Is there much chance this isn't a serious heart/lung problem?

[asknotwhat]

I've posted a couple of times before about my DM. She's late 70s, and in the last 5-7 years has experienced a steady decline and a kaleidoscope of health problems that now completely dominate her life and conversation. Problems have included chronic insomnia, gastric problems (bloating, nausea, diarrhoea), dizziness and balance issues, memory loss, confusion, anxiety, irritability and depression, along with variable hypertension and hypotension. She's had all sorts of tests, none of which have concluded anything at all (except a diagnosis of Mild Cognitive Impairment - which I think has probably now tipped over into dementia).

That's the background - but in the last couple of months she seems to have declined further and faster, and is now just feeling 'so unwell' all of the time. Over these weeks, she's also noticed a big increase in breathlessness. She's had a high degree of unfitness for ages, because she never really moves much any more, but this has hit a new level recently. When I saw her a couple of weeks ago I noticed that she was quite out of breath when she'd been up and down the stairs, and now she says that she has to lie down panting for breath every time she goes upstairs at home. She can't walk more than a hundred yards outside (very slowly) without feeling overwhelmed, both by breathlessness and dizziness.

Having had so many 'it must be X' moments with her over the years, and being proved wrong when all the tests come back clear, I'm not sure what to think now - but I'm concerned this has all the hallmarks of heart failure or COPD - and I also wonder whether this could have been behind some of her other symptoms for ages. Her GP referred her for a chest X ray, which she had today, so I guess I'll know something soon enough - but I'm just coming on here in the meantime to be anxious and ask for any thoughts. I've already been worried for a long time about what the future will look like for her and my poor dad - and feeling more worried than ever now. Is there any chance this could be better than it seems?

It could be low iron, a chest infection, something to do with the heart, GERD any number of things. You could contact Asthma and Lung UK, they have a good helpline: www.asthmaandlung.org.uk/

That sounds really tough. it’s impossible to say what it is, but even heart failure can be alleviated with medication or surgical interventions. Hopefully she will get a diagnosis in the coming weeks.

Unfortunately, I would say that your suspicions are not unfounded when you describe her symptoms, her age, and history with fitness. Is she a smoker or a former smoker? If she is, then you could add other things to that list.

The other possibility with the dizziness and breathlessness is a heart arrhythmia, that while not a purely benign thing at her age because it can make her susceptible to stroke, it is treatable.

Many people do not even realize that their heart is out of rhythm, but have those symptoms. With the cognitive impairment there are many new medications on the market that have had some success that could possibly be an option for her.

Exercise is important though and while you don't want to risk an injury due to a fall, any type of resistance training, even in a chair, is better than nothing. But of course, after you get answers and treatment for her lung/heart issues.

Thanks all. Some possibilities I hadn't thought of there. To answer the question, yes, she was a 20 a day smoker for most of her adult life, though she did give up about 18 years ago. The exercise thing is so difficult - on top of her other issues, she's had osteo arthritis for many years, which has made it hard for her to walk or exercise much (and she was never someone who was keen on exercise, even before that, so the motivation to find alternatives was never there). More recently, her cognitive and mood issues, along with the dizziness, have meant that she doesn't really want to go anywhere or do anything, so her movement has reduced even further. We could try to persuade her into some chair exercises, once she's heard back from the doctor, but tbh she's become pretty intractabke in the last couple of years. I'm also conscious that she drinks a, bit more than she probably should - I think she's become increasingly reliant on a couple of large drinks a night to help with the insomnia.

That all sounds really bad when I write it down. It's just all so insidious, the way it creeps up on you - she's gone from basically fine with a few issues, to being in a right old state, in the space of a few years. It's really hard to see.

My mum had many similar symptoms and loads of complicated tests. Turned out nobody had started with a simple blood test and she had serious anaemia. Make sure GP has tested for that.

Also (sorry, just remembered!) Her memory got bad and that is related to very low vitamin B so she had injections and that improved too .

Thanks, she's had so many tests, but it's really hard to know what for, as I'm not directly involved. I do have POA, but because my dad's around to look after her, I don't have any dialogue direct with her doctor. Dad's generally very capable, but I've noticed that he's becoming a bit less sharp these days, and I don't think he always asks the right questions or completely takes in the answers - hard to know which. I'm really trying to encourage him to write down mum's symptoms before they go to appts, so they don't forget to mention stuff (like the breathlessness, which I suspect they've never mentioned to the GP before last week).

Part of me feels that I ought to involve myself more and try to go to some appts, but it's so hard - I live an hour and a half away and work full time, with kids and a MIL to factor in as well, and I'm really conscious of the endless advice on MN that you should never take on more than you can sustainably manage. I do phone very regularly and try to advise them.

As for blood tests, I'd be surprised if they hadn't checked for anaemia and B12, given the battery iof tests and blood tests she's had over the last couple of years, but who knows? She had another blood test test yesterday, so we'll see, but neither of them knew what it (or the 'scan', aka chest X ray) was actually for.

Yes blood test for iron.. breathlessness is often a sign of heart issues. I have a neighbour she was fit healthy,gym, Zumba classes at 83, become breathless blocked coronary artery. I would check these things out before embarking on excercise. COVID,has a lot of these symptoms . I had it the first time September 23,,up till then I hadn't had so much as a cold for 15 years,no one could remember me being ill, I couldn't walk 6 feet across the room, without gasping for breath and laying down.its left me with tinnitus, deafness and dizziness. Audiology tests?