Q: I am a 24-year-old lady and since childhood, I have been experiencing recurrent chest pains. These chest pains are especially severe after I inhale smoke, dust or during cold weather.
I have been investigated severally (I am not sure what the results have been over the years) and have been treated for both chest infections and asthma. The doctors even thought that I had a stomach ulcer.
When I wake up in the morning, my chest is usually very tight and I cannot breathe properly.
However, as the day progresses, my lungs open up and the discomfort clears. I am very frustrated by the lack of diagnosis about my condition. None of the medication I use seems to work. Could I be suffering from pneumonia or TB?
Well, let us start by tackling your final question. You would like to know if you have pneumonia. The answer is, no, you do not.
Pneumonia is an infection of the lungs. It is caused by germs such as bacteria or viruses. Sometimes, it may be caused by fungus. Usually, pneumonia presents with cough (often with production of sputum), rapid breathing, fever and chest pain.
The chest pain occurs when you either cough or take in a deep breath. If untreated, pneumonia leads to difficulty breathing, infection and can even cause organ failure. It is impossible to live with pneumonia for decades without treatment and survive.
Your other concern is the possibility of tuberculosis (TB). It is also not a likely diagnosis in your situation. TB presents just like pneumonia but most people report sweating excessively at night and weight loss. If untreated, TB destroys the lungs and causes one to cough up blood. It can even lead to respiratory failure and death.
You sound like you are having bronchospasms. Normally, when you breathe in and out, air moves through small tubes located in the lungs. These tubes are called airways. If these airways become irritated, they can narrow and make breathing difficult. This narrowing is medically known as bronchospasms.
Bronchospasms are usually triggered by irritants or allergens (such as dust, mould, animal dander, pollen, perfumes, chemicals). They can also be triggered by an infection in the respiratory system (including the flu). In addition, some people get bronchospasms when exposed to cold or during exercise.
Severe bronchospasms can be heard as a wheeze or whistling sound every time one breaths out. Mild bronchospasms are not audible but they can still cause chest tightness and discomfort.
Bronchospasms are a symptom and not a diagnosis. It is important to find out exactly what the underlying condition in your situation is.
I would recommend that you go to a physician or a chest specialist for a physical check up. Your doctor needs to have a good history from you about your symptoms.
Carry any medication that you may be using (including herbs). If you have had tests done in the past, take them to the doctor for review.
Let him know what triggers your chest discomfort and what relieves it. Find out if there is someone else in your immediate family who has similar symptoms.
The doctor will give you medication to prevent the bronchospasms and to relieve it each time it occurs. You may need some medication to deal with allergens such as dust.
Avoid cigarette smoke: If possible, avoid use of wood and charcoal to cook or warm yourself.
Avoid possible allergens like dust, pollen, pet dander, perfumes.
Remove any heavy carpets from your house. If you must keep them, wash and air dry them and vacuum them at least twice weekly.
Remove any stuffed toys like teddy bears from your bedroom.
Avoid piling books and papers in your house (especially in your bedroom).
Thoroughly clean your sofa, mattresses and curtains. Wash beddings weekly and avoid using perfumed detergents and fabric softener.
Ensure that the walls, cupboards and areas in contact with water do not have mould.
Always warm up before exercises.
Do not mix the prescription medication with herbal therapies.
Your heart must also be assessed. Occasionally, such symptoms are due to an underlying heart condition. A doctor will assess your heart and make sure that it is functioning effectively.
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