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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified MD
Category: Medical
Satisfied Customers: 63757
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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Hi, Im a 26 year old male who has smoked approx 15 cigarettes

Customer Question

Hi, I'm a 26 year old male who has smoked approx 15 cigarettes per day for the past 11 years.

Over the last 10 years I have been intermittent with exercise ranging from 1-3 times a week however in the last 2 years I have done no exercise.

I work in a manual labour job and am constantly on the move during the day and work approx 6-7 days a week and very long hours each day. However in the evenings it is more computer/office type work as opposed to manual labour.

I have always had slight wheezing however it was very intermittent and has got better as I have got older. When I was a child I was diagnosed with Asthma however have never had an asthma attack and rarely used inhalers or noticed any difference when I even did use them. I haven't used an inhaler for over 7/8 years. In my line of work there is a lot of dust from fillers and sanding which is generated which may attribute to the wheezing however I am unsure.

The past 2 months I have had a permanent wheeze, much worse in the mornings or late at night, however it is still present during the day and not going away.

Whilst sleeping I feel like I am not taking enough breath in and I feel like I am suffocating, I thought I was dreaming at first however my partner has now confirmed that she has noticed recently I have been struggling with my breathing and not getting enough breath and gasping at some points whilst sleeping. I have been to the GP before and also referred to the hospital for testing regarding the snoring however they confirmed I never had sleep apnoea and were not willing to treat/investigate any further. That was approximately 1 year ago.

My biggest issue is that recently (last 6 months) I have had 3 or 4 sharp pains in my chest to the left. Not a sharp severe pain, but enough to notice it was sore. However it dissipated after a few seconds/minutes. 4 days ago I had a sharp pain again in that area however the pain spread across my chest to the right as well as the left and the pain never left for approx 10-15 minutes. I wanted to go to the hospital just incase however I was at work and didn't want to make a scene of it - felt embarrased.

As some background diet info - I have a bad diet unfortunately, I eat very little fruit/veg, a takeaway almost every day of some sort either for lunch or dinner (most days I have some sort of fast food) - and a lot of ready meals. I do my best to eat better meals however most of my food is consumed outside of home and a lot of fuel station type snacks. I also drink approx 4-6 cups of tea with 1 sugar per day.

I weigh 16 and a half stone and am 183cm tall.

My biggest concerns are the chest pains and struggling to breath when sleeping. I feel like if I go to the GP they just give a generic answer like 'you should quit smoking' or 'improve your diet'. Something just doesn't feel right............
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 3 years ago.
Hello from JA
I am Dr. Thomas, double board certified doctor, and I will help you with this and any follow up questions.

In fact you do need to improve your diet and stop smoking, or you are going to fall victim to one or both of these.

You have given me a very clear picture of what is happening, but not of what work up you have had [EKG, stress test, chest x ray, echocardiogram], what medicines you might be on, and what medical diagnoses you have.

Please let me know so we can continue properly
Customer: replied 3 years ago.

Hi, thank you for the quick response.


 


I do not believe I have had any of those tests. Approximately 3-4 years ago I thought I was having palpitation type symptoms with a faster than normal heartbeat and breathlessness. At the time my GP referred me to the hospital, however at the time the conclusion was they couldn't find anything irregular. Although from memory no 'extensive' testing was carried out. However it was some time ago and I can't remember the exact tests that were carried out.


 


Since then I have had no further testing at all for any of the conditions and none of the tests you mention above.


 


I have been on no medication for 12 months however prior to that I was prescribed to Citalopram for approx 6 months as I suffered from moderate to severe depression.

Expert:  Dr. Thomas, MD replied 3 years ago.
OK
Of course this can be anxiety.
Of course it can still be asthma.

Tests you need


Pulmonary function testing: to look at lung function.

EKG and holter monitor for 24 hours...to look for heart problems and heart rhythm problems, and this would also help rule out conditions such as pericarditis, heart failure and pulmonary embolus.

Also I would do thyroid function testing, as this is often not included in routine labs, but is important.

Please let me know if you have further questions.
Please don’t forget a positive rating.


Customer: replied 3 years ago.
Relist: Answer quality.
I don't feel the answer was a high detail answer which is what I requested.
Expert:  Dr. Thomas, MD replied 3 years ago.
Hello
I gave you numerous tests that you need.

This is a q and a, back and forth format...so you have to respond with further questions


What detail are you still looking for
What questions do you still have, about anything I have written or anything else?

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