Monday, June 16, 2008

Diagnosing my Grandfather

My Grandfather was in the hospital again this last week for a couple of days because of shortness of breath and he has a doctor that seems to just beat around the bush by not giving my grandparents a definite diagnosis. He was told that he did have a blood clot behind that knee that is taking Lovenox for at home, yep my Grandmother is giving his shots in the stomach. I saw her do it today, she does a good job.

The problem my grandparents are having is that this doctor has never given a good distinct diagnosis of what is causing his breathing issues that he has been into the hospital for two times this year and has also been in before, so as a good RT I am going to lay out the facts and give my diagnosis. Maybe a good case study here.
  • He is 86 years old
  • Has had 2 heart attacks both with CABG surgery
  • He smoked for over 50 years, quit about 15-20 years ago
  • He does a lot of woodwork with lots of sawdust
  • He gets very SOB when it is hot and humid
  • Has a productive cough
  • When SOB he sleeps better sitting up
  • Breathing treatments do help him
  • He gets bronchitis fairly often
  • He is diabetic
  • He is very active, does woodworking, walks to mow lawn, plays with grand kids
Ok from what I have here I really think that he has a good case for COPD. I understand that there could be some heart issues here, but I would rule out COPD and would like for him to have a PFT test done. There is a good possibility that a corticosteroid would do some good for him and a rescue inhaler.

This particular doctor will not say what this could be. He has said there could be a touch of emphysema, and that the cough is "chronic in nature", but he will not send him for the proper tests to check to see if the lungs have problems. This is driving me nuts. How hard is it to order a PFT testing to be done? Why not send him home with some MDI's. He did send him home with a antibiotic called Avelox that after reading is supposed to be good for upper respiratory infections. This med only takes 4 pills to kick bacterias butt, pretty cool and powerful.

This is added as a late entry, but this doctor also stated to my grandparents that the Sawdust from his hobby has no effect on his lungs as the particle size is to large to get into his lung. Huhh. Yep he said it's gets stuck in the upper airway and that's why there is sawdust in his sputum when he coughs because it is filtered out by the nose and upper airway. Yea ok quack.

Well that's the deal, I really hate this cannot make up my mind mentality of this particular doctor and I'm glad he is not from my hospital.

Let me know what you think.


Heidi said...

For 5 straight years I worked only in the Adult world of chronic COPD. Based only on his smoking history of 50 years, regardless of the fact that he quit so long ago, wasn't enough to diagnose the COPD. The smoking coupled with his hobby of breathing in saw dust isn't that a no brainer?

I think I'd be urging them to find another doctor.

The moment the weather shifts and humidity is in the air, the chronic COPD'ers are lining up in the ER where I was at.

It makes sense to me that he needs a PFT, Combivent and some sort of cordicosteriod. It's kind of like "well, DUH"

Djanvk said...

Thanks for backing me up. This doctor also told him that Sawdust is to big to get into the lungs to effect them...Huh...

CH said...

Oh brother,

Have your grandfather invite you to an office visit!! I would not only suggest it is possible he has COPD I would say, if it looks like a duck and quacks like a duck--it's definetly not a pigeon. Maybe time for a trip to a consultant specialist