Pulmonary evaluation long overdue

Dear Dr. Gott: I am hoping you can help me with a problem that I have had for more than 20 years.

It seems that very little effort will cause me to wheeze and have difficulty breathing. I also have a rasping noise in my lungs about 50 percent of the time.

My doctor seems unconcerned about it, but it is hard for me to tell, as my visits are usually limited to two or three minutes.

I am 70 years old and about 10 pounds overweight and had two heart attacks about two years ago. I use nitro spray to get my heart calmed down.

Often, while coughing I will bring up large amounts of phlegm, mostly white or colorless.

My doctor has prescribed Ventolin and Flovent, but the Flovent seems to tighten my lungs so that it is hard to breathe.

I am retired and not very active due to arthritis settling into my knees and hips.

I have had chest X-rays but my doctor doesn’t share the results with me. Also, I am scheduled for a pulmonary function test in late September.

During my working years, my occupation was carpenter and cabinet-maker.

Any help you could give me would be greatly appreciated. Thank you.

Dear Reader: The combination of cough, wheezing and difficulty breathing suggests asthma, spasm of the muscles in your bronchial tubes. The causes for this are numerous; in addition, chronic asthma, if not treated properly, may lead to lung damage and chronic obstructive pulmonary disease.

Your occupational history is significant in that you were exposed to air pollution (sawdust, lacquer fumes and so forth). Also, heart disease can lead to a condition called “cardiac asthma.” Certain medicines, called angiotensin converting enzyme inhibitors (used for high blood pressure), often cause cough and wheezing. Finally, a multitude of primary pulmonary disorders, including tumors and infections, can lead to the symptoms you described.

In my opinion, your problem should have been diagnosed 20 years ago. One of the tests that has been delayed is the pulmonary function evaluation.

I urge you to insist on a referral to a pulmonary specialist. Such an expert can examine you and recommend blood tests and imaging studies. Your breathing difficulties are, apparently, beyond the scope of your family doctor’s abilities; hence, a second opinion is mandatory. Let me know the outcome.

To give you related information, I am sending you a copy of my Health Report “Pulmonary Disease.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.