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Respiratory Therapist/Breathing problems

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QUESTION: Hi
About 3 years ago I started having breathing difficulties.  A pulmonologist had me have a CT scan, repeated 2 times and after 2 years gave me a clean bill of lung health.  By this time the breathing was much worse and I was sent to a heart doctor who put me through all tests up to a catheterisation,and said my heart was of a 20 years old. I'm 74.  Meanwhile, the breathing difficulties are getting worse specially in the morning, after I get up and move a little. I cannot take a walk anymore, don't have any energy.  There's also a wheezing in my chest. Caffeine seems to be one thing that gives some relief.  I hope you may have heard of cases like mine that a lung specialist and a heart specialist never heard.  Thank you for the attention you may give my problem.

ANSWER: Ana,
    I am sorry that you are having breathing problems. It is a problem that makes everything we do extra hard and extra tiring.
    You did not mention whether your pulmonologist administered a Pulmonary Function Test (PFT). This test measures the airflow in and out of the lungs and the capacity of the lung to hold various volumes of air. It is usually given with a bronchodilator so that the physician can see if this particular type of medication is effective.
    Most lung diseases cause not difficulty with getting the air into the lung but, conversely, getting air out of the lung. I am assuming that the wheezing you mention is on expiration, when you breath out. Caffeine is a vasoconstrictor and, therefore, may be reducing the effects of inflammation in your lungs.
    The next time you find yourself wheezing do this: breathe in through your nose and out through pursed lips (make your lips like you are going to kiss someone). If this seems to help your breathing you may have an obstructive type lung problem.
    If you have not had a PFT you need to have one. Two years is a long time and if you had one then I would suggest you get another PFT for comparison.
    You have something going on and I would suggest a second opinion. Medication is available that will alleve and control your symptoms. You need not be a pulmonary cripple.
Good Luck.
Peace,
Richard

---------- FOLLOW-UP ----------

QUESTION: Thank you, Richard, for being so prompt in answering.
As far as I know, I never had a PFT test.Well, maybe I had without realizing it.  I remember blowing into something and the doctor saying categorically that I did not have asthma, as I had suggested.  Every time I saw this doctor was in the afternoon, when I'm usually better and my chest doesn't wheeze.
This morning I did what you suggested and indeed the wheezing got instantly better. I just saw in this site an advertisement for a walk-in clinic at Walgreen.  Do you think they can give me something there?.  After my experience with 3 doctors, I feel that I need some different approach.  I'm immensely grateful for your help.

Answer
Ana,
    I am glad my suggestion for pursed lip breathing was of help.
    Here is what I would do if I were in your position. I am not sure if the walk-in clinic would be of value but it sure wouldn't hurt anything. If I were you I would go to Walgreen's and ask for a Peak Flow Meter. It is a device that measures how fast you can get air out of your lungs. Asthmatic's use it to measure how they are doing day to day and if they are nearing their danger zone for a protracted asthma episode.
    Once you have the peak flow meter every morning blow in it and keep a log of your reading. You might want to do it in the morning, afternoon and at night. If, indeed, you are having greater difficulty in the AM as opposed to later on in the day this will give you measurable proof to show your physician.
    It does sound like your doctor did do at least a peak flow measurement. However, if you were not symptomatic of course it wouldn't show anything. There is a PFT component that challenges the lungs with an irritant to provoke an asthmatic type episode. At any rate, I would still insist on a pre and post bronchodilator PFT with flow volume loops. This test would put to rest, once and for all, any question of any type of obstructive lung problem you might have.
Good luck.
Peace,
Richard

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Richard Manlove

Expertise

All questions regarding the cardiopulmonary system, respiratory care, critical care.

Experience

Practicing registered respiratory therapist since 1969 in all respiratory care settings. Educator - co-owner Texoma Healthcare Educators. Lecturer at Oklahoma State University School of Nursing

Education/Credentials
RRT, CRT, ACLS, BS, AS (nursing)

Awards and Honors
Invited speaker: 51st International Respiratory Care Congress

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