Tuesday, 19 July 2011

More Medical Incompetence: My Lung Infection

For over two years now I have suffered from a significant increase in mucus production ('slime' produced in the lower airways and coughed up), as well a near-constant cough and episodes of shortness of breath. I have written about this before already a few times. When visiting multiple family doctors and ER doctors over the past years I have been given the following range of diagnoses: 'nothing unusual', 'just a bad cold', 'a slight infection in the chest, will pass in two weeks', 'asthma'.

First of all, the persistent cough is a very big hint, together with the increase in mucus production: "A change in the amount, color or tenacity of sputum is often extremely significant and may indicate the presence of a bacterial infection or other type of lung condition, such as pulmonary edema, chronic bronchitis or bronchiectasis." [1]
"Bronchitis may be indicated by an expectorating cough (also known as a productive cough, i.e. one that produces sputum), shortness of breath (dyspnea) and wheezing. Occasionally chest pains, fever, and fatigue or malaise may also occur. Mucus is often green or yellowish green and also may be orange or pink, depending on the pathogen causing the inflammation." [2]

There's a big difference between asthma and chronic bronchitis, the latter being part of the group of Chronic Obstructive Pulmonary Diseases (COPD): "Distinguishing between asthma and COPD can be quite challenging, even for the most seasoned medical professional. In fact, COPD is often misdiagnosed as asthma, leading to ineffective treatment and management of the disease.

Although asthma and COPD share similar characteristics, they are two very different animals in terms of disease onset, frequency of symptoms, and reversibility of airway obstruction. "

Looking at the symptom comparison, plus considering the additional symptoms which are not part of asthma, but are part of COPD like the mucus production and the consistent cough it seems pretty clear that we're talking COPD here, and not asthma. For one, the symptoms of having restricted air is near-constant, and just worsens at times. The inhalator I got from my current family, the one who insisted it had to be asthma without even listening, having a scan made or anything, does exactly nothing positive, as is to be expected if it is COPD.

So, in a nutshell, my experiences in this matter are pretty much a mirror image of those with my intersex issue, with symptoms ignored, no proper examinations carried out and the patient not being taken seriously. If they did, they'd do the following:

"The presence of a productive, long-term cough that lasts 3 months out of the year for 2 consecutive years points doctors in the diagnostic direction of chronic bronchitis.
A diagnosis of chronic bronchitis is made by obtaining a complete history, including family, environmental and occupational exposure, and smoking history. Diagnostic tests may include:
    Arterial Blood Gases
    Chest X-ray
    Pulmonary function tests
    Complete blood count"
The nasty thing about chronic bronchitis is that it's irreversible, and will lead to reduced lung function during the life of the patient. Treatment is required to prevent further degradation of lung function. If it's truly what I have, then treatment is required immediately.

Unfortunately, as I pointed out with my comparison with the intersex case, it's unlikely I'll find a doctor willing to take me seriously in this country. I'm really not sure what to do here, considering that without treatment my lung function may be degrading every day a bit more. Help?


[1] http://copd.about.com/od/glossaryofcopdterms/g/mucusproduction.htm
[2] http://en.wikipedia.org/wiki/Chronic_bronchitis
[3] http://copd.about.com/od/fa1/a/asthmaorcopd.htm
[4] http://copd.about.com/od/chronicbronchitis/a/bronchitis.htm

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