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Getting shortness of breast. Crackling and gurgling started in lungs. Any thoughts?

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General & Family Physician
Practicing since : 2004
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47 yr old male. Past history of very physically fit. Past 4 years no exercise at all. Eat decent, not optimal. Not over weight but belly has grown, not out of control though. Last August I noticed when throwing a football around with son I would get extremely short of breath. No chest pains, or neck or arm pains. Now a year later, things have not improved much. I'm a pharmacist, and with my past physical fitness, I would swear, it's like having heart failure. When I lay down I start to get a gurgling/ crackling sound from my lungs, worse if I lay on my left side. That was bad for a while, got much improved over the past four to five months. But, now just walking a short distance I get alarmingly short of breath again like a year ago. No productive cough ever. No history of smoking. Chewed tobacco age 13 to 25 . Quit that, but have been chewing nicotine gum since it went over the counter in 1995. Don't have problems sleeping, although last winter I had a period of time where I would wake at precisely 3 in the morning needing to urinate, and often would wake every hour or so needing to sit up, not gasping for breath, but could tell that's what my body wanted me to do. To breath easier. Those events don't occur any longer but the crackling and gurgling in my lungs seems to be starting up again. Not sure how common these symptoms are presented to physicians. I have not been to a doctor in nearly 12 years. Aft divorcing (12 yrs ago) and with three kids, and at the time being in tremendous physical shape, I've never so much as had a worry about my health, and work too, too much.
Some additional past history. When I was seeing a doctor regularly, my diastolic BP was borderline hypertensive 120/94 to 130/95. Just before divorcing my doctor started me on lisinopril 10 mg daily, my blood pressure (diastolic) dropped so much they cut the dose in half. Also they started me on Lipitor at this time (2003 was the year) for borderline high cholesterol. 10mg of Lipitor a day dropped my cholesterol very significantly but liver enzymes raised enough that my doctor cut that dose in half also. Since divorcing I've never been back to any doctor. Although I'm a pharmacist I won't continue using any medication unless a doctor or qualified health professional can monitor what the drug is doing in an appropriate manner( if I could do my own blood work I suppose I would, but you see what I mean ). My own thinking at that time, 2003, was that I chewed so much nicotine gum (>10 2mg pieces / day) that that was raising my diastolic BP. Also worked a long term care job where I sat all day and enjoyed hour and a half lunches, never ate like that in my life before or after. At the time of my divorce I weighed around 215 to 220 pounds, now I weigh 190 to 195 maybe less, I am 5'11". From the ages of 14 to 30 I was a daily weight trainer, some casual jogging. Up to about 5 years ago, when people would XXXXXX me they would typically ask if I was a football player or bodybuilder. I've leaned up quite a bit in the past five years, but the lack of exercise (none) has reduced muscle mass significantly. I can really tell the changes in my body since turning 40.
Maybe helpful, I do wood work. I exclusively work with Mexican rosewoods. These woods contain oils that are very bio reactive, causing allergy in many people. If I do not cover thinner skin, like on forearms, I will itch. I mention this because I did start sawing up quite a bit of this wood in my garage workshop a bit over 2 years ago. I do wear a mask, but there are times when I do some quick sanding or cutting w/o a mask. Because I work so much, I have not been doing any woodwork for the past year. Interestingly though, about a year ago I sawed up an old wood swing set. These are constructed with mostly treated lumber. Kind of seems as though the gurgling and crackling in my lungs started a little after sawing this wood up. I wouldn't really have concerns if it were just the strange lung sounds, but the extreme shortness of breath with just a little exertion, considering my past physical fitness, really concerns me. Sometimes I think to myself XXXXXX we'll, I've never been out of shape in my entire life. . . Maybe this is what being out of shape is like" but this doesn't explain the strange lung sounds.
I just don't feel that two years ago I could get up and jog a couple miles, and now, the anxiety of having this extreme shortness of breath prevents me from even trying is just from being out of shape or getting older, again, considering my past level of physical fitness.
More history. Mother and father are both alive, mid seventies, both were considerably obese much of their adult life, both have gained some control but I still consider them to heavy for their age. Neither has now or has ever had any treated chronic disease state in their lives, and they go to the doctor regularly. Both grandmother died in their eighties. Both grand fathers died of heart disease in their fifties. Both had previous heart attacks, I think each had two before dying, but this was at a time when people were told to just rest after surviving a heart attack. Both were large men who smoked, even after their heart attacks.
Hope this info gives you enough insight to help me with what's going on?
Any initial thoughts?
Posted Sat, 13 Oct 2012 in Hypertension and Heart Disease
 
 
Answered by Dr. Chakravarthy Mazumdar 5 hours later
Hi,

Thank you for a very good description. Since you are a allied health professional I guess you know the importance of history like this.

First things I could think of given the description
1) Hypertensive Heart disease
2) Restrictive lung disease because of wood dust
3) Bronchitis / Obstructive lung disease because of wood dust.

You need an immediate evaluation with the primary physician importantly a physical examination. Heart failure needs assessment of jugular venous pulse, pedal edema, lung breath and heart sounds along with abdomen and liver enlargement.

1) Hemogram
2) Chest Xray
3) Resting ECG followed by Stress tests
4) BNP
5) Spirometry
6) Blood pressure check
7) serum electrolytes

I do not want you to waste time anymore.

Let me know if you have further questions to address before you reach your doctor.







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