Can't Breathe Deeply

[Elmo]

I've searched the forum before posting this & can't find an answer, but if I've missed a thread I'd be greatful if someone could point me in the right direction.

I am 4 months post op after my AVR and I am having problems taking a full deep breath. I was fine when I came out of hospital, doing lots of walking & could breathe deeply with no problem.
Since about the middle of January I found my breathing was getting a bit restircted as if soemone had put a cough lock around me & tightened it up.
The problem seems to be that I can't expend my chest.
My GP & consultant are currently going through a range of things with me but seem to be more concerned that my blood pressure isn't coming down far enough, fast enough, than about my breathing.

I have had 3 chest infections since my op - the last one has now cleared up.
So far we have eliminated: chest infections; fluid in lungs; there is nothing shown on a chest x-ray; I am not asthmatic & all the medication I am taking are things I took prior to my op & didn't have any problems with.

Has anyone else experienced this problem or does anyone have an idea of what it might be?

Thanks

Tony

 

[Duff Man]

Yes, I have experienced this problem with a pulmonary embolism. I would not mess around with it... I'd go in to the ER if it gets any worse and I'd be aggressive with finding a fix for it with your doctor. With the symptoms you describe, I would want a CT scan of my chest.

For what it's worth, I walked around with a pulmonary embolism for a couple weeks or so before i figured out what was going on.

 

[Greg a]

Tony three months post op 1 I collapsed at home unable to breath and that was due to infection then three more months and I had gained over thirty pounds of fluid and wound up on IV lasix

I track my weight daily

Also have they done a blood draw to totaly rule out a blood related infection such as an MRSA

 

[DebbyA]

Hi Elmo,
How worrisome! How recent was your chest x-ray? Have you gained weight? Even though you say they've ruled out fluid on the lungs, I'm posting what happened to me at 3 months after surgery to see if this sounds like what you are feeling:
"...I didn't have typical symptoms, except for a feeling of fullness. Over several weeks, I felt like a big hard ball was filling just south of my sternum when I got my heart rate up. It wasn't painful, but unpleasant, and I slowed down more and more to prevent it. I never would have characterized as shortness of breath. I described it to the cardiologist at 3-month checkup, and still didn't manage to use the words to trigger any followup but to call back if it was still there next week. In the same appt I did just fine on a pre-rehab stress echo. When I did call back, the nurse advised me to take ibuprofen, stating it was not likely a heart problem. I told her I felt like I was losing ground and couldn't move around as well as several weeks earlier. She talked to the doctor, I had a chest xray, then another echo, and 2 days later, drainage..."


(The complete thread: http://www.valvereplacement.org/forums/showthread.php?24877-Bump-found-me&highlight=BUMP+FOUND

My symptoms were atypical because fluid problems usually happen before 6 weeks after surgery, my blood pressure was high, not low and I think because I didn't use the phrase "shortness of breath". The feeling of fullness was really 2 liters of fluid around my heart pressing on my diaphragm. By the time I got their attention, it was definitely showing up on xray, but still they did an echo to confirm it.

I hope you get a solution soon. Please let us know what you find out.

 

[tobagotwo]

Take these with a big grain of salt, but here are some possibilities:

- Partial collapse of a lung segment (can happen if it doesn't get fully expanded shortly after surgery - unlikely at this late date)
- A herniation into the diaphragm area (rare, but it happens)
- Loss of some diaphragm function, due to damage to the phrenic nerve (uncommon, and likely to have shown up earlier, but it does happen)
- Ascites (fluid in the chest and abdomen, as mentioned above, can be left over from the infections)
- Pulmonary embolism (as mentioned above - you don't have to be a tennis player to get this)
- Fluid around the heart (pericardial effusion, usually from pericarditis - this can have a chest-tightening effect)
- Constrictive pericarditis (when the pericardial membranes around the heart constrict the heartbeat)
- Costochondritis, which is inflammation of the rib cage (this is more likely to manifest as pain)
- Chest muscle spasm (intercostals)/pinched nerve issue that literally tightens your chest when you expand it

...or none of the above.

The one thing I would absolutely say is that if your GP and consultant (?) are not sufficiently concerned and focussed on the fact that you can't breathe properly, and that there have been several infections, then maybe you could go back to your surgeon for a consultation, or have their office recommend someone who they think is good - and don't wait weeks for the appointment. I'm not certain of your options in Great Britain.

This needs to be resolved, and quickly. If you can't get anyone, then tell your GP that you're ready to go to the ER. Maybe that will shake him up a little, and get him active on the problem again.

Best wishes,

 

[Elmo]

Thanks for all your replies.
To answer some of the questions you raised:
I recently started taking diuretics which have helped the breathing to an extent.
My chest x-ray was taken last Wednesday ( 2nd March ) & examined by the cardiologist the next day when i spoke to her about my breathing.
I haven't gained any weight & don't feel a bloated "hard feeling" like you describe DebbyA.
I don't have any pain.
I'm not what I would call "breathless" in the way a was pre-op.
My GP has always told me that if I feel unwell & am worried I should ring 999 fro an ambulance.
I am not having any trouble exercising & don't need to slow down, it's just that I can't go faster. I walk a couple of miles a day with no problem

Interestingly, when I went for my chest x-ray they made me tuck my hands into my belt behind my back, pull my shoulders back & push my chest out for them to take the picture. As I was walking out of the hospital, I noticed my breathing was markedly easier. So I have been gently stretching like this for several days & found that things are improving.
I have also noticed that good posture, like granny used to tell me, "sit up straight,, shoulders back, stomach in, chest out seems to help too.
I am wondering if part of the problem is a loss of muscle & upper body strength that I need to work on.

I will keep you informed, but once again thanks for your concern & advice.

Regards

Tony

 

[froggo]

I had quite a few episodes of what they called dressler's syndrome or pericarditis took doctors awhile to work it out but the pain was in the shoulder blades mostly when I breathed in. They finally put me on prednisone and things got better. Have had a quite a few episodes now but I know what it is and take the prednisone and then I am better again. I know there are some people like me who have also had dressler's.

 

[Elmo]

When I woke up this morning I was laying on my front. I don't sleep on my front & haven't really since I was a kid. The strange thing was, that with pressure on my chest I could breathe deeply & normally!!
This is "wearing off" slightly now I've been up & about for a couple of hours. Will see how things go through the day.

Froggo, I have looked up the symptoms of Dresslers Syndrome & don't have any of these but thanks anyway - its another thing to bear in mind.

Tony

 

[Country]

have you been in to see the doc or have they told you anything?

i have noticed that i am having problems breathing at different points of the day. but my next check up isnt untill the 20th of aug.

 

[Elmo]

I've now had lung function tests which showed ther's no problem with asthma or anything like that But the volumes i was able to breath were 12-15% less than they estimated i should be able to breathe.
I then had an echo which showed no problems with the valve (or anything else). The cadiologists opinion is that I need to build up the muscles in my chest. I am now doing physio and finding after each session my chest seems "free-er" & I can breathe more easily. this wears of over the rest of the day, but I seem to be improving.
If at the end of my physio sessions I'm not markedly better, they will look to see what else could be wrong.

Anyway, my general fitness is much improved since before the op so not everything is bad!!! I also think I may be expecting to progress much facter than I actually can.

Tony

 

[Duffey]

Good to hear!

 

[Jeff Edmonton]

Hey Tony, Good to hear that everything is checking out semi good. I am 6 weeks post op and still feel the difference in my lungs. I believe that it just takes time to recover from this all out assault on our bodies. I am lead to believe that it will take a year before everything balances out so thats what I am going with.
I hate those lung function tests that make you blow until you are blue in the face and am not sure how accurate they really are!
Were still here and thats the good part, cheers!

 

[Elmo]

A mate of mine has suggested a Power Breathe may be worth getting. Obviously I'll check with my cardiologist before getting/using one, but does anyone have any experience of them & if so was it useful?

Tony

 

[Elmo]

I am now waiting for the Power Breathe to arrive & will see how that helps.
In the meantime I have been referred to a rehab gym which is run by our local county council. it is specifically for people with disabilities & those recovering from accident illness & surgey. i have an exercise programme which concentrates on my chest & stretching & working the muscles. After only 2 visits my chest feels much better & I can breathe far more deeply, but still not quite enough. So just some simple exercise seems to be doing he trick. Interestingly my chest now aches in a "tired" way rather than hurting in a post op way, so things are looking much better.
I think I was trying to do too much too soon!

Tony