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Asthma, CHF, Pneumonia? Suggestions?

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  • Asthma, CHF, Pneumonia? Suggestions?

    I would love to hear from anyone who has asthma and CHF who could describe the difference in sound. If you also have had pneumonia, could you describe what it sounded like to you. Also, can CHF cause pain? I have pain in my right lung when I lie on my right side, but have trouble lying on my left side because of the HCM.

    I know. I know. Go see a doctor. I will do this tomorrow (Monday here), but for today, I would like to know what to do.

    Briefly, I had a mild bout of diverticulitis early this last week so started on Flagyl and Keflex, which my gasterenterologist gave me to bring for such situations, on Monday. On Tuesday and Wednesday I did not feel very well (felt like a little fever and chills and achyness), but figured it was taking time to work. By Thursday I had a full fledged respiratory infection with fever and chills, explosive sneezing and coughing, as well as diarrhea (not a nice combination). I spent Fri and Sat in bed but fever broke Sat night and I thought surely I would be better. I was developing some wheezing so started 20 mg of prednisone. (The allergist gave this to me and lectured me severely about beginning it at the first sign of lung involvement.) But the cough moved deep into my chest. I now have a deep rolling cough and a noise coming from my chest that is so loud that I cannot sleep. My husband can hear a loud rolling sound deep in my right lung when I breathe deeply. I do not have any ankle swelling, which I had last semester when the doc here said I had CHF as well as pneumonia. I doubt that I have pneumonia considering I am taking both gram + and gram - effective antibiotics, although viral pneumonia is possible, I suppose.

    Any suggestions other than going to the doc tomorrow? I would like to have some idea of what to say to the doc. Obviously I hear from many of you that docs have had trouble distinguishing asthma, pneumonia, and CHF, so I guess I like to have ideas of what to suggest so that I get the right answer the first time. I am getting tired of coughing!

    Thanks!
    Rhoda

  • #2
    Re: Asthma, CHF, Pneumonia? Suggestions?

    Ok as far as asthma goes it's more of a wheezing sound very tight, CHF does cause a cough, pneumonia and CHF does sound alike as far as congestion goes it's hard to tell the difference, wheezing is almost like a whistling sound and you are not able to take a deep breath, that has woke mr up in the middle of the night and after sitting up for a few minutes i can take a deep breath, I take Advair now 500mg twice a day and it has gotten better. I hope that helps a bit, good luck

    Shirley
    Diagnosed 2003
    Myectomy 2-23-2004
    Husband: Ken
    Son: John diagnosed 2004
    Daughter: Janet (free of HCM)

    Grandchildren: Drew 15,Aaron 13,Karen 9,Connor 9

    Comment


    • #3
      Re: Asthma, CHF, Pneumonia? Suggestions?

      Hi Rhoda,
      Boy, I hear you. Iíve had Diverticulitis in the past so I know what that is. I had my fourth angioplasty and stenting the end of April. The stents were coated so I had to take Plavix for six months. Thatís a blood thinner which caused my hemorrhoids to bleed for a few months. I was all set to have them Ďfixedí when I stopped the Plavix and they healed on their own.

      I had a cold in early February which cleared off, but the cough lingers on. I had a HCOM episode last Monday and wound up in the Hospital for three days Ė they did a few EKGís and on Tuesday they did another echo. I should get the results in the next week. While in the hospital I asked the attending physician about CHF because various doctors said I had it, or didnít have it, during this coughing period. Ė (My PCP said the lungs were clear but I had bronchitis.) Anyhow, the attending said my lungs could clear or fill in as little as an hour. (In the hospital they were clear.)

      Had another HOCM episode this afternoon, but it appears to be easing a bit since I had dinner. The cough induces chest pain which seems to involve my lungs and also the middle of my chest - very much like an angina attack. My cardiologist will be back on Monday, and first thing in the morning I will call to see if I can get an appointment that day. Maybe he can come up with something for this cough Ė I now suspect its CHF related Ė and I think my drugs may be in need of adjusting too.

      I donít know what to tell you to do, other then what you already have planned. Being a day ahead you get to see your doctor before I get to see mine. Hope he can do as well for you as I hope mine can do for me. Iím going to Maryland in a week, for a couple of weeks, and I sure donít want to be messing with this while Iím there. Take care, and please keep us posted on your progress.
      Burt

      Comment


      • #4
        Re: Asthma, CHF, Pneumonia? Suggestions?

        Thanks! Sorry, I forgot to mention that I already take Advair and Singulair for asthma daily. So, I do know what asthma usually sounds like in me, but it has always been high in my chest whereas this noise is very low in my lungs and is similar but not the same as the noise in Nov that supposedly was pneumonia and CHF. Oh, well, I hope I get a doc that listens. There is no concept of "My doctor" here as far as I can tell.

        Rhoda

        Comment


        • #5
          Re: Asthma, CHF, Pneumonia? Suggestions?

          Thanks! Sorry, I forgot to mention that I already take Advair and Singulair for asthma daily. So, I do know what asthma usually sounds like in me, but it has always been high in my chest whereas this noise is very low in my lungs and is similar but not the same as the noise in Nov that supposedly was pneumonia and CHF. Oh, well, I hope I get a doc that listens. There is no concept of "My doctor" here as far as I can tell.

          I had read of a wheezing sort of sound for CHF, but do not know how it is distinguished from asthma. The doc here said CHF. The allergist there said asthma. Neither was absolutely sure.

          Bert, you got the pic on the hemorroids!

          Rhoda

          Comment


          • #6
            Re: Asthma, CHF, Pneumonia? Suggestions?

            Sounds like this is something a lot of us HCMers are dealing with right now. My coughing fits are down right terrible right now especially at night when I lie down. But for the most part of the day I do ok. When I go for my walk I get a little short of breath. I guess I will give a call to my cardiologist as well on Monday.


            Mary S.

            Comment


            • #7
              Re: Asthma, CHF, Pneumonia? Suggestions?

              There is too much going on here. You have likely ended up dehydrated with all the issues you have had going on. Please go check in with a cardiologist. I am not sure they have the test available, but ask if they can check your BNP - normal is under 100 (most people with HCM will be in the 200-300).

              What is BNP:
              A quantitative test for measurement of B-type Natriuretic Peptide, a protein marker for Congestive Heart Failure

              About Natriuretic Peptides

              B-type Natriuretic Peptide (BNP) is a hormone produced predominantly by the heart ventricle.

              BNP is released from the heart in response to ventricle distension due to blood volume expansion or pressure overload

              Plasma BNP increases with the severity of CHF based on the New York Heart Association (NYHA) as demonstrated by various studies (1)(2)(3)

              BNP Correlates well with left ventricle hypertrophy.(5)

              1) Mukoyama et al. Brain natriuretic peptide as a novel cardiac hormone in humans : Evidence for an exquisite dual natriuretic peptide system, atrial natriurtic peptide and brain natriuretic peptide. J. Clin. Invest. 1991, 87:1402-1412.

              2) Clerico A. et al. Circulating levels of cardiac natriuretic peptides (ANP and BNP) measured by highly sensitive and specific immunoadiometric assays in normal subjects and in patients with different digrees of heart failure. J. Edocrinol. Inves. 1998, 21: 170-179.

              3) Marantz PR et al. The relationship between left-ventricular systolic function and congestive heart failure diagnosed by clinical criteria. Circulation 1998, 77: 607-612.

              4) Pardee H, Nomenclature and criteria for diagnosis of diseases of the heart, NYHA, New York, 1942, pp. 9-10.

              5) Khono et al. Brain natriuretic peptide as a cardiac hormone in essential hypertension. Am J. Med 1992, 92: 29-34.


              Hope this helps!

              Lisa
              Knowledge is power ... Stay informed!
              YOU can make a difference - all you have to do is try!

              Dx age 12 current age 46 and counting!
              lost: 5 family members to HCM (SCD, Stroke, CHF)
              Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
              Therapy - ICD (implanted 97, 01, 04 and 11, medication
              Currently not obstructed
              Complications - unnecessary pacemaker and stroke (unrelated to each other)

              Comment


              • #8
                Re: Asthma, CHF, Pneumonia? Suggestions?

                Thanks everyone for your support and concern. Lisa, unfortunately, I did not have a chance to check this before I saw the doc (an Aussie, btw), so I did not ask for this test. But, the doc did run many tests, so I think I got a pretty clear answer that the problem was left sided CHF. I got pretty thoroughly chewed out for not coming in when I first got sick, but the doc is SO nice that the chewing out was not upsetting. I had tried an albuterol inhaler on Sunday night in the middle of the night because I was unable to lower myself below at all below sitting straight up. It did not help at all and caused moderate chest pain for about 30 min, so they wanted to check for muscle damage, but found none. When I was home in January, my allergist insisted that she did not think I had chf, and that I needed to treat the asthma more aggressively when I got a cold or respiratory problem here. She had been quite insistent that I use the inhaler and that I take prednisone when I had congestion. Well, I guess that was the wrong idea, because apparently the progesterone increases fluid retention (Duh, I am a biologist. I knew that! But sometimes the obvious is not obvious.) So, I guess I just managed to push myself over the line into further chf.

                So, that's the bad news. The good news is that the doc here talked with a cardiologist in Hong Kong and also with Dr. Gilligan and has called me twice. They are basically in agreement that I had to stop the progesterone - so I did yesterday. Not take any more albuterol, which I wouldn't have done anyway. And double the HCTZ for a few days until I can clear off all the fluid. Dr. Gilligan also wants a repeat of the heart enzymes on Thursday as well as a potassium level. Meanwhile, I slept well last night and other than a little coughing and wheezing am doing quite well today.

                The nice thing is that this doc listened to me about the finances and I gather is really going to try to keep the costs down. Apparently, Dr. Gilligan thought that the problem may be that some sort of arrhythmia is causing the fluid retention by making my heart beat poorly, so if the problems continue, wants me to do a Holter monitor, which the doc said would be difficult to do here, but not impossible. I hope this does not all become necessary, because we are very concerned that the insurance will not cover anything here due to differences in coding and things like that. (Theoretically, it should cover 80% after a big deductible, but who knows.) Yesterday's trip cost one month salary for me. We are not totally dependent on our salary here because of savings and a small early retirement check for Ed, but major things cannot be dealt with here.

                On a light note, I had a smile thinking about the Aussie talking to the Irishman! They decided to keep in touch by email.

                I hope that the rest of you who are having trouble with CHF or something (Mary and Burt, in particular) can get such helpful docs!
                Rhoda

                Comment


                • #9
                  Re: Asthma, CHF, Pneumonia? Suggestions?

                  Rhonda I'm glad you are getting things settled, I too am battleing the fluid thing and CHF, but my Liver function test came back elevated so i will be going back to the doctor but i think i'm just going to call dr. Gilligan's office tomorrow and talk to him about it be well

                  Shirley
                  Diagnosed 2003
                  Myectomy 2-23-2004
                  Husband: Ken
                  Son: John diagnosed 2004
                  Daughter: Janet (free of HCM)

                  Grandchildren: Drew 15,Aaron 13,Karen 9,Connor 9

                  Comment


                  • #10
                    Re: Asthma, CHF, Pneumonia? Suggestions?

                    I saw my cardiologist today. The echo looked pretty good, but Iím toting three extra pounds of water which he feels is causing the problems. Iím upping the Lasix for a few days and that should do the trick. Iíve been a bit negligent about the daily weigh-in, but Iíll try to do better from now on. (Didnít realize it was that important.)

                    Iím OK for the trip to Maryland. Hope you guys find such simple solutions.
                    Burt

                    Comment


                    • #11
                      Re: Asthma, CHF, Pneumonia? Suggestions?

                      "Not take any more albuterol" - - IN SHORT UFF DA!!

                      Please do not do that again. UFF DA! (my norweigian is coming out!)

                      I am glad the lines of communication are open between East and West - I must admit that must be an interesting converstation to listen too - the Irishman and the Aussie!

                      Be well,
                      Lisa
                      Knowledge is power ... Stay informed!
                      YOU can make a difference - all you have to do is try!

                      Dx age 12 current age 46 and counting!
                      lost: 5 family members to HCM (SCD, Stroke, CHF)
                      Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
                      Therapy - ICD (implanted 97, 01, 04 and 11, medication
                      Currently not obstructed
                      Complications - unnecessary pacemaker and stroke (unrelated to each other)

                      Comment


                      • #12
                        Re: Asthma, CHF, Pneumonia? Suggestions?

                        I'm sure coming in on the end of a different discussion BUT...I was given Advair by my new pulmonologist. It is an inhalant combination of steriod and salmeterol which, I believe, is something like albuterol. I tried it for a few days. It controlled my asthmatic cough but I felt bad. Not specifically heart-related but aching all over. Do others with HCOM use Advair or is it contraindicated? Would hate to think my new doc isn't paying attention.

                        Sue

                        Comment


                        • #13
                          Re: Asthma, CHF, Pneumonia? Suggestions?

                          I'm taking a calcium chanel blocker and i take advair and my cardio doc hasn't said anything about it i know when i took beta blockers he said it was a nono, your doc or lisa would be the people to ask. Take Care

                          Shirley
                          Diagnosed 2003
                          Myectomy 2-23-2004
                          Husband: Ken
                          Son: John diagnosed 2004
                          Daughter: Janet (free of HCM)

                          Grandchildren: Drew 15,Aaron 13,Karen 9,Connor 9

                          Comment


                          • #14
                            Re: Asthma, CHF, Pneumonia? Suggestions?

                            I don't know that I ever noticed the difference in sound, but I have asthma and chf and I have had pulm. hypertension and broncitis more times than I can count. The only way that I could tell chf from asthma is when I have had chf I always had a clear runny nose and my spit getts very frothy and I have had very, very bad pain around the middle of my back from the pressure of the fluids building up, but that time I had been in chf for 7 days before it was treated. My chf has been under controll for about 3 years now.
                            Jen

                            Comment


                            • #15
                              Re: Asthma, CHF, Pneumonia? Suggestions?

                              Hi all,
                              Iím on vacation and I do not have access to a scale so Iíve been checking my legs for fluids. I still have some, so I am continuing the double (80mg) dose of lasix. It must be doing the job Ė my cough is gone.
                              Burt

                              Comment

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