Posted by JohnM
on 9/23/2009, 7:33 am
86.177.17.171
Hello,
I wonder if you could help. I would like to ask your advice about my girlfriend. She is 50 and quit smoking three years ago, having smoked heavily for over thirty years.
Despite not smoking for that time, she is still very wheezy, gets short of breath easily and has a chesty cough.
Although exercise makes it worse, I can sometimes hear a faint wheeze from her chest even when she is just sitting quietly without any exertion. In general the wheeze seems louder when she exhales, although I can sometimes hear high pitched sounds when she breaths in, too. Her wheeze has a distinctly "wet" quality, often with a bubbly or rattly sound. It sounds as if there is too much fluid in her lungs, and is quite different from the tight, "hissing" type of wheeze asthmatics sometimes have.
You can also hear it in her voice, which sometimes sounds sort of “thick” and congested.
For some reason her wheeze gets worse when she lies down. In fact, sometimes it is loud enough to keep me awake at night (although she seems able to sleep through it without problems).
The biggest problem, though, is with any exertion. We both love walking, and she can walk along the flat without any difficulty. However, as soon as we come to an incline she gets into trouble. After only a minute or so she is wheezing noticeably and panting for breath, and before long we have to stop until she has caught her breath again.
In fact the shortness of breath is her biggest difficulty, I would say. When she’s breathless she takes these incredibly deep, heaving breaths which make her ribs, collar bones and neck cords stand right out, as if she is trying to get every last drop of air into her lungs.
Incidentally, I've noticed that her chest is an unusual shape. Her sternum protrudes forwards with a row of visible ridges down each side. I guess you'd call it pigeon chested, or perhaps barrel chested. I'm not sure if that is the right term, but whatever - her upper chest is bony and protuberant (which isn't helped by her being somewhat underweight). I mention this simply because she says it is caused by her lung condition. Can this really be true? I've never heard of that. It's a shame, because I think she is embarrassed by it - she is a beautiful woman, but I've noticed she seems to choose clothes which keep her chest covered.
I need to complete the picture by telling you about her cough. She coughs frequently, and it sounds very wet and congested. I'm pretty sure she coughs up fluid, although I've never seen or heard her expectorate. As with her wheeze, the cough gets worse when she lies down, and she coughs frequently through the night. Exertion often causes a coughing fit after the wheezing has got bad.
Of course, I've discussed all this with her. She says it is a combination of emphysema and chronic bronchitis due to the smoking, that her lung damage is quite severe, and that there isn't much more that can be done about it. However, she does use an inhaler (brown, I think) first thing in the morning and a few times through the day.
Despite the picture I've painted, for most of the time she is able to lead a perfectly normal life. But getting any sort of exercise does seem difficult for her. Also - and I truly hope I'm not over-stepping any bounds of decency here - her coughing and shortness of breath does make our love life difficult for her. If you'll forgive me for going into it, we have found that it is best if she remains upright and is in charge of setting the pace, as it were.
I'm telling you all this because I'd like to ask your advice. How can I best help her remain comfortable and healthy? At the moment we avoid hills as far as possible when we go for a walk. But should I encourage her to exert herself, despite the shortness of breath, or discourage it? I don't know if working her lungs is good for them or bad for them.
Is there anything I should be doing in our love life to help her be fulfilled without becoming distressed?
Also, is there anything I can do to help with the disease itself? I've seen on the TV someone patting all over their patient's chest to loosen the phlegm and help expel it. I'd be quite happy to do that if it's appropriate.
Any thoughts, advice or comments would be most gratefully received.
(Oh, don't be offended if you see this note on other similar forums - I'm just hoping to get a range of views).
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