Nov 3, 2008 9:12 am US/Pacific
Dr. Mallika's Files: Case Of 'I Can't Breathe'
BOSTON (CBS) ―
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Mallika Marshall, M.D., shares experiences highlighting medical cases.
WBZ
Dr. Mallika Marshall is the medical reporter for CBS station WBZ-TV in Boston and a regular contributor to the CBS Early Show. Trained as both a pediatrician and internist, Marshall currently treats patients at an urgent care clinic near Boston. Names and identifiable characteristics of patients have been omitted or changed to protect patient privacy.
This Week's Case
A 25-year old man comes to the clinic saying he's having trouble breathing. He was diagnosed with asthma as a child and has had more frequent asthma attacks over the past couple of years. Last night he woke up in the middle of the night with a dry cough, wheezing, and shortness of breath. He has not had a fever, but he has had a mild cold for the past week. He ran out of his asthma inhaler a few weeks ago. He smokes a pack of cigarettes a day. On exam, the patient appeared winded and was wheezing.
Diagnosis/Discussion
Asthma is a chronic lung condition caused by inflammation of the lining of the airways. It affects about 12 million Americans and the number of people with asthma is increasing worldwide. Typical symptoms include wheezing, cough, and shortness of breath. An asthma attack can be triggered by a number of things including viral infections, cold air, allergies to dust, pollen, molds or animal dander, and tobacco smoke.
This patient has at least two possible triggers for his asthma attack, namely an upper respiratory tract infection and cigarette use. It may be hard to prevent the common cold, but he could certainly help himself by not smoking. Cigarette smoke not only increases the risk that someone will develop asthma, but also makes asthma symptoms worse. And studies have shown that by quitting smoking, asthmatics can reduce the severity of their asthma considerably.
This young man also ran out of his asthma inhaler weeks ago so that when he developed an asthma attack in the middle of the night, he had no medication to help him. As a result, by the time he arrived at our clinic, he was in significant distress. All asthmatics should make sure they have plenty of medication on hand at all times. Asthma is a serious illness that can be fatal if not treated promptly.
Follow-up
With several breathing treatments and oral steroids, the patient was feeling much better. He was given refills on his inhalers and instructed to quit smoking. He was referred to our Asthma program where he will get advice on how to manage his asthma at home and how to kick his smoking habit.
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