Introduction
Cathy R. informs that she does not enjoy her physical training the way she enjoyed them several years ago. She does not want to connect these changes with her age because she thinks that her health is good. She does not want to quit running. At the same time, she wants to change the situation because her constant breathing difficulties distract her from achieving the required results.
Further Questions for Cathy
- Do you observe the same breathing difficulties at other seasons?
- When did the cough cases begin?
- In what periods of the day/night are the cough cases observed the most?
- Have you ever tried to sleep while sitting?
- Have you observed the changes of your weight?
- Can you describe your current appetite?
Differential Diagnoses
- Obstructive sleep apnea (G47.33): is a sleeping disorder that is usually characterized by complete or partial cessation of breathing during sleep (Hoth et al., 2013, p. 811). This disorder happens because of upper airway obstruction so that the patient could get the required portion of air for breathing and has to wake up in order to change the location and find a more comfortable sleeping pose. Sleeping fragmentation, insomnia, and bothersome snoring are the main symptoms of OSA (Balachandran & Patel, 2014, p. 5). Cathy may be diagnosed with this disease because of frequent cases of breathing difficulties at daytime and during nights. Her husband states that she has frequent cases of snoring and awakes because of the inabilities to breathe freely. A cough was the reason why she awaked at nights.
- Chronic obstructive pulmonary disease, unspecified (J44.9): is one of the main global health problems (Vestbo et al., 2013, p. 347) that is characterized by certain abnormalities in the lungs in a form of inflammatory response and restricted airflows. Shortness of breath, chest tightness, and chronic cough are the main symptoms of the disease. Still, people, who could be diagnosed with COPD, may suffer from the lack of energy and weight loss. Cathy. R. may be diagnosed with COPD regarding her breathing difficulties and the necessity to use an inhaler to reduce her pain. Tobacco smoking is one of the main cause of COPD, and Cathy has his own smoking history that could influence her health in the future (Vestbo et al., 2013, p. 349).
- Malignant neoplasm of unspecified part of unspecified bronchus or lung (C34.90): also known as lung cancer is the disease that bothers a number of Americans in a form of an uncontrolled cell growth in lung tissues. As a rule, lung cancer is caused by a number of behavioral factors such as smoking (Terpenning, Ling, & White, 2015, p. 24). Besides, a family history plays an important role in the identification of the disease. The first symptoms people should pay attention to are the shortness of breath and chest pain (Malik, Gysels, & Higginson, 2013, p. 647). It is important to diagnose this disease at its early stage in order to choose the required treatment and help the patient. In this case, Cathy R. is at high risk of having lung cancer because of the presence of such symptoms as the problems with breathing and the absence of energy to keep running. Her rich family cancer history is also a serious point for consideration because her father died from lung CA, and her mother had breast cancer. Cathy’s smoking history should be included (she had a 10-year-old experience of smoking between 25 and 35).
Body Systems to Examine and Tests to Offer
Taking into consideration the possibility of lung cancer, it is possible to make the following conclusions. The respiratory system should be properly examined. Computerized tomography (CT) is used to diagnose lung cancer. Still, if the patient has a smoking history, it is better to consult the doctor about the pros and cons of lung cancer screening and determine the dose of CT (Terpenning, Ling, & White, 2015, p. 24). A biopsy is also recommended in case CT shows abnormalities.
As well as lung cancer, COPD influences the work of the respiratory system of a human body. Chest X-ray could be used to detect emphysema that is the main signal of possible COPD. Besides, the arterial blood gas analysis may be used to identify the level of oxygen that could be brought to the lungs (Patel, Mehta, Chauhan, & Solanki, 2014, p. 10). In addition, COPD could influence the digestive system because of the possibility to cause the lack of appetite (Norden et al., 2015, 256).
Sleep apnea influences the work of many body systems such as respiratory, cardiovascular, and digestive. Blood pressure changes during the cough episodes and influences the work of heart. The quality of food used by the patient could also influence the quality of breathing. Finally, the organs that bring air to the body are at risk. A person should have clear channels and breathe free. Therefore, primary diagnostic tests that include a physical examination and questionnaires about the quality of sleep can be offered to this particular case study (Balanchandran & Patel, 2014, p. 5).
References
Balachandran, J.S. & Patel, S.R. (2014). Obstructive sleep apnea. Annals of Internal Medicine, 161(9), 1-16. Web.
Hoth, K. F., Zimmerman, M. E., Meschede, K. A., Arnedt, J. T., & Aloia, M. S. (2013). Obstructive sleep apnea. Sleep and Breathing, 17(2), 811-817.
Malik, F.A., Gysels, M., & Higginson, I.J. (2013). Living with breathlessness: A survey of caregivers of breathless patients with lung cancer or heart failure. Palliative Medicine, 27(7), 647-656.
Patel, P.J., Mehta, N., Chauhan, S., & Solanki, P. (2014). Arterial blood gas analysis in chronic obstructive pulmonary disease cases. The National Journal of Integrated Research in Medicine, 5(1), 10-12.
Terpenning, S., Lin, C.T., & White, C.S. (2015). Lung cancer screening: pros and cons. Applied Radiology, 44(7), 24-28.
Vestbo, J., Hurd, S.S., Agusti, A.G., Jones, P.W., Vogelmeier, C., & Anzueto, A. (2013). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: Gold executive summary. American Journal of Respiratory and Critical Care Medicine, 187(4), 347-365.