Hi Doctor, I am preparing to quit smoking after 22 years, and I have smoked very heavily up to 2 packs daily. I am a 105 lb female with history of anxiety and depression (chronic) yet I have taken no medications for this. The reason is fear of medicine side affects. I have extremely light yet poor eating habits and in winter I live a sit still lifestyle daily. I work from home and this allows me to be lazy. I don t exercise at all, and I m aware this has to change yet I ve feared the shortness of breath and fatigue that activity brings on. I always attributed it to smoking and not exercising. Also I currently feel another episode of ovarian cyst pain, which my GYN diagnosed a few times. I don t know if that makes a difference. I take no medication other than Camila POP mini pill birth control . I ve had no period in months and no sex in 9 months. Pregnancy tests negative. Also have history of GERD/acid problems. Last week I attempted to lightly shovel snow after having sat around lazily for a few months. At the end of shoveling with mild lifting of snow, I walked up stairs and felt my heart progressively beating harder/faster, which initiated panic, which led to constriction in my chest, tightness under my Adams apple , slight queeziness, and heart continued pounding. It felt like terror. The feeling of my heart racing outside seemed to trigger immediate anxiety which escalated to panic... Yet I convinced myself I have seriously damaged my heart over the years. Pulse after 20 min resting was 101 in 60 sec, dropping to 99 a few min later. Sometimes carrying heavy laundry makes my chest feel like its on fire. It subsides after telling myself I m fine and sit down. Appt with new doc was this past Tuesday. Advised of my symptoms, emphasizing fear of heart damage & urgency to get help to quit smoking and explore symptoms. He suggested stress test in his office after listening to my heart beat. He didn t take my BP, and seemed to be pushing too hard while I layed flat and he listened through stethoscope. It was actually painful as I m very thin and my ribs are sensitive, but I digress. I asked for blood work and he allowed it and took it himself. Two days later I went for stress test. Anxiety was 8 out of 10, and had been extremely high since last appt. I was extremely nervous and smoked prior to test though I knew I shouldn t. Results as follows: Level 1 on slightly inclined treadmill was full of extreme anxiety that I d fail test. Docs nurse said my oxygen was 99% as soon as I began walking. As suspected, sitting so much in crouched position made muscles instantly tired, and I hadn t eaten all day which didn t help. Made it thru 3 min to level 2. Level 2 provoked higher anxiety. Felt lightheaded. Told doc who tried to joke with me and push me to keep going. He said I was doing good and kept saying I had a lot longer to go and I think the number on the screen that the nurse was monitoring said 174 (?). He said I had to get up into the 200s. I was afraid something bad would happen and kept walking best I could. Without warning they kicked it to level 3 and I felt like it inclined more. I was pushing way too hard at that point, in full blown panic. I instantly got dizzy, weak, legs felt like jello, felt like I was going too fall. Doc was saying keep going! and I demanded they shut it off.., I couldn t handle it. The doc told me to hurry up and lie on table so he could use the ultrasound tool on my heart and he kept jerking me forward and backward as I lied on my left side and he reached in front of me. He said it was sometimes hard to get a reading & at that point I didn t even care. I felt defeated and sad, as I knew I failed, as I knew I would. Doc stated, your heart is fine. You have emphysema! He then said remember we knew that- you saw it on the chest X-ray we did weeks ago! and laughed. I told him he had me confused with someone else as he never gave me an X-ray. I was only in there 3 times, unrelated to my heart. He said Are you sure we didn t do X-ray? Oh well, anyway... You have emphysema. I was in shock, though I should ve expected it. I asked, Why do you say I have this? You can tell that from the stress test? He said, Yes, because your oxygen started at 99%, and dropped to 94% right before you got off. No ones oxygen should ever go down. You have emphysema. I asked, Well what do I do now? Do I have to get more tests or take medicine? and he said, You do nothing but quit smoking. and smiled. I felt like a child whom he was telling to be a good girl. Just quit. That was a no-brainer, yet I still had no idea if I would be dead in 6 months. He didn t tell me anything to do but quit, so I feared the worst yet was so confused. My bloodwork was all normal (CBC plus b12 & TSH), other than MCV and MCH. He said I don t have pernicious anemia like an old doctor told me I had years ago. I asked for B12 to confirm and it was normal. I don t drink a drop of alcohol and never did. He said the only other thing it could be was folate deficiency or liver disease. He said folate was too expensive to test for so since I have no insurance he would just give me a Perscription for it. Please advise me if I should see a doctor like yourself who can help me, or should I do anything? I am not confident in my doctor, and I have so many questions... Like... How bad is it? Will I die in 3 years like so many websites say? I am very afraid. I have a few methods to quit smoking. I would have filled the prescriptions that he gave me that I asked for but he wrote the wrong persons name on them when he wrote them in front of me. I just didn t realize it until I went home. I have not called because I m embarrassed. If I go to another doctor, I don t know which kind I should go to. I am totally at a loss. I give myself 30 days or less to quit smoking with a combination of methods. Thank you for listening. Please help me. I am desperate and not sure what to donor where to go. I want to confirm whether I have emphysema. He wrote COPD on my chart but he didn t write emphysema.
Asked On : Wed, 20 Feb 2013