encourage him to lose weight IMO that should be his priority now. Quitting smoking as well, but his excess weight taxes his entire well being especially his cardiovascular system.
Hard choices I know. He has to be committed to improving his own health. Perhaps a visit to a nutritionist or supervised weight loss physician led programs. Not sure he would be a candidate for bariatric surgery with his compromised respiratory system.
Good luck!
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I wonder how many of the (!) 366 lbs are retained fluid? Water is heavy. Is your husband taking his diuretic as prescribed?

How long has he been in such a poor state of health?
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