Wwyd?

[Shingles824]

I've been unwell for nearly a year and am getting very impatient with my Dr.

I have been breathless for 10 months and very fatigued. I got very weak and was vomiting. I had blood tests which showed an infection but little else.

Did peak flow tests which were good. Had an ultrasound for gallstones,no sign of any or anything else wrong. Had an X ray that showed chest infection. Had 5 day course of antibiotics and don't feel so rough but still have cough and breathlessness.

Have now got "shingles", severe nerve pain in shoulder and armpit. Dr doesn't think it's shingles but can't explain symptoms. Have got a lump under the armpit. Dr is booking me in at Breast clinic...

Would you see another Dr, go private (I have no insurance but have some savings) or carry on with what the Dr is doing?

Will your GP do a sputum test? 5 days isn’t a very long course for antibiotics, and if you have a sputum test you could have targeted antibiotics if you still have an infection. I also wonder if your GP could be persuaded to refer you to a respiratory specialist, I think your GP should do this, given your ongoing breathlessness. I saw a respiratory specialist privately who ordered a CT scan of my lungs which showed that I have a condition called Bronchiectasis, many people with this condition have breathlessness, and frequent chest infections, but if you know you have it, you can work to clear mucous from your lungs and prevent chest infections.

If you keep getting chest infections ask for spirometry. Peak flow on it's own doesn't tell you much. My peak flow just gives me a baseline really. I have a genetic form of COPD which makes me breathless and get chest infections easily. The shingles could be because you're run down.

Thanks. I did suggest a sputum test but the Dr was focusing on the armpit lump at our last appointment. I chased up spirometry today and the waiting list is 3 months. I contacted rheumatology and am hoping my rheumatologist gets back to me as they can often skip waiting lists.

I'm absolutely fed up with feeling like this.

Thanks. I already sorted out a spirometry referral (through another Dr). The waiting list is 3 months. I don't often get chest infections but I believe I had walking pneumonia. The last chest infection I had was a decade ago.

Oh ok. Maybe it will shed some light.

I would absolutely ask to see another doctor, ideally at the same practice. I’d say “Dr X, I know you have been doing your best but this has been going on too long without getting to the bottom of it, so I’d like an appointment with one of your colleagues to see if they have any fresh ideas and to give me the comfort of a second opinion”.

I wouldn’t personally spend money on a private GP for something this complicated, but if you can get the GP to refer you to whatever a/he thinks is the type of specialist most likely to be helpful, I would pay for an appointment with a private consultant n the specialisation of you can afford it.

Breathless and fatigue can be a sign of other things than just respiratory too.

So in the meantime whilst waiting for spirometry I'd be wanting to know if it could be cardiac related, which can cause breathlessness and in turn fatigue.

Do your ankles / feet swell during the day? Do you have to sleep propped up on pillows due to your chest or can you sleep lying flat on one or two pillows? Any cardiac family history? Have they done an ECG and a blood test called BNP?

Armpit limp may of course be something, but it could also be an inflamed gland due to being generally unwell. So definitely good to be checked out but in the meantime I would still be pushing for other tests as suggested.

Thanks all. I think the armpit lump is inflammed lymph due to 'shingles' / being run down but obviously it needs to get checked out.

No ECG, no swelling, fine lying flat. Yes, family history of heart disease. Yes BNP level done in Feb.

PRO-BNP LEVEL
Se N-term pro BNP conc
Result< 5 ng/L
Normal range0 - 400
Normal

I'm going to give thought to speaking to another Dr.

I felt so dreadful that I contacted NHS Direct today and the Dr confirmed pneumonia and prescribed more antibiotics and a pump for the breathlessness. I have a rheumatology appointment on Friday so will push for further blood tests and a CT scan and breast clinic appointment next week. I'm circumventing my Dr.

What are you under the rheumatologist for? Could that be relevant?

It could be relevant. I have Sjogrens and it can effect the lungs.

Oh, it could be very relevant then. Could also explain the armpit lump?
'Lucky' that you have a rheum appointment booked in!

Nb I have rheumatoid arthritis but may also have sjogrens as well.

Oh, maybe you should get a definitive answer for whether you have shingles before you go to your appointment?

@TheSpottedZebra I think I can only get a definitive answer on Shingles if I have a blood test. It could be the armpit lump pressing on nerves. I chased the rheumatology appointment as the rheumatologist can sometimes speed things up.

In my very unqualified opinion, the lump is from being so run down but the Dr did an examination and thought she felt something.

Wishing you well, hope you get quick resolution!

Are you swallowing ok? You may be aspirating. Was your chest infection right sided? Do you cough, throat clear or have a wet voice post swallow?

To be fair, it does sound like the doctor has carried out various tests, sent you for a chest xray etc.,

I don't know about aspirating. No wet voice. I think the infection is lower left lung, but would need to check.

Took DH months and months to recover from mild pneumonia he was young and pretty healthy and fit at the time.

She referred me for a chest x ray six months after I first saw her. I've had pneumonia for 9 months.

I feel absolutely exhausted and can't really do anything as I'm breathless when I move.

I saw my rheumatologist today and had another x ray. The Dr is referring me to the urgent respiratory pathway for suspected lung cancer.

Low iron will cause all your symptoms - have you had that checked recently?

I haven't had my iron checked since Feb but have been taking Ferritin for months. I have a shadow on the lungs.