Brief Answer:
Graded exercises and physiotherapy.

Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will answering your query.

Based on your clinical history and query, my opinion is as follows:

1. Remeron was prescribed for depression. It rarely causes dyspnea.

2. I would expect your recent penumonitis and its recovery phase leading to severely short of breath phase. However, if you think you do not feel much depressed, you can stop it for time being and discuss with your doctor during the next visit.

3. Lungs are still recovering from infection and it would take atleast a month for your to recover to your former self.

4. Continue the medications as prescribed. Other than that, she requires,

a. Try to do Graded exercises to improve endurance. Chest physiotherapy and breathing exercises with spirometer is beneficial. Deep breathing will be helpful.
b. Periods of fatigue is going to be present. Try to pace periods of activity and rest.
c. Avoid any exposure to indoor or outdoor pollutants
d. Improve protein in diet. Check Hemoglobin levels, if its low, you will need additional Vit B12, Iron and folic acid.
e.If possible, caretaker to support and help in your exercises is necessary.
f. You will recover shortly within a month, completely to your former self. Patience is necessary. Try to remain active. Always avoid stretching beyond the limits at present. Know when rest is necessary, and take it.
g. Regular sleep and hygiene during this period is essential to avoid any further debilitating infection.
i. Avoid risk of falls, especially when you are moving around. Fatigue can increase risk of falls.

5. For limb edema, try elevating limb in sleeping position. Try to put two or three pillows during your sleep or resting period. It will come down. Avoid lasix at night as it can disturb sleep due to frequent urination.

Hope it helps.
Any further queries, happy to help again.

Take care.

Dr. Prakash HM

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Brief Answer:
Breath deeper

Detailed Answer:
Hi XXXXXXX

Thanks for asking again.

Hemoglobin of 9g% along with your recent pneumonitis is causing severe shortness of breath.
It would be better if you can get physical therapy.

However, you can try other things as suggested above. Importantly deep breathing exercises will be very helpful.
Eat nutritiously and do increase breathing exercises gradually. You will definitely improve.
Avoid being around anybody with any infection, particularly respiratory. It will be difficult period again, if you have a reinfection.
Breathe deeper should be your moto.

You are on the right path. Hemoglobin improvement will occur along with your nutrition. Add egg, fish, lean meat, pulses, legumes into your diet. These should improve your nutrition.

Hope it helps.
Any further queries, happy to help again.

Dr. Prakash HM

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Brief Answer:
Taking iron supplements will help.

Detailed Answer:
Hi,
Thanks for asking again.

Continue with the treatment and do add iron supplements to our medication. Iron supplements will help improve anemia and also iron is essential to fight infections too. Use only till anemia improves. Stool might be black due to iron. Do not worry. However, if you get nausea or any gastro-intestinal symptoms due to iron, go for increasing iron in diet.

However, improve your diet to include more nutrition. Nutritious diet will help in overall being.

Increasing activity is very good, however, don't over do it now only. You are still in recovery phase and go slow. Fatigue is ok, trying to over do it might complicate things.
When you are seated, go for deep breathing exercises. Try to blow powerfully. Using a pipe to blow through would help. Tie a cloth or bag and try to blow it. It will help in breathing powerfully.

Until your hemoglobin crosses 12-13g%, use supplements. After that continue with diet modification to include the nutrients adequately.

Get well soon.

Hope it helps.
Any further queries, happy to help again.

Dr. Prakash HM

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