[19F] Experiencing shortness of breath and upper back pain

Patient Description

A 19-year-old female presents with shortness of breath persisting for about a month, accompanied by occasional cough attacks. The patient reports that the shortness of breath is exacerbated by lying down, exposure to cold, and sometimes exercise, but is relieved by changing position. Episodes of shortness of breath occur more frequently before sleep and are sometimes accompanied by wheezing. The patient's albuterol inhaler does not alleviate the symptoms. Additionally, the patient experiences upper back and shoulder pain, particularly at the back top area, which may be related to weightlifting activities. There is a family history of asthma, as the patient's mother has asthma. The patient denies any previous diagnosis of asthma or other respiratory conditions.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few possible explanations:

  1. Asthma or Reactive Airway Disease: Given your family history of asthma and the wheezing you experience, it's possible that you might have a form of asthma or a similar condition. Asthma can cause shortness of breath, wheezing, and coughing, especially when exposed to cold air or during exercise. The fact that your albuterol inhaler isn't helping could mean that your asthma is not well-controlled, or it might be a different respiratory issue.

  2. Exercise-Induced Bronchoconstriction: This condition can cause shortness of breath and wheezing during or after exercise. It might explain why you experience symptoms when lifting weights.

  3. Musculoskeletal Strain: The upper back and shoulder pain could be related to muscle strain from weightlifting. This type of pain can sometimes be mistaken for respiratory issues if it affects your breathing muscles.

Typical treatments for asthma or reactive airway disease include inhalers like albuterol, but if these aren't effective, a healthcare provider might prescribe other medications or suggest lifestyle changes. For musculoskeletal pain, rest, ice, and over-the-counter pain relievers can help, along with proper exercise techniques.

What you can do

Shortness of Breath and Wheezing:

  • Since your inhaler isn't providing relief, it's important to consult a healthcare provider. They might adjust your medication or explore other causes.
  • Try to avoid triggers like cold air or allergens, and consider using a scarf to cover your mouth and nose in cold weather.

Cough:

  • Stay hydrated to help thin mucus and make coughing more productive.
  • Use a humidifier in your room to keep the air moist, which can ease coughing.

Upper Back and Shoulder Pain:

  • Ensure you're using proper form when lifting weights to avoid strain.
  • Consider taking a break from weightlifting to allow your muscles to recover.
  • Apply ice to the affected area for 15-20 minutes several times a day to reduce pain and inflammation.

What you should look out for

It's important to seek medical attention if you experience any of the following:

  • Severe shortness of breath or difficulty breathing
  • Chest pain or pressure
  • Persistent or worsening symptoms despite using your inhaler

Remember, while I can provide information, it's crucial to consult a healthcare professional for a formal diagnosis and treatment plan. You can also use MDandMe to journal your symptoms, track your progress, and share your notes with your healthcare provider.

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1 mo ago

People Also Ask

What could be causing my shortness of breath and wheezing if my inhaler isn't working?

If your inhaler isn't providing relief, it could mean that your asthma is not well-controlled, or you might have a different respiratory issue such as reactive airway disease. It's important to consult a healthcare provider for a proper diagnosis and treatment plan.

How can I differentiate between asthma and exercise-induced bronchoconstriction?

Asthma typically involves chronic symptoms that can be triggered by various factors like allergens, cold air, or exercise, while exercise-induced bronchoconstriction specifically occurs during or after physical activity. A healthcare provider can perform tests to help differentiate between the two.

What are some effective ways to manage upper back and shoulder pain from weightlifting?

To manage upper back and shoulder pain from weightlifting, ensure proper form during exercises, take breaks to allow muscles to recover, and apply ice to reduce pain and inflammation. Over-the-counter pain relievers may also help.

When should I seek medical attention for my respiratory symptoms?

Seek medical attention if you experience severe shortness of breath, difficulty breathing, chest pain or pressure, or if your symptoms persist or worsen despite using your inhaler.

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