ex-smoker - quit 2014
Asthma as a child
Thank you very much for referring Richard along for further investigation and management of his three-four month history or worsening shortness of breath on exertion. As you are aware, he was diagnosed with severe COPD, with an FEV1 or 25% of predicted and at that stage, gave up smoking. Despite the very limited lung function, since that time he has coped very well. He continues to work in a clerical role with a very supportive company and lives with two housemates. He will walk his dog for 30 minutes, twice a day. On the weekends, he goes for a walk of an hour and forty-five minutes on a Saturday and an hour and a half on a Sunday. While he was walking slowly, he did notice that on the flat at his own pace he was able to achieve 4-5km distance. His breathlessness did get worse when he had any hurried exertion or steep incline, but he has been quite happy with his progress.
Three to four months ago, he noticed a dramatic and sudden decline. This was associated with worsening a mildly productive cough of whitish sputum, and he had therefore assumed that it was viral at the time. There were no other changes in exposures in his home or work environment, and he has never had any issues with dog allergies or any allergies otherwise. He had no worsening with this with the thunderstorm event recently.
Thank you to Dr Ingram for trialling antibiotics. Unfortunately, these have not helped. He had a two-week course of prednisolone, wherein the first week he had 25gm and the second week 12.5mg with no benefit whatsoever. He was off prednisolone for two weeks and has now been on prednisolone for six weeks, with the first four weeks bein...
... middle of paper ...
...owever, coronary artery calcification.
Richard 's lack of response to any prednisolone does raise the question of whether or not there is another cause for his breathlessness. It does appear that he has been on quite good treatment for his COPD and therefore I would have expected some improvement over the last three to months if all of this was done to his COPD. I therefore think it is important to rule out pulmonary emboli and also a reversible ischemia. As such, I will organise an urgent VQ scan and a myocardial perfusion scan. Given his inability to exercise, we will perform the perfusion scan as a chemically-induced scan.
I am hoping to have these organised first thing next week and I will see him with updated lung function tests to assess his progress and management moving forward. I have also organised some baseline blood tests.
Need Writing Help?
Get feedback on grammar, clarity, concision and logic instantly.Check your paper »
- Patient experiences in end-of-life stage. During the course of the disease, COPD patients experience several exacerbations, particularly as they approach the end-of-life stage. However, many patients are unaware that end-stage COPD does not allow for a recovery to a pre-exacerbation state (Lowey, Norton, Quinn, & Quill, 2013). A qualitative study conducted by Lowey et al. (2013) involving twenty participants, found that patients were unaware that they were actively dying. Moreover, they thought that they were experiencing yet another exacerbation that would improve with treatment as it had in the past (p.... [tags: Asthma, Chronic obstructive pulmonary disease]
1417 words (4 pages)
- Breathing in and out is an innate behavior that we are born with; also, it is a behavior that people take for granted. Let’s say, people who smoke think a cough, or a cough with phlegm is a sign that they are about to get a cold, but then again it can be a sign of a potential health problem like emphysema, asthma, or tuberculosis. People smoke for different reasons; nevertheless, it is an addiction that they can recover from. It may take them several tries to quit smoking, but they can quit. People don’t think about the harm that they are putting on their lungs and alveoli when they put a cigarette to their mouth.... [tags: COPD]
1252 words (3.6 pages)
- Chronic Obstructive Pulmonary Disease “COPD affects 24 million Americans and reaches people in all the 50 states” (COPD statistics across America). What exactly is this disease that is affecting so many people across the United States. It’s chronic obstructive pulmonary disease, or COPD. COPD is described almost exactly as it sounds. It is a chronic disease that obstructs breathing, making it difficult to breathe. According to Mayo clinic staff, it is defined as a chronic inflammatory lung disease that causes obstructed airflow from the lungs.... [tags: Asthma, Chronic obstructive pulmonary disease]
920 words (2.6 pages)
- Introduction Respiratory disorder mostly affect the upper or the lower respiratory tract, however bacterial or viral infection are the causative agent and the disease is common in all ages. In addition, the lungs and the bronchi can also be affected causing inflammation and obstruction of the airflow resulting to wheezing, chest tightness, stridor, low grade fever, cough, and hemoptysis due severe damage to the lung tissues. Some common disease condition of the respiratory system are pneumonia, croup, asthma, bronchitis, or laryngitis, and tuberculosis, affected disease location determines the signs and symptoms.... [tags: Asthma, Immune system, Mucus, Inflammation]
858 words (2.5 pages)
- According to World Health Organization “Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by chronic obstruction of lung airflow that interferes with normal breathing and is not fully reversible. The more familiar terms 'chronic bronchitis ' and 'emphysema ' are no longer used, but are now included within the COPD diagnosis”. The disease can be tested by a simple test called spirometry. Spirometry measures how deep and how fast air can move in and out of the person’s lungs.... [tags: Chronic obstructive pulmonary disease, Asthma]
729 words (2.1 pages)
- Thank you very much for sending Gary along for investigation of the likely respiratory contribution to his twelve-month history of worsening shortness of breath. Thank you for also including correspondence regarding his cardiac work up which reassuringly did not reveal any obvious cardiac cause for the breathlessness. I note that a stress sestamibi scan ??. some myocardial ischemia. The echocardiogram showed some diastolic relaxation issues but normal filling pressures and no other significant issues.... [tags: Asthma, Pulmonology]
702 words (2 pages)
- Chronic Obstructive Pulmonary Disease is an incapacitating condition that can severely alter even the basic day to day activities. COPD is a progressive disease, which means it worsens over time. The key feature of this disease is that it makes it hard to breathe. There are many medical and dental considerations to look at when seeing a patient with this disease. It is important to understand how the lungs work to understand how COPD affects someone. When a person breathes the air goes down your windpipe or trachea and into your bronchial tubes.... [tags: Asthma, Chronic obstructive pulmonary disease]
1308 words (3.7 pages)
- Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease, or COPD, is not just one specific disease. It is actually a group of diseases common to the lungs that make it difficult to breathe normally and also blocks airflow. It most commonly stems from smoking tobacco, but has been linked with inhaling fumes from cooking and heating in a home that has not been vented correctly. In rare instances, COPD can be caused from Alpha-1-antitrypsin deficiency, which is a genetic disorder where your body does not have enough of the protein Alpha-1-antitrypsin.... [tags: Chronic obstructive pulmonary disease, Asthma]
1279 words (3.7 pages)
- Chronic Obstructive Pulmonary Disease or (COPD) is a common chronic inflammatory lung disease that restricts airflow from the lungs. People with COPD have a high risk of obtaining the condition. The symptoms you can develop from this disease are ass follows; trouble with breathing, chronic coughing, wheezing, weight loss, morning headaches, and swollen feet or ankles. There are two common conditions that contribute to this disease; these are emphysema and chronic bronchitis. Emphysema is a condition in where the alveoli at the end of the bronchioles of the lungs can be destroyed as a result of the damaging exposure.... [tags: Asthma, Chronic obstructive pulmonary disease]
716 words (2 pages)
- Hearing the word, asthma stops a mom in her tracks, sends her heart into palpations and sends her mind into a whirlwind. Asthma means a child cannot breathe and if the child cannot breathe, surely, the child will die. To the untrained parent, that is the take home message from the child’s pediatrician visit. However, in the vast majority of the cases, dying from asthma is simply not the case. Asthma is a chronic lung disorder that does not have to define the child but rather be part of the many identities that make up a child much like blue eyes.... [tags: Asthma Essays]
917 words (2.6 pages)